Every living being generates some heat in their body. This heat is required for all the chemical reactions happening in our bodies. Our bodies conserve heat or shed it to maintain a constant body temperature.

The aim of discarding and preserving our body’s heat is to keep body temperature of all human beings strictly at 370C for both – adults and kids. At this temperature, hormones and enzymes in our bodies function at their best.

At a higher or lower body temperature, we all feel uncomfortable. We are quickly tired as the efficiency of the hormones and enzymes is drastically reduced with a change in body temperature.

God has designed humans’ bodies to survive better in mildly warm and humid climates. The mechanism for shedding heat from the body in the summer is more efficient than conserving body heat in cold weather. We see a maximum human population and dense flora and fauna in coastal areas and near the equator, these areas are warm and humid.

God has created a robust system in our bodies for stabilizing it’s temperature. Due to the strength of this system, humans can reside anywhere from cold heights to desert plateaus. The uninterrupted existence of humans on earth for the last six million years has been possible due to this system. An appropriate response to the changing weather and acclimatization in no time is the strength of this system.

In this article, a detailed description of the mechanism of body temperature control is given –

Physiology, Thermal Regulation

https://www.researchgate.net/publication/329718029_Physiology_Thermal_Regulation

Our bodies loose heat in four ways –

1. Passing out heat to the air that is in contact to our body surfaces. This method is called convection. If air is flowing and is cool it takes away heat from our bodies faster.
2. Evaporation of skin water. Our skin is moist from inside. The cells of the skin surface contain water. If air is dry, that is if humidity of the air is low due to low content of natural water vapors in the air, the water from the cells of the outer surface of the skin evaporates in the air. This evaporation takes away body heat. And the elasticity of the cells is lost, so it looks rough and sometimes it cracks. The cells of the outer surface of the skin are called epidermis, and the loss of water from them is called Trans Cutaneous Water Loss – TCWL.
3. Evaporation of sweat. In response to heat outside our bodies excrete sweat. Evaporation of sweat takes away heat. The process of sweating is different from the TCWL. Sweating is an active process while TCWL goes on passively and body doesn’t have any control over it.
4. Our breathing organs loose heat in the air we breathe out of our lungs. This loss occurs right from biggening, that is nose, throat, the wind pipe and the lungs. The loss increases if the air is dry, that is if the humidity is less.

1. Our bodies actively reduce blood circulation in the open areas of the body. So, we look pale in winter, and if the cold is excessive, free parts of the body may look blue, and our palms, the tip of the nose and ears feel cold. With reduced blood flow in open areas, the heat loss is minimal. By covering the body with clothes that don’t transmit heat out, we can reduce transfer of heat out of our bodies. Minimizing flow of air in our surroundings will reduce loss of heat to the surroundings further.

2. Body stops sweating.

3. Body doesn’t have any control over TCWL. But application of oil or other oil-like substances reduces this TCWL. If we increase the humidity of the air, this TCWL reduces, thus loss of heat.

4. Our bodies produce extra heat.

To maintain body temperature in cold weather, the body has to implement means of producing additional heat. For this, we have two types of means – shivering and non-shivering methods.

When we first go into the cold, our bodies start shivering. This shivering produces heat in the body. By staying in the cold for some time, the burning of brown fat in the body gradually becomes active. It becomes a source of heat production. Soon, we are able to live in the cold without shivering. In this way, our bodies get used to living in the cold. This is called acclimatization by the body.

Brown fat is different from the fat that causes obesity. The fat that increases obesity is white and is accumulated just below the skin. Brown fat accumulates around internal organs. Brown fat also contains some protein and iron along with fat. This fat contains energy-rich mitochondria in abundance, which are called the powerhouses of the body – i.e. sources of energy. In infants and adults, heat is generated by burning this fat in the body in cold environments.

