title: Children sleeping outdoors in winter: parents' experiences of a culturally bound childcare practice.
abstract: OBJECTIVE
  The purpose of this study was to describe parents' opinions about their children sleeping outdoors during the Finnish winter and the prevalence of this practice in the city of Oulu.
  
  
  METHODS
  A cross-sectional study using a questionnaire.
  
  
  METHODS
  Data were collected using a questionnaire compiled for the purpose of giving us a window into this childcare practice in northern Finland. The questionnaire was distributed to the parents of children under 2 years of age using the services of child welfare clinics in Oulu (n = 116). The study was mainly quantitative and partly qualitative.
  
  
  RESULTS
  Allowing children to sleep outdoors in the winter was considered a common practice and was taken for granted. It usually began when the child was 2 weeks old, and was carried out once a day. Children took longer naps outdoors compared with naps taken indoors. Outdoor temperatures ranged between -27 and +5 degrees C. Parents' experiences were mainly positive and most parents had not faced potentially dangerous situations. However, parents reported that the children's fingers felt cold in 3% of the children sleeping in 0 degree C temperatures and in 25% sleeping in -15 degrees C temperatures. Almost half of the children had sweaty necks at 0 degree C, but the most frequent symptoms were red cheeks and cold nose tips.
  
  
  CONCLUSIONS
  In addition to this cross-sectional study and the parents' subjective and mainly positive experiences, objective measurements and an extensive study about parents' experiences are needed before guidelines for allowing children to sleep outdoors in the winter can be updated.
authors.affiliation: Finnish Post-Graduate School in Nursing Science, Institute of Health Sciences, University of Oulu, Oulu, Finland. marjo.tourula@oulu.fi
authors.forename: Marjo
authors.initials: M
authors.lastname: Tourula
authors.forename: Arja
authors.initials: A
authors.lastname: Isola
authors.forename: Juhani
authors.initials: J
authors.lastname: Hassi