Should infants be exposed to central heat and air conditioning (AC) systems?

Infants Can and Should Be Exposed to Central Heat and AC

No, it is not true that infants should avoid central heat and air conditioning—in fact, maintaining appropriate environmental temperature through these systems is essential for infant safety and preventing both hypothermia and overheating. The American Academy of Pediatrics emphasizes that infants should be kept in environments where they can maintain normal body temperature (36.5-37.5°C), and central heating/AC systems are appropriate tools to achieve this 1.

Key Temperature Management Principles

Infants should be dressed appropriately for the environment with no more than one layer more than an adult would wear to be comfortable in that environment 1. This principle applies whether using central heat, AC, or any climate control system.

Avoiding Overheating (Critical Safety Concern)

• Parents must evaluate infants for signs of overheating including sweating or chest feeling hot to the touch 1
• Overbundling and covering of the face and head must be avoided 1
• Overheating is associated with increased risk of SIDS, though specific temperature thresholds vary across studies 1
• Hyperthermia (>38.0°C) should be avoided due to potential associated risks including seizures and adverse neurological outcomes 1, 2

Avoiding Hypothermia (Equally Critical)

• Room temperature should be maintained at least 23-25°C (73-77°F) for optimal infant thermoregulation 1, 2
• Hypothermia (temperature <36.5°C) is strongly associated with increased mortality and morbidity in infants 2
• Even modest hypothermia carries at least 28% increased mortality risk for each 1°C below 36.5°C 2

Practical Guidelines for Central Heat/AC Use

Safe Use of Central Heating

• Central heating is appropriate and recommended to maintain room temperatures of 23-25°C during cold weather 1
• Avoid placing infant cribs directly next to heating vents or radiators where localized overheating can occur 1
• Monitor infant for signs of overheating: sweating, flushed skin, rapid breathing 1

Safe Use of Air Conditioning

• Air conditioning is appropriate to prevent heat-related illness, which can be fatal in infants 3, 4
• Infants are particularly vulnerable to heat due to immature thermoregulation, less sweating capacity, and high surface-to-body mass ratio 3, 5
• Higher ambient temperatures are associated with increased infant mortality, hospital admissions, and infectious diseases 4
• Avoid directing AC vents directly at the infant's sleeping area to prevent localized cold exposure 2

Critical Distinction: Central Systems vs. Problematic Heating Sources

The concern is NOT with central heat/AC systems, but rather with specific heating sources that produce indoor air pollutants:

• Gas space heaters are associated with increased episodes and days of wheeze in infants 6
• Wood stoves are associated with increased days of cough 6
• Kerosene heaters are associated with increased episodes of cough 6
• Central heating and AC systems do not carry these respiratory risks 6

Monitoring and Assessment

Parents should check infant temperature and comfort level regularly:

• Feel the infant's chest—it should feel comfortably warm, not hot or cold 1
• Check for sweating (sign of overheating) 1
• Observe skin color and activity level—lethargy or decreased activity can indicate temperature stress 2, 7
• Rectal temperature is the gold standard for core body temperature measurement when concerns arise 2

Common Pitfalls to Avoid

• Do not dismiss the importance of environmental temperature control—both extremes are dangerous 2, 4
• Do not overbundle infants "just to be safe"—this increases SIDS risk 1
• Do not use thermal mattresses or heating pads for warming—these increase burn and hyperthermia risk 2
• Do not assume infants will cry or show obvious distress when too hot or cold—young infants often become lethargic with temperature stress 3, 7

The bottom line: Central heat and AC are safe and often necessary tools for maintaining the appropriate environmental temperature that allows infants to maintain normal body temperature. The key is proper use—maintaining room temperature at 23-25°C, dressing infants appropriately, and monitoring for signs of temperature stress.