Hot Tips to Keep Your Baby Cool This Summer

Long before it’s officially declared summer here in the South, we are H-O-T HOT! But, why is that a danger to babies or young children?

Well, children have a larger body surface area in proportion to adults - the smaller the child the greater the ratio of skin to their size. And the outer layer of that skin is thinner than adults. That puts babies and children at risk for losing more body fluid through the skin and just being more susceptible to the heat in general.

But, even though they lose more fluid, they don’t sweat very efficiently, which is a way that adults and older children cool off. So babies and young children can get dehydrated very easily.

When taking children out into the heat, they are going to be more susceptible to heat related illness much more easily than an adult -  Some estimates say 3-5 times more easily.

As a parent, you may not even notice the heat or be uncomfortable, but your baby may already be experiencing symptoms of a heat related illness.

We also have to remember that children can’t yet tell us how they are feeling  - we have to look at their behavior and determine what is going on with them.  But some symptoms of heat related illnesses are mild in the beginning and may just look like an overtired child. Who hasn’t had an overtired child on a family outing who is acting fatigued, cranky, and irritable...  

So, just what are Heat Related Illnesses? 

Heat cramps   

This is the first sign of heat illness. It happens when children are not drinking enough. You may never know this if your child is not able to tell you.  You may just see some fussiness.

 The best way to know if your child is not drinking enough is to count the number of wet diapers and check the color of the urine. If the number of diapers has decreased from normal while you have been out in the sun and the urine is darker or smells stronger, you will know that your baby is not drinking enough. Give enough fluid to make sure the diaper is heavily wet with  light yellow or clear urine.

Heat cramps aren’t dangerous by themselves but can quickly progress to heat exhaustion if not treated.

Heat exhaustion 

Heat exhaustion is more serious than heat cramps. It happens when the child is overheated and not drinking enough. Look out for these symptoms: Your child may be  

• very thirsty
• weak
• feeling faint or actual fainting
•  muscle cramps
• nausea/vomiting
• cranky, fussy, very irritable
•  headache
• more sweating than usual
• skin feels clammy
• Temperature goes up but less than 104
•  Decreased number of wet diapers and/or darker, stronger smelling urine
   

Heat stroke

This is the most dangerous situation. The child’s body can’t regulate its own temperature. The temperature can soar to over 106 degrees very quickly, leading to brain damage and death.

 This is typically seen with children locked in hot cars or inside hot spaces where heat quickly rises to dangerous levels. But, that is not always the case, especially with younger children and babies. 

 In this situation you would notice that the previous symptoms have progressed to: 

• Severe headache
• weakness
• dizziness
• confusion
• Nausea and vomiting
•  rapid breathing and rapid heartbeat
• Loss of consciousness
• seizure
• In this case the child has stopped sweating
• Now the skin is flushed, hot and dry
• high temp > 104 to  over 106
   

 The problem with these symptoms in young children is this: Some of these earlier signs are very hard to notice in a busy situation.

Weakness and fatigue may not be recognized in a hot baby, who just seems to be taking a longer than normal nap.

Irritability may be mistaken as being tired or fussy.

If a child is napping in a stroller and gets overheated, and not able to be seen easily, some symptoms may go unnoticed until very late.

 What should you do if you think your child has a Heat Illness?

In all of these scenarios, it is important to:

• Get out of the Heat
• Take the child somewhere air conditioned preferably but into some shade at the least - (a public building or restaurant, even a car with the air conditioner on, or your home if you are nearby) 
• Take off the child’s clothes
• Apply cool (not cold or ice) water to skin
• If not unconscious, give fluids
  • if breast or formula feeding and <6 months -  continue this
  • if > 6 months - 1 year - give water in small sips
  • If > 1year  - give water or sports drinks such as powerade or gatorade for replacement of sugar and salt imbalance
• Call the child’s health care provider - Your child may not be able to replace enough fluids by mouth and may need IV fluids
• If your child is unconscious or looking very ill, Call 911 for further evaluation
• Continue doing all of the above but do not give fluids if a child is not conscious

Now, we do not want your child to have a heat related illness. My goal with this series is to give you guidelines for a safe and healthy summer. So, here is what you can do to PREVENT getting into any of those overheating situations.

