The functioning of the systems of newborn children is not yet stable: the intestines are just beginning to be populated by microflora, the eyes are learning to see, and the ears are learning to hear. The thermoregulation of infants is also not established; accustomed to being in a warm womb, the baby’s body will not soon adapt to new conditions.
The thermoregulation system allows us to maintain a constant body temperature under different conditions through certain mechanisms.
If the environment is cool, active breakdown of fats and carbohydrates begins, generating energy that is used for heating. When this mechanism is not enough to maintain the desired body temperature, the muscles are activated - due to their trembling, the person becomes warmer.
If you are hot, the body directs blood closer to the skin to cool down. Thus, the vessels at the surface of the body dilate, and excess heat is transferred to the environment. If these measures are not enough, the sweat glands begin to act, and wet skin cools faster.
In newborn children, such a system has not yet been adjusted, so the baby can quickly become hypothermic and overheated, depending on the air temperature and the amount of clothing worn on it.
Heat is generated from reserves of brown fat accumulated by the body over the last third prenatal period. Using this energy source, the baby can slightly maintain his body temperature. Newborns do not yet have a trembling mechanism, so the child will instinctively warm up through active movement of the limbs.
Sweating in newborn babies does not yet function properly, so babies overheat quite easily in hot weather.
A child may sweat when he is incorrectly dressed, but in this case evaporation does not occur in infants, since the moisture remains under the clothes, and therefore the body does not cool down.
In the adult body, blood vessels take an active part in the process of thermoregulation. If a person is hot, they expand, blood rushes to the surface of the skin and excess heat goes out. In the cold, on the contrary, the vessels narrow, preventing blood from flowing to the periphery and preventing the body from cooling. In newborn babies, the subcutaneous layer of fat is still too thin and it is not able to retain heat inside the body, even if the blood vessels narrow.
Newborn care
Hypothermia is very harmful for newborn babies. If the baby freezes, the protection of the mucous membranes of the nose and mouth will decrease, and the microbes present there will awaken in the intestines and lungs. A decrease in body temperature by 2.5 degrees will certainly lead to serious metabolic disorders that can cause the death of the baby.
Overheating also reduces the protective functions of the newborn's body, and heat rashes, allergies and dermatitis appear on his skin. It is noted that due to a lack of tactile sensations, children who are constantly bundled up experience developmental delays.
You must control whether the baby is comfortable in the clothes that you put on him by touching his neck or nose. If they are cool, then the newborn is freezing; if they are hot or damp, the baby should be undressed, wiped dry and dressed in something lighter.
To monitor whether your baby is overheating, you should constantly check him with a thermometer. The temperature of newborn children can sometimes reach 37.5 degrees, and these are quite normal numbers. After an episode of crying, the thermometer scale may rise to alarming levels, but after 5-10 minutes the temperature usually returns to normal.
How can you tell if your baby is freezing?
- the baby turns pale;
- the nasolabial triangle turns blue;
- the newborn is worried or, conversely, slightly inhibited.
To quickly warm up your baby, hold him close to you, creating skin-to-skin contact - living warmth your body will best warm a frozen baby whose thermoregulation is not yet perfect.
How can you tell if your baby is overheating?
Typically, the condition of overheating can be determined by measuring the newborn's temperature. If the baby did not cry, but it sharply increased to 38-39 degrees, while the baby’s neck is hot and wet, and he is dressed in warm clothes, undress the baby immediately.
The state of overheating is also characterized by redness of the child’s skin, apathy and refusal to eat. If you do not notice in time that the baby is hot, his brain may trigger a defensive reaction - the baby will fall asleep, and his sleep will be quite long.
If you notice signs of overheating, immediately undress your child and give him something to drink. breast milk, mixture or water. After sweating, your baby has lost a lot of moisture, and to avoid dehydration, you need to give him plenty of fluids. If the baby's temperature does not drop after half an hour, call a doctor.
Training the thermoregulation system
Over time, thermoregulation will return to normal, and the baby will cope with overheating and hypothermia with the help of mechanisms own body. In the meantime, you will have to carefully monitor whether your newborn is comfortable and change him if he is not.
In order for the thermoregulation system to work as quickly as possible, you need to help your baby adapt to temperature changes environment.
