The JCDHE Child Care Licensing Division offers the following tips to help parents and providers keep children safe in very cold and very hot weather. If you have specific questions that are not answered here, please contact us at (913) 477-8339 or (913) 477-8382.
Cold Weather Tips for Parents and Childcare Providers
Download this Child Care Weather Watch chart to help determine what temperatures and weather conditions are appropriate for outdoor play.
Winter brings colder weather. Children get cold (and hot) more easily than adults. This is because young children have relatively more surface area for their body mass than those who are older. Still, going outside when it is cold is a good idea. Germs are less concentrated in the outdoor air. Take the group outside while fresh air circulates from opened windows and/or the ventilation system in the emptied rooms.
Outdoor play in cold weather encourages more vigorous physical activity. In addition, going outside in all types of weather gives children opportunities to learn about changes in the environment. The Centers for Disease Control and Prevention offers tips to enjoy cold weather.
Dress for the Weather
Adults and children lose body heat more quickly if they don’t wear a hat. Choose tightly woven fabrics that keep you warmer by holding in more heat and keeping wind from taking body heat away. Wool or tightly woven synthetic fibers are better than cotton. Cold air holds less moisture than warmer air. So if it is very cold, wear a scarf or knitted face covering. This reduces drying of exposed skin and linings of the nose and throat. Getting too warm can cause sweating. So dress to stay warm, but avoid over-dressing. Perspiration wets clothing. Moisture on the skin wicks heat away from the body. However, wet weather doesn’t need to keep everyone inside. It can be fun to be outside in snow and rain – if you dress in water-resistant clothing that keeps skin dry.
Watch for Shivering
Shivering is the movement of muscles to generate warmth when the body is getting too cold. If someone is shivering despite increased activity, it is time to go inside. Otherwise, body temperature will start to fall.
Defining Cold Injuries
The following definitions of cold injury are from Pediatric First Aid for Caregivers and Teachers, 2nd edition, 2012, pp. 298-303. This manual was written by the American Academy of Pediatrics and the National Association of School Nurses.
Hypothermia: Lowered body temperature is called hypothermia. Suffering from hypothermia doesn’t require very cold temperatures if the skin gets wet. In addition to shivering, at significantly lowered body temperatures, drowsiness, confusion, slurred speech and shallow breathing can occur. Body temperatures lower than 95 degrees F. are dangerous. First aid for hypothermia is to call EMS. Then take the child to a warm room, remove cold wet clothing, and replace it with warm dry clothing or a blanket. If a warm room isn’t available, wrap the cold person and a warm person together in a blanket.
Frost nip: In freezing temperatures, smaller, exposed body parts suffer cold injury first. Blood vessels in these areas constrict in response to cold. This constriction can make fingers, toes, ear lobes and tip of the nose pale and numb. They are painful as they warm up again. If the part doesn’t actually freeze and no permanent injury occurs, the condition is called “frost nip.” First aid for frost nip is similar to the first aid for hypothermia. Do not rub the injured part. Until you can get to a warm room and replace cold wet clothing with dry warm ones, put the cold body parts close to warm body areas, e.g. hold cold hands in armpits. For 30 minutes, slowly rewarm injured areas in warm (not hot) water around 100 degrees F. Apply warm compresses to the injured area. If warm water isn’t available, gently wrap the area in warm blankets. If the area seems to return to normal, have caregivers/families watch for any evidence of injury that signals the need for medical care.
Frostbite: If body tissues actually freeze, the injury is called frostbite. Frostbite requires medical attention as it can cause permanent damage. The severity of frostbite is graded like burn injuries. First degree frostbite is when tissues become white and hard, and then mildly red and swollen when rewarmed. Second degree frostbite is when blisters appear the next day. Third degree frost bite is when permanent skin damage occurs. First aid for frostbite is to contact EMS and then follow the same procedure as for frost nip until EMS can take over.
