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.

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What can happen from hypothermia? • Emergency condition. • Can quickly lead to unconsciousness and death

if heat loss continues.

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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.

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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.

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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.

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Hypothermia

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.

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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. Slide 8

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

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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.

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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.

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Hyperthermia

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.

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Hyperthermia Stats by Year

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Hyperthermia Stats by State

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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.

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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) Slide 16

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.

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Vehicle Heating Dynamics

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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.

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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.

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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.”

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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

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Safety and Clothing • Too many clothes/overbundling:

– 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.

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Clothing Selection

• Hand me downs are fine. • Fewer clothes needed when small

due to fast growth. • Simple and functional design.

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Dressing an Infant and PIES

• 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

When a child is comfortable and secure with appropriate clothing, physical, intellectual, emotional and social development is stimulated.

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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

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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°.

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Safe and�Comfortable�Temperatures�and Clothing�for InfantsHypothermiaSlide Number 3Slide Number 4Slide Number 5Slide Number 6Slide Number 7HyperthermiaHyperthermiaHyperthermiaHyperthermiaDanger in the�Unattended VehicleHyperthermia�Stats by YearHyperthermia�Stats by StateWhy the Increase?Hyperthermia�CircumstancesLegal�ImplicationsVehicle�Heating DynamicsPreventionGood�Environmental�TemperaturesClothing�Factors to ConsiderOther Clothing�Factors to ConsiderSafety�and ClothingClothing�SelectionDressing an�Infant and PIESDressing an�Infant and PIES�– continued Review