Guidelines for prevention of heat related illness in children

(These guidelines work for parents too!)

Dress in lightweight, light colored, breathable clothing

Dress the child in natural fibers like cotton rather than synthetics so that moisture is not trapped near the body.

Wear a hat with a 3 inch brim or a baseball style (don’t underestimate how much cooler your baby will be by wearing a hat!)

Stay out of the hottest part of the day   

The sun is at its hottest between 10am and  2pm. Go outside in the  early morning and late afternoon if possible.

Stay hydrated  

Breast feeding baby < 6months  

Continue to breastfeed on your usual schedule but you will need to give some additional snack feedings to supplement fluid losses and heat. Let baby feed as often as he is acting hungry (or thirsty). Watch for signs - chewing on hands, rooting around, pulling on breasts.

Baby will probably only feed for a few minutes at a time - as if just getting a drink. That is fine. Breastmilk is composed mostly of  water and that is what baby needs on a hot day. The foremilk is thinner and when baby snacks he isn’t  getting the heavier, calorie laden hindmilk, but mostly the fluid he needs to stay hydrated.

If the baby does not act hungry, feed as often as you are drinking or at least every hour. Wake baby to get fluids in.

Formula fed baby < 6 months 

You need to give some increased formula in the hot summer. Offer formula as baby seems hungry but in small sips or amounts to thirst. Don't limit baby. 

He most likely won’t take a full bottle every hour but will need to take more frequent feedings to satisfy thirst and fluid requirements.

If baby doesn’t seem thirsty, give him some formula every time you drink or every hour. Wake baby to get fluids in.

DO NOT GIVE BABY UNDER 6 MOS WATER - There is a danger of causing an imbalance between the baby’s salt and water balance in the body if you give a young  baby water.

There is also a chance that the baby will drink too much water and decrease his appetite for his formula or breast milk and not get the nutrition he needs. A baby’s only form of fluid should be breastmilk or formula before 6 months

.

Babies > 6 months 

You can continue frequent breast or formula feedings. But you can now offer sips of water from a sippy cup or straw cup frequently. You can make small portioned breastmilk or formula popsicles for baby to suck on to get more fluids. Offer baby fluids every time she wants them, as often as you drink or hourly.

Do not give juice or sugar sweetened fluids as this may make the baby dehydrate more quickly

.

Heat makes babies sleepy. They may sleep deeply and not wake up for a feeding. Overheating is one of the SIDS risks. This is a time to wake a sleeping baby. Wake your baby often to drink.   

Older babies/children

They need water every 20 minutes to an hour depending on how hot it is outside and their activity level. Start with water. But if they are out for longer than an hour and are very active, begin offering sports drinks such as gatorade and powerade. These drinks have the proper amount of sugar and sodium to replace fluid loss.

Do not give juice, sodas or caffeinated drinks as these may cause children to dehydrate faster.

Children may not say they are thirsty. Offer the fluids frequently and monitor urine output. Children should urinate every few hours and urine should be light yellow. Increase fluids as needed.

Take Shade Breaks Frequently

Seek out shady areas to get out of the direct heat. Use this time to drink, cool down, do safety checks, check urine output.

Cool off Frequently

Use cooling towels or cloths  - Cooling towels come in a variety of different fabrics and types but basically all work the same way. They are activated when the fabric is wet, then placed on the body to help cool by evaporation.

Cooling towels are widely available online and in most retail stores.  They may help to keep the body cooler for longer periods of time. (Some people say wetting a dish towel may provide the same benefit although some cooling towels feel dry to the skin even when wet.)

Use a mist bottle with or without a  fan to wet the child down occasionally. This will help to cool the body down.

Wipe the child down with a wet cloth during drink breaks.

Block the heat

For a baby in a stroller, use the sunshade or umbrella to block direct sunlight and heat.

You can also use open front or ventilated beach- type tents for shade.  

Make sure that the baby has adequate ventilation.

Do not ever cover a stroller with anything other than the sunshade to keep the sun out.  Even a lightweight blanket can increase the temperature inside dramatically causing a baby to overheat. A recent test in Sweden showed that the temperature went up in a matter of minutes from the high 70’s to 99 degrees by placing a blanket over a stroller.

