Children in the Outdoors...thoughts on keeping them safe

Children are physiologically and psychologically different from adults. You must take these differences into account, and act accordingly, when you bring your children into the outdoors. Below are a few things to think about before you head outside with kids.

Small children live completely in the present and are easily distracted; this makes it difficult for them to remember and follow the new and unfamiliar rules that accompany outdoor activities. In addition, the hazards presented by outdoor living and adventure sports are different than those most children are accustomed to. Young children and children new to a specific outdoor activity must be closely monitored at all times. When you decide to bring a child into the outdoors, the trip must focus on the child's needs rather than your own; get your enjoyment by watching them explore, grow, and have fun.

Keep in mind that children are individuals and will not respond in the same way physiologically and psychologically. Common problems and solutions are discussed according to their mechanism below.

Trauma Related Concerns & Solutions

• The large heads of toddlers (in relation to adults) together with their general lack of motor skills predispose them to falls. Helmets are always a good idea and have become common place in most outdoor adventure activities; remember to be a good role model and wear one yourself.
• Cuts and scrapes will happen. Come prepared with first aid supplies for cleaning, dressing a, and bandaging partial and full-thickness wounds. Young children like bandaids with their favorite cartoon characters; they also like it when Dad or Mom makes a special bandage for them using gauze and flexible medical tape, etc.

Environmental Related Concerns & Solutions

• Since the head is a source of rapid heat loss, children are predisposed to the cold and hypothermia. Their high metabolism requires constant intake to maintain. Coupled with their excellent compensatory mechanisms, they maintain and maintain and maintain, and then suddenly crash. Add this to their love of playing in water and snow, getting their clothes and boots soaked, and losing their mittens (etc.), there's a lot to look out for. Remember that immersion in cold water conducts heat from your child's body 30 time faster than air alone. ALWAYS take extra clothes and food, have hot food and shelter readily accessible in cool or cold climates, and plan for short trips and days with lots of stops to explore and play. Unless you are an exceptional story teller, bring a couple of children's books.
• Hot weather and the related heat illnesses, including dehydration, are also a concern. In general it's best to keep daytime temperatures below the mid-80s F when playing outside, unless you are near cool or cold water safe enough for children to play in (and keep cool). Carry sweetened beverages to help make sure your child drinks enough to stay hydrated. Also carry powdered or liquid Pedialyte® or other commercial or home-made oral rehydration solution with electrolytes to treat dehydration. See the print or digital editions of the Wilderness Medicine Handbook for an ORS recipe.
•  In addition to sight, smells, sounds, and tactile sensations, infants and toddlers also use taste to explore their environment. There are plants that no one should ingest, especially a child. Make sure to know the poisonous plants (and venomous reptiles) in the area and keep small children away from them.
• Know what poison ivy, oak, & sumac look like. Carry Goop® or Tech Lab's Oak & Ivy Cleanser if your travels take you into an area where they exist. Avoid areas where the plants are prolific with infants, toddlers, and young children. Consider carrying calamine lotion or other drying agent for treatment in the event your child is allergic to the plants.
• Allergies are unpredictable and stinging insects are common. Be prepared and carry epinephrine and an oral antihistamine. Benedryl may be purchased over-the-counter in 25 mg tablets or capsules. You will need a prescription to purchase epinephrine; the dose for children under 75 pounds is 0.15 cc and can be carried as an autoinjector (EpiPen Jr.®). Review the signs and symptoms of a systemic life-threatening allergic reaction and epinephrine use with your physician before embarking on a trip.
• Sunburn is a common problem during the hot months of summer and leads to dehydration. Make sure your child wears clothing, including a broad-brimmed hat, and uses sunblock or high SPF sunscreen when in the direct sun; bring lots. Sun screen is labeled effective as water resistant for 40 or 80 minutes in the water.
• Keep young children out of the camp kitchen to avoid burns from hot water, grease, and pans.
• All children should wear a coast guard approved life jacket when engaging in water sports. Young children should be closely monitored when near water, even shallow water, to prevent accidental drowning.

Medical Related Concerns & Solutions    

• Children contract colds, seemingly overnight, and, in most cases, bounce back within a few days with rest. That said, they can be quite miserable during those few days. It makes sense to carry children's pain relievers and antipyretics (fever reducing drugs): acetaminophen, ibuprofen, and/or naproxen sodium. Make sure to mark each Nalgene bottle (consider making the label on a computer and then tape it to the bottle with packaging tape). You can include dosage on the bottle, on a laminated "med" card that's carried in your first aid kit, or both. Check with your physician to see if you can use both acetaminophen and ibuprofen at the same time for fevers that don't respond to one med; they act differently.
• Vomiting is a common problem with young children; focus on hydration. Persistent vomiting can be controlled with ondansetron (Rx, see your physician) especially if oral rehydration is not working to maintain fluid status.

Common Mistakes

• Both parents not on board with the trip outcomes.
• Focusing on what YOU want to do or on YOUR time schedule rather than your child's needs.
• Planning over night trips where temperature extremes are likely.
• Not having rapid access to shelter and food.
• Not bringing favorite toys and books.
• Traveling too far.
• Not having a bail-out plan.

Think Progression

• Start young with simple outings and progress to longer trips, as your children's interest increases. Backyard/park exploration > backyard camping > car camping > raft/canoe trips. Short trips > longer trips.

Want more information on this and other wilderness medicine topics? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course.

Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available.