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This is a life-threatening emergency. Call 911 immediately, then follow these steps while waiting for help.
Hypothermia in a Child
Content reviewed against published AAP, Red Cross, CDC guidelines
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Hypothermia occurs when body temperature drops below 95F (35C). Infants and young children lose heat faster than adults and cannot shiver effectively to warm themselves. Hypothermia can progress rapidly to a life-threatening emergency if not treated.
Immediate actions
- Call 911 immediately
- Move child to a warm, dry environment immediately
- DO NOT: Do NOT rub or massage cold extremities — this can cause dangerous heart rhythms
Step-by-Step Response
Get to warmth
Move child indoors or to a sheltered area out of wind and cold. If outdoors and cannot move, shield from wind and insulate from the cold ground.
Remove wet clothing
Wet clothing (including diapers) pulls heat away from the body 25 times faster than dry clothing. Gently remove and replace with dry layers.
Rewarm gradually
Wrap in blankets or sleeping bag. Apply warm (not hot) compresses to neck, armpits, and groin. Hold the child close for skin-to-skin contact (especially effective for infants).
Warm beverages if alert
If child is fully alert and can swallow safely, offer warm (not hot) sweet drinks. This provides gentle internal warming and energy. No caffeine.
Monitor temperature
Check rectal temperature if possible (most accurate). Mild hypothermia: 90-95F. Moderate: 82-90F. Severe: below 82F. Moderate and severe require emergency medical care.
Watch for worsening
Signs of dangerous hypothermia: stopped shivering (paradoxically worse than shivering), slurred speech, confusion, extreme drowsiness, weak pulse, slow breathing.
Continue rewarming until help arrives
Handle gently — rough handling can trigger cardiac arrest in severe hypothermia. Keep monitoring breathing. Be prepared to perform CPR if needed.
What NOT to Do
- ✕Do NOT rub or massage cold extremities — this can cause dangerous heart rhythms
- ✕Do NOT use direct heat sources (heating pads, hot water, hair dryers) directly on skin — can cause burns
- ✕Do NOT give hot drinks to a child who is confused or semiconscious (choking risk)
- ✕Do NOT put child in a hot bath (rapid rewarming can cause cardiac arrest)
- ✕Do NOT delay removing wet clothing
- ✕Do NOT ignore shivering — it is an early warning sign
When to Seek Help
Call 911 if:
- Body temperature below 95F (35C)
- Child is confused, extremely drowsy, or difficult to rouse
- Child has stopped shivering but is still cold (sign of severe hypothermia)
- Breathing is very slow or irregular
- Child is unresponsive
- Child was submerged in cold water
Go to ER if:
- Temperature below 95F that is not quickly responsive to warming efforts
- Frostbite (hard, white or grey skin, especially on fingers, toes, ears, or nose)
- Child was in cold water for an extended period
- Confusion or altered mental status even if mild
- Infant who feels unusually cold with reddish or bright red skin and lethargy
Call your doctor if:
- Child was exposed to cold and is shivering but alert and responding to warming
- Mild frostnip (pale, numb skin that resolves with warming)
- Child seems cold after being outside longer than planned but is warming up well
Age-Specific Guidance
0-6 months
Newborns and young infants are at highest risk because they cannot shiver effectively, have a large surface-area-to-mass ratio, and limited fat insulation. Keep room temperature 68-72F. An infant with hypothermia may appear lethargic with bright red skin.
6 months - 3 years
Toddlers playing outside may not recognize or communicate that they are cold. Check them frequently. Wet diapers and clothing accelerate heat loss. Limit outdoor time in temperatures below 32F.
3-8 years
Children engrossed in play may ignore cold signals. Set firm time limits for outdoor winter play. Ensure they come in for warm-up breaks. Teach older children to recognize when they feel too cold.
Prevention
- Dress infants and children in one more layer than an adult would wear
- Cover head, hands, and feet in cold weather — children lose significant heat from their heads
- Keep infants indoors in very cold weather — they cannot regulate temperature well
- Change wet clothing immediately (snow play, rain)
- Set time limits for outdoor play in cold weather
- Ensure children eat well before cold weather activities (calories = heat production)
- Keep the car emergency kit stocked with blankets in winter
- Monitor car seat children — remove puffy coats before strapping in (add blankets over straps)
Frequently asked questions
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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.