How to Keep Babies and Toddlers Safe During a Heat Wave

Welcome to Ask Dr. Harvey Karp, our fatherhood advice column at Esquire, where the author of The Happiest Baby on the Block and creator of the SNOO answers your burning questions about parenting. Got a query? Drop us a line in the comments.

Summer is here, and it’s the time for pools, playgrounds, camping, and beaches! That means it’s time to slip/slop/slap (slip on a shirt, slop on some SPF 30+, and slap on a hat) to protect against sunburns and the sneaky heat.

Every year, we see tragic outcomes from heat-related illness. Little kids aren’t mini adults. Their compact, pudgy bodies help them resist the cold but don’t help them beat the heat. Our little ones overheat faster. With short arms and legs, they have a lot less surface for their sweat to evaporate and cool them off. And their baby fat insulates them like a little coat, keeping heat trapped inside.

In fact, when they get hot, they get very red—flushed cheeks, fiery-red ears—and they start to breathe quickly. That’s their bodies trying to radiate the heat away. And remember, the way they articulate when something feels wrong is by becoming crabby or extra quiet. Overheating can also boost the risk of dehydration, seizures, and even SIDS.

Fortunately, parents have a few ways to help their little ones keep cool.

To prevent overheating, use light, breathable clothing. Skip hats indoors and make sure your home is kept at a safe temperature, ideally 68° to 72°F. Fans and air-conditioning are safe to use, so long as cool air isn’t blowing directly on your child. When outdoors, seek shade and take frequent breaks to cool off. If you aren’t sure if your child is getting too hot, feel their ears, not hands and feet, which can be misleading, and check around the neck and under their arms for sweating.

A car can heat up shockingly fast, even when it doesn’t feel that hot outside. With the windows up, it can reach deadly temperatures in just ten minutes, even on a 70°F day, according to the National Highway Traffic Safety Administration.

This heartbreaking phenomenon, known as “Forgotten Baby Syndrome,” can happen to anyone. Every year, dozens of children die from heatstroke when left in a parked car. Even smart, loving, attentive parents can forget a sleeping child in the backseat when they’re tired, stressed, or out of their routine.

This tragedy is preventable:

• Always check the backseat when you park, and place your phone, purse, or left shoe in the backseat, as a reminder to check.
• Never leave a child unattended in a vehicle, not even for a minute.

Surfaces in the hot sun, like black rubber mats and metal slides and swings, quickly reach temperatures that can cause skin burns. According to the AAP, a child’s skin can burn in seconds when touching hot surfaces.

Here’s how to stay safe:

• Do a touch test. Press your palm against playground equipment for a few seconds. If it’s too hot for your hand, it’s too hot for their skin.
• Play early in the morning or late in the afternoon to avoid peak sun.
• Take frequent shade breaks.
• Keep water on hand for drinking and to wet their heads and T-shirt.

On hot days, consider finding some cool fun at a museum, a library, or even your local mall.

Hydration is important to staying safe in the heat. Big kids can slug H2O, but don’t wait until you hear whines of “I’m thirsty!” That means dehydration has already started. (You’ll see less pee, and it will be dark yellow.) Babies get all the water they need from extra breast milk or formula, but after six months you can definitely offer extra water as you keep an eye out for signs of dehydration. If you are unsure if your child is too hot, it’s a good idea to take their temperature. If they are over 100.5° to 101°F (rectally) it’s time to take action.

Water helps outside their bodies too! Help your kids by putting a sprinkle of room-temp water on their heads or limbs or using a slightly damp onesie/T-shirt. Don’t use cold water, which can feel too shocking to their hot bodies. A wet T-shirt helps the most when you aim a fan in their direction, or even use a little hand fan, to encourage evaporation. As the water evaporates, it pulls the heat right out of their bodies. This is especially helpful if the weather is not just hot but very muggy. If your baby’s internal temperature is too high, dunking your baby in a half-filled tub of room-temp water can help too.

There are a few ways you can help your little one stay cooler at home:

• Open windows on two different sides of your home to get a cross breeze.
• Consider using a box fan in your window. During the cooler times of early morning and night, box window fans work best when they suck the hot air out of your home and blow it outside. While you do that, keep another window open so cool night air will be sucked in to keep the house comfy.
• During the day, use dark shades over windows to block the hot sunlight from overheating your home. In a pinch, you can even secure a flattened cardboard box against a window to block the heat.
• Remove excess clothing and use all the tips mentioned above regarding using water on the body to promote cooling.
• If you have air-conditioning, set it to a comfortable level—usually 75° to 78°F is low enough to be comfortable without raising your electric bill too much.

If, despite everything you do, your child shows signs of lethargy, confusion, vomiting, or has a body temperature over 101°F, immediately dunk them in a cool bath and give your health-care provider a call.