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Apr 23, 2015

Using a hot tub when pregnant

I am often asked what the risks are of using a hot tub when pregnant. I am asked even more often if it is safe for small children to use a hot tub. I've decided to put my thoughts down for people to weigh up for themselves and make their own decision - that is what this is - my thoughts, experience and facts from research that I have read.

Everyone is so afraid of being sued that the rules in public places seem to have put the fear of God into us all. Most health clubs that I have visited do not allow children under 12 years old to go in the hot tub, sauna or steam room. As for pregnant ladies, the guidance not to use them is there, but if you do decide to, you are asked to sign a disclaimer.

But why?

What are the dangers of using a hot tub when pregnant? - What are the dangers posed to a small child using a hot tub?

Answer = Overheating or the technical term hyperthermia. Hot tubs are designed to maintain a set temperature, so unlike a bath, they shouldn't cool down the longer you stay in it. Children under 5 years old are not as effective at controlling their body temperature. Pregnant women have a similar problem in the fact that they overheat much quicker with their little hot water bottle growing inside them.

The most common form of overheating is heat stroke. Symptoms are dizziness, vomiting, headaches, low blood pressure - pretty unpleasant really. I remember feeling like this and ending up on the floor of a restaurant in Cyprus when I was 14 years old, I know it sucks and it can be quite dangerous. So like sitting in the midday sun, using a hot tub requires caution and a little common sense.

Applying common sense when using a hot tub

Even though the incident in Cyprus was many moons ago, I still worry about ending up prostrate due to overheating. This is what I do, did while I was pregnant and allow my children to do.

The temperature of our hot tub is kept at 37.5c - this is slightly above the normal body temperature of a human being (37c), so shouldn't cause body temperature to rise above it's normal level. As far as I understand, the problem of overheating normally occurs when the temperature of the hot tub water is around 40c and higher. This just isn't necessary, you will find the hot tub much more enjoyable at 37.5c than you will sweating away at 40c.

Children in the hot tubMost hot tubs have seats with varying heights. Move around the hot tub and make sure that every 5 minutes or so you sit in a seat where your shoulders are above the water level. This will help you to regulate your body temperature. Children under 5 years old are highly unlikely to be sat still in a seat. They are more likely to be walking around on the seats, swimming across the hot tub or throwing the water out over the side. Having said that, I always make sure that little J does not spend more than a few minutes stood in the middle of the hot tub where his shoulders are under the water.

Do not stay in the hot tub for too long. The recommended time is 20 minutes. I am the first to admit that I stay in longer, but I do make sure that my shoulders are regularly out of the water. I am strict on the length of time little J stays in though - much to his disgust!

Take a drink of water (in a plastic cup) with you and sip it regularly. As with heat from the sun, a hot tub can make you feel thirsty.

Make sure the water is maintained correctly and is balanced. This will make sure there is no bacteria in the water that could cause any skin irritation or infection.

Little J always wears a disposable swim nappy and a happy nappy to stop and unwanted debris floating on the hot tub water. This would mean a drain and refill, so for £8.99 it is worth the investment.

Never leave a child unsupervised near the water, even for a second. If you are pregnant, always make sure someone is with you - if for no other reason than to help you in and out.

Just like you would if you were taking your child to a swimming pool, discourage them from drinking the water. I operate a 3 strike policy, then they're out. I'm not suggesting it's dangerous, but I can't see that it is good for you either.

Regularly check the condition of the suction covers in the footwell of your hot tub.

Make sure long hair is tied back when in the hot tub.

I didn't use the hot tub during my first trimester of pregnancy (first 12 weeks). I felt pretty rough anyway, but there is research out there that lead me to the opinion that it wasn't worth the risk - even though the water in our hot tub is kept at a lower temperature. Exposing your body to high temperatures (whether that be sun, sauna or hot water) during the first trimester of pregnancy doubles the risk of neural tube defects. The doubled risk is about 6 in 1000, rather than 3 in 1000*, but doubling the risk of anything makes me think twice.

The other concern I've heard is the risk of ear infections. Logic tells me that you are less likely to pick up an ear infection from the water in your own hot tub than you are in a public swