How mothers keep their babies warm.

Abstract

Details of room temperature, clothing, and bedding used by night and by day and in winter and in summer were recorded for 649 babies aged 8 to 26 weeks. Room temperature at night was significantly related to outside temperature and duration of heating. Total insulation was significantly related to outside temperature and to minimum room temperature, but there was wide variation in insulation at the same room temperature. High levels of insulation for a given room temperature were found particularly at night and in winter, and were associated with the use of thick or doubled duvets and with swaddling. At least half the babies threw off some or all of their bedding at night, and at least a quarter sweated. Younger mothers and mothers in the lower social groups put more bedclothes over their babies, and the latter also kept their rooms warmer. Many mothers kept their babies warmer during infections.There has recently been interest in the thermal environment of sleeping babies, arising mainly from suggestions that some cases of sudden infant death syndrome (SIDS)'" and haemorrhagic shock and encephalopathy syndrome (HSES)5 may be linked with overheating. A difficulty in evaluating this hypothesis has been the lack of control data. There have been four published surveys, from Exeter,6 Nottingham,7 Leicester,8 and Dunedin (New Zealand),9 of how mothers keep their babies warm.We present the findings of a population survey of the thermal environment of 649 sleeping babies by day and night in summer and in winter. weeks (n=238), or 26 weeks old (n=207). The interviewer recorded full details of clothing and bedding used for the baby's sleep the previous night and for sleep on the day of the visit, inspecting all items to check their type and material. She also recorded the social background of the family, the gestation and birth weight of the baby, the type and duration of heating, the ventilation of the room, whether the baby sweated while sleeping, and what adjustments the mother made if the baby had an infection.The ambient temperature of the baby's sleeping place was measured, for day by a recording at the time of the visit, for night by a maximumminimum thermometer left near the cot and collected next morning (temperature recordings were not available for three babies). Outside temperatures for the same times were obtained from the Meteorological Office. The study continued through all months of the year except August. The data were analysed separately for the 326 mothers who were interviewed in summer and the 323 who were interviewed in winter, summer being defined as the period of British summer time. and were approached for interview. Of these 329 (33-6%) declined to participate or were not available. The social class distribution (by father's occupa-

Possible aetiology of haemorrhagic shock and encephalopathy syndrome in the Negev area of Israel.

“…In this regard, it is important to compare the clustering of admission times (5.00 am to 9.00 am) in our study with those reported by Bacon and Hall (8.00 am to 11.00 am), which supports the notion that hyperpyrexia started and peaked at night when the infant is particularly at risk from heat injury. 22 In summary, our data support previous suggestions that some environmental manipulations or other physiological stress, for example common viral infection, in a genetically determined, susceptible individual may cause hyperpyrexia resulting in HSES with multiple organ failure.…”

Evaluation of the thermal insulation of clothing of infants sleeping outdoors in Northern winter

“…Our results show that the selection of thermal insulation of clothing was not always suYciently based on outdoor air temperature, which is in line with the Wndings of Bacon et al (1991). The commonly used clothing ensemble from the Finnish maternity package and pram gives appropriate insulation at ¡5°C; probably due to this it seems that observed and required thermal insulation of clothing was equal at around ¡5°C.…”

“…However, in our previous questionnaire study some parents in Finland estimated that their infants had cold extremities after sleeping outdoors in a pram (Tourula et al 2008), and according to skin temperature measurements a decrease in ambient temperature increased the cooling rate of outdoor sleeping infants despite winter clothing (Tourula et al 2010). Tuohy and Tuohy (1990) suggested that parents may decide on the amount of indoor clothing of the infant based on outdoor temperature, and according to Bacon et al (1991), based on their tradition and expectations rather than immediate conditions. McCullough et al (2009) have developed a model for determining the insulation of cold weather clothing of children from the age of 4 years for the activity level of walking.…”

Swaddling: A Systematic Review

“…[53][54][55][56] On the other hand, 3 studies indicated that swaddling might be protective against SIDS in cold winters, because swaddled infants cooldown less. 46,47,57 Williams et al 58 demonstrated that SIDS is also associated with too little thermal isolation, and this is particularly the case when (nonswaddled) infants are not firmly tucked-in.…”