Keeping Your Baby Warm

Warmth is important to new babies. If their environment is kept warm, they do not have to use any energy in warming themselves and they also tend to be relaxed and contented. If their environment gets cool, they have to use energy on heat-production instead of using it for the activities of living and growing. They tend to be fretful and restless, too. If they are allowed to get cold, there is a possibility of dangerous chilling (see below). 

Newborn babies need to be kept warm. That is why your baby was bundled up in a receiving blanket in the hospital nursery. Your baby does not have the ability to adjust his body temperature the way you do, so it is up to you to keep him at the right temperature. 

Use your own outfit as a guide. Many doctors will tell you to dress your baby as you are dressed plus one thin layer. If you are wearing a T-shirt and jeans on a nice warm day, then baby will be comfortable if he is similarly covered, perhaps with an added undershirt. If you need a sweater, so will your baby. Here are some tips for keeping your baby at the right temperature:

• Keep your home temperature at 68 to 70 degrees F (20 to 21.1 degrees C). That is a comfortable temperature which will not require your baby to be bundled up all the time.
  
  
• Avoid drafts. Do not place your baby near the draft of an open window, open door, or in front of a hot- or cold-air register that blows air. Even ceiling fans can create a breeze that is too cool.
  
  
• Go for the layered look. Use undershirts and easy-to-remove tops to layer clothing for warmth.
  
  
• Put a hat on baby. Keep your baby's head covered in cold weather and when his hair is wet.
  
  
• Do not overdo it. Babies need to be warm, but not hot. If your baby feels too warm, remove a layer of clothing. 

Ideal Warmth

All human beings make heat for their bodies in the same way. When we need more warmth, our metabolic rate goes up, with a faster heartbeat and quicker breathing. We use up some of our food-calories to release energy in the form of heat. This process of heat-production is efficient in a baby from the moment of birth, but unlike older people the new baby is not very good at conserving the heat that he makes. Instead of getting warm and staying warm, he loses heat as fast as he makes it. He has to go on and on using energy to make warmth until extra heat provided from outside relieves him of the necessity.

Experiments have shown that a naked newborn baby does not stop using energy to make warmth until the temperature immediately around his body reaches about 85 degrees F (29 degrees C). While this is too hot for an ordinary family room, it is a reasonable temperature to aim at in a room where you bathe a brand new baby. The rest of the time you can ensure that the air around his body stays at this ideal temperature simply by dressing him. Three light layers of clothing (such as T-shirt and diaper, a stretch suit and a blanket) will keep the air inside the bundle warm enough with room temperatures around 68 degrees F (20 degrees C). 

Warmth and Temperature Regulation

Babies are not as adaptable as adults to temperature change. A baby's body surface is about three times greater than an adult's, compared to the weight of his body. Babies can lose heat rapidly, as much as four times more quickly than adults. Premature and low birthweight babies usually have little body fat and may be too immature to regulate their own temperature, even in a warm environment. Even full-term and healthy newborns may not be able to maintain their body temperature if the environment is too cold.

When babies are cold-stressed, they use energy and oxygen to generate warmth. If skin temperatures drop just one degree from the ideal 97.7 degrees F (36.5 degrees C), a baby's oxygen use can increase by 10 percent. By keeping babies at optimal temperatures, neither too hot or cold, they can conserve energy and build up reserves. This is especially important when babies are sick or premature.

Ways to keep babies warm

There are several ways to keep babies warm, including the following:

• Immediate drying and warming after delivery

A baby's wet skin loses heat quickly by evaporation and can lose 2 to 3 degrees F (Immediate drying and warming can be done with warm blankets and skin-to-skin contact with the mother, or another source of warmth such as a heat lamp or over-bed warmer.)   

• Open bed with radiant warmer

An open bed with radiant warmer is open to the room air and has a radiant warmer above. A temperature probe on the baby connects to the warmer to regulate the amount of warming. When the baby is cool, the heat increases. Open beds are often used in the delivery room for rapid warming. They are also used in the NICU for initial treatment and for sick babies who need constant attention and care. Babies on radiant warmer beds are usually dressed only in a diaper.   

• Incubator / isolette

Incubators are walled plastic boxes with a heating system to circulate warmth. Babies are often dressed in a T-shirt and diaper.