Wind Chill Wind: Wind chill wind removes heat from the body faster than would occur just by exposure to the cool temperature. The National Weather Service has a helpful guide. This guide indicates when conditions are comfortable, require caution, or are dangerous for outdoor activities. Outdoor play with proper clothing is OK unless the temperatures are at or below minus 15 degrees F. Check children frequently when conditions require caution. Look for shivering and any signs of early cold injury to hands, toes or other vulnerable body parts. This CDC chart indicates the amount of time until frost-bite occurs at varying combinations of air temperatures and wind speed.
Hot Weather Guidelines for Child Care Providers
As temperatures across the country continue to escalate above average highs, it is more important than ever to understand the health effects for children. Infants and young children are particularly sensitive to the effects of extreme heat and must rely on others to keep them safe. When left in a hot vehicle, a young child’s body temperature can increase three to five times as quickly as an adult’s.
The recommendation states that if the heat index is 90ºF to 95ºF (32ºC to 35ºC) or if there is a heat advisory in effect, children should only be outside for short periods of time (15 to 30 minutes or less.)
Base the amount of time outside on the children's appearance and behaviors. If the children are running around and actively playing and do not exhibit any signs of heat exhaustion or heat stroke (see signs below), they can be outside on the longer end of the timeframe. If children are sitting or standing around in the shade, take them inside sooner. Morning is the best time to be outside, as it is the coolest part of the day.
A heat index of 95ºF (35ºC) or higher is considered to be the regulations definition of "extreme." On these days it would be expected that children would not have to go outside at all. This is where we see regulation violations occur most. It is important to note that heat indexes are measured in the SHADE. When planning activities in which children will be exposed to full sunshine, add 15 degrees to the stated heat index. Strong winds can also make the heat worse.
Additionally, when there is an excessive heat warning as defined by the National Weather Service, it is recommended that outdoor summer camps be moved to their inside locations for the afternoons.
On "extreme" heat days, it is recommended that field trips only be taken to indoor, air-conditioned locations. If the mode of transportation for the field trip is walking or in a vehicle without air conditioning, the predicted temperature/heat index at the time of the return trip must be considered.
The regulations pertaining to children outside in extreme weather are as follows:
Licensed Child Care Centers (including Mother's Day Out and Preschools): K.A.R. 28-4-438(b) and K.A.R. 28-4-126(a)(1).
Licensed School Age Programs: K.A.R. 28-4-590(f)(2) and K.A.R. 28-4-587(a).
Outdoor Summer Camps: K.A.R. 28-4-586(b)(1)(c) and K.A.R. 28-4-586(2).
Licensed Day Care Homes and Group Day Care Homes: K.A.R. 28-4-116(a)(4), K.A.R. 28-4-117(a)(7), and K.A.R. 28-4-126(a)(1).
Heat related terms can be confusing. Here are the definitions provided by the National Weather Service.
Excessive Heat occurs from a combination of high temperatures (significantly above normal) and high humidity. At certain levels, the human body cannot maintain a proper internal temperature and may experience heat stroke.
Excessive Heat Outlook is a Climate Prediction Center (CPC) product that is a combination of temperature and humidity over a certain number of days. It is designed to provide an indication of areas of the country where people and animals may need to take precautions against the heat during May to November.
Excessive Heat Warning is issued within 12 hours of the onset of a heat index of at least 105ºF (40ºC) for more than 3 hours a day for 2 consecutive days or a heat index of more than 115ºF (46ºC) for any period of time.
Excessive Heat Watch is issued by the National Weather Service when heat indices in excess of 105ºF (40ºC) during the day combined with nighttime low temperatures of 80ºF (27ºC) or higher occur for two consecutive days.
Heat Advisory is issued within 12 hours of the onset of the following conditions: a heat index of at least 105ºF (40ºC) but less than 115ºF (46ºC) for less than 3 hours per day or nighttime lows above 80ºF (27ºC) for 2 consecutive days.
Heat Exhaustion is a mild form of heat stroke, characterized by faintness, dizziness, and heavy sweating.
Heat Index (HI) or the "Apparent Temperature" is an accurate measure of how hot it really feels when the Relative Humidity (RH) is added to the actual air temperature.
Any time there are conditions of high temperature (over 90ºF) coupled with high relative humidity, causing a high heat index, the body has to work very hard to maintain its core temperature of 98.6º. A child's body temperature increases three to five times faster than an adult's body and children are not able to dissipate heat as effectively as adults.