A balanced diet and exercise play an important role in forming brown fat in adults. The amount of brown fat in a newborn baby depends on the nutrition received in the womb. A well-nourished newborn carries about five per cent of her body weight as brown fat. Scientists call it Brown Adipose Tissue. That’s why weak and premature babies become cold quickly, as they could not get enough nutrition. They did not have enough time to accumulate enough brown fat while growing in their mother’s womb.

After birth, it starts forming in the baby’s body with proper nutrition. Breastfeeding plays a vital role in this.

Don’t fall into the misconception that eating more fat will result in more brown fat. The diet should be balanced, and the child should be physically active; only then will brown fat be produced in appropriate quantities in the body. Otherwise over intake of calories leads to deposition of white fat only leading to obesity.

How birds keep themselves warm is well written in this article; we can learn a lot from them about how to care for ourselves and our babies during winters – https://www.fws.gov/story/how-do-birds-keep-warm-winter#

The inner surface of our respiratory organs is covered by a smooth lining called mucus membrane. Its function is to continuously produce some mucus to keep the inner surface respiratory passage lubricated and smooth. The mucus membrane, which runs from the nose to the lungs, also reacts to hot and cold. During respiration, a limited amount of heat and moisture is also dissipated from its surface. We know that air that we breath out is warm and moist.

If the air coming in with the breath is cold, the mucus membrane starts producing more mucus, reducing heat dissipation. The mucus is protective and is secreted in the respiratory passage in response to any distressful stimulus to cover it up. Our nose starts running due to cold air. The mucus from the running nose and lungs, which is secreted due to cold air, doesn’t always indicate an infection of the respiratory system. Just stimulation from cold air can produce excess mucus.

The body’s temperature control system is immature in babies. Babies’ bodies become hot or cold even with mild temperature changes.

When the baby is in the mother’s womb, a constant temperature is maintained around the clock. So, the baby in the womb has minimal need for this controlling system. It takes time for this system to mature once the baby comes out in open. Until then, we will have to provide some extra support to our children.

1. There is a centre for controlling body temperature in the hypothalamus of the human brain, which coordinates all the activities of the body to control temperature. This centre is not fully mature in children.
2. In infants, the blood volume in relation to body weight is less, and the heart rate is higher than that of adults. Therefore, temperature-controlling actions that involve the quantity of blood circulation are not effective. For example, skin blood circulation doesn’t increase much in summer in our babies. But the circulation reduces fast in winter as the blood volume is low. A lower blood circulation spreads heat slowly in the body from internal sources.
3. If the baby is malnourished, she will not be able to produce any extra heat and will become cold in winter. The baby’s hand and feet turn cold faster.
4. There is no or very little shivering in the baby’s body in response to cold. Therefore, the baby depends more on brown fat for heat production.
5. The amount of brown fat in a baby’s body depends on her health and nutrition. Due to the lack of brown fat in the body of an underweight baby or a premature baby, heat production is reduced. This is also a reason for a weak child getting cold quickly.
6. The baby is entirely dependent on her caregivers, who have to understand from their experience whether she is feeling hot or cold. After this, preventive measures also depend on the experience of the caregiver. The child cannot decide on her own the right way to relieve her suffering.

Due to all above reasons, under normal circumstances, the baby will keep her temperature stable. But when the environment’s temperature changes more than usual, this system gets stressed. Since the control centre is not mature, the body’s response to changing temperature remains insufficient, the baby becomes cold in cold weather.

Winter clothes

From the start of the winter, we see attractive, colourful acrylic winter clothes in the stores. They cost less and look good, too. But they are not a bad conductor of heat. Heat passes through them quickly, so they don’t maintain the warmth of our baby’s body inside like pure wool. Their weight is an extra, useless burden on the child’s body with minimal benefit.

Avoid acrylic clothes in places where winter is extreme. They look good but are not helpful.

In winter, warm inners are heavily advertised. Never use inner warmers for your baby. Manufacturers have named them thermals as if they are thermal power plants. It is not so. I have found them to be one of the reasons for a baby to cry excessively, it constantly irritates skin of delicate babies.

