Joanna Fortune: My two-year-old hates the cold 

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My two-year-old daughter is highly sensitive to the cold, particularly in the mornings. It helps when I preheat the car seat with a hot water bottle. She also wants to be up in my arms all the time. I’m still breastfeeding her as it seems to be a huge source of comfort. Should I be worried?

Feeling cold when outdoors without adequate clothing or when it is especially cold outside is a normal sensory response but feeling cold all of the time or when indoors (once the space is adequately heated) can indicate an intolerance to cold or a temperature sensitivity.

Be aware that she is used to the reassuring warmth of skin-to-skin contact enabled by breastfeeding and lying in your arms against your body. This would represent great comfort and contentment to her and it stands to reason she would seek out that type of warmth and cosiness, seeking to be up in your arms, when she feels cold.

There are many reasons for cold sensitivity and I suggest you mention this to your public health nurse as you approach your daughter’s two-year-old developmental check-up. Your daughter may be referred for blood tests if deemed necessary.

In the meantime, observe as best you can how your daughter reacts to other sensory stimuli (noise, light, tastes, smells etc) to see if it is just the cold she is especially sensitive to or other sensory stimulation as well. Observe if her skin changes colour noticeably when in/out of cold — if her skin, especially around fingers or toes pales to very white or even a blue tinge in the cold and switches to rosy pink once back in a warm environment. This is all helpful information when discussing with your Public Health Nurse/GP.

Believe her when she says or shows you that she doesn’t like how the cold feels for her. Dress her in extra layers that add warmth when outside but can be easily removed when indoors. Synthetic materials as under layers serve to pull moisture away from the skin and can be more effective in the cold than layers of cotton. Give her lots of cuddles and hold her close when outdoors. Heating her car seat is very helpful. A hand warmer might also be a helpful addition, just double-check its temperature before you give it to her. Warm drinks and food before or after being outdoors can also help.

Ensure she gets plenty of physical activity and movement as this will increase her body temperature. Plan for time running around a park or climbing and sliding in a playground and when you get home have a little disco together so that you can dance the cold away. Play ‘mirrors’ asking that she copy you in moving her arms in circles and wiggling her fingers and toes.

Have warm, fleece-lined slippers for when you get home and warm fluffy socks. Cold can be very unsettling for a small child so responding practically and playfully with comfort and nurture will be reassuring to her.

• If you have a question for child psychotherapist Dr Joanna Fortune, please send it to [e-mail]