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This is a life-threatening emergency. Call 911 immediately, then follow these steps while waiting for help.
Heat Stroke in Babies and Toddlers
Content reviewed against published AAP, CDC, NIH guidelines
Last reviewed:
Heat stroke occurs when the body's core temperature rises above 104°F (40°C) and the cooling system fails. Babies and toddlers are especially vulnerable because they cannot regulate body temperature as well as adults, cannot remove their own clothing, and depend on caregivers to recognize danger signs. Heat stroke can cause brain damage, organ failure, and death. It is most commonly caused by being left in a hot car or overdressing in hot weather.
Immediate actions
- Call 911 immediately
- Call 911 immediately — heat stroke is life-threatening
- DO NOT: Do NOT immerse baby in ice water or apply ice packs directly to skin — can cause shock and paradoxical temperature rise
Step-by-Step Response
Recognize heat stroke
Signs: core temperature above 104°F (40°C), hot/flushed/dry skin (may not be sweating), rapid heart rate, rapid shallow breathing, confusion or lethargy, seizures, vomiting, loss of consciousness. In babies: extreme fussiness then sudden lethargy, very hot skin.
Call 911
Heat stroke is a life-threatening emergency. Call 911 immediately. Begin cooling while waiting for emergency services.
Move to cool environment
Get baby into air conditioning if available, or into shade. Remove from the heat source. If found in a hot car, remove immediately.
Remove all clothing
Undress baby completely, including diaper. Clothing traps heat. Every layer removed helps cooling.
Active cooling
Spray or sponge cool (not cold) water over baby's entire body while fanning. Place cool, wet cloths on the neck, armpits, and groin (areas where blood vessels are close to the surface). Fan continuously to promote evaporative cooling.
Monitor temperature
If you have a thermometer, take rectal temperature every 5 minutes. Stop active cooling when temperature reaches 102°F (38.9°C) to prevent overcooling. Continue monitoring.
Position for safety
If baby is vomiting or unresponsive, place on their side (recovery position). If baby is alert, keep in a comfortable position. Be prepared to begin CPR if breathing stops.
Hospital care
At the hospital, baby will receive IV fluids, continued cooling, and monitoring for organ damage (kidneys, liver, brain). Blood tests will check for complications. ICU admission may be needed.
What NOT to Do
- ✕Do NOT immerse baby in ice water or apply ice packs directly to skin — can cause shock and paradoxical temperature rise
- ✕Do NOT give fluids by mouth if baby is vomiting, confused, or unresponsive
- ✕Do NOT give fever-reducing medications (Tylenol/ibuprofen) — they do not work for heat stroke and can worsen liver damage
- ✕Do NOT wrap baby in cold, wet sheets — this can trap heat
- ✕Do NOT delay calling 911 to try cooling first — call while you cool
- ✕Do NOT leave a child in a parked car for ANY amount of time — not even 1 minute
When to Seek Help
Call 911 if:
- Baby has a temperature above 104°F (40°C) from environmental exposure
- Baby is lethargic, confused, or unresponsive in hot conditions
- Baby is not sweating despite being very hot (sweating mechanism has failed)
- Baby is having a seizure in hot conditions
- Baby was found in a hot car
- Baby has hot, flushed, dry skin and rapid breathing
- Baby is vomiting in the heat and unable to drink
Go to ER if:
- Any suspected heat stroke (temperature above 104°F with altered consciousness)
- Baby was in a hot car for any period of time and seems unwell
- Heat exhaustion that is not improving with home cooling and fluids (temperature 100-104°F, heavy sweating, weakness)
- Baby is vomiting and unable to keep fluids down in the heat
- Baby has not urinated in several hours during hot weather (dehydration)
- Baby is extremely lethargic in hot weather, even if temperature is not confirmed high
Call your doctor if:
- Baby seems excessively hot and fussy but is alert, drinking, and responsive (may be heat exhaustion — precursor to heat stroke)
- Baby has mild heat rash or sun exposure and you need guidance
- After ER treatment for heat-related illness — for follow-up care
- Questions about safe outdoor time and temperature limits for baby
Age-Specific Guidance
0-6 months
Newborns and young infants cannot regulate body temperature well and cannot sweat effectively. They are completely dependent on caregivers to manage their environment. Overbundling is a common cause of overheating. Keep room temperature 68-72°F for sleep. Never leave in a car.
6-12 months
Babies at this age may be in strollers or car seats for extended periods. These enclosed spaces trap heat. Avoid stroller covers that block airflow. Check on baby frequently in the heat. Offer extra breast milk/formula or water in hot weather.
1-3 years
Toddlers are active and generate more body heat during play. They cannot tell you they are too hot and will keep playing until they collapse. Enforce shade breaks and water breaks every 20-30 minutes in hot weather. Indoor play is safest on extreme heat days.
Prevention
- NEVER leave a child in a parked car — not even for 1 minute, not with windows cracked (car interiors reach 120°F+ in minutes)
- Create habits to prevent forgotten-child-in-car: always check the back seat, keep a shoe/phone/purse in the back seat, use car seat alarms
- Limit outdoor time when temperatures exceed 90°F (32°C) or heat index is high
- Dress baby in light-colored, loose-fitting, single-layer clothing in the heat
- Offer extra fluids frequently in hot weather — breastfeed more often or offer water (over 6 months)
- Never place car seat in direct sunlight — use window shades and cover the seat when parked
- Keep baby in shade when outdoors — use stroller canopies and umbrellas
- Watch for signs of overheating: flushed face, rapid breathing, fussiness, warm skin
- Do NOT overbundle babies in warm weather — the rule is one more layer than you are comfortable in
- Avoid baby carriers/wraps in very hot weather — body heat plus carrier creates excessive warmth
- Check the temperature of car seat buckles and surfaces before putting baby in — metal can cause burns
Frequently asked questions
Should I call 911 for heat stroke in babies and toddlers?
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What should I NOT do?
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Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Emergency Guides
Bottom line
This is a serious emergency. Always call 911 first, then follow the steps above while help is on the way.
You are doing the right thing by learning what to do in an emergency. Being prepared is one of the best things you can do for your child.