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Most children cannot tolerate temperatures lower than 10 to 15 deg C, so ensure your child is properly clothed in cooler climates
 When it comes to keeping her family warm on holiday in colder climates, mum-of-two Sarah Woo does not take matters lightly. A down jacket, pullover, long-sleeved T-shirts, jeans, hats, gloves, leggings, stockings and boots were the essential items she packed for her daughters, aged five and 23 months. And they indeed kept the young ones – used to only Singapore’s tropical climate – from feeling the cold when the family vacationed in California for two weeks recently. The mercury was at a comfortable five to 12 deg C on average but it was better to be safe than sorry. “I was scared they would get sick,” says the 34-year-old engineer, who believes prevention is better than cure. After all, colder weather can pose a risk to children who are not well protected, say paediatricians and dermatologists.
Most children cannot tolerate temperatures lower than 10 to 15 deg C without a lot of protection, although individual responses to the cold may vary, says Dr Lim Kar Seng, consultant dermatologist at Dermatology Associates. The most common problems affecting newborns and toddlers are frostbite, red patches on the skin – also known as cutis marmorata – and hives induced by the cold weather called cold urticaria. Preschoolers and primary school children, on the other hand, face problems such as dry skin, eczema and hives. “Children are less tolerant of cold weather as they have a greater body surface area to body mass ratio. Hence they lose heat faster and are more susceptible to cold temperatures,” explains Dr Lim. In addition, he says, because they have less hair and their head to body ratio is smaller than adults’, children should wear hats as extra protection. Otherwise, they could be more prone to catching a cold or falling ill. Associate Professor Anne Goh, senior consultant and head of allergy service at the Department of Paediatrics at KK Women’s And Children’s Hospital, notes that in a worst-case scenario, asthmatics would be particularly affected. She says: “Children with asthma that isn’t yet adequately controlled could have an asthma attack.” Infants are particularly susceptible to low temperatures, says consultant paediatrician Dr Dawn Lim of Kinder Clinic.
Exposing your baby to cold temperatures can lead to the child experiencing poor feeding, drowsiness and difficulty in breathing. Children, regardless of age, have thinner skin and narrower blood vessels than adults. Ms Malia Ho, principal podiatrist at The Foot Practice @ Singapore Sports Medicine Centre, says that in cold climates, these blood vessels constrict to maintain the core temperature of the body and limit the blood flow to the toes. “If this is prolonged, the cells in the toes will die, leading to frostbite,” she adds. She recommends that children wear leather boots as these insulate the feet. They should also be waterproof with thick rubber anti-slip outer soles to prevent falls on icy or slippery ground.
Choosing the right fabric for winter clothing is also important. Wool, for instance, is notorious for aggravating eczema, says Dr Lim of Dermatology Associates. And just because your child is wrapped under many layers does not necessarily mean all is fine. Parents sometimes do not realise that their babies may be feeling uncomfortable. Dr Lim of Kinder Clinic says: “Because babies are unable to verbalise their discomfort, they can sometimes get too cold or warm because they are underdressed or over-swaddled.” Babies, especially, can easily become overheated under layers. “Babies do sweat. They sweat when they are overheated and they can generate heat when they are cold,” she says. When overheated, babies can experience difficulty in breathing, fits and a loss of consciousness. However, Dr Lim adds that this is unusual if parents keep a close watch on the child. She advises parents to check if their babies are cold by paying special attention to their hands and feet. They should also check if the child’s lips and fingertips are turning blue or if he is feeding poorly and feeling lethargic.
A tip: For a better sign of your child’s body temperature, touch his tummy or back rather than hands or feet. For extra peace of mind in choosing clothing, Ms Cynthia Lim, general manager of children’s apparel and lifestyle distributor Global Outsource Solutions, suggests that parents look for items with the Oeko-Tex standard 100 certification. This system, created by the International Oeko-Tex Association, an outfit of 15 textile research and test institutes in Europe and Japan, certifies that textiles do not contain hazardous chemicals. Its Class 1 classification, comprising items from brands such as BabyBjorn, is meant for textiles and toys for infants and small children up to the age of three. However, clothes should not be the only thing weighing heavily on parents’ minds. Consultant paediatrician Dr Liew Woei Kang of SBCC Baby & Child Clinic says most parents forget that skin, including lips, gets dehydrated, resulting in sensitivity and itching. “Regular moisturising of the skin and use of lip balms would be useful,” says Dr Liew.
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