- At home, you don’t have to put a cap, mittens and socks on your newborn, so his body will breathe;
- carefully select and monitor whether the baby is hot or freezing;
- choose hats that suit the weather so that the baby’s head does not sweat - its overheating will negatively affect work nervous system and baby development;
- do not forget about the benefits of hardening, if the temperature in the room is comfortable - undress the child and let him lie naked for a while;
- walks should be arranged in any weather, at least for a short time, so the baby’s body will quickly adapt to temperature changes;
- the temperature in the room where the newborn sleeps and eats should be about 25 degrees in the first month of his life, gradually it should drop and by six months it should be about 20 degrees;
- the temperature of the bathing water should be identical to the body temperature of a newborn baby; as he grows up, the water will become cooler;
- Dress your baby at home as you dress yourself - if you wear short sleeves at home, do not wrap the baby in warm clothes;
- When walking in the warm season, fold the stroller canopy so that the air inside does not stagnate and overheat.
A newborn baby seems to be the most defenseless and unadapted creature in the world. At first, it is sometimes difficult for young parents to even cope with the fear of picking him up - the baby looks so fragile.
Source: shutterstock
What can we say about adaptability to the external environment - it is clear that you want to protect the baby. Hug and, of course, wrap up better so as not to freeze.
The notorious woolen socks and sweaters with hats that our grandmothers tortured us with as children no longer seem like excess when a newborn appears in the house.
However, in last years Obstetricians and pediatricians are increasingly talking about how harmful overheating is for a child. It turns out that in our desire to protect the baby from a cold, we can harm his health.
Heat exchange in an infant is strikingly different from that of an adult. But, alas, for some reason they often forget to warn about this in courses for young parents. Dr. Alexander Kobasa talks about the rules of heat exchange in a baby, which all parents should know.
There are several simple rules attitudes towards heat transfer in young children.
Rule #1
- When an adult is cool, a child is comfortable.
- When an adult is comfortable, a child is warm.
- When an adult is warm, a child is hot.
- When an adult is hot, a child is overheated
Rule #2
The second rule is that the child must be dressed according to the air temperature.
Rule #3
Third, children tolerate cooling more easily than overheating.
If the child is cold, it is very easy to warm him up. You need to undress yourself, strip the child naked, put him on top of you and cover him on top. The child will warm up quickly. But with overheating the situation is more complicated!
A newborn baby is so tiny, so fragile, tender and touching that you want to protect him all the time, do something for him. This instinct is designed to protect the baby, but in our civilized times it often greatly harms the child’s health. A typical picture in the maternity hospital: a temperature of 24 degrees and a bag of a baby, a diaper, a suit or bodysuit, and two diapers. In more gentle cases, they are limited to a suit, a hat and a blanket. As a result, many babies come home with red and prickly skin. I admit, my first child arrived exactly like this.
Why is it necessary to harden children from the first days of life?
Your most wonderful baby in the world lived in your tummy in warmth and comfort. His body did not bother to deal with the issues of hydration, cleansing, heating and cooling. But now he was born and many different sensations and problems fell upon his body. And yours the main task– teach all body systems of your little miracle to quickly and adequately react in order to be able to protect themselves.
All three of my children got sick only once in the first year of their lives, and that was because I infected them. But, surprisingly, while I suffered with laryngitis for two weeks, they were sick for no more than a week. After a year, their illnesses were limited to a slight runny nose, maybe a cough, about twice a year. I never worry about their clothes - let them at least walk naked on the street if they are not cold, I never forbade them to climb in puddles in the spring, at home they only walk barefoot, without socks, without slippers, some in pants and a jacket, someone in only shorts. At the same time, our house is no more than 18 degrees.
I was raised according to standard rules - warm clothes, warm cap, warm shelter, fear of drafts. Under these seemingly optimal conditions, I managed to end up in the hospital with pneumonia at the age of three. Throughout my childhood, as long as I can remember, I was sick. IN adolescence came with chronic tonsillitis. And now I get sick an order of magnitude longer and more severely than they do, and I freeze much faster than them. I didn’t want this for my children, so I taught their body to react correctly to the cold already in the maternity hospital.
How does thermoregulation work in babies?
A newborn baby is born with an effective thermoregulation system, it just differs from the system of an adult. This was done by nature specifically so that the baby has the opportunity to form a new system of thermoregulation and immunity from scratch, ideally suited to the conditions in which he will live. If you are constantly wrapping up your baby and he is on the verge of overheating, then this new system formed as if he lived in some equatorial climate. The body will not cope well with cooling, which will constantly affect the immune system. Hence the frequent colds.
So, in a newborn, brown subcutaneous adipose tissue, which is located between the shoulder blades, on the chest, on the neck, and near individual organs, is responsible for heating the body. It is formed from the 26th week of pregnancy specifically for the moment when the miracle of birth occurs. If the baby is cold, then the processes of fat oxidation with the release of energy begin to actively occur in this adipose tissue - the body heats up. A simple but effective mechanism for heat production.