The same would be true for covering a portable crib or baby bed that is in the heat. Unless there are ventilated sides, a baby would get too hot inside with a blanket or covering on top.This would make it like an oven for the baby.

Be careful of placing baby in front carriers and slings in hot environments where heat can be transferred to baby from another person.  Airflow may be limited and heat builds up much like in the previous examples and baby can become overheated very quickly.

Check the baby frequently in any hot situation

Make sure that the baby can be seen at all times,  and that the baby is not sleeping too deeply. Overheating is a SIDS risk.

Check for other symptoms  - irritability, fussiness, decreased wet diapers, increased sleepiness, vomiting.

Check baby frequently for arousability.  Wake baby often and provide fluids.

Do frequent child checks for symptoms of Heat Illness.

Look for increased thirst, irritability, headache, muscle cramps, excessive sweating, or hot, flushed, dry skin, and decreased urine output.

What do you do if you are worried that your child may be suffering from heat illness?

Or beginning to head in that direction?

• Get to someplace cooler as quickly as you can - preferably some place with air conditioning.
• Get the child’s clothes off, and wet him down.
• Start getting some fluids into him.
• Observe for the child to perk up.
• If that does not happen quickly, consult your child’s healthcare provider.
• If your child has many symptoms, consult your health care provider immediately.
• If your child looks ill or is not responsive, call 911.

Now, I can think of a lot of scenarios where overheating could be a problem. Simply playing outside in Georgia on a 90 degree day can cause overheating this time of year. Going to the park to play is one. Being on a ball field watching an older sibling or adult, or even watching a professional game is another.

One situation that happens commonly this time of year is a family vacation to an amusement park - such as Disney World. The long lines, high heat and long days make it difficult to keep babies and children cool.

Planning ahead is going to be your best defense against heat problems in any of these situations - and many more -  so that your child doesn’t get into trouble.

And, of course, all of these situations can effect adults as well. So be aware of how you are feeling when in the heat. It is easy to neglect your own needs when caring for others.

One scenario I have been asked about is how to keep children cool in a hot car seat. Remember, we are talking about getting into a hot car with a child or baby, not leaving a baby in a hot car. The temperature inside a car can soar from 78 degrees to over 100 degrees in a matter of minutes. If you are coming out of a store or your home and must get into a hot car with your child, here are a few tips that will help.

Keeping  Your Child Cool In the Hot Car seat

Block the Sun

Get Tinted windows.  Your car may come with them or you may purchase them after market.  Check to make sure tinting is legal in your state.

Use Reflective windshield shades.  (I’m sure you have seen these silver folding screens) Put them on the windshield or wherever you need to keep the sun from shining onto your child’s seat.

Stick on or Roll Up Shades may be dangerous due to blocking the driver’s view and by being a flying projectile that could injure passengers during a crash. I don’t recommend these.

Park in the shade. 

Of course this may be obvious but it also may not always be an option. If you can’t, try to park so that the sun doesn’t shine directly on your baby’s side of the car.

Light colored cars and light colored interior are cooler than dark colors.

Now I did not just tell you to go buy a new car but if you are in the market….

Light colored Infant and Child CAR SEAT interiors are cooler than dark colors.

So if you have not purchased a car seat yet, look for a light colored fabric that is also lightweight. When switching to a convertible car seat or booster, choose light.

If you have a darker car seat, cover it with a light colored muslin blanket when you get out of the car to keep it cooler.  

Snap the car seat buckle back after getting the child out of the carseat so that the metal is not exposed to the sun.

Yes, this will take longer to get baby, back in, but it may be  cooler.

Check temperature on all the car seat parts before putting the baby in the car.

Car seat straps, buckles, harnesses and shields may be too hot to touch baby’s skin until it is wiped down or allowed to cool.

Make sure the car seat is in middle of back seat

This is the safest position anyway but is also farthest away from windows.

If you have more than one child, try to park away from where direct sun will face the other child’s seat.

Close the sunshade on the carseat when you get out of the car to keep sun off of the seat.

Direct air conditioning vents upward to get airflow to the back of the car.