Sweating is one way the body tries to cool itself, However, sweating only cools the body when the water is removed by evaporation. High relative humidity retards this process. Under these conditions, the heart is beating much faster to pump blood through dilated circulatory vessels. The sweat glands are pouring liquid -- including essential dissolved chemicals, such as sodium and chloride -- onto the surface of the skin.
Heat disorders generally have to do with a deduction or collapse of the body's ability to shed heat by circulatory exchanges and sweating or a chemical imbalance caused by too much sweating. When heat gain exceeds the level the body can remove heat, or when the body cannot compensate for fluids and salt lost through perspiration, the temperature of the body's inner core begins to rise and heat-related illness may develop.
There are three major types of heat related illness.
Heat Cramps are painful spasms usually occurring in muscles of the legs and sometimes in the abdomen. First aid for this situation is to apply firm pressure on cramping muscles or gently massage to relieve spasm. Give sips of water but discontinue water if nausea occurs.
The symptoms of Heat Exhaustion are heavy sweating, weakness, skin that is cold, pale, and clammy, weak pulse, vomiting, and fainting. First aid for heat exhaustion is to get the victim out of the sun immediately. Have the person lie down and loosen their clothing. apply cool, wet cloths. Fan or move victim to air-conditioned room, if possible. Give sips of water but discontinue water if nausea occurs. If vomiting, seek medical attention.
The symptoms of Heat (or Sun) Stroke are hot dry skin, rapid and strong pulse, and possible unconsciousness. Heat stroke is a SEVERE MEDICAL EMERGENCY. Summon emergency medical assistance or get te victim to the hospital immediately. DELAY CAN BE FATAL. While waiting on medical help to arrive, move the victim to a cooler environment. Reduce the body temperature with cold bat or cold wet cloths. Remove clothing and use fans or air-conditioners. DO NOT GIVE FLUIDS.
To prevent heat-related illnesses, follow these tips:
- Outside activities should be reduced, eliminated or rescheduled to the coolest part of the day.
- Dress for the hot weather. Lightweight, light-colored clothing reflects heat and sunlight and helps your body maintain normal temperatures.
- Decrease foods that increase your metabolic heat production and increase water loss.
- Drink plenty of water or other non-alcoholic, non-caffeinated fluids. A person can become dehydrated before they feel thirst. Exceptions to getting increased fluids are people with epilepsy, kidney or liver disease, on fluid restrictive diets or have a problem with water retention.
- Avoid sunburn. Sunburn makes the job of heat dissipation much more difficult.
Preventing Heat-stroke Related Injury or Death
On average, every 10 days a child dies from heatstroke in a vehicle. These deaths are preventable and everyone in the community, especially child care providers, have a role to play in protecting our children.
Here are a few simple things you can do:
- Get in touch with designated family members if a child who is regularly in your care does not arrive as expected.
- Make it part of your everyday routine to account for all children in your care. Set up backup systems to check and double-check that no child is left in the vehicle. Never leave a child unattended in a vehicle—even if the windows are partially open or the engine is running with the air conditioning on. Vehicles heat up quickly; if the outside temperature is in the low 80s, the temperature inside a vehicle can reach deadly levels in only 10 minutes, even with a window rolled down 2 inches.
- Always make a habit of looking in the vehicle—front and back—before locking the door and walking away.
- Create reminders to ensure that no child is accidentally left behind in the vehicle. Place an item that is needed at your final destination in the back of the vehicle next to the child or place a stuffed animal in the driver’s view to indicate that a child is in the car seat.
- Call 911 or your local emergency number immediately if you see a child alone in a hot vehicle. If he or she is in distress due to heat, get the child out as soon as possible and cool him or her down rapidly.
For additional information on heatstroke, visit the Safe Kids website.
Share this Information
As with any recommendation, the data collection and research is ongoing to provide information that is in the best interest of our children in out-of-home care. Feel free to share this information with families of children in your care.
If you have any questions, please contact us at (913) 477-8339 or (913) 477-8382.