Tuesday, April 8, 2014

Let's Not Let Any More Babies Die in Hot Cars

It's (finally) spring, and some parts of the country and world are starting to warm up quickly. With the sun coming out come the reminders about the dangers of leaving kids (and pets) in the car. Cars warm up very quickly in direct sunlight, even when the temperature is fairly mild, and a child or animal trapped in a hot car can suffer dehydration, heat stroke, hyperthermia, and even death if left long enough.

Every year in the U.S., more than 30 children die from being left in hot cars. Most of these incidents are unintentional. That is, the parent or caregiver didn't mean to leave the baby in the car. Rather, they forgot the child was there and only upon returning to the car discovered that they had made a tragic error.

When news of such horrendous events gets out, two responses typically emerge. The comments start off with some type of judgment against the parent, such as, "He must be an abusive parent" or "She was obviously neglectful," or "If she can't remember her kids, she probably shouldn't have them." It is assumed that a parent who would leave a child in the car long enough to die in the hot sun must by definition be a "bad" parent. Next, you'll find a series of sanctimonious declarations that, "My children are always the first thing on my mind. I would never do that" and "How could anyone forget their kids? That would never happen to me!"

Five years ago, Gene Weingarten wrote a Pulitzer Prize-winning piece for the Washington Post on this subject. He tells the terrible stories of parents from all walks of life who returned to their cars to find their babies dead in their car seats. Some forgot they were supposed to drop the baby off at daycare and continued on to work. Some thought they had made the drop off only to show up at daycare for pickup with the child still in the back seat of the car. Every year, there are dozens of stories like this.

Weingarten interviewed a memory expert who explains that, "...in situations involving familiar, routine motor skills, the human animal presses the basal ganglia into service as a sort of auxiliary autopilot. When our prefrontal cortex and hippocampus are planning our day on the way to work, the ignorant but efficient basal ganglia is operating the car; that's why you'll sometimes find yourself having driven from point A to point B without a clear recollection of the route you took, the turns you made or the scenery you saw." 

In other words, when we're preoccupied with other things, we go on autopilot for the routine things. I'm sure we've all had the experience of getting in the car and starting to drive to work when we really meant to go the opposite direction to the grocery store, or of setting the table for the usual four people when only three are home that night, and so on. We do things without thinking about them while our conscious mind is busy with something else, like planning the meal we're about to make or thinking about tomorrow's schedule or making a phone call.

Weingarten's expert explains that when we are stressed, "What happens is that the memory circuits in a vulnerable hippocampus literally get overwritten, like with a computer program. Unless the memory circuit is rebooted -- such as if the child cries, or, you know, if the wife mentions the child in the back -- it can entirely disappear." 

So something that is not routine - like the fourth person not being home for dinner, or not going to work on a weekday - can be easily forgotten by the conscious memory if it's not reinforced, and the autopilot takes over.

The article is wonderful, for its excellent writing (as anyone would expect from Gene Weingarten), its sensitive handling of a delicate subject, and its exploration of how and why these tragedies happen. It is not, as Weingarten point out, because the parents are "bad" or "neglectful." It's not because they don't love their children. There's usually a perfect storm of stress, preoccupation, distraction, and change of routine that leads to a parent doing the unimaginable and leaving their child to die in the car.

We, the public, of course, hear about this happening when a child dies, but I wonder how often it happens that the child is forgotten but found and rescued before overheating, or that the baby is discovered or remembered by the parent before anything terrible happens. How often does it happen on a cold, cloudy day where the child might be hungry and upset but thankfully not overheat? How many times have parents left for just a few minutes before something reminds them to go back to the car and get the baby? I'm sure it's not as uncommon as we'd hope.

The trouble with the assumption that only neglectful, abusive, unloving parents would forget their baby in the car is that it means that those of us who know we are good, loving, attentive parents may not take precautionary measures. After all, if it's not going to happen, why bother worrying about it? The problem with knowing it wouldn't happen to us means that we are just as susceptible.

