Q: Are cold hands a sign of sickness in a baby? My child's hands are always cold even though her body is warm.
A: The temperature of the center or core of the body -- where the vital organs are housed -- is quite strictly regulated. That's why we measure body temperature through the mouth or rectum.
Body parts that are far away, such as the hands and feet, are often cooler. Like the outer rooms of a house, they are more affected by environmental variations.
When it is cold, the body conserves heat and energy by restricting blood flow to the extremities, making the hands and feet even cooler. In almost all cases this is quite normal.
When it is warm and the body wants to get rid of heat, it opens up blood vessels, especially the ones near the skin, and the hands become warm and pink.
When babies -- and older persons too, for that matter -- are very, very ill, their extremities may get cold, clammy and blue because they are so sick their bodies cannot circulate blood adequately. In this case, cold hands develop only after many other indications of grave illness.
It certainly doesn't apply to your baby!
Dr. Wilson is director of pediatric primary care of the Johns
Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.