Once a baby is stable and can maintain his own body temperature without added heat, open cribs or bassinets are used. Babies are usually dressed in a gown or T-shirt, a diaper, and a hat. A baby can lose large amounts of heat through his head. Often, a blanket is wrapped snugly around the baby, called swaddling.

Dressing your baby for a trip outdoors

When you are taking your baby outdoors for a walk, a trip to a relatives, or a quick run to the grocery store, here are some tips on how to keep him comfortable:

• Dress your baby appropriately for the outdoor temperature.
  
  
• In cold weather, always cover baby's feet, hands, and head.
  
  
• In warm weather, you do not need to keep booties on your baby.
  
  
• For car trips on cold days, warm up the car first before loading your baby inside. 

Bundling baby 

The nurses at the hospital will show you how to properly bundle your baby. The standard method is a lot like making an open-topped burrito. Be careful not to bundle him too tightly and pay close attention to how his arms are positioned. Once he can roll around on his own, he will want to be bundled less.

For car trips on warm days, you should shield your baby from hot direct sunlight by using a blanket in the window or a shade made especially for car windows.

Cooler Temperatures

A baby's ability to conserve his own warmth improves with age and weight. His ability to spare some energy for heat-production improves too. A baby who was premature and now weighs only around 6lbs (2.7kg) should definitely be kept indoors at a steady temperature and should only be undressed in really warm places. On the other hand, a three-month-old baby weighing around 12lbs (5.5kg) will have begun to be able to conserve warmth and can well afford to use some energy on keeping himself warm for at least some of the time.

Between those extremes, commonsense precautions will keep your baby warm enough to be both safe and contented. Exposure to very cool temperatures should be kept brief. A short trip in his carriage with the air temperature in the 50s will not hurt him. The insulation of his wrappings will conserve his warmth for some of the time, and making his own heat for the rest of it will not drain him of energy. A whole morning in the carriage in the yard is a different matter. Why should he be forced to work at keeping warm for so long when he could get just as much fresh air beside an open window?

Don't let him cool right off while he is deeply asleep. As long as he is awake or merely dozing, his heat-producing mechanism will "switch on" as soon as it is needed and prevent him from getting chilled. But if his sleep is so deep that the cold does not disturb him, the mechanism will not come into play and he could go straight from sleep into a chilled state (see below). If your house cools off markedly during the night, you must make sure that his room is separately heated at least for a few weeks.   

How to Keep your Baby Warm In Winter

In winter, babies need about the same number of layers as adults for comfort and protection, indoors or out. It is important that you make sure your baby stays warm and dry. A newborn’s ability to regulate body temperature is not well developed, so you need to pay special attention to how they are dressed.

A baby that is too cold may fuss, but may not complain if too warm. Mottled looking skin or pale cheeks may be a sign a baby is too cold. If the neck feels damp from sweat or cheeks are especially rosy, the baby may be overdressed.

Use layers of clothes

Diapers and a cotton knit undershirt are important as the first layer of clothing and should be kept dry with frequent changes. Knit cotton undershirts can be pullover or wrap style with ties.

For tiny babies, cotton jersey knit gowns that tie at the bottom keep feet warm and are convenient for changing diapers. As baby grows, soft one-piece knit sleepers with feet and a gripper or zip opening from neck to toes make baby easy to handle. These do not gap open at the waist as can happen with two-piece outfits. Some sleepers have cuffs that fold over to keep hands warm, but as babies find their mouths with their fists, be sure the sleeve cuffs are kept dry. Evaporating moisture in wet clothes tends to cool the hands and body.

The first week or two, your baby may feel more secure if wrapped snugly in a flannel receiving blanket. Keep blankets away from the infant’s face, and place babies on their backs for sleeping at night to reduce the risk of smothering.

Cloth diapers need to be changed more often than disposables. Change them whenever you find them wet, to reduce the chance of diaper rash. Disposable diapers may be required by day care providers and are more convenient for travel.

When babies are older, they squirm and turn a lot during nap time. Blanket weight fleece sleepers are a good choice for infants when sleeping. When a child starts walking, be sure that sleepers have non-skid soles on the bottom of the feet.

Taking baby outdoors

If you take a baby outdoors in winter, a knit or fleece cap, sweater,and blankets or a snowsuit are needed over their indoor clothes. Wrap small babies in a soft cotton flannel “receiving” blanket. Wrap heavier fleece or quilted blankets over the first one for added warmth and protection. When you dress a baby for travel in a car, a snowsuit or car seat-friendly bunting with a button hole for the seat-belt is needed to fasten the baby in the car seat.