Even back vents may not reach a backward facing car seat well. Directing front and back vents upward may help cool  air to reach baby more quickly. Play around with different positions to see what works best.

Cool baby off when you put her into the seat.

Use a mister to get her to start to sweat a bit.

Older children can use hand held misting fans. Make sure they are designed for children with no choking hazards or foam pieces they can bite off.

Cooling towels that were discussed earlier are a great use in the car to keep babies and children cool.

Wipe her down with a wet cloth. 

Make sure that you do not get the child too cool or too wet if you are taking them from the hot car into an air conditioned  building such as a cold restaurant.

Dress children appropriately 

You need to dress for summer time as above then layer if going into cool buildings.

 Look Before You Lock 

Now, the last thing we need to discuss when talking about Heat Dangers is another kind of Hot Car Safety. This one is preventing heat stroke in children by being left in hot cars (Vehicular Heat Stroke).

Now, I know that the majority of parents will say “I would never leave my baby in a hot car”. Unfortunately, the majority of the approximately 38 children who die every year in hot cars were unintentionally left there by loving parents or caregivers.

Probably all of us have seen children who have been left in cars alone. I know the reaction I have had.  I hope that this information will be enough to convince anyone who thinks of leaving their child for “just a minute”  to reconsider that action.

But, it is also dangerous for a baby whose parent thinks “I would never do that”. Because the majority of those parents whose babies died in hot cars thought the same thing. Every parent needs to have a plan to ensure that this tragedy won’t happen to them.

Parents are tired, and busy and often under a lot of stress. You run late and get distracted. Schedules and routines change. And there is a whole brain function rationale for how you can drive the same route to work every day and realize you don’t remember any part of the trip. ( Who has wondered that before? Me. )

That is how a baby can fall asleep in a carseat and a protective and caring parent can think they left them at daycare, or forget they had them in the car today at all and the baby gets unintentionally left in the car.  

The only way to be absolutely sure you will never leave your baby in the car is to have a system in place to make sure EVERY time that the child is not in the car seat when you leave the vehicle.

KidsandCars.org has posted a Look Before You Lock facts sheet which has some very helpful information as well as tips for setting up a strategy to make sure your child never gets locked in a hot car. I have linked to the full fact sheet here but here are some Prevention and Safety tips for making sure you never leave your baby in the car:

Look Before You Lock  Make it a habit of always looking into your back seat and checking your child seat before locking your car and walking away.

Create a reminder to check the back seat

Put something you will need in the back seat so you will have to open the back door to get it every time you park - wallet, purse, briefcase, cell phone, key card for work etc.

Put a large stuffed animal in the child seat and move it to the front seat when child rides with you. When the stuffed animal is in the front seat, it is a reminder that the baby is in the back.

Have a policy in place that the daycare provider calls you if the child has not arrived at the usual arrival time, if you did not notify her of a delay or absence.

Keep vehicles locked at all times.

Keep keys and remotes out of reach of children.

Never leave children alone in or around cars for even a minute.

Be especially careful during busy times, schedule changes, holidays and stressful times because that is when many of these tragedies happen.  

If you see a child alone in a vehicle, act quickly.

Call 911 and stay with the child until help arrives. If the child looks ill, hot or is unresponsive, get them out of the car as soon as possible. Break the window  farthest away from the child. Don't be afraid to get involved.

This was a lot of information to cover about the dangers of heat related illnesses for babies and children. I have given you a lot of symptoms to look out for but more importantly, I have given you tips for keeping your baby and child cooler and well hydrated this summer so that we can prevent these heat related events.

I have covered a lot of information, but my main objective is always to make sure that you are educated, then give you and tips and strategies to prevent bad things from happening to your baby.

I talked about preventing one of the biggest tragedies I can think of, heat stroke from being locked in a hot car. With a plan in place, you can make sure that a simple tragic accident like this never costs your child’s life.

I hope that you will find this information to be helpful for your family this summer.  Put some plans in place and let me know how they work for you. And if you have other tips that work well for cooling off your family, please share those with us too. Come on over to the Facebook community and share your thoughts with us there. And as always, if you find this helpful, please share it with a friend or on Facebook.

Happy Summer - 

 LuAnn