Discharge Instructions: Keeping Your Newborn Warm

Your baby can’t tell you in words when they're too hot or too 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 them comfortable and healthy.

How to know if your baby is uncomfortable

A baby will usually let you know if they're uncomfortable by fussing and crying. Or sometimes by "shutting down" and becoming quiet and sleepy. You may be able to tell if the abnormal behavior is due to an uncomfortable temperature by looking at and touching their skin:

• Hands that feel cold or look blue don't always mean the baby is cold. It's normal for newborns to have cool, even bluish hands and feet in the early days. Instead check between your baby's chin or neck and shoulder. If the skin feels cold, snuggle the baby skin-to-skin on your own chest beneath your clothes or a blanket. If this isn't possible, you may also try wrapping them with a blanket. Or have them wear a hat, sweater, onesie with feet, or socks.

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

• If none of these things work and your baby is still very fussy, sleepy, hot, or cold, take their temperature and call their provider. 

How to swaddle your baby

Wrapping your baby securely in a blanket (swaddling) is a common practice worldwide. But some research has found an increase in infant deaths from swaddling. Infant deaths from swaddling are thought to be rare. But you should talk about swaddling with your baby's healthcare provider. Most experts advise not swaddling your baby at all. Or they may advise stopping the practice as soon as your baby is 2 months old, or sooner if your baby tries to roll over. Swaddling can help a baby feel warm and safe if you aren't able to hold and snuggle skin-to-skin. Here is 1 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's a good idea to leave at least 1 arm free so the baby can suck on their fingers.

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

• Wrap the other side of the triangle across the baby’s chest at the level of the armpits. Make sure you can still insert 2 or 3 fingers between the baby and the blanket.

• After your baby is swaddled, place them on their back for sleep, even at nap time. Check often to make sure:

  • The blanket stays secure. A loose blanket can cover the baby’s face and cause suffocation. Swaddling is linked to 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 isn't overheated. If your baby is hot, remove the blanket. Use a lighter blanket or sheet and swaddle again.