Do babies need hats?

No and yes. | S&D for  snackdinner

No and yes. | S&D for snackdinner

Does my baby need to wear a hat when she leaves the hospital? Does she need to wear a hat from the house to the car? In the car? When we walk three blocks on a cold but sunny day? What about at a restaurant with air conditioning? Should she wear a hat during naps? If so, how do I get her to keep it on?

Parents have a surprising number of baby hat queries, and the answer to nearly all of them depends on how cute your baby looks in hats.

The only time a baby may need a hat is in the delivery room. So lets zoom in on those first hours or days in the hospital. Do newborns need hats shortly after birth?

The medical argument for newborn hats is that they aid in heat retention, which may be important after delivery. Babies heads are huge in proportion to the rest of their bodies, so covering the exposed skin of the head can help babies retain heat. This is especially important for preterm infants or those with low birth weight, as both groups are at risk for hypothermia.

If youre looking for a scientific study that proves hats help prevent hypothermia in infants, though, there arent many to choose from, though it was the subject of a dissertation in the same year I was born that suggests hats keep preterm babies warmer.

Its not clear how much heat those hats keep in, perhaps because during those crucial early hours of life doctors and medical researchers have better, potentially more life-saving interventions to study than hats. But even if they did have time to spare, they might not test babies with hats and without hats, because hats are part of the standard of care in many hospitals and it may be considered unethical to break from that standard and assign babies to hatless groups.

Although there hasnt been a lot of research into hats, some researchers have asked whether the hypothermia those hats are attempting to prevent leads to serious health consequences for infants. The Cochrane review of hypothermia prevention methods found that there was no reduction in deaths from the various means of preventing hypothermia and only limited improvement in short-term complications or illnesses normally associated with being cold. Basically, although we assume babies who are cold may suffer more complications, something else (low birth weight, for example) may be a more likely cause. Hats might keep babies slightly warmer, but most healthy babies might not need to be kept slightly warmer to begin with.

The medical argument for infant hats assumes that the hats benefit the infants. The evidence for this conclusion is mixed, with perhaps a slight nudge toward hats for the additional heat retention. But the most powerful argument for infant hats is the benefits they give to parents.

Newborn hats have tons of non-medical uses. They cover up the babys skin so that parents obsess less over washing it right away. They look darling in birth announcements. They cover bald spots and make the first thrown-on onesie from the drawer look like a careful sartorial choice.

They also make babies look less scary. In a photo taken the night of his birthday, my splotchy, lanugo-covered, ear-crumpled, NICU-bound baby looked terrifying. The next night, outfitted with an IV and NG tube, he looked even scarier.

But the third night, with an eye-popping swaddle and that ubiquitous white, pink, and blue hospital-issued hat, he lookedcute. You could almost ignore the tube. On the fourth night, after the box of hand-knit hats from my mom arrived, he looked downright adorable.

Fourteen nights after that, I noticed that the first of those tiny cabled hats was too small, and experienced for the first time the special joy of a child outgrowing his clothes.

All those tiny hats helped me through the terror of the NICU, and the run-of-the-mill terror of becoming a parent for the first time. Babies may not need hats. But sometimes, their parents do.