If brown adipose tissue cannot cope, then the ability of muscle tissue to create heat during work comes into play. The baby wakes up, begins to cry and move actively. If this does not help, then after all the reserves of nutrients in the body are depleted, the newborn becomes silent, stops moving, the body begins to quickly cool down and death may occur.
But there are not many opportunities to combat overheating. The sweat glands still work poorly, and the layer of clothing prevents the sweat from evaporating. But it is completely impossible to stop the production of heat, because it is produced all the time as a result of many oxidative reactions occurring in the body. These reactions are necessary for cells to receive nutrition, to create new cells, and for the transition of one substance to another. Heat is also released from the constant movement inside his body - blood moves, internal organs move, cells move.
An overheated baby becomes inactive, hot, wet, and does not even have the strength to cry. After all, now his body saves on movements. If he is not helped, then the body begins to collapse and everything can end in death. In milder forms, we observe overheating in the form of prickly heat or a sudden illness.
As an infant grows, the thermoregulation system changes and becomes similar to that of adults. The hypothalamus matures and takes on the responsibility of maintaining a constant body temperature. He now has a wide range of tools at his disposal: the creation of subcutaneous fat, hormones, nutrients from the digestive system, sweat glands, muscles, etc. So, the task of parents is to teach the hypothalamus to master these tools perfectly. To do this, you need to harden the child from the first days.
How to harden?
In general, there are many hardening methods. You choose the method that suits you best due to your lifestyle and living conditions. But there are several general rules that must be followed regardless of the technique:
- If a newborn is cold, his nasolabial triangle turns blue, he screams, twists his arms and legs, he may begin to tremble, and his thighs feel cool to the touch. But the nose, arms and legs should normally be cool, because... they are wet all the time.
- If the baby is hot, then his back, neck, armpits become wet, his face and body turn red, he becomes lethargic and sleepy. When severely overheated, the baby can go into hibernation for several hours, which allows him to reduce all reactions in the body.
- Any hardening procedure should not cause a crying attack in the child. If you lower the temperature in the bath and the baby begins to cry, then quickly take it out and calm it down, and next time lower it a little less.
I did something like this:
In the maternity hospital itself, we were all forced to measure the babies’ temperatures, and in the first days after the first baby’s arrival from the hospital, I regularly measured his temperature to know how it changed depending on how I dressed him. I determined the well-being of the second and third child with my hand and vision.
There is no need to put a cap on your head if the room temperature is above 20 degrees. In the maternity hospital they looked at me askance, because my children (except for the first) lay in a light suit and without a cap (the temperature in our room was 24 degrees), and after changing the diaper for some time they lay completely naked on the diaper - airing out.
When changing a diaper, do not rush to dress your baby - let the skin breathe a little. The blood vessels of the body learn to narrow in order to save heat. At our house the temperature was about 22 degrees, but in the village it was 18 - 19 degrees - they still lay there naked.
If it’s 30 degrees or higher outside, then you don’t need a blanket or a closed suit for a walk. It is best for the baby to ride in his stroller in only a diaper. The diaper can also be unfastened to prevent the perineum from sweating.
There is no need to wash your baby in water with a temperature above 36 degrees. It is better to gradually reduce the temperature, bringing it to 28 degrees. I haven’t even washed newborns at 37 degrees. I have never boiled water. I only added potassium permanganate in the first two weeks.
At the end of bathing, pour cold water into the bathtub from the legs to lower the temperature in the bathtub - this contrast procedure is more gentle than dousing it with cool water. I put the babies in the bath in a diaper - this way they were less scared and rarely flinched from the cool water. After lowering, the diaper simply sank to the bottom.
Komarovsky describes hardening quite well in his books, but there are other less fashionable methods. Although I didn't follow his books as clear instructions.
In general, in hardening I have always been of the opinion (and still am): if he feels normal and does not complain, then he is not cold. My second child was born at the end of May, and in mid-June the swimming season began - we also circled his body in the water in the river (there were a lot of sidelong glances). By the way, during pregnancy I did not deny myself the pleasure of swimming in the river, even at recent months(the eldest was born in mid-September). Although I have never seen pregnant women swimming in a pond. So I admit that I am the only one.
It is known that the central system-forming factor of each functional system is the result of its activity. The adaptive result of the activity of the thermoregulation system is the maintenance of optimal temperature in the body, ensuring the normal course of its metabolic processes.
