Cold exposure and respiratory symptoms
For children with sensitive airways or early asthma, cold air can trigger wheezing, coughing, and breathing difficulty. This is especially relevant in places where children may spend time outdoors in extreme cold or in unheated spaces. Cold air can cause the airways to narrow, triggering symptoms in children who would otherwise be well.
Cold exposure — what to watch for
- Coughing that starts or gets worse after being outside in cold air
- Wheezing after cold air exposure
- Breathing harder than normal after coming in from outside
- Runny nose and congestion triggered by cold
Protecting children from cold-triggered symptoms
- Cover the nose and mouth: a loose scarf or face covering over the nose and mouth when going outside warms the air before it reaches the lungs
- Breathe through the nose: nasal passages warm air before it reaches the airways — encourage nasal breathing
- Limit cold exposure for children with known wheezing or asthma
- Warm up gradually: bring children in from the cold gradually — sudden temperature changes can also trigger symptoms
Allergen triggers
Allergens are things in the environment that cause an immune reaction. In rural Alaska, common allergen triggers for young children include:
- Wood smoke: from wood stoves — one of the most significant indoor triggers in rural Alaska
- Mold: common in homes with moisture issues — often associated with lack of running water or poor ventilation
- Dust mites: in bedding and carpets
- Animal dander: dogs, cats, and other animals in the home
- Oil fumes: from oil-burning heaters
- Outdoor allergens: grasses, tree pollen — more relevant in spring and summer
Reducing allergen exposure at home
- Wood stove: burn dry wood only — wet wood produces more smoke. Ensure good ventilation. Keep children away from smoke
- Mold: fix moisture sources. Use ventilation fans. Check for visible mold under sinks and in corners
- Bedding: wash bedding weekly in hot water. Encase mattresses and pillows in allergen-proof covers if possible
- Pets: if pets trigger symptoms, keep them out of the bedroom
- No smoking indoors: tobacco smoke and cannabis smoke are major triggers — always smoke outside and away from the home
Log allergen exposures in MamaBear whenever your child has a symptom episode. Over time, patterns will emerge that help your provider identify your child’s specific triggers.
| 📞 Call your provider if: Wheezing or coughing triggered by cold air or allergens Symptoms that follow a clear pattern (same trigger, same response) Symptoms improving when away from home environment Skin rash or hives after exposure Repeated episodes — log and report to provider | 🚨 Go to the ER immediately if: Severe wheezing or difficulty breathing after exposure Throat swelling or difficulty swallowing Hives spreading rapidly across the body Child is pale, limp, or unresponsive after exposure Any signs of anaphylaxis — call 911 |
11. DEHYDRATION
What is dehydration?
Dehydration happens when a child loses more fluid than they take in. It can happen with fever, vomiting, diarrhea, or any illness where your child isn’t drinking well. Young children get dehydrated faster than older children or adults. Dehydration makes every illness worse.
Signs of dehydration to watch for
- Fewer wet diapers: normal is 6 or more wet diapers per day for infants. Fewer than 4 is concerning
- No tears when crying
- Dry mouth and lips
- Sunken eyes
- Sunken fontanelle: the soft spot on a baby’s head sinking in
- Very dark yellow urine: or no urine for 8+ hours in older toddlers
- Skin that stays ‘tented’: pinch the skin on the belly gently — if it stays tented instead of snapping back, dehydration may be significant
Keeping your child hydrated
- Infants under 6 months: breast milk or formula only — offer more frequently in smaller amounts
- Infants over 6 months: breast milk, formula, or small amounts of water. Oral rehydration solution (like Pedialyte) for active dehydration
- Toddlers: water, diluted juice, broth, popsicles, oral rehydration solution
- Small and often: if your child is vomiting, try 1–2 teaspoons every 5 minutes — small amounts more likely to stay down
- Avoid: sugary drinks, full-strength juice, sports drinks — these can make diarrhea worse
| 📞 Call your provider if: Fewer than 4 wet diapers in 24 hours No urine for 6–8 hours in a toddler Dry mouth, no tears Not keeping any fluids down for more than a few hours Child seems very tired or less active than usual | 🚨 Go to the ER immediately if: Sunken eyes, sunken fontanelle Limp, very difficult to wake No wet diaper for more than 12 hours Skin that stays tented Lips and mouth very dry, child not responding normally |
UNIVERSAL EMERGENCY REFERENCE — ALWAYS SEEK CARE FOR THESE SIGNS
Regardless of what illness your child has, these signs always mean seek emergency care immediately. Do not wait to see if they improve.