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Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA

International Board Certified Lactation Consultant

www.virginiathorley.com

Blog

Your baby in heatwaves (exreme heat)

Posted on February 11, 2017 at 7:30 PM Comments comments (1)
The current extreme hot weather this February, and over the last few weeks, is very difficult for mothers of babies, especially very new babies who cannot regulate their temperatures as well as adults can. Even adults are struggling in extreme heat.
Have a look at my earlier posts on this blog for specific topics. Here is a summary of key points that are relevant right now:

- If you have air-conditioning, please use it for your baby. It doesn't have to be at the coldest setting, but enough to let you and your baby feel comfortable.
- If you don't have air-conditioning, work out the best way to make use of fans.
- The best place for your baby, if you don't have air-conditioning, is well away from external walls of your house or unit, perhaps in a central passageway.
- Light clothing, or just a nappy, is all your baby needs indoors.
- Draw the curtains or blinds to keep the glare (and heat) out. Bright light only makes it hotter.
- Sponging your baby down will help keep him cool. If the water in the "cold" tap is hot (which it is at my place right now), you may need to put a small bowl of the water aside for a few minutes to cool down.
- Avoid the beach with a baby, especially a very young baby. It can be a very hot place to be, with some spots on the beach even hotter. The dangers result from direct sunlight and reflected light from the sea, sand and other bright surfaces.
- It's  best to avoid backyard pools till the sun is low, e.g. after 5 pm,  for similar reasons.
- If you have to go out, avoid being in direct sunlight in the heat of the day if at all possible. A hat for your baby and a light wrap to keep the sun off delicate skin is important if you have to take your baby out into strong sunlight between your car or bus and the supermarket or other buildings.
- If you are in a shopping centre with its air-conditioned public areas, I'm sure you know that is a good place to stay for a while, sitting, meeting with friends, or window shopping. Air-conditioned libraries are also good places to hang out for a few hours.
- Breastfeeding as often as needed will keep your baby well hydrated and safe on the hottest days as the composition of the milk changes to meet needs. (See my other blog topics on hot weather.)  It often means lots of small breastfeeds to assuage thirst and longer breastfeeds when it is cooler, e.g. after the sun goes down.
- You may need to place a small towel between you and your baby during feeds if skin contact is hot and sweaty. 
- If your baby is sleepy and not showing interest in the breast, sponging her down with cool water will often help her feel comfortable and ready. You may want to sponge her down part way through the feed, too.
- If you baby is lethargic and sleepy and not as alert as usual, and her urine looks dark or she isn't passing much urine, medical help is indicated.

ADULTS
- For you (and other adults), urine is a good guide to hydration. Your urine should be clear and light in colour. If it becomes darker, this is a signal to drink more fluid, immediately.
- It is easy to forget your own needs when you are busy with a baby.  Keeping some water beside you when you sit or lie down to feed is a good idea - and old tip, but a good one.
- It is good to see most adults now carry a water bottle, often a large, refillable one, so that they can stay hydrated on the go all day.
- Light, cotton clothing is cooler than tight clothing or synthetic fabrics.

Stay cool and hydrated

Posted on January 17, 2017 at 6:46 PM Comments comments (4)
In the current heatwave conditions in Australia, it is important to remember that it isn't just any day, but a special situation.  Your needs and your baby's needs are paramount.

How to keep cool

If you have air-conditioning, even in one room, this is a great help in keeping your baby cool, and yourself, too. Without air-conditioning, hanging wet towels on the backs of chairs and directing an electric fan at them, can make the air that circulates a little cooler. (Evaporation cools.)
It can be important to sponge your baby with cool water if she becomes hot or red. You may need to do this several times a day. On scorching days, the water in the "cold" tap may actually be hot in some regions. If this is so, pour some water into a bowl and put it aside for a short time till it is cool and safe to use. 
You will realise that this is not the time for dressing your baby in onesies and jackets.  Indoors, just a nappy is often enough in a heatwave. If you absolutely have to go out and cannot avoid it, loose cotton clothing is best, with a cotton wrap to keep the sun off delicate skin, e.g. when you take your baby from the house to the car.
Of course, going out may be a Good Thing if you don't have air-conditioning. Lots of mothers and pregnant Mums spend a few hours at an air-conditioned shopping centre or a cinema. Does your local library have quiet activities for very young children? 
Beaches are NOT safe places for babies in hot weather.  Besides direct sunlight, there is reflected light (and heat) from the sand and sea, and the windscreens of cars in the parking lot. The same applies to pools that aren't fully shaded. So check out how good the shade is, first. 
Infant-care lambskins are useful as a surface for a baby to lie on as they absorb about one-third of their weight in water before they feel wet. I was lucky enough to be one of the mothers with a new baby in a trial of infant-care lambskins, while living in a remote arid region, and it was a good experience. (No, I have no conflict of interest in mentioning this as I had no financial benefit from the long-ago  study.)
For yourself, loose clothing is your coolest option.  This isn't the time to catch up with heavy housework - just the basics. Forget what you "should" do - it's more important to focus on keeping you and your baby cool. This can be a time to watch a DVD. You may find you are not hungry in the middle of the day, and a cool soup or a sandwich or small salad might be all you feel like eating.  Then in the evening your appetite is up again. Like so many Mums now, you probably carry a water bottle so that you can take a swig any time you need to. Your urine is a good guide to whether you are probably hydrated; if it becomes dark, that means you need to drink more fluid straight away.

