Daycares without air conditioning risk heat illness in babies and toddlers, advocates say

On the hottest days last summer, Lyndsay MacKay would pick up her 16-month-old son from daycare to find him sticky with sweat, his hair plastered to his head. He would collapse in her arms. Some nights, he'd fall asleep at the dinner table.

MacKay, an early childhood education professor at Humber Polytechnic in Toronto, is among a growing number of parents, educators, health and legal advocates across Canada lobbying for maximum indoor temperature standards at daycares—likely 26 degrees Celsius, modelled on standards Ontario has already adopted for long-term care facilities.

Infants, toddlers and preschool-aged children face higher risk of heat exhaustion and heatstroke than adults. Their metabolism generates more heat in their bodies. Their sweat glands are less efficient at cooling them down. And babies and young toddlers cannot tell caregivers they are overheated.

Dr. Kirstin Weerdenburg, a pediatrician in the emergency department at Halifax's IWK Health Centre, notes that even preschoolers lack the ability to explain how they are feeling. "They don't have a way to explain how they're feeling, so it's knowing their behaviours and all those other physical signs and symptoms," she said. "If someone's not paying attention to that, they might get looked over until you get to the more extremes."

Symptoms in young children include fatigue, flushed skin, irritability, and trouble walking—a sign of dizziness. Kids can often be treated at home with fluids and a cool room. In extreme cases, dehydration can leave babies too tired to drink, requiring IV fluids. In the most severe cases, organs like the liver and kidney can shut down as the body redirects blood to the skin to cool it. The heart speeds up, causing arrhythmia.

Educators say monitoring for signs of heatstroke is stressful when they are not trained health-care professionals. Amy O'Neil, executive director of Toronto's Treetop Children's Centre, introduced air-conditioning at her centre in 2019. She also chairs Toronto Community for Better Child Care, an advocacy group of parents and educators for well-funded, publicly available child care. "It's really hard to understand why the legislation—and in Ontario, it's the Child Care and Early Years Act—is so clear," O'Neil said, implying that stronger temperature standards should already be law.

Daycares currently address heat through ice cubes in water tables, popsicles, darkening rooms, and cool cloths—measures MacKay saw at her son's centre. "But they're still hot, they're sweaty, they're exhausted," she said. "From a health and safety and from a development perspective, the children are almost just surviving the day."