Safe Sleep and Overheating: What Every Parent Should Know

Babies cannot regulate their body temperature as well as adults, which makes them more vulnerable to overheating. Overheating can be harmful, leading to dehydration, heat rash, heatstroke, and in severe cases, sudden infant death syndrome (SIDS).

This guide covers the latest recommendations on:

• Signs of overheating in babies
• Health risks and when to seek help
• What to do if your baby gets too hot
• Safe sleep and seasonal prevention tips

Signs and Risks of Overheating

Overheating in babies can sometimes be mistaken for a fever or dehydration, since many of the symptoms overlap. Unlike adults, babies can’t tell us when they’re thirsty, uncomfortable, or feeling too warm. That’s why it’s important to know the specific signs of overheating, so you can quickly recognize the difference and take action before it becomes dangerous:

• Feels hot or sweaty (though babies can overheat without sweating)
• Flushed or red skin
• Rapid heartbeat
• Vomiting
• Dizziness or appearing confused
• Lethargy, unresponsiveness, or unusual sleepiness
• Fussiness or restlessness

If you’re unsure whether your baby is simply overheated or running a true fever, checking their temperature can help you sort it out. Keep in mind that a baby’s body temperature can vary depending on the time of day, how active they’ve been, and even the method you use to check it. Here are some general guidelines:

• Underarm (axillary): 97.5°F – 99.3°F is considered normal
• Rectal: Up to 100.2°F is considered normal for infants

A rectal temperature of 100.4°F (38°C) or higher is considered a fever and should be evaluated by your child’s provider. Remember, babies can be overheated without having a fever — especially if they are overdressed, swaddled too tightly, or in a room that’s too warm. If your baby feels hot, looks flushed, or is unusually fussy, check their environment and clothing as well as their temperature.

Which Thermometer Should You Use For Your Baby?

The American Academy of Pediatrics (AAP) recommends a rectal thermometer as the most accurate way to measure a baby’s temperature, especially for infants under 3 months old. Other types can be helpful as your child grows, but each has limitations:

• Rectal: Best choice for babies under 12 months; provides the most reliable reading.
• Forehead (temporal artery): Convenient and quick, but may be less accurate if your baby is very hot, sweaty, or bundled.
• Ear (tympanic): Useful for children over 6 months, but not recommended for newborns due to their small ear canals.
• Underarm (axillary): Safe and non-invasive, but less accurate — should be confirmed with a rectal reading if you’re concerned.

No matter which thermometer you use, follow the manufacturer’s instructions closely. If your baby’s temperature is borderline or their symptoms don’t match the reading, trust your instincts and contact your provider.

Health risks of overheating include: sleep disruption, heat rash, heatstroke, dehydration, and an increased risk of SIDS.

What to Do if Your Baby is Overheating

If your baby shows signs of overheating, the most important step is to act quickly and calmly. Most cases can be managed at home if caught early, but it’s important to know when symptoms are severe enough to require medical help. Here’s what you can do:

1. Move them to a cooler room or shaded spot.
2. Remove extra layers of clothing or blankets.
3. Offer breast milk or formula more frequently for hydration.
4. Gently dab their skin with a cool, damp washcloth.
5. If your baby is vomiting, unresponsive, or not cooling down, seek emergency medical help immediately.

Safe Sleep and Overheating Prevention

Following safe sleep guidelines not only reduces the risk of SIDS, but also helps prevent overheating.

General Safe Sleep Guidelines

• Always place your baby on their back to sleep, on a firm, flat sleep surface.
• Keep the crib free of pillows, blankets, toys, and bumpers.
• Use a wearable blanket or sleep sack instead of loose blankets.
• Maintain a room temperature of 68°F – 72°F year-round.

Summer Safety Tips

• Dress lightly: Use breathable clothing. Consider a TOG-rated sleep sack for naps and nighttime.
• Avoid direct sunlight: Especially between 11 a.m. and 5 p.m. Use stroller shades outdoors.
• Car safety: Never leave your baby in a parked vehicle. On a 90°F day, a car can reach 109°F in 10 minutes (NHTSA).
• Check car seats: Cool seat surfaces before placing your baby inside.

Winter Safety Tips

• Dress appropriately: Dress your baby as you would yourself indoors, plus one extra light layer if needed.
• Avoid overheating in cribs: Skip heavy blankets, hats, or thick sleepwear indoors.
• Car seat caution: Remove coats or snowsuits before buckling into the car seat.
• Maintain consistent room temperature: Stick to the 68°F – 72°F guideline, even in winter.

Quick Baby Safety Checklist

• Place baby on their back to sleep, with no loose items in crib
• Keep nursery between 68°F – 72°F year-round
• Dress baby in light, breathable layers
• Use a wearable blanket or sleep sack instead of loose blankets
• Watch for flushed skin, restlessness, or unusual sleepiness
• Keep babies out of direct sun and never leave them in cars

When to Call a Provider

If your baby has a rectal temperature of 100.4°F or higher, is unusually lethargic, or you’re unsure whether they are overheated or sick, call your provider right away.

If you have questions about safe sleep or keeping your baby comfortable in hot or cold weather, speak with your child’s provider for personalized guidance.

If you do not have a provider, feel free to go to our Find a Provider page. If you need help finding the right provider for you, use our Help Me Find a Provider Form or call our Find a Provider line at (812) 885-8500.