In the fetus, thermoregulation is provided by the mother. The heat production of the fetus is only 10-15% of the heat production of the mother, and heat transfer occurs through the placenta, which, at a constant temperature of the environment surrounding the fetus, allows it to maintain isothermia.
The main feature of the thermoregulation system in children is the insufficiency of its regulatory processes. The imperfection of thermoregulation mechanisms in children is explained by a number of reasons:
- incomplete development of the nerve center of chemical thermoregulation;
- imperfection of heat transfer mechanisms (physical thermoregulation). In children, vasomotor reactions that regulate blood supply to the skin and, consequently, heat transfer are not sufficiently developed;
- greater relative surface area of the child's body - than younger child, the greater the surface area of the body per unit mass. Since the amount of heat transfer depends on the size of the body surface, in children this process is carried out more intensively compared to adults. In this regard, the need for heat generation is also higher in children than in adults;
- structural features of the skin as a peripheral apparatus of physical thermoregulation (abundance of blood supply, thinness of the epidermal, subcutaneous fat and stratum corneum, poor development of sweat glands).
An increase in heat production during cooling or a decrease during heating (chemical thermoregulation) is already observed in infants. A feature of the mechanisms for increasing heat production in infants is the absence of a thermoregulatory reaction of trembling. Increased heat production in muscles during cooling is achieved by increasing the so-called thermoregulatory tone. This is proven by recording the bioelectrical activity of the muscles, which increases as the child cools down. In newborns, brown adipose tissue is an important source of heat.
The mechanism of heat transfer (physical thermoregulation) in a newborn and infant is not developed enough, so overheating, which is so dangerous for a child, very easily occurs. In newborn children, reflex regulation of the lumen of skin vessels is already carried out: narrowing of skin vessels during cold exposure, both at the site of cooling and on a symmetrical area of the skin. But the latent period of the reaction is long and the intensity is low. Thus, at an early age, the main mechanism that maintains a constant body temperature is chemical thermoregulation. With age, the role of physical thermoregulation increases. The boundary of transition from one type of maintaining a constant body temperature to another is 9 years of age.
After 1-1.5 years, up to 4-5 years, there is a large flow of heat through a unit of body surface (the growth rate slows down, the basal metabolic rate is still high). A high level of heat production at this age serves as a factor in compensating for heat losses caused by underdevelopment of physical thermoregulation. At 6-7 years of age, there is an increase in the possibility of physical thermoregulation with a simultaneous decrease in the role of chemical (development of the muscular wall of arteries and arterioles, increased possibility of blood redistribution). At the age of 10 years for girls and 11-12 years for boys (prepubertal period), as a result of hormonal changes, a decrease in the capabilities of physical thermoregulation occurs, which is compensated by the increasing role of chemical thermoregulation. With the appearance of the first signs of puberty, the formation of the balance of physical and chemical thermoregulation achieved by the age of 10 is noted. Physical thermoregulation improves more intensively the earlier hardening measures are started.
Due to the imperfection of thermoregulation mechanisms, the child’s body is thermolable, i.e. temperature instability. This thermolability is especially pronounced in children. early age. Thus, eating, restlessness, movement, sleep, hunger, and occasional cooling very easily affect their temperature curve. From 6-10 months these fluctuations become smaller. There is a high dependence of body temperature on the ambient temperature: if it is below 20°C, then rapid cooling of the newborn occurs, above 35°C - overheating.
The body temperature of a newly born child (when measured in the rectum) ranges from 37.7 to 38.2 ° C, i.e. usually 0.1-0.6°C higher rectal temperature mother. This depends on the fetus’s ability to produce heat independently. 30-60 minutes after birth, the baby’s body temperature decreases noticeably and after 2-3 hours drops by 2.0-2.5°C. Then, in healthy children, the temperature begins to rise again and after 12-24 hours (sometimes after 2-3 days) reaches 36.0-37.0°C. The temperature asymmetry of different areas of the skin is very pronounced. For several more days, the temperature in newborns is somewhat erratic, and only gradually the temperature curve characteristic of healthy infants is established. The reasons for the initial decrease in body temperature in newborns are sudden change ambient temperature and physical thermoregulation not immediately established in the newborn.
Monothermy is not typical for an infant. The average fluctuations in the difference between the maximum and minimum temperatures during the day in newborns are approximately 0.4 ° C, and in older children they can reach up to 1 ° C. By six months, a daily rhythm of changes in body temperature is formed.
