On June 22nd, Emily France of Superior, Colorado, feared her overheated four-month-old baby would die in her arms while they waited to evacuate a United Airlines flight at Denver International Airport. By the time an ambulance rushed Owen away, the plane had been sitting on the tarmac for over two hours. Though crew members allowed France to come to the front of the plane and hold her son in front of the open door while they brought bags of ice, Owen was struggling with the heat. It was an unusually warm day, with temperatures in the 90’s.

France said, “His whole body flashed red and his eyes rolled back in his head and he was screaming. And then he went limp in my arms. It was the worst moment of my life.”

After the paramedics were called, another thirty minutes passed before Owen finally left by ambulance. Owen is now home and healthy. In a statement, United apologized and said they are taking steps to find out how this happened in order to prevent future occurrences.

While this situation may find many parents thinking twice before flying with little ones, it’s important to consider the facts before calling off your summer air travel plans.

Overheating happens when the rising temperature of your body outpaces its ability to regulate itself or to cool itself down. Overheating can lead to heat stroke, which is potentially fatal. Babies are especially vulnerable to heat stroke because their nervous systems, responsible for temperature regulation, are not yet mature. Physician and mother of three, Ivy Pointer, M.D., who works in the pediatric intensive care unit at Wake Med in North Carolina, explains why.

From a physiology standpoint, [babies and children] have a higher metabolic rate, meaning that they physically create more heat per kilogram of body weight. They have higher heat absorption due to the fact that they have a higher surface area to mass ratio. And they have a lower rate of sweating.

According to Florida physician and mother Micheyle Goldman, D.O., M.P.H., medical director of the pediatric emergency department at Memorial Hospital West, though heat cramps and heat exhaustion are common in the summer months, heat stroke, which is the most severe form of heat illness, is relatively rare. Goldman says that though young children and infants, in particular, are at higher risk, heat-related illnesses are more commonly seen in adolescent athletes who do not hydrate adequately.

Both Goldman and Pointer noted most infants who come to the hospital with heat-related illnesses were left in cars. Says Pointer, “Even on days which do not seem extraordinarily hot, the car can heat up quickly resulting in an infant’s death.”

Risk Factors

Babies are vulnerable to overheating when they are:

  • Exposed to a hot environment. This is especially true when there hasn’t been a chance to acclimate (i.e., during a heat wave, on vacation in a warmer climate, at the beginning of the summer).
  • Overdressed. According to the National Institutes of Health, SIDS is more likely to occur in the winter months than during the warmer months. It’s during the winter when caregivers are more likely to bundle babies in more blankets and layers than are necessary. Instead, babies should sleep in light clothing in a room set to a temperature an adult would find comfortable.
  • Dehydrated. Pointer recommends parents watch for fewer wet diapers, dry mouth, and a lack of tears.

Signs and Symptoms

Unfortunately, your baby can’t tell you she’d like to take her hat off or that she’s feeling parched. Fortunately, there are non-verbal cues you can pick up on.

Symptoms of heat exhaustion, which is milder than heat stroke, include:

  • Increased thirst.
  • Dehydration.
  • Drowsiness.
  • Skin that is cool and moist to the touch.

Symptoms of heat stroke include:

  • A temperature of 103F, but the baby is not sweating.
  • Hot, red, dry skin.
  • Increased pulse rate. (Pointer advises parents to remember that an infant’s normal heart rate can be up to 150-160 beats per minute, depending on the age.)
  • Rapid, shallow breathing.
  • Vomiting.
  • Lethargy. Unlike a baby who is just sleepy, a lethargic baby may not rouse when you call his name, tickle him, or rub his back or chest in an attempt to wake him.
  • Loss of consciousness.

Care

If your baby is overheating, but the symptoms aren’t severe enough to warrant emergency medical care,

  • Offer your baby fluids. Experts recommend babies under four months old drink breastmilk and/or formula, as opposed to water.
  • Get your baby into a cooler environment. If you’re outside, go inside to an air-conditioned place, or find a shady spot if indoor shelter isn’t available.
  • Give your baby a bath in cool water.
  • If symptoms do not improve or if they worsen, seek medical care.

Prevention

According to Goldman, it’s vital to be prepared for overheating when flying. She advises parents to:

  • Bring extra fluids for your kiddos in case the airline doesn’t have the beverage your child will drink.
  • Travel in lightweight clothing.
  • Bring a small, battery operated fan. On an upcoming flight with her eight-year-old, Goldman said she plans to bring a battery operated misting fan.

When most of us fly with an infant, our biggest concerns are that they’ll have a blow-out or an earache. The fact that they might overheat during a delay doesn’t enter our minds. While the recent United incident is certainly not the norm – Goldman says she’s never seen or heard of anything like it in over a decade of working in emergency pediatric medicine – it’s something to be prepared for.

Says Pointer, “I can understand how boarding a plane with an infant, already an anxiety-provoking moment, could be even scarier now, but I think moms can make sure they prepare by bringing plenty of fluids (either for themselves if breastfeeding or for their infant) and layers of clothing for their infant. I hope that the airlines will also be more cognizant of specific needs of an infant and adjust protocols accordingly.”