There has been a lot of media attention lately on how rapidly cars heat up on a hot day, but how safe is it to cover your infant’s pram with a blanket or cloth?
News outlets have run many stories recently about the potential hazards of placing blankets over the pram. Is it safe or not?
In a nutshell: Some health professionals have been concerned about this infant care practice for many years and a Swedish study published in 2014, in which they tested the temperature of a pram before and after they covered it with a blanket and left it in direct exposure to the midday sun, has acknowledged their concerns. Alarmingly, the temperature was seen to rise from 22 degrees Celsius to 37 degrees in an hour, creating an extremely hot and unsafe environment for an infant. Link to news
Why are parents covering the pram, why did this practice start? Over the years, we have become more aware of the need to protect our skin from the direct sun. As a mum of five children, I remember simply being told we needed to ‘cover up’ and protect our children from being exposed to sunburn and skin damage from UV rays.
But, as professionals, perhaps we need to look a little more deeply into what the message we are giving should be, and, as parents, what practices we are taking up. Observations indicate that, as part of normal infant care practice, parents are increasingly covering prams with blankets or materials to shield their infant whilst they are in a pram, whether they are outdoors or inside environments such as a shopping centre or home where sun exposure is not an issue.
The practice of covering prams and strollers now also appears to be used for other reasons, including encouraging their infant to sleep by reducing visual stimulation and impeding other people from approaching and waking or disturbing their infant.
The real message: In Australia, the Cancer Council of Australia has been promoting effective prevention programs to reduce the incidence of skin cancer.
To reduce the chances of sun damage to infant and toddler skin, they have a list of recommendations including to “Seek shade, if baby is outdoors, keep baby in the shade. When buying a pram, check that the hood can be adjusted, so that it can be moved to block out the direct sun. For the best protection, pram shade covers should completely cover the pram and be made of densely woven fabric that combines a mesh section – so the baby can see, and air can circulate – and a shade fabric section”[1]. Covering a baby in a pram with a “light sheet” whilst “ensuring adequate ventilation” was never stated as best practice and only recommended in circumstances when baby was exposed to direct sunlight[2].
Is there a danger? There are concerns that the practice of placing blankets or coverings over the pram or stroller can reduce ventilation and airflow and raise the temperature around the infant, increasing the risk of thermal stress (overheating), rebreathing of exhaled carbon dioxide and reduction in their ability to arouse.
Infants are safest placed on their back on a flat surface in the pram, dressed appropriately to the room or environmental temperature with their head and face uncovered and airways clear. Following this advice to keep your infant’s head and face uncovered also allows parents /carers to observe and check their infant regularly.
Soteria Safe Sleeping Advice recommends:
Use a safe pram that complies with the current mandatory standard based on AS/MZS 2088: 2000. Read and follow the instructions and warnings supplied by the manufacturer. Click here to find out more
Be aware that, according to the Australian Competition and Consumer Commission (ACCC), there are no specific regulations for pram canopies or covers so:
* If you are using a cover which was supplied with your pram, ensure it is an aerated UV cover made of mesh material to ensure air can circulate and regularly check baby
* Staying in the shade or staying indoors and out of the heat, when possible, is a safer alternative than placing a blanket or material over the pram.
We also strongly suggest that you:
Always stay with your infant/child while they are in the pram or stroller
Always actively supervise your infant/child and be able to observe, hear and assess your baby
Place your infant on the back with five-point harness restraint fastened.
If using a capsule to transport baby in the car, take baby out of the capsule and lie them their back in the pram on a flat surface, not elevated or tilted.
Dress your infant/child in appropriate clothing to be comfortable in the environment and protect them from the direct sun. A useful tip is to dress your infant or young child as you would dress yourself to feel comfortable, not too cold and not too hot.
A reliable way to check your infant’s temperature is to feel their back or chest – this should feel just warm (don’t worry if their hands and feet feel cool, this is normal). If baby is showing signs of heat stress, including signs such as sweaty, flushed in the face, or hot to touch, remove some bedding or clothing. This may also be necessary if baby is unwell, in which case you should seek medical attention.
Always keep baby’s head and face uncovered
Baby regulates their temperature through their head and face. Do not use hats, beanies or hooded clothing in the pram if it is warm or hot; in cold weather your infant/young child may need a hat or beanie but observe your infant and check they are not too hot or too cold.
Speak to your health nurse about best ways to keep your infant hydrated in warmer weather.
Is your baby left to sleep in their pram, either at home or in their childcare centre?
Soteria Safe Sleeping Advice offers safe sleeping workshops which provide evidence-based education to childcare educators, family day care educators and other. Learn more here
We also run regular webinars on Sleeping your baby Safely
For further information about pram safety, visit
References
[1] http://www.sunsmart.com.au/downloads/resources/info-sheets/sun-protection-babies-toddlers-info-sheet.pdf
[2] Cancer Council of Victoria. (2004) Sunsmart Information for Infants 0-3. Pamphlet in Wilson, L. (2008). Discussion paper: the great pram cover-up: a cautionary tale. Neonatal, Paediatric and Child Health Nursing, 11(1), 26-28.
Updated 13/12/2019
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