What this is about
You brush an arm in the crib, or an icy little hand lands on your neck during a feed, and the first worry is that your baby is freezing. Usually, your baby is fine. Hands and feet often feel cool even when the rest of the body is warm enough.
To know how warm your baby really is, slip your fingers inside the collar onto the back of the neck or the upper chest.
Why are baby hands cool?
A baby's body keeps the middle warm first, around the heart and lungs. The hands and feet are last in line for that warmth, so they are the first to cool.
Why are baby hands cool?
The warmth starts in the middle.
Warm blood leaves the heart, warms the chest and tummy first and then flows out along the arms and legs. In a warm room, enough of it reaches the fingers and toes to keep them warm too.
In cool air, the body holds the warmth in.
The small blood vessels to the hands and feet narrow, so less warm blood goes out to them, and more stays around the heart and lungs. The hands and feet feel cool and can look pale or bluish. Newborns show it most.
Moving brings the warmth back.
While your baby sleeps, feeds or rides in the stroller, less blood goes out to the hands and feet. Once the arms and legs move, cool hands soon look pink again.
Wet skin cools faster.
A fist or thumb that has been in the mouth is wet, and wet skin loses heat as it dries.
Your hands are cool too.
Rest your fingertips on your forehead. The forehead feels warm and the fingertips feel cool against it, because your body also keeps its middle warm first.
Cool hands at night do not need mittens
Cold hands cause the most second-guessing at night. You look into the crib and see bare hands resting on top of the sleep bag, cold to the touch. It looks like something is missing from the bedtime outfit. You may notice it most after the switch from a swaddle to a sleep bag, when the hands are no longer tucked in.
Nothing is missing. A sleeveless sleep bag leaves the hands free, whatever your baby wears under it. Babies use their hands to explore, touch the face and soothe themselves back to sleep.
Leave the hands bare and let your baby sleep. A hat stays off for sleep indoors too, because a baby cools down through the head and face. If you would rather cover the hands, the fold-over cuffs on a newborn sleepsuit are sewn to the sleeves, so they can't come off in the crib like loose mittens. For a baby who sucks the hands, leave the cuffs open, so no wet fabric sits on the skin all night.
When the chest feels cool too, the instinct is often to fix everything at once: thicker pajamas, socks, mittens and a heavier blanket. Change one thing instead, such as warmer pajamas under the bag or a warmer sleep bag in its place, with no blanket on top. Give it twenty minutes before you check again. Changing one thing at a time keeps a pair of cool feet from turning into an overheated baby.
When should I worry about cold hands?
In newborns, hands and feet can look slightly mottled or bluish in a cool room or after a bath. The color comes back once your baby is dry, dressed and warm in your arms. The lips, tongue and inside of the mouth keep their usual pink all the while.
Call your emergency number (911 in the US, 999 in the UK) right away if your baby's lips, tongue or face turn blue or gray, if the skin looks unusually pale or blotchy, or if blue hands and feet stay blue once your baby is warm. The same goes for skin that feels cold or clammy all over, and for a baby who is floppy, hard to wake or struggling to breathe. On black or brown skin, these changes are often easier to see on the palms, the soles of the feet, the lips or inside the cheek, so look for a change from your baby's usual color.
Outdoors, hands and feet need covering
Outside it is a different matter, because cold air and wind chill bare skin fast. As it gets colder on a stroller walk, the feet need covering first and the hands last.
12–23°C (54–73°F)Thin socks
With pants, from mild days down to chilly ones. A footed sleepsuit already covers the feet.
Below 12°C (54°F)Warm socks and booties
Warm socks take the place of thin ones, with booties over them. Inside a footmuff, the warm socks are enough.
Below 8°C (46°F)Mittens
Pull the cuffs up over the jacket sleeves, so no wrist shows between the two.
Babies are famous for kicking socks off inside footmuffs, and older babies chew their mittens until the cuffs are soaked. Feel now and then whether a sock or mitten has turned damp from rain, snow or drool. Wet fabric against cold air chills skin fast, so swap damp pieces for a dry spare pair before adding anything heavier.
In a carrier, your body warms your baby's middle, but the legs hang out in the wind and the pants ride up above the socks, so warm socks go on a step sooner than in the stroller.
Questions parents ask
When do babies' hands stop being cold?
There is no set age, and older babies and toddlers often have cool hands and feet too.
My baby's feet are cold. Do they need socks?
Not just because they feel cool. Indoors, thin socks go on when the room is cool and the feet are bare, and in a warm room bare feet are fine. At night, a footed sleepsuit or a sleep bag already covers them.
My baby has a fever but cold hands and feet. Should I add a layer?
No. Keep the clothes light, as in dressing a baby with a fever. Hands and feet that feel much colder than usual during a fever are a reason to call your emergency number.
Will my baby wake up if too cold?
Sometimes, but you can't count on it, and cold hands alone don't explain a restless night. A baby who is too cold usually looks pale, and the chest feels cool.