A newborn can easily tolerate a decrease in body temperature of 3-4°C, but it is very difficult to tolerate an increase. Overheating of a child occurs extremely easily, since he has a small body weight and less time and energy is required to warm it up. If the temperature rises by more than 2°C, this not only causes a painful condition, but also poses a danger to life. This, apparently, explains the peculiarity and biological expediency of vascular reactions in the early stages of ontogenesis - vasodilation to both warming and local cooling of the skin. However, there is also a risk of hypothermia, since the increase in heat production can occur no more than 2 times, and only due to chemical thermoregulation, there is practically no mechanism of cold shivering, low sensitivity of cold receptors.
Gradually, vascular reactions become more perfect: their latent period, duration, and rate of return to the original level decrease. But even by the age of 7-12 they do not reach the level of adults.
It has been established that there is an inverse relationship between the value of skin temperature and a person’s age: the younger he is, the higher his skin temperature. In females aged 8-12, 18-25 years, the skin temperature is higher than in males. At the ages of 1-3 years, 4-7 years, gender differences in skin temperature do not appear. The rate of skin temperature recovery after local cooling is greater in younger people than in older people.
In adaptation to temperature influences, hardening is of great importance, i.e. exercises, training of vascular and neurohumoral processes (cold rubbing, bathing, air baths, etc.). This helps to increase the thickness of the epidermal layer of the skin, train vascular reactions and sweat glands, i.e. development of the structural and functional apparatus of the skin.
Thus, the development of the thermoregulation system is associated with an increase in body mass involved in heat production and a decrease in the relative surface area of the body from which heat transfer occurs; the formation of sweat glands that promote heat transfer; improving the heat-insulating properties of the skin due to the thickness of the layer of subcutaneous fat; improving the regulation of vascular reactions to cooling and heating; a decrease in the lower limit of the thermoneutral zone, which reduces the body’s dependence on changes in environmental temperature.
Questions and tasks
- 1. Expand the concept of assimilation and dissimilation.
- 2. What are the features of protein metabolism in children?
- 3. Tell us about the features of carbohydrate metabolism in children and adolescents.
- 4. Characterize the fat metabolism of children and adolescents.
- 5. What are the features of water and mineral metabolism in children and adolescents?
- 6. Give a brief introduction about age-related changes basal metabolic rate and sex differences in total daily energy expenditure.
- 7. Tell us about the norms and diet of children.
- 8. List the main features of energy metabolism in children and adolescents.
- 9. What are the features of thermoregulation in children and adolescents?
Children have insufficiently established heat exchange mechanisms. They overheat easily and lose heat easily. Infants react to cooling with violent, chaotic movements that warm them up. They have a great role in heat transfer from the processes of evaporation of water vapor during respiration.
In the first years of life, processes of chemical thermoregulation predominate in the child’s body. Due to the high level of metabolic processes, the child’s body quickly heats up. The skin temperature and internal body temperature of a preschooler are higher than those of adults.
The abundance of blood vessels in the skin determines the rapid transfer of heat from the temperature core of the body to its shell, and insufficient reflex regulation of the lumen of the skin vessels does not provide protection against large heat losses. With low muscle mass, children have low thermal insulation of the integumentary tissues. High heat loss is also due to the relatively large surface of a small body. With the transition to primary school age, the boundaries of thermoregulation expand, and heat exchange mechanisms improve. Rise muscle mass improves the heat-insulating properties of the body, improving vascular reactions facilitates the regulation of heat exchange on the surface of the skin. The regulation of sweating improves, information from the body's thermoreceptors and the activity of thermoregulation centers are clarified. All this makes it possible to better maintain a constant body temperature under different environmental conditions and at different forms activities. Junior children school age Compared to preschoolers, they are less susceptible to overheating and hypothermia, however, their resistance to changes in temperature conditions is still not sufficiently perfect. With age, the role of physical thermoregulation increases. The age of nine is identified as the boundary of transition from one type of maintaining a constant body temperature to another. After 1-1.5 years, up to 4-5 years, there is a large flow of heat through a unit of body surface (the growth rate slows down, the basal metabolic rate is still high). The high level of heat production at this age serves as a factor in compensating for the weak capabilities of physical thermoregulation. At 6-7 years of age, there is an increase in the possibility of physical thermoregulation with a simultaneous decrease in the role of chemical (development of the muscular wall of arteries and arterioles, increased possibility of blood redistribution). At the age of 10 years for girls and 11-12 years for boys (prepubertal period), as a result of hormonal changes, a decrease in the capabilities of physical thermoregulation occurs, which is compensated by the increasing role of chemical thermoregulation. With the appearance of the first signs of puberty, the formation of the ratio of the activity of physical and chemical thermoregulation achieved by the age of 10 is noted. Physical thermoregulation improves more intensively the earlier hardening measures are started.