Inner’s fabric contains wool and synthetic material that irritates the baby’s skin & causes rashes. I don’t recommend it to our babies. A thick cotton cloth as the innermost clothing will be warmer and more comfortable for a baby than an inner thermal. Full sleeved and round necked Egyptian cotton clothes are the best as innermost layer.

Recently, mothers have started asking me – How many layers of cloth will be good for their children.

My dear MOM, it is not the number of layers, but the quality of layers that matters.

In India, two and a half layers are enough, if the room temperature is maintained well between 23- 25°C and humidity above 50%.

My suggestions for layering would be:

For upper top

• Inner most full sleeved garment made of soft Egyptian cotton.
• Then a thick full sleeved top. You may use thick flannel fabric and get it stitched by a tailor .
• Sleeveless pure wool sweater as the upper most layer
• A pure wool full sleeved sweater if the room temp is not well controlled. It will be good if someone could knit it for the baby.
• Knitted cap and socks, or get them stitched from tailor using flannel.

For lower

• A diaper changed every three hours.
• A thick cotton or flannel trouser.
• Soft socks or a full romper. Home knitted woollen socks would be the best.

Every living being craves warmth – emotional and physical. It comes from the mother or father or any caring caregiver for a baby; closeness gives both – the body heat and the emotion. Try to give it as much as possible. But a baby has to live in a home. It should be warm.

Warmth is not only about the area’s temperature. It is an interplay of many other factors, such as humidity, airflow, room insulation, exchange of fresh air, quality of heating or cooling equipment, clothing, and the family culture of applying oil and lotions. Unfortunately, there is not much research done on this issue. All depends on where you live with your baby.

I have experience of living in the freezing weather of North America as well as tropical India. In both places, I lived with families having babies. Trying to adjust the room temperature very meticulously against the extreme weather conditions will put a lot of strain on the cooling and heating equipment. Also, a baby should go out in the open air regularly after three months. A sudden change in surrounding temperature will strain the temperature control mechanisms of the baby’s body, which is weak.

Western literature tells us that the ideal room temperature for a baby is around 22⁰C with 55% humidity. The environment there is primarily cold, and people are not accustomed to fans.

In India, I find it too hard for our babies. Even adults feel chilly in it. I have experienced that around 23⁰C to 25⁰C with 55% to 65 % humidity is most comforting for our babies. Humidity makes us feel warm. If we neglect humidity, we may feel cold even at 25⁰ C– 26⁰ C

Fresh air should always be allowed through small windows for some time. Fresh air and sunlight are the best sanitizers.

Buying a good quality room thermometer with a hygrometer to monitor temperature and humidity is essential. It is available on e-commerce sites like Amazon and Flipkart.

In houses where central heating and cooling arrangements are unavailable, we have to arrange extra gadgets to warm the home in winter. Out of all devices, I prefer a radiant warmer without any airflow. It is more physiological. Radiant warmers are available in a wide range from a few hundred rupees to several thousand. Less expensive ones will have heated wire, and expensive & sophisticated ones will have quartz & automatic temperature controllers. All are equally good. It is a myth that wire heaters consume the oxygen of space. None of the heaters consumes oxygen.

Oil filled warmers are also good. I don’t prefer blowers. These make noise and flowing air is not good. As it may encourage TCWL.

Any heating equipment will make the dry air of winter drier, so a humidifier is essential. They are not expensive. With proper humidification, the warmth of a heater becomes more pleasant for caregivers also. Avoid – air purifiers. Nobody knows about their health implications, and most of them make noise.

Never never use any smoke producing coal or wood in closed rooms for warming homes.

Still, the best way to warm your baby is to keep her close to you as much as possible. It is natural and safe.

Mother Kangaroos have a pocket on their belly to keep baby kangaroos warm. The baby kangaroo remains in touch with its mother’s skin, getting warmth at the right temperature. We call this Kangaroo Care.

Humans can do that, too. The clothes available for Kangaroo Care help tie a baby to the caregiver’s chest, providing direct skin-to-skin contact. Either of the parents can do that. Their body heat keeps the baby warm. It is the physiological way of warming a baby.

