Discharge Instructions: Keeping Your Newborn Warm

Your baby can’t tell you in words when he or she is too hot or cold. So you need to keep your home warm enough and make sure the baby is dressed right. Keep the temperature in your home in the low 70s. Dress the baby the way you would want to be dressed for that temperature. During sleep, dress the baby in a sleeper or an infant zip-up blanket. Keeping the baby’s temperature in a normal range helps keep him or her comfortable and healthy.

How to know if your baby is uncomfortable

A baby will usually let you know if he or she is uncomfortable by fussing and crying or sometimes by "shutting down" and becoming quiet and sleepy. You may be able to tell if the unusual behavior is due to an uncomfortable temperature by looking at and touching his or her skin:

• Hands that feel cold or look blue do not necessarily mean the baby is too cold. It is normal for newborns to have cool, even bluish hands and feet in the early days. Instead, check between the baby's chin or neck and shoulder. If her skin feels cold, snuggle her skin-to-skin on your own chest beneath your clothes or a blanket. If this is not possible, you may also try wrapping him or her with a blanket or putting on a hat, sweater, jumper (“onesie”) with feet, or socks.

• Flushed, red skin means the baby is too hot. Restlessness (or excessive sleepiness) can be another sign. Remove some clothing or a blanket.

• If none of these measures work and your baby remains unusually fussy, sleepy, hot, or cold, take her temperature and contact your baby's healthcare provider. 

How to swaddle your baby

Swaddling infants is a common practice worldwide. But some research has found an increase in infant deaths from swaddling. Although infant deaths from swaddling is thought to be rare, discuss the practice with your baby's healthcare provider. Most experts recommend either not swaddling your baby or stopping the practice as soon as your baby is 2 months old, or sooner if your baby tries to roll over. Wrapping your baby securely in a blanket (swaddling) helps the baby feel warm and safe if you aren't able to hold and snuggle him or her skin-to-skin. Here is one method:

• Fold a square blanket diagonally to make a triangle. Turn the triangle so the flat base is at the top and the point is at the bottom.

• Lay the baby on top of the blanket with the head above the straight base of the triangle (the shoulders should be even with the base of the triangle) and the feet toward the point.

• Pull one side of the triangle all the way over the baby’s torso and tuck it under the baby’s body. It is a good idea to leave at least one arm free so the baby can suck on his or her fingers.

• Bring the bottom of the blanket loosely over the baby’s feet and all the way up to the neck. It is very important to keep the baby's feet and legs free to move. Your baby's legs should be able to bend up and out at the hips. Tight swaddling may cause a condition called hip dysplasia. If your baby has hip dysplasia, don't swaddle him or her. Hip dysplasia is when the hip joint does not form normally.

• Wrap the other side of the triangle across the baby’s chest at the level of the armpits. Make sure you can still insert two or three fingers between the baby and the blanket.

• After your baby is swaddled, place your baby on his or her back for sleep, even at naptime. Check often for the following:

  • The blanket stays secure. A loose blanket can cover the baby’s face and cause suffocation. Swaddling is associated with an increased risk for SIDS (sudden infant death syndrome) and this may be part of the reason. It may also be that some babies who are swaddled sleep too deeply.

  • The baby is not overheated. If your baby is hot, remove the blanket and use a lighter blanket or sheet, and swaddle again.