But what can we do to prevent it?

It's important to remember that these "forgetting" incidents usually happen when we are doing something outside our normal routine. If Mom usually takes the baby to daycare but today Dad is doing it, Dad's routine is disrupted. If Mom doesn't usually take the baby to the store with her but today she does, then Mom's routine is disrupted. If there is usually a baby-sitter at home but today the baby was going to Grandma's house, then the parents' routine is disrupted by dropping the baby off somewhere instead of going straight to work. Also, the typical scenario seems to be that not only is the routine disrupted, but that there are additional distractions, especially stress, that prevent the hippocampus from recording the memory that the baby is in the car. 

I suggest a two-pronged approach. 

First, we need to inform and educate. People need to know that this happens to wealthy parents and poor parents, working parents and stay-at-home parents, white parents and minority parents, adoptive parents and birth parents, parents of many children and parents of one child. Be aware that it could happen, and the circumstances under which it is more likely to happen. Rethink your judgment of others when you read about it in the news. Don't let your knee-jerk reaction be, "I wouldn't let that happen to my child," but rather, "How can I make sure I don't make the same mistake?" 

Also on the subject of education, many people don't realize just how hot a car can get and how fast it can get there. The interior of a parked car on a sunny, mild day can reach 110 degrees Fahrenheit in about 90 minutes even with the windows cracked open. Within 15 minutes, the temperature will already be uncomfortably warm. Think about how it feels to get into your car after it's been sitting in the sun for a few hours. It's hot! You open the windows to cool it off, blast the A/C, try to bring the temperature down to a comfortable zone. Well, imagine that you had been sitting in that car for an hour or two. You'd be very, very hot. Now, remember that babies are not as efficient at regulating their own body temperature as adults are. Plus, they tend to be overdressed for the weather (we don't want them to be cold!) and are cocooned in their bucket-style car seats. They can't unbuckle themselves and open a door to cool off. They can't take off an outer layer of clothing or fan themselves. They'll just keep getting hotter and hotter with no way to get relief. Many well-intentioned parents simply are not aware of the danger they are placing their babies in by leaving them in a car for any length of time (even 10 minutes) on even a mild day.

Second, we need to devise strategies for ourselves to prevent this memory blip from happening in the first place, or to recover the memory before anything terrible happens. Keeping in mind that these events often happen when you are out of your routine, come up with something you do as part of your normal routine and try to disrupt that as well, to jog your conscious memory into thinking about the baby. Once you've decided that you are going to take preventative measures, it's simply a matter of taking steps to minimize the risk. Some suggestions I have are:

  • When the baby is in the car, put something you'll have to take with you when you get out of the car beside, under, or near the baby's car seat in the back, for example, your briefcase, purse, cell phone, work badge, or office key. This way, when you reach for said item and it's not where you'd expect it to be, you'll remember it's in the back with the baby.
  • Leave yourself some kind of visual reminder, such as a brightly-colored Post-It note on the steering wheel or dashboard when you start driving. Maybe write on it "BABY".
  • Give yourself a visual cue for when you glance in the rear-view mirror and see the baby's car seat that will remind you that the baby is in the seat. Perhaps a red ribbon around the handle, or something else that will catch your eye that is only there if the baby is.
  • Keep a teddy bear in the car seat when it's empty. When you put the baby in the car seat, put the teddy bear in the front seat with you. If the teddy is in the front seat, then check the back for the baby!
  • Talk to yourself about the baby and the fact that you are taking the baby somewhere as you drive to reinforce the memory. Better yet, talk to the baby!
  • Have a plan with your partner that whenever you take the baby somewhere s/he will call to check in. For example, if Mom takes the baby to daycare, Dad should call Mom in the morning and ask how drop-off went, or if the baby did anything cute, just to jog the memory.
For resources and information about kids' safety in and around cars, see www.kidsandcars.org. For more on vehicular hyperthermia/heatstroke specifically, see http://www.kidsandcars.org/heatstroke.html.

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