Bundle baby up good, but not too good
The breeze carried a hint of winter as the new moms hurried into the Elizabeth Blackwell Center near Riverside Methodist Hospital. Once inside, they lifted their babies from car seats and strollers, unzipped jumpers and popped off knitted caps.
While the babies crawled and slept and fussed and played, the moms shared parenting tips and listened to Yvonne Gustafson's advice on keeping babies warm and safe all at once. As it turns out, a baby can be too warm and too bundled up, and both can contribute to serious problems, even death.
The threat of overheating and asphyxiation has garnered more attention in recent years, in part because the American Academy of Pediatrics issued new information on Sudden Infant Death Syndrome three years ago. The academy reinforced the importance of back sleeping and made other sleep-related recommendations, including advising parents to avoid overheating babies. As a general rule, babies should be dressed just one layer warmer than what is comfortable for their parents, Gustafson, a parent consultant, told the moms.
A good way to check their temperature is to feel the back of their necks, not their hands or feet, which tend to be cooler. If a baby's neck is hot and sweaty, she said, remove a layer of clothing. "Your baby might not complain," Gustafson said, saying that, as people become overheated, they become lethargic. And a normal comfortable temperature in the home-68 to 75 degrees-is perfectly fine for infants, she said.
"If you overbundle your baby or you bundle it too tight, you create a risk for overheating and increase risk for a SIDS (sudden infant death syndrome) or sleep-related death," said Karen Gray, who leads Columbus Public Health's task force on reducing SIDS and promoting safe sleeping for infants. Furthermore, if blankets used to bundle a baby get loose during the night, they could suffocate the child.
Lightweight sleep clothing is generally enough for babies, experts say. For those who might benefit from swaddling, including colicky babies, companies now make special sleep sacks that are good at regulating temperature and aren't a suffocation risk.
Sleep time at home isn't the only concern. A blanket tossed over a carrier is fine to protect a baby's face from icy wind between the car and the mall, but it should not be used longer than a short walk. "How long would you keep your baby in a box?" Gustafson asked the support-group mothers.
Bulky snowsuits or other clothes that push up into a baby's face while he or she is in the car seat also can be a problem. They can contribute to overheating, block air flow and cause the baby to breathe in too much carbon dioxide. "We don't need to be putting 20 layers of clothes on these infants when we're trying to transport them," Gray said.
Specially made car-seat liners should be checked by an expert to ensure that they don't interfere with the operation of the seat. Last year, 20 infants died of sleep-related deaths in Franklin County, said Kathryn Reese, child fatality-review program manager. The data don't specify whether overheating or asphyxiation was involved in any particular case.
Anya Beaupre, who took her 10-month-old daughter, Vienna, to the recent support group meeting, said it was a good reminder that just because mom is feeling cold doesn't mean the baby is. Beaupre, who lives in Hilliard, said she's concerned when she sees over-bundled babies but understands that finding a good middle ground can sometimes be difficult. She said her biggest challenge is sleep time. She doesn't use a blanket and worries that Vienna might be uncomfortable. Usually she dresses her in a onesie and footed pajamas.
Gustafson said hats can be a good solution, both inside and out. They're easy to put on and take off, and they keep the baby's body heat from escaping too quickly.