Either of the parents can lie the naked baby on their bared chest and covering her with appropriate cloth. It is the best way to keep a small baby warm.

Kangaroo care has numerous other advantages. Babies who receive kangaroo care experience better growth and development and a higher sense of security.

Feel the baby’s nose, forehead, and palm. If they are cold, increase the room temperature; if they are warm more than usual, reduce the heat or cool the room.

To be very sure, measure the baby’s body temperature in the armpit. If it is less than 97.6°F or 36°C, the baby is cold and needs warming up. Wear warm clothes, warm the space, and increase humidity. If your baby’s body temperature is more than 99.5°F or 37.6 °C in the axilla, reduce her clothing, reduce the ambient temperature.

If it is unreasonably cold, the baby will look pale or blue and become dull with shallow respiration. The body temperature will dip much below the standard 370C.

Increase room temperature and humidity. Bring the baby close to you and give your body warmth. You can also place lukewarm water bottles near your baby but not in direct contact.

Increasing clothes immediately may not help. It takes time for a baby to start generating body heat. Once the baby is warm, put on winter garments. You can also put the baby in a sleeping sack.

While organising winter care for your babies, keep these facts in mind –

• Tiny babies don’t produce heat readily in response to cold weather.
• The respiratory passage of babies is very delicate. It loses body heat fast if the baby has to breathe in cold and dry air.
• The internal lining of the respiratory tract dries up quickly and is damaged if the air is dry.
• Transpiration of the skin water (TCWL) is predominant in babies to lose body heat. It is not regulated by the temperature controlling centre of our body. Body systems don’t have any control over TCWL. A baby may feel cold if the air is dry and warm if air is humid. TCWL increases in dry air and decreases in humid air.
• So, clothing a baby with lots of warm clothes only doesn’t help. Babies will not produce heat to get the benefit of warm clothing. The atmosphere surrounding them should be warm and, at the same time, sufficiently humid.
• Applying a thin layer of natural oil or lotion on the baby’s skin will also help keep the baby warm. It prevents TCWL from the skin, so the skin doesn’t feel cold. And don’t crack in the dry air of winter.
• If we use a room humidifier in dry weather conditions and maintain ambient temperature 23 to 250 Celsius and humidity around 50 to 65 %, our babies will remain comfortable. They will do good in ordinary clothes. So a humidifier is must for all households.
• In India, a room temperature of around 23 degrees to 25 degrees centigrade and humidity around 50 % to 65% is ideal. Modern room thermometers incorporate a hygrometer to measure the humidity in the ambient air.
• The baby may get respiratory infections if the room is not adequately humid. Dry air damages the respiratory tract lining even if the air is warm. Bacteria and Viruses deposit quickly on a damaged lining. Use a room humidifier along with heating.
• The baby’s bathing or sponging should be done with warm water at 37 °C to 47 °C. The baby’s cleaning area should be warm without airflow; there should not be a fan. If a fan is there, put it off. It will be good to have a radiant single rod heat warmer. Avoid heat blowers.
• Avoid overcrowding in the room. Cross-infection with others may cause respiratory diseases in your baby.
• Maintain your hand hygiene. Don’t be lazy about washing your hands due to the cold. You will keep giving your baby some infection. Wash your hands with soap and warm water frequently.
• Clothes & linen should be washed & changed regularly. Prolonged use of the same linen may invite parasitic infections of the skin, like lice and scabies.
• You have to combine various means judiciously to keep your baby warm.
• In India weather changes frequently and conditions are at times extreme. In extreme conditions the challenge is to maintain our body temperature at 370C. At this temperature our body functions well.
• The body of babies find it difficult to maintain their temperature at 370C. Their temperature control apparatus is not mature. They are vulnerable and need extra care. Our babies are mostly confined to the safety of home.
• Our homes don’t have automatic systems to control optimum climatic conditions inside. We have to operate heating devices. We try to control the temperature in our homes, but often overlook the humidity.
• To be sure about if our babies are maintaining their body temperature, we can check it. If it is less than 36 0 we can increase baby’s clothes. If it is higher than 38 degree we will have to reduce the room temperature. We have to think about comfort of parents and other care givers also.
• For bigger children who can’t be confined to the interiors, we will have to choose clothes. We should look for weather-appropriate clothing. Good quality cotton clothes are good for everyone.
• Winter clothes should have wool mark on them for surety of the purity of wool. Cotton wool or down stuffed clothes are also good as winter clothes. These all are bad conductors of heat and preserves our body heat inside to keep ourselves warm.