A snowsuit should have feet and hand covers. A snowsuit should have a wind and water repellent outer layer and an inner layer of fiber-fill, flannel, or fleece that holds still air to insulate. A warm blanket may be neededover these suits, if it is very cold outdoors.

Remember to protect the baby’s face from wind and sun-burn. Usually, you can drape one of the blankets loosely across the face during trips between the house and car. Be sure to uncover the child’s face afterward. Be careful that the blankets used to wrap the baby are not so slick that the baby slips and falls out of your arms.

If you are indoors, such as at a mall for an extended period of time, take the baby out of the snowsuit or from under the covers, to prevent overheating and perspiration that can dampen clothes. Clothes that are damp will not be warm when you return outdoors again.

Choose and manage your baby’s clothing carefully to keep your baby safe and warm in winter.

Keep baby's skin from getting too dry

Especially in cold-winter areas, the chill wind outside and dry heat indoors can sap moisture from the hardiest of skins — and your baby's delicate skin is especially vulnerable.

Keep your baby's skin moisturized. Many lotions and creams are made especially for babies' sensitive skin. If you are heading outdoors, make it a habit to put on some lotion to prevent dry, chapped skin. (Pediatricians recommend you not to put lubricants on a newborn's skin, though — wait until he's a month old or so.) A moisturizing stick that tucks into your diaper bag is handy for on-the-spot TLC.

Soap and water are drying to your baby's skin, so be careful not to overdo the baths in the winter months. When you do wash your baby, use a mild soap and warm, not hot water (A thermometer is handy for testing the water temperature.) Don't let him soak in the tub too long. Wrap him in a hooded baby towel as soon as you take him out of the water and pat (don't rub) him; dry him quickly. Put a mild baby lotion on his skin, and then bundle him up.

If the house is very dry, you might consider putting a cool-mist humidifier in the room where your baby sleeps to help keep his nasal passages moist. 

Signs of Chilling

A baby who is managing to keep himself warm but would be happier if outside conditions relieved him of the task will be restless. His breathing will be faster than usual and he may cry. While his hands and feet may feel cool, his chest and stomach, under his clothes, will still feel normally warm. As soon as you take him to a warmer place (especially out of a cool breeze), he will become calmer and more relaxed.

A baby who is losing the battle to stay warm and is in danger of becoming chilled behaves quite differently. He is very quiet and still. He will not cry until he is beginning to get warm and can therefore spare the energy which crying takes. His hands and feet will feel cold and even the skin of his chest under his clothes will feel cool to your hand. Do not simply add more wrappings. He is already cold and is showing you that he cannot make more heat for himself at the moment. Extra wrappings will insulate the coldness in. He needs to get warmer first — perhaps by being taken into a warm room and given a warm feeding or by being cuddled under a wrap or blanket. After that, extra wrappings will insulate in the warmth that he needs.

If such a baby were given no help in getting warm or was left asleep with his heat-producing mechanism not working, he could slip into the next stage of chilling which is called the "neo-natal cold syndrome." This is very rare but it is dangerous. Vital bodily functions run so slowly that the baby is lethargic, floppy, difficult to wake up and unable to suck. His hands and feet look swollen and bright pink. His skin is very cold to touch. A baby in this condition needs urgent medical attention as he will have to be re-warmed slowly and with great care.     

Getting Too Hot

Hot weather seldom bothers babies as long as they have plenty to drink so that they sweat freely, and loose light clothes so that the sweat can evaporate and cool them. When it's really hot, banish plastic pants, which prevent evaporation, and use a sun-canopy instead of the stroller hood, which traps warm air around the baby. If he is irritable and his skin is dry, sponge him with warm water and fan him. Overheating is more often caused by clothes than high air temperatures, though. Don't leave your baby to sleep in a carry nest or even in a snow suit; once you have brought him inside, you must take off outdoor clothes, however reluctant you are to disturb him. And don't overdress him in a warm room. He doesn't need wrappings and blankets and a quilt. . . . 

Direct Heat

Direct heat is a hazard to small babies. Until the friction of clothes and exposure to air, wind and sun have toughened it, the baby's skin is very fragile. Guard it from obvious threats like sunburn and hot water bottles, and from less expected ones too. Don't leave him on a rug close to the fire, a light bulb or a radiator.