Is swaddling overheating your baby? Know how to avoid heat stroke in the newborn

Babies need an air-conditioned environment to avoid heat stroke. In fact, newborns are at a very high risk of hyperthermia or heat stroke because they have a very low weight, which means they can have only that much fluids but have a relatively high surface area for evaporation of water.
'What compounds the problem of sweating and water loss is the cultural belief that babies need to be kept warm. Everyone tends to wrap babies in an extra layer of clothing. They tend to not switch on coolers or air conditioners for the baby. But babies also need to be in a temperature controlled environment, especially when the outdoor temperatures are above 40 degree celsius,' says Dr Ramesh Agarwal, neonatal specialist at the All India Institute of Medical Sciences (AIIMS), Delhi. Babies can't regulate their body temperature as efficiently as adults, making them more susceptible to overheating from excessive clothing or blankets. 'Extra layers of clothing or swaddling can trap heat against the baby's skin, preventing it from dissipating and causing a rise in body temperature,' he adds.
It is also important to ensure that infants are kept indoors when the day's temperatures are at their peak, say between 11 am and 5 or 6 pm. 'During these hours, all curtains should be drawn. The windows should be opened only after 6 pm to cool the house again,' says Dr Agarwal.
Keep your baby hydrated. Dr Agarwal says that those below the age of six months should be exclusively breast-fed on demand. 'They should be given breast milk as many times as they want it,' he says. For those up to the age of two years, fluids should be given in addition to breast milk.
The challenge is that even a little bit of water loss can be a lot for children. 'The amount of fluid in one's body is proportional to their weight. So, children tend to have very small reserves. If an adult loses even 500 ml of fluids, they can be okay. However, for a small child weighing say 12 kg, even the loss of 250 ml of fluid is a lot,' says Dr Nitin Verma, director of paediatrics at Madhukar Rainbow Children's Hospital.
The most important thing for children is to maintain hydration, he says. 'They might not be able to articulate that they are thirsty or keep a track of how much they are drinking like adults do. Parents should ensure adequate fluid intake in the form of not just water but different drinks such as coconut water, lemon shikanji, chaach, lassi, fruit juices among others,' says Dr Verma. This, of course, does not include any aerated soft drinks that are usually loaded with a lot of sugars and can increase the thirst.
Dr Agarwal suggests that parents carry a bottle of water and a bottle of ORS when heading out with children. 'When children sweat, they not only lose water but also other nutrients. ORS can play an important role in maintaining the sugar-salt balance,' he says.
Dr Verma says a child below the age of 2 years may require just a litre of fluids a day. However, older children may need 2 litres or more. Children who are participating in various sports may need a little more.
Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government's management of the Covid-19 pandemic and closely followed the vaccination programme.
Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports.
Dutt also takes a keen interest in the country's space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan.
She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University's Dart Centre. Dutt has a Bachelor's Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times.
When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More

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