hot carIn the last two months five American children died of hyperthermia in hot cars.  They were ages 9 mo-2 years.  Two were toddlers who climbed into unlocked parked cars and couldn’t get out.  One 2-year old was “playing” in the parked car for about 15-30 minutes before she was found dead from hyperthermia.  A family member was supposedly watching her while her mother changed her twin’s diaper.  Two had parents who went to work, forgot to drop children at childcare, and left their sleeping infants in the backseat.  Other mothers, who suffered the same tragedy, have actually driven to childcare centers to pick up their children, never noticing the dead baby in the back seat.

Have you ever forgotten your baby in the car?  I have.  Just last week my family arrived at a friend’s house for a party.  My husband offered to change our 2 year-old’s diaper before we went inside.  I said I’d be in charge of our other four children.  Our three oldest went tearing into the friend’s home, and I scrambled to follow, leaving our sleeping infant in the car where my husband was changing the 2-year-old.  About 15 minutes later we realized the baby was still in the car.  I panicked.  I knew she could be dead on this 80 degree day.  This was going to be my worst nightmare.  But it wasn’t.  She was asleep, a bit warm, but OK.

In the 1990’s the pediatrics and automotive industries recommended that car seats be moved to the back seat to avoid airbag injuries, but no one anticipated the tragic reality that this move would cause.  Out of sight and asleep in the back seat, infants are regularly forgotten in cars.  To further improve safety, we’ve recommended that infants and toddlers remain rear-facing in their car seats until age two.   Now, with sleeping babies even less visible to drivers, these tragic deaths are becoming more common.

These deaths have happened on relatively mild days, in northern climates, and to children ages 5 days-14 years.  Last week in Canada, not one but 2 toddlers died in hot cars.  A three-year-old girl died the same day as the funeral for Maximus Huyskens, who was just days shy of his second birthday.

There have been 611 U.S. heatstroke deaths of children left in cars since 1998, averaging 38 deaths per year, according to Jan Null, a researcher at the Department of Geosciences at San Francisco State University.  In 52% of cases the child was forgotten by a caregiver.  29% were children playing in an unattended vehicle.  In only 18% of cases were children intentionally left in vehicles by adults.

Even when outdoor temperatures are only about 70 degrees, vehicles heat up rapidly, within only 15-30 minutes, according to a study in the medical journal Pediatrics.  In ten minutes, the average rise in vehicle temperature was ~19 degrees F.  “Cracking” the window does almost nothing to prevent heat rise.  Children’s bodies are not able to tolerate high heat as well as adults.

Who forgets about a baby in a car?  We all do.  Parents of every socioeconomic level have done this.  Professionals, stay-at-home parents, grandparents.  Good people.  Afterwards, many contemplate suicide.  One father tried to wrestle a gun from a police officer at the scene—to end his own life.  As if this suffering is not enough, 49% of caregivers responsible for these children are charged with a felony, according to a study by the Associated Press.  81% resulted in convictions.   Only 7% involved drugs or alcohol.

Here’s what you can do to help prevent heatstroke deaths from children in vehicles:

  • If you see a child alone in a car, call 911 immediately.  In many cases, several people saw these kids in the cars before they died, but never called for help. 
  • Never let kids play unattended in a car, even if it is in your driveway.  Lock your car so that kids can’t get in to “play.”
  • Use a detachable infant car seat that can be easily removed from the car without waking up a sleeping baby.  These are the kind of infant car seats that have an installed base and a detachable seat-part with a handle.  Many people call them “pumpkin seats” and they often come with strollers that the seat latches onto.  Convertible car seats, on the other hand, require that you unstrap your baby from the car seat and pick him or her up in order to get them out of the car.  It is awful tempting to let a sleeping baby keep sleeping if you can’t get them out of the car without waking them up…
  • Leave a purse, wallet, cell phone, or work ID badge in the back seat of the car next to your baby, so that you have to check the back seat before you leave the car.
  • Never leave a child unattended in a car, even with the windows partly open.  Not even for a minute.
  • Have a plan for your childcare provider or school to call you if your child does not arrive as scheduled.

Copyright 2014 Kathleen Berchelmann, MD