"Snowflakes are like kisses sent down from heaven" (Unknown).

They provide the background for a perfect winter wonderland: making snowmen, drinking hot chocolate, turning on the fireplace and creating snow angels on the ground. It sounds like something straight out of a Walt Whitman or Emily Dickinson poem. But as a parent it is not all fun and games or poetic. In addition to shoveling snow and coordinating childcare with school closures, we have to deal with the realities of keeping our kids safe from the dangers of cold.

One of my professors in medical school told me "Children are not little people … but adults are." This statement is particularly true when it comes to cold weather. Here is Dr. Nina's What You Need To Know about keeping your kids safe in the cold:

•Children are more vulnerable to drops in temperature. They have larger heads and large body surface areas compared to their body mass, leading to rapid heat loss.

•Young children and adults shiver, which is a special way the body has to engage our muscles to help produce more body heat; however, it is important to know babies are unable to shiver.

•Drops in temperature can lead to two dangerous conditions - hypothermia and frostbite. Hypothermia develops when a child's temperature falls below 95 degrees Fahrenheit (normal 98.6 degrees). It can result from playing outdoors in cold weather without proper clothing or if their clothes get wet. Symptoms include shivering, paleness or bluish, cold extremities. If severe, your child may become drowsy, have slurred speech or demonstrate confusion. Frostbite occurs when the skin and outer tissues become frozen. The fingers, toes, ears and nose are most vulnerable to this. They may become pale, gray or even blister. Your child may complain their skin is burning or feels numb.

Here are some tips to nip the cold in the bud and keep Jack Frost from nipping at our nose and toes:

•Layering. Similar to a party or an eight-layer dip, the more the merrier. As a general rule of thumb, kids should wear one more layer than an adult. This also permits removing the wet layer to keep moisture away from the skin.

•Choose fleece and wool for inner layers over cotton. They are better at insulating when wet. This can also help avoid Sam McGee's gripe of having the "cold take hold 'til I'm chilled clean through to the bone."


•The Mad Hatter. Children can lose 60 percent of their body heat if their heads are not covered. What better excuse to mimic a Disney character than the cold weather.

•Change the lyrics. Instead of "Head, shoulders, knees and toes. Knees and toes" remember "Ears, nose, hands and feet. Hands and feet." These areas are most vulnerable to frostbite so keep them covered up with gloves, socks, and earmuffs.

•Time out to warm up. Make sure kids come inside often. Having warm drinks like hot chocolate and yummy snacks can help entice them. Capitalize on those nostalgic scents and tastes such as pumpkin spice, cinnamon, nutmeg, gingerbread, and roasted marshmallows.

•The gift of warmth. Donate your kid's outgrown winter clothing to help needy families dress their children appropriately and safely.

•Keeping a watchful eye. There is no substitute for vigilant supervision. Whether at home, school, or playing at a friend's place, our children need special cold weather supervision by an adult to monitor signs of hypothermia, frostbite, or other potential problems.

Whether or not we are hit with another Polar Vortex over the next few weeks, it does not take the training of a meteorologist to forecast that there will be cold weather days before spring is upon us. As parents we must be prepared so that our children can stay safe and enjoy the memories of a winter wonderland. Afterall, "What good is the warmth of summer, without the cold of winter to give it sweetness."

Dr Nina Radcliff, of Galloway Township, is a physician anesthesiologist, television medical contributor and textbook author. Email questions on general medical topics to her at drninaradcliff@aol.com