Excessive Sweating in Babies - Causes and Treatment

Introduction:

Sweat exits the body through small skin pores and evaporates, thus cooling down the body. Ammonia and urea are left behind as the body breaks down the protein. Sweat does not smell, but when it combines with the bacteria on the skin, it gives out an odor. In addition, certain hormones get activated at puberty which too can affect the smell of sweat. Slightly excessive sweating is normal, but too much sweating in babies can cause concern.

Why Do Babies Sweat?

Common causes for babies to sweat include:

• Adapting to the External Environment: Usually, exertion during physical activities makes one sweat in excess, but babies do not engage in any strenuous physical activities, yet they sweat under certain conditions. A baby's immature body may try to cope with the ambient temperature outside the womb. This process of regulation can cause babies to sweat.

• Over Warmth: Wrapping the baby with too many clothes to keep them warm can also cause excessive sweating. Excessive sweating is called 'hyperhidrosis.'

What Are the Types of Excessive Sweating (Hyperhidrosis)?

The following are the types of excessive sweating:

• Primary Focal Hyperhidrosis: This is a common type of excessive sweating and can run in families. The particular affected part sweats excessively, and the episode can occur at least once a week. Sweating usually occurs equally on both sides of the body in the affected area and can increase stress and a warm climate. It can interfere with daily activities, and it usually stops during sleep.

• Secondary Hyperhidrosis: This condition occurs in adulthood as a result of diabetes, obesity, or due to certain medications. Excessive sweating covers a large body area and continues even during sleep.

What Are the Other Causes of Excessive Sweating (Hyperhidrosis) in Babies?

1. Crying: Crying for long durations can make them sweat, and this can occur especially on the palms and feet when babies get upset.

2. Fever: Fever occurs due to infection, and the body temperature is elevated during fever. Though the fever and sweating resolve upon administration of medicines, treating the underlying cause of infection is necessary; else, there can be a relapse of fever.

3. Idiopathic (Unknown) Hyperhidrosis: The cause for this condition is unknown. It is believed that it can be due to elevated activity of a part of the nervous system, which causes the sweat glands to be rapid in their activity. It is common in infants, and excessive sweating is noticed in the palms (palmar hyperhidrosis), but parents need not be alarmed. The size and the number of sweat glands are the same as that of a normal person. Certain adults may choose to undergo surgery as this condition may interfere with their daily routine or if it makes them embarrassed. Surgery involves minimizing the activity of the part of the nervous tract, which makes the sweat glands hyper.

4. Sleep Apnea: Sleep apnea is common in premature babies when babies stop breathing for more than 20 seconds while sleeping. This can happen when babies are overheated when wrapped in many clothes. Overheating may also lead to sudden infant death syndrome (SIDS) or heat-related illness.

5. Medical Conditions: Sweating can be an early sign of some serious health issues like:

• Congenital Heart Disease - About one percent of babies are born with congenital heart disease and have signs like bluish skin and shallow breathing. These babies sweat all the time, even while feeding. This is because the heart exerts more pressure to pump blood to all parts of the body. It is a serious issue, and it is mandatory to consult a pediatrician (child doctor).

• Endocrine system disorder.

• Cancer.

• Diabetes.

• Lung disease.

• Infections.

6. Abnormalities at Birth or Genetic Defects: Cold-induced Sweating Syndrome (problem with regulating body temperature accompanied by other abnormalities) is a condition wherein babies sweat when cold and can have certain features like flat-bridged nose, weak facial muscles, seizures, high fever, and other health issues. Apert Syndrome, a genetic disorder is characterized by skeletal abnormalities such as fused toes and fingers, abnormal development of the face and skull, and sometimes accompanied by heart problems. Excessive sweating can occur in babies with Apert Syndrome.

7. Deep Sleep: Babies sleep for longer but shorter durations, like three to four hours. During this time, babies go through various sleep phases like drowsiness, rapid eye movement (REM sleep), light sleep, deep sleep, and very deep sleep. When in a deep sleep, they may sweat in excess and wake up sweaty.

How Is Excessive Sweating (Hyperhidrosis) Diagnosed?

There is no specific test to diagnose excessive sweating. However, it can be diagnosed in the following ways:

• Physical Examination: The pediatrician examines the baby and monitors the vital signs like pulse rate, blood pressure, temperature, respiratory rate, and body weight.

• Clinical History: The doctor will ask the parent about the onset of excessive sweating, like when and how it began, and ask for a family history of hyperhidrosis.

What Are the Treatments for Excessive Sweating (Hyperhidrosis) In Babies?

Most babies usually respond to treatment. Mild cases or less frequent episodes of excessive sweating can be treated by:

• Avoid Overheating: Remove extra clothes that can make the baby feel hot. It is safe to avoid thick blankets, quilts, or any other covering which can interfere with the baby's breathing. Dress the baby in light clothing during summer and a single slightly thick clothing during winter. If needed, the baby can be kept warm by placing them on a cozy baby bed.

• Surrounding Factors: If sunlight shines brightly on the baby's cradle or bed, position them away from sunlight. Babies can be breastfed when they sweat excessively to prevent dehydration. Portable thermometers can be used to assess the room's temperature. The room should be warm and not hot. When babies sweat excessively, move them to a cooler area but do not place them directly in front of the source like an air conditioner.

Consulting a healthcare provider at the earliest is necessary when the following signs are noticed in babies:

• Fever or pain that does not resolve within a day or two can denote infection.

• Sweats excessively in general or specific areas, even at warm temperatures, and lasts longer.

• Sweats during feeding.

• Reduced urine output.

• Frequently occurring sleep apnea (long gaps between breathing while sleeping).

• Abnormal weight gain, gasping, wheezing, snoring while sleeping.

• Poor appetite.

The elevated temperature range in babies includes:

• Infants younger than three months have a rectal temperature of 100.4 degrees Fahrenheit (38 degrees Celsius).

• Infants over three months have a temperature of 102 degrees Fahrenheit (38.9 degree Celsius) or higher.

• Infants over three months have a temperature longer than two days.

If one or many of the above signs are reported to the doctor, they will carefully examine and suggest the following treatments:

• Antiperspirants (Liquids That Prevent Sweating): Gels, powders, ointments, or lotions can be recommended by doctors to be applied to the areas of excessive sweating.

• Oral Medicines: Oral medicines, called anticholinergics, block excessive stimulation of the sweat glands.

• Iontophoresis: Mild current is given to areas of excessive sweating to reduce their activity.

• Botox Treatment: Botulinum toxins, like anticholinergics, reduce the activity of sweat glands. The procedure might be required to be repeated after a few months.

• Underarm Surgeries: It is a rare procedure wherein the sweat glands in the underarm are excised by surgery and are usually preferred in older kids and not in infants.

• miraDry: This procedure uses controlled electromagnetic therapy to destroy the sweat glands.

Conclusion

Sweating is a normal process in adults and infants. Simple reasons, as discussed above, can contribute to excessive sweating in babies if, when corrected, they can settle the issue. However, persistent episodes of excessive sweating can be a matter of concern and should not be ignored by parents as it can denote an underlying health issue.