Feeding

A breastfed baby needs to have unrestricted access to the breast, which will supply all fluid needs, changing through the day in response to your baby's demands.  You may find that your little one takes quick "snacks" at the breast in the heat of the day, spending longer at the breast and having big feeds after the sun goes down and in the early morning.  A study of breastfed infants in the hot, extremely arid Negev desert found that they remained adequately hydrated if they had unlimited access to the breast. (This may not apply to formula-fed babies, who may need small amounts of additional water on the hottest day - but check with a Child Health nurse in your area.)

Finally

A darkened room is cooler. Drawing the blinds or curtains keeps out the heat, whereas opening them, or having sheer or lace curtains, lets in the heat with the light. With thin curtains, or with the curtains opened wide, often even the wall opposite the windows feels hot to the touch.  

Heatwaves and emergencies

Posted on February 22, 2014 at 1:00 AM Comments comments (4)
Emergency information:
 
This message was prepared for people in Australia in areas of the southern states suffering serious bushfires, but it applies in other emergencies. Please be aware that ABC Local Radio is your emergency channel with regular updates specific to your location.  If you are a health professional, you will want to remind the families you work with about this.
 
Hot weather:
 
While other adults and children need extra fluid in the heat, breastfeeding mothers need to remember to drink plenty of water, too. A good guide in hot weather is to drink enough to keep urine clear (not dark).
For mothers:  A healthy breastfed baby, given unrestricted access to the breast, will obtain enough fluid to avoid dehydration, but make sure your baby doesn't become overheated, especially if a newborn. Unless you have air-conditioning, that means:
- undressing your baby to just a nappy (diaper),
- sponging her/him with cool water as often as necessary
- your baby's biggest feeds may be in the early morning and evening, with short, frequent feeds through the heat of the day to quench thirst
- if you  baby is too listless to feed or you are concerned about her/his condition, seek medical attention
 
It's worth repeating that
- the coolest spots in the home are away from windows and external walls, such as in an internal passageway
- pools and beaches are a no-no in the daytime, because there is reflected heat as well as direct heat. This can be overheat a baby, as well as damage delicate skins
- glare means heat.  So keep the curtains drawn to block the glare
 
 

Baby safety in heatwaves (extreme hot weather)

Posted on January 6, 2014 at 6:04 PM Comments comments (22)
Baby safety in hot weather is an important topic at the moment with the continuing extreme temperatures in much of Australia and other parts of the Southern Hemisphere at similar latitudes.
 
Unfortunately, one of my books, Feeding Baby & Child (Virginia Phillips, Hyland House, 1984, 1992), which has a whole chapter on hot weather care, is now out of print. However, here are a few quick tip:
 
- keep your baby indoors and out of direct or reflected heat as much as possible
 
- air-conditioning is desirable. If you don't have it, electric fans do a better job if wet towels are hung over furniture (NOT the  baby's cot, for safely issues) as evaporation caused coolness
 
- if you don't have air-conditioning, shopping centres do, and are a good place to visit on the hottest days
 
- NEVER leave your baby in the car - risks include overheating and dehydration (which can happen quickly and be fatal), and if you leave the air-conditioning on with the keys in the car, there is the risk of a car-jacking with your baby in the car
 
- if you really have to go out, avoid the middle of the day if you can and make sure your baby is shaded
 
- the beach is NOT a safe place for a baby in the daytime, because there is reflective heat from the sun shining on the sand and water, as well as direct heat. If you want to go to the beach, go very late in the day and protect your baby
 
- for the pool (late in the day when the sun in low, e.g. after 4 or 5 pm), babies - just like other children - need to wear sun-safe tops with long sleeves to protect their delicate skins. In fact, in schools in North Queensland sun-safe clothing in the pool is mandatory for swimming classes. It is needed for babies, too.
 
- the coolest parts of the house are away from the windows and the outside walls (which can get very hot) and in an internal doorway. You can check which spots have a  better current of air if you hang a mobile in different areas. (I found this a useful way to check when my youngest was a baby, it was over 40 degrees Celcius, and we didn't have air-conditioning.)
 
Note: Vitamin D is a different issue. What I'm talking about is safety in extreme conditions. Stay safe this long summer.
 

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