Surely it is not an exaggeration to say that we all find it pleasant when we can enjoy fresh air again after a long stay in an overheated room. This discomfort in overheated rooms is not only caused by the lack of oxygen, but is mainly caused by heat accumulation in the body. However, not all people react equally to the effects of heat. This can be observed very clearly in crowded classrooms, for example, where children are frequently exposed to such heat accumulation. If this exceeds a certain level, some children only experience a feeling of discomfort, others experience fainting spells, while some do not react at all.
Causes of overheating in babies and infants
Hydration and a cooling bath can quickly put an end to overheating, because in such cases the lack of fluids is the main cause. Several causes must be used to explain this varied response. Some children are simply dressed too warmly, or their clothing is not sufficiently air-permeable. Furthermore, the different heat regulation capacity of the individual child plays a role. Skin circulation and perspiration are not the same for everyone. Finally, the responsiveness of the nervous system is also of considerable importance. Mainly sensitive, easily excitable children often respond to even minor heat accumulation with pathological reactions. Experience has shown that small children are particularly at risk, especially because in the first years of life body temperatures rise relatively quickly to values of around 40 degrees and above. Although infants and older children have the ability to adjust to the same body temperature as adults, this is more difficult for young children than for older ones for various reasons. Body temperature is regulated by a special heat center in the brain. Most important are the physical processes in the organism, which consist of the alternation of blood flow through the skin, the evaporation of water especially through the surface of the skin, but also through the lungs, and finally the generation of heat through muscle movement. The infant is in a particularly unfavorable situation here. In him, the function of the hair-thin blood vessels is not yet fully developed. In addition, there is the inability to escape from an unsuitable covering of one’s own accord or even to perform active muscular work. Incidentally, this inability to regulate temperature appropriately applies equally to overheating and hypothermia, especially in premature births. However, while hypothermia is relatively rare, overheating is frequently encountered, especially in families where the child is cared for with special care. For many years, however, doctors have observed that infant mortality as a result of nutritional disorders decreases during the summer months. Nevertheless, there are several causes of infant mortality. On the one hand, increased outside temperatures easily lead to the accumulation of germs in food, on the other hand, infectious intestinal diseases are particularly frequent in summer, and finally, the accumulation of heat, which has been mentioned several times, plays a role that should not be underestimated. Many parents wrap their infants in beds in summer and winter, which prevent the release of heat. It is also undeniable that children who live in overheated rooms, e.g. in attics and eat-in kitchens, fall ill more often. In this context, it should be noted that short-term overheating only results in increased temperatures, which, however, are quickly compensated for when the care defect is recognized and eliminated. Often, however, parents do not notice anything noticeable at first. Thus, especially during longer periods of heat, babies are repeatedly brought to the doctor in a threatening condition. They suffer from excessive temperature, faintness, hardly react to their environment, have a dry tongue and breathe rushed and panting, which is a typical sign of heat accumulation.
Treatment
Hydration and a cooling bath can quickly put an end to this condition, because in such cases the lack of fluids is the main concern. Children lack the ability to compensate for heat accumulation by increased water output. Children who suffer or have suffered from diarrhea and consequently have reduced water and salt levels are particularly at risk.Dehydration and salt deficiency, however, cause swelling changes in the tissue as well as increased blood thickening with simultaneously slowed blood flow. These metabolic changes can cause severe clinical pictures with disturbances of consciousness and symptoms of poisoning within a few hours. In febrile patients, any accumulation of heat requires immediate action. The physician must first ensure tolerable temperatures and good ventilation in the patient’s room, remove heavy feather beds and replace them with light blankets. For many years now, open-air treatment for children with pneumonia has proven to be very effective in hospitals. Even infants can be brought outdoors at temperatures as low as minus five degrees Celsius, but then appropriately wrapped up. This method has been successfully used in the treatment of severe pneumonia associated with whooping cough. Very concerned parents, and especially grandparents, often make serious mistakes in an effort to do what is best for their child or grandchild. Particularly contributing to this is the widespread belief that drafts are harmful to children. In such cases, infants who have already had temperatures around 40 degrees at home, wrapped deeply in feather pillows and dressed in warm woolen clothes, are brought to the clinic. Of the unfortunate little ones, at most the tip of their nose is visible. No wonder such children are brought in with considerable heat accumulation, especially during longer transports.
Examples
In July, for example, a febrile infant of three and a half months was brought to a hospital. He was suffering from otitis media and had suddenly started moaning and breathing. The ambulance ride took about an hour. Nevertheless, despite his fever, the child was packed in thick blankets and pillows. Linens and pillows were considerably sweaty. The fever thermometer registered 42 degrees, and the infant was already unconscious. Despite all immediately initiated measures, the child died after only 12 minutes. Together with the underlying condition, overheating had caused death in this case. A case, which is unfortunately not so rare, if it succeeds fortunately also in most cases to compensate the occurred overheating again. Another example may explain how dangerous heating pads can sometimes be, even if they do not cause burns. The mother of a six-week-old infant thought the bedroom was too cold. Around one o’clock in the morning, she put the child on an electric blanket. At about four thirty she noticed that the temperature was already too high by touch. The baby’s face was remarkably pale, and fluid was dripping from her mouth and nose. Again, only death could be determined in the nearby hospital. The three and a half hours of hyperthermia had been sufficient to cause the infant’s death, as the investigation revealed. A similar case occurred with a nine-week-old baby. When it developed diarrhea again shortly after inpatient treatment for feeding disorders (see also our article: Baby Feeding and Eating Disorders Part 1), the doctor prescribed heat on the abdomen, among other things. The infant had received food for the last time around midnight and had then been covered with a heating pad and a moist compress. When the parents checked on the infant four hours later, it had already died. Minor skin burns were noted on the abdomen and thighs, but the child’s death had not occurred from the burns, but from overheating.
Prevention
To prevent such tragic accidents, parents and especially grandparents, who are often overanxious, should adopt some basic rules. The most important seems to be, especially infants and toddlers in no case to put in an oven temperature out of fearfulness. It is much healthier for children to sleep in unheated rooms than to expose them to dry, warm air. During the summer heat, infants should be kept only lightly clothed and in cool rooms if possible. See also our article: Baby Outdoors in Summer and Heat Part 1. Sufficient hydration should be provided, although again the amount should not be too great. On very hot days, it is advisable to offer babies a few sips of tea outside of meals. A feverish child should never be wrapped in thick feather pillows. If a feverish child is transported outdoors, it is best to wrap it in a light blanket; in an ambulance, this is also unnecessary.The principle is to always give the child the opportunity to lower the excessive temperature naturally through evaporation, sweating and exercise.
