Ask a Pediatrician: My Kid Refuses to Put His Coat On. Will He Get Sick If He Doesn’t Layer Up?

“My stubborn 4-year-old refuses to put his jacket on…even in 40 degrees weather! I’m really sick of the power struggle every morning just to get out the door, but I obviously don’t want him to catch a cold (or worse). How bad is it to let him leave the house without a jacket this winter?”

The cold weather has arrived in my neck of the woods and I’m officially on high alert for any and all symptoms, undoubtedly compounded by news of the Omicron variant of Sars-CoV-2. Related to winter, something I’ve heard from parents for years is that they think their child “caught a cold” because he or she went outside without a coat on. Or a hat. Or they insist on wearing shorts. Kids will often vehemently assert their independence by refusing to or insisting on doing something—my two do it regularly! But back to the topic at hand: Often, kids don’t want to wear big, bulky winter coats because they feel that they’re too restrictive and they claim they are “not cold” even when temperatures are low.

This, of course, can drive parents crazy (raising my hand)! We also remember what our mothers told us: that a child is at risk for getting sick, specifically a cold or pneumonia, if they go out in the cold without a jacket. This is, in fact, a myth. There is no specific, definitive scientific data to support the claim that sending a child outside in cold weather without a coat (or, with wet hair, for that matter) will increase their chances of “catching a cold.”

There’s a good reason for this, and that is that these types of illnesses are caused by germs (usually viruses), not exposure to cold. While it is true that cold viruses (there are over 200 of them!) can travel more easily in cooler temperatures, being exposed to cold does not directly correlate with whether or not a child becomes infected. There is some lab evidence that indicates a lower body temperature may actually decrease proper immune response slightly, but it is unclear whether this particular data has any significant real world effect in this scenario. If a child happens to be exposed to germs while their body temperature is lowered, the body could be less likely to activate a fully effective immune response to fight off infection. But again, the direct correlation between a child not bundling up and a cold infection is simply not there.

Here are some other cold weather questions and concerns that I hear during this time of year.

How cold is too cold for my kids to play outside?

If we’ve learned anything from the last two years, it’s that playing outdoors is much safer than indoor gathering when it comes to most viral infections. However, there is a threshold for unsafe temperatures when outdoor play should simply be taken off the table. Look at temperature and wind-chill to determine if the conditions are too cold for a child. If the wind-chill is at or above 32 degrees Fahrenheit, it is deemed safe for children to enjoy outdoor play for an unlimited amount of time. The younger the child, the more layers they need. If the wind-chill drops the temperature below 32 degrees Fahrenheit, I’d recommend limiting time spent outdoors until temps warm up. Any temperature under 13 degrees Fahrenheit, with or without the wind-chill factored in, could be considered dangerous due to the potential of hypothermia. These are general guidelines of course, but good to keep in mind.

What about the risk of pneumonia when my child spends lots of time outdoors and isn’t bundled properly?

Pneumonia is spread after contact with droplets containing germs from an infected person’s throat, nose or mouth and breathing them in. Community acquired pneumonia is fairly common and can affect anyone at any time. However, it should be noted that it occurs most often during the cold months, not because of the temperature or exposure to cold itself, but because many of these germs thrive in cold weather and also because we all spend more time indoors in close contact with others so they can travel more easily. Another benefit of masks: Wearing one outside can mitigate this risk for your kids, and it may also help keep their faces a bit warmer as well! This is also a good time to mention the importance of coughing into the elbow instead of covering the mouth with the hand to help avoid spreading germs: teach kids this strategy early.

My child gets extremely red cheeks after playing outside in the cold. Is this cause for concern?

Some kids will get really red cheeks that can look infected from being outside in the cold for prolonged periods. This is called “cold panniculitis” and while it may look dramatic, it is harmless and will go away on its own. One way to avoid it is by applying an ointment like Vaseline on the cheeks prior to going outside.

The bottom line

I suggest worrying less about your older child refusing to layer up and instead focus your energy on other tactics to mitigate viral spread like hand-washing, enforcing mouth covering when sneezing or coughing, and keeping their immune systems strong through proper nutrition, hydration and sleep. What is most important is that kids should be comfortable when playing outdoors. When playing outside in cold weather, take frequent “warming breaks” to protect their skin from the elements, make sure they stay hydrated (dehydration can still happen in the winter), and it certainly won’t hurt to have their coat, hat, and mittens available if they change their mind (in my experience, they often do!).

Dr. Christina Johns is a pediatrician + Senior Medical Advisor at PM Pediatrics, the largest pediatric urgent care group in the U.S.

Ask a Pediatrician I Plan on Vaccinating My Kids but Is There Any Benefit to Waiting a While?

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Dr. Christina Johns


Dr. Christina Johns is a pediatrician + Senior Medical Advisor at PM Pediatric Care, the largest pediatric urgent care group in the U.S. She received her undergraduate degree at...
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