Oh don’t you love when it’s the height of summertime once again – well I do! All those barbeques on the deck, pino gris on the deck, swims in a pool, late evenings on the terrace, and sandy toes from the beach. Even the scent of summer can be glorious – with all the vibrant flowers, sizzling sausages and salty air.
For those parents who have given birth during winter, this can also be such a lovely time to see their Bubs without bulky layers of clothes on …and instead just a cute t-shirt and sunhat!
Which brings me to a first topic:
Hyperthermia, or high body temperature. I need to begin by explaining that without fever from infection being involved in the equation, it used to be fairly difficult for an infant to become hyperthermic. Traditionally, an infants’ main temperature concern is hypothermia, which is having too low a body temperature.
But … these days we have motor vehicles that heat up like mobile greenhouses! And so for the first time in human history really, the potential for overheating a baby is rampant due to babies being left in a closed car on hot sunny days.
It is normal for a baby to only sweat on the head, which means that generally babies’ bodies are unable to fully utilize the normal cooling mechanism of sweating, so signs of hyperthermia are not always easily apparent. Generally the symptoms consist of the baby being restless and crying leading to an increased heart rate and breathing rate – but of course that can be easily misinterpreted as simply the baby crying because that’s what babies do! The baby may also be attempting to reverse the hyperthermia by extending its limbs to aid heat loss.
The other serious sign is the baby’s face and extremities (arms, hands, legs, feet) becoming red as the body dilates surface blood vessels in an attempt to cool the circulating blood. If the baby’s temperature rises above 41°-42°C then there are severe risks of shock, convulsions, brain damage and coma.
If you are aware your infant is heat-stressed, firstly correct the cause of the hyperthermia (such as removing from a hot car interior), and take off most of the baby’s clothes – and then the temperature should return to normal within one hour. Damp-sponging babies is not recommended as it encourages too rapid a heat loss, potentially leading to cold-stress shock. (The two other most common causes of infant hyperthermia are overdressing and dehydration – which brings me to my next topic.)
Dehydration is always of serious concern with babies, and the main causes with infants is inadequate fluid intake (such as poor feeding), or increased fluid output (such as fever, vomiting or diarrhoea), or as a result of an overly warm environmental air temperature (from heaters or a hot day).
The signs of this FVD (fluid volume deficit) include the baby being lethargic (sluggish unresponsiveness, irritable or excessively sleeping); dry mucous membranes (such as dry lips or parched tongue); tearless crying or a sunken fontanelle on the baby’s head.
As a mechanism to reverse the FVD, the kidneys begin reabsorbing more water, resulting in the other dehydration symptom of a reduced amount of urine pee, which is probably dark and smelly.
One of the very serious concerns with dehydration is that it results in water and electrolyte (essential mineral ions) imbalances and potential acid-alkaline imbalances, resulting in impaired bodily functions. Left untreated, dehydration will eventually manifest as dull sunken eyes, a weak irregular pulse, increased heart rate, convulsions and coma.
Obviously dehydrated infants need water – but not fruit juice – although heavily diluted fruit juice can be okay if it helps to make the water more appealing to the infant to drink. Another great solution are the commercially prepared electrolyte-rehydration drinks available from chemists. (Another cause of dehydration can be severe burns, which leads me to my final topic.)
Sunburn or a first-degree burn destroys the epidermis, and has the well-known symptoms of redness and pain. In adults first-degree burns tend to heal in 2-3 days, but an infant’s skin is substantially thinner and delicate, so is way more susceptible to being burned – even within just 10-15 minutes!
Second-degree burns injure the epidermis and upper part of the dermis, with the symptoms of redness, pain and blistering. In adults so long as infection doesn’t occur, the skin typically regenerates in 3-4 weeks, but this ideally should never be able to happen to a baby! (The very serious third-degree burns requiring skin grafting occurs from causes other than sunburn from the sun’s ultraviolet (UV) radiation.)
Sunburn can still occur on cloudy cool days, and is not always immediately evident, because the redness and pain can take several hours to appear. Treatments for first-degree mild sunburn can include gently placing a cool damp flannel on the sunburned area for 10-15 minutes 2-3 times in the first hours after the burn, bathing the baby in tepid (lukewarm) water with 1-2 teaspoons baking soda or oatmeal, and applying soothing Aloe Vera gel (available from health-shops, chemists or from simply breaking open one of the plant’s cactus-like leafs and squeezing out the gel).
With second-degree sunburn it is recommended to contact your GP doctor for advice, who may also prescribe infant paracetamol for the discomfort pain, an antihistamine for the itching, and perhaps antiseptic ointment and sterile dressings for the blisters.
But the big point is to prevent a baby from getting sun-burnt in the first place. To do this recommendations are to keep a baby out of direct sunlight as much as possible, especially between 10am and 3pm. If that is impractical, then it’s essential to use a pram canopy or stroller umbrella, plus legionnaire-type sun-hat that covers the ears and neck, a baggy t-shirt, lightweight trousers, and applying 20+ SPF sunscreen on the exposed skin areas such as arms, hands, feet and face – especially the nose and lips.
Sunscreen should be re-applied two-hourly – plus these days there is also sun-protection clothing that helps block out UV, which is particularly great as swimwear for the beach.
At the end of the day, our goal is always to enjoy our summer with enormous fun – but trust me that looking after a hyperthermic, dehydrated or sunburnt infant can dramatically reduces everyone’s fun! So vigilance is the key!
Love & Light