Reduced Ciliary Movements

Small microscopic sized cilia are found on the internal lining of the nose and respiratory passage. They move wave-like and expel harmful bacteria, viruses, or allergy-causing agents out of the respiratory passage. Cold air suppresses the wave-like movements of the cilia. If we continuously expose our kids to cold air the movements of cilia are depressed and the infection causing germs are not expelled out. So, the kid may get infection of the respiratory system.

If we or our kid’s breath warm and humid air the movements of the cilia remain active and the disease-causing germs are continuously moved out.

Hand Washing

During winters children and care givers don’t want to wash their hands, so they transfer infection easily to one another.

Over crowding

During winters we tend to crowd ourselves in one room close to each other, we transfer infections to each other.

All the factors described above are the reason for the increased incidence of respiratory infection in children during winter. We can prevent them by being careful.

Effect Of Food

Drinking lukewarm beverages in winter makes us feel warm, and drinking cool beverages in summer makes us feel better. But if the food is too hot, the ears turn red, as if we have gone to a hotter climate. Just by keeping something cold in the mouth, the nose starts running as if it is winter season.

In India, there are misbeliefs about the hot and cold effects of certain foods. Lemons and oranges are considered to have some biochemical cold effect. In contrast, dry fruits and black pepper are thought to have some internal hot effect. It is not true. The cooling and warming effect of foods is due to their actual temperature, not any biochemical properties.

Don’t stop children from eating fresh seasonal fruits like banana, oranges or guavas. Eating extra dried fruits will not give extra warmth. So, don’t ask them to eat extra dry fruits in winters. Let every food be balanced in diets.

While living in cold weather, we may need some extra calories for extra physical activity. But these should also come from a well-balanced food. Extra fat or extra proteins are not beneficial.

Dryness of air

During winter, the air becomes dry. When we use any heating device to warm our rooms, the air becomes drier. When we inhale dry air, the mucus lining of the respiratory passage gets dried and starts cracking. To prevent this, more mucus is secreted from the mucus lining. If exposure of mucus membrane to warm and dry air continues, it may give up mucus formation and get infected with bacteria. This is one reason that our kids often get infection of lungs even if we keep them secured in warm room.

Mucus secreted from respiratory passage and nose is not nasty. It is a protective action. It protects the respiratory passage and flows out harmful agents. No attempt should be made to dry this mucus with medicines. Instead, facilitate its action and cleanse it out. Normal saline nose drops are the best to clean nose mucus. We can use a nose cleaning bulb along with normal saline drops. Two to three drops of saline in nose and followed by cleaning with a bulb will clean the nose. It will be best treatment of common cold for babies. It cleanses the allergy causing antigens and infection causing germs. It will also dissolve out the thick mucus.

To help easily clean the mucus from the lungs, we give normal saline as mist through a nebulizer. Coughing brings out the mucus and the infection causing germs and allergy causing antigens along with it.

So, it is now easy to understand how do we prevent respiratory infections in our children.

1. Keeping the child’s room warm and humid.
2. Frequent cleaning of nose with saline water and using a nose cleaning bulb. Avoiding medicines that may dry up the mucus.
3. Frequent hand washing.
4. Avoiding overcrowding in the child’s room and taking the child to crowded places.
5. Letting in fresh air and sunlight in the room. Both are the best air sanitizers.