Infant heat exhaustion symptoms: what to do

Heat exhaustion develops when an infant loses fluid and salt while becoming overheated. The infant may feel warm, look pale, sweat more than usual, feed poorly, or have dark urine. A dry mouth, fewer wet nappies, or marked thirst can point toward dehydration. Dizziness and headache cannot be described reliably by a baby, so changes in alertness, behaviour, balance, or crying are useful clues. Heat intolerance may make repeated episodes more likely, but symptoms can also follow a hot room, layered clothing, travel, or time outdoors.

Move the infant to a cool, shaded or air-conditioned place. Remove extra clothing, loosen nappies, and cool the skin with a lukewarm wet cloth and gentle airflow. Offer breast milk or the usual formula in small, frequent feeds; do not force feeds or give salt drinks unless a clinician advises it. Never leave an infant alone in a parked car or hot room. Record when the symptoms began and how much the infant has fed and urinated.

Get emergency help if the infant is difficult to wake, confused, has a seizure, collapses, breathes with difficulty, or feels very hot and stops sweating. Seek prompt medical advice for repeated vomiting, poor feeding, very few wet nappies, worsening weakness, or symptoms that do not improve after cooling. Infants can deteriorate quickly, so do not delay assessment when dehydration or heat illness is suspected.

How should feeds and fluids be managed for this infant? How can we tell whether dehydration is developing? Which cooling measures are suitable at home?