Safe and Comfortable Temperatures and Clothing for Infants

Hypothermia What is hypothermia? Hypothermia occurs when the body gets cold and loses heat faster than the body can make it.

Hypothermia What can happen from hypothermia? Emergency condition. Can quickly lead to unconsciousness and death if heat loss continues.

Hypothermia What are some symptoms of hypothermia? Adults: Shivering violently. Stumbling, confusion. If treatment is not provided, shivering stops and the body begins to shut down. Weak pulse, shallow breathing. Infants: Bright red, cold skin. Listlessness.

Hypothermia Why are infants at greater risk? They have a larger body surface area to mass ratio than adults, allowing greater heat loss. They cannot produce as much heat as adults through muscle activity. They can’t make enough body heat by shivering.

Hypothermia Precautions: Keep rooms at a comfortably warm temperature in winter months. Keep infant in warm clothes during winter. Dress infant appropriately if you must go outside – avoid being outside in extreme cold or heat. Never leave an infant in an unattended vehicle.

Hyperthermia What is hyperthermia? Hyperthermia occurs when a person‘s body temperature produces or absorbs more heat than it can dissipate. Body temperature rises and remains above the normal 98.6°F.

Hyperthermia What can happen from hyperthermia? Emergency condition. Heat-regulating mechanisms of the body eventually become overwhelmed and unable to effectively deal with the heat, causing the body temperature to climb uncontrollably (heat stroke). Can lead to disability and death if heat continues. Can be confused with fever due to illness. If infant is exposed to high temperatures and becomes overheated, he/she may develop hyperthermia.

Hyperthermia What are some symptoms of infant hyperthermia? Dry mouth or tongue Few tears when crying Few wet diapers (less than 6 a day) Dark yellow or smelly urine Sunken “soft spots,” eyes, or cheeks Mottled, grayish, skin that’s cool to the touch High fever Listlessness

Hyperthermia Why are infants at greater risk? They are unable to tell someone they’re hot/thirsty. Their temperature-regulating systems aren’t fully developed. They have fewer sweat glands than adults, so not as efficient as adults in keeping cool.

Hyperthermia Precautions: Keep rooms at a comfortably cool temperature during the summer. Dress infants in cool clothing in hot summer months. Use wide-brimmed hats in light colors if you take infant outside. Use sunscreen/sunblock on infant if outside. Avoid outdoors in extreme heat. Keep the infant hydrated during heat waves. Never leave infant in an unattended car.

Danger in the Unattended Vehicle Prior to 1990-1992: 11 known deaths of children from hyperthermia (extreme heat) in a vehicle. 1998-2011 close to 500 children died from being inside hot cars. 75% of them were less than 2 years old.

Hyperthermia Stats by Year

Hyperthermia Stats by State

Why the Increase? Airbags became standard in most cars by 1998, requiring infants and children to now sit in back seat. More than half of the deaths that occurred were due to the fact that the caregiver forgot the infant/child was back there. NOTE: This does not imply that we should not have airbags or that children should sit in the front seat.

Hyperthermia Circumstances An examination of media reports about the 494 child vehicular hyperthermia deaths for a thirteen year period (1998 through 2010) shows the following circumstances: 51% - child "forgotten" by caregiver (253) 30% - child playing in unattended vehicle (150) 17% - child intentionally left in vehicle by adult  (86) 1% - circumstances unknown (5)

Legal Implications Although all states have laws against endangering the welfare of a child, only 15 states presently have laws prohibiting leaving a child unattended in a car. Considered abuse/neglect and could result in criminal charges.

Vehicle Heating Dynamics Used with permission from : Department of Geosciences, San Francisco State University

Prevention NEVER leave an infant/child in a car – even for a minute! Place your purse/ briefcase/jacket in the backseat with the infant. Place a teddy bear in the front seat in a visible location to remind you that the infant is in the back seat.

Good Environmental Temperatures Home temperature – winter: 68°-72° F. Home temperature – summer: 75°-78° F. Don’t over bundle infant. Dress infant in one extra layer than yourself. Lightly clothed for sleep – so keep bedroom at comfortable temperature for light clothing.

Clothing Factors to Consider Security and protection – infants need to be clothed. Comfort is most important. Use size-appropriate clothing. Soft, lightweight fabrics for moderate temperatures. Knit fabrics = easy care. All cotton and cotton blends = “breathability.”

Other Clothing Factors to Consider Check for ease of changing and safety. Check care labels = hot water/dryer eliminates bacteria. Check labels for “flame resistant.” Consider clothing colors: Dark = absorb heat and keep infant warmer Light = reflect heat to keep infant cooler

Safety and Clothing Too many clothes/overbundling: Loose clothing: Potential over heating Potential heat rash Loose clothing: Potential suffocation from infant getting wrapped up in it Potential for catching on fire Snug fit – not tight. No drawstrings. Lightweight clothing and full coverage when outdoors for sun protection. Sunscreen for exposed skin.

Clothing Selection Hand me downs are fine. Fewer clothes needed when small due to fast growth. Simple and functional design.

Dressing an Infant and PIES When a child is comfortable and secure with appropriate clothing, physical, intellectual, emotional and social development is stimulated. Physical Development Appropriate clothing = health, safety, comfort, security Exercise and later cooperating with changing Physical stimulation Prevent diaper rash Intellectual Development Talking = language development Routines important: Sleeper → daytime clothing and back Positive parenting and bonding = brain development

Dressing an Infant and PIES – continued Emotional Calming aspect to feeling clean Bonding = positive emotional development Social Talking /singing during the process = enhanced brain development and bonding Regular routine for social interaction Positive physical and verbal = good parent/child socialization Cooperation through parenting modeling

Review Scenario 1: 20 month old Luke has bright red skin, cold to the touch. He has been riding in an unheated car for 30 minutes. Outside temperature is 35°. Scenario 2: 4 year old Michelle has been playing in the family car in the driveway. Windows are rolled down. Outside temperature is 85°. Scenario 3: 3 month old Jose has been left in his infant seat in the back seat of the car. Windows are rolled up. Outside temperature is 75°.