Prickly Heat (Miliaria Rubra):
A parent's guide for infants and babies

Prevention and treatment consist of controlling heat and humidity. Acetaminophen or ibuprofen can help to reduce fever. Remove any occlusive clothing, limit activity, and seek air conditioning or any cooler environment. Cool compresses can also help with the discomfort. Most infants recover uneventfully within a matter of weeks. Young infants should not be given fluids other than breastmilk or formula unless instructed by his or her doctor.
The most common complications include secondary infection from scratching and heat exhaustion.

Call your child's doctor if they are scratching significantly. There are medications that can help relieve the itching and thus prevent infection. Infected areas may need antibiotics. Call your child's doctor if the area develops pus, redness, crusting, swelling, or tenderness.

In cases of heat exhaustion, the skin will appear hot and flushed without any sweat. Your child may complain of dizziness, nausea, weakness, headache, confusion, or difficulty breathing. This can progress to heat stroke, so medical care should be obtained right away. Symptoms of heat stroke include a very high temperature, of 105°F or greater, decreased or loss of consciousness, or seizure.

Heat intolerance is recognized by a lack of sweating of the affected skin, irritable behavior, and a change in alertness. Call for emergency medical help if your infant shows one or more of the following symptoms:

• Your baby is sweaty and restless, then suddenly lethargic and sleepy. If your baby is awake, he or she may seem sort of "glazed" and limp or go from flushed to pale.
• Your baby shows signs of dehydration: a dry mouth, no tears with crying, cracked lips, sunken eyes, or has less than 1 wet diaper every 6–8 hours.
• A decreased desire or ability to feed.
• Vomiting.
• Seizure.
• It feels like he or she has a fever.

If you notice some combination of these signs, do everything you can to cool your baby off and have him or her seen by a doctor right away.

• Get your child into the shade or into an air-conditioned space.
• Undress your child and apply cool compresses.
• Do not give fluids.
  

Last Modified: 3 Mar 2008

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