Hypothermia and Frostbite in Kids at Camp

This guide is general safety information for parents, based on CDC and Mayo Clinic first aid guidance. It is not a substitute for a doctor. When in doubt, call 911 or your child's doctor.

Why kids get cold faster than adults

A child has more skin surface for their body weight than an adult, so heat leaves them faster, especially when they stop moving. Kids also go from running flat out to sitting on a cold log with no warm-up in between, sweat into their clothes during play, and almost never announce that they are getting cold. By the time a young child complains, they are often already shivering.

The other half of the problem is water. Wet clothing pulls heat out of the body far faster than dry clothing, which is why the CDC points out that hypothermia can happen even above 40 degrees F when someone is chilled by rain, sweat, or cold water. On family trips, the classic setup is a kid who falls in a creek, plays in wet leaves all afternoon, or sweats through a cotton hoodie, and then sits down at the picnic table as the sun goes down.

Hypothermia: the signs, from early to serious

Hypothermia means the body is losing heat faster than it can make it, and core temperature starts to drop. It comes on gradually, which makes it easy to miss. The changes in a child are often behavioral before they are physical.

• Early: shivering, cold and pale or blotchy skin, clumsy hands that struggle with a zipper, whining that is out of character, and a talkative kid who goes quiet. This is the stage to catch it, and it usually reverses with dry clothes, food, and warmth.
• Getting worse: hard, constant shivering, stumbling, slurred or slow speech, confusion about simple things, unusual sleepiness, and not caring about being cold. The CDC lists exhaustion, confusion, fumbling hands, memory loss, slurred speech, and drowsiness as warning signs.
• Serious: shivering that stops while the child is still cold, a child who is very hard to wake, or one who cannot walk or answer normally. This is a medical emergency.
• Babies: infants cannot shiver well. The CDC says to look for bright red, cold skin and very low energy. Our camping with a baby guide covers how to keep the smallest campers warm overnight.

A quick field check: ask a simple question you know the answer to, like what they had for lunch, and watch them try to zip their own jacket. A kid who cannot do either the way they normally would needs to be warmed up now, not after one more marshmallow.

What to do in the first 30 minutes

Mild hypothermia caught early is very treatable at camp. The steps below follow the CDC's first aid guidance.

1. Get out of the cold. A running car with the heater on is the best warm room at most campgrounds. A heated cabin, bathhouse, or camp store works too. A tent gets the child out of the wind but does not warm them up on its own.
2. Get wet clothes off. All of them, including socks and the base layer, then put on dry clothes and a warm hat. Wet clothing keeps pulling heat out even after the child is out of the weather.
3. Warm the core first. Focus on the chest, neck, head, and groin, not the hands and feet. Wrap the child in dry blankets or a sleeping bag. Skin-to-skin contact with a parent under loose dry layers works well for small kids. An Primacare Emergency Mylar Thermal Blankets, 10-Pack wrapped over the outside of those layers traps heat and blocks wind on the walk to the car.
4. Feed them. If the child is fully awake and can swallow normally, give a warm, sweet drink, like cocoa or warm apple juice, and something to eat. Food is the fuel the body uses to make heat. A THERMOS Stainless King Vacuum-Insulated Beverage Bottle, 40 oz filled with hot water in the morning means a warm drink is ready without lighting the stove. Never give food or drink to a child who is drowsy or not fully alert.
5. Keep them wrapped after. Once they warm up, keep them dry and bundled, including the head and neck, and keep watching. A child who had hypothermia should not go back out to play in the cold that day.

Handle a cold child gently and keep them still and lying down if the signs are serious. Do not rub their arms and legs to warm them up, and do not put them in a hot shower or bath, which can pull blood away from the core too quickly. If things do not clearly improve in about 30 minutes, or any serious sign shows up, call 911.

Frostbite and frostnip

Frostbite is freezing of the skin and the tissue under it. It hits the parts farthest from the core and most exposed: fingers, toes, ears, cheeks, chin, and the tip of the nose. It needs temperatures below freezing, plus wind or wet gloves and socks make it far more likely. Kids who take their mittens off to build a snowman or pack snowballs are the classic case.

• Frostnip is the mild first stage. The skin turns red, then pale, and feels cold, tingly, or numb. It warms back up with no lasting damage, and it is the warning to go inside.
• Frostbite shows up as white or grayish-yellow skin, skin that feels unusually firm or waxy, and numbness. The CDC notes that redness or pain may be the first sign. A child may not feel it at all, which is why it gets missed.

What to do

• Get the child somewhere warm, remove anything wet, and warm the whole body first.
• Rewarm the affected skin in water that feels warm, not hot, to your own unhurt hand, or tuck fingers into an armpit or a parent's warm hands. Expect it to sting and turn red as it warms.
• Loosely wrap the area with dry gauze or cloth, and separate fingers and toes.
• Any white, gray, waxy, hard, or blistered skin needs to be seen by a doctor.

What not to do

• Do not rub or massage frostbitten skin, and never rub it with snow.
• Do not warm it near a campfire, camp stove, or heater, and do not use a heating pad or an activated hand warmer on it. Numb skin cannot feel heat, so it burns easily.
• Do not let the child walk on frostbitten feet or toes unless you have to.
• Do not thaw it if there is a chance it will freeze again before you reach shelter. Thawing and refreezing does more damage than staying frozen a little longer.

When to call 911, and when to just go home

Call 911 right away if a child:

• Is confused, very drowsy, hard to wake, or slurring words
• Cannot walk normally or keeps stumbling
• Was shivering hard and has stopped while still cold
• Is not responding, or is not breathing (start CPR)

The CDC says a body temperature below 95 degrees F needs medical attention immediately. Many campgrounds have spotty cell service, so know before you arrive where the nearest signal, ranger station, and emergency room are, and keep the car keys somewhere everyone knows.

Short of an emergency, pack up and go home or to a hotel if a child has warmed up from mild hypothermia but the forecast is still cold and wet, if you are out of dry clothes, or if sleeping bags got soaked. A miserable night is not worth it, and there is no prize for sticking it out. The camping when the weather turns guide has a full stay-or-go checklist.

Prevention: the habits that matter most

Almost every cold injury on a family trip is preventable with a few routines:

• Dress in layers, with no cotton. A synthetic or merino base layer like the ViCherub Kids Thermal Underwear Set dries fast and stays warmer when damp. Our how to dress kids for cold-weather camping guide covers the full layering system.
• Change wet clothes immediately. Socks and gloves get wet first. Pack spares, including waterproof mittens like the Zelda Matilda Wildbreakers Waterproof Kids Mittens, and swap them the moment they are damp.
• Check in every 20 to 30 minutes. Feel the back of the neck, look at cheeks and ears, and ask kids to wiggle their fingers and toes and tell you if they can feel them.
• Feed and water them often. Cold dulls thirst, and a hungry, dehydrated kid gets cold fastest. Hot meals and snacks are covered in cold-weather camping meals.
• Use hand warmers the right way. HotHands Hand Warmers, 40 Pairs go in a mitten or pocket, never directly on bare skin, and never on skin that is already numb or frostbitten.
• Sleep warm. Most nighttime cold comes from the ground, not the air. See how to keep kids warm camping for the sleeping bag and pad setup, and never run a fuel-burning heater inside a tent; tent heater safety explains why.

Put the emergency blankets and a few hand warmers in your family first aid kit from October through April, so they are there the one time you need them.

Frequently asked

What are the first signs of hypothermia in a child?

Shivering, unusual tiredness, clumsy hands, and a change in mood, like a chatty kid going quiet. In babies, look for bright red, cold skin and very low energy.

Can kids get hypothermia when it is not freezing?

Yes. Hypothermia can happen above 40 degrees F when a child is wet from rain, sweat, or a creek. Kids lose heat faster than adults, so a wet kid on a cool evening is at real risk.

What should I do if my child has frostbite at camp?

Get them warm and dry, then rewarm the area in warm, not hot, water or against warm skin. Never rub it or use a fire, heater, or hand warmer on it, and get white, gray, or waxy skin seen by a doctor.

When should I call 911 for a cold child while camping?

For confusion, drowsiness, slurred speech, trouble walking, or shivering that stops while the child is still cold. A body temperature below 95 degrees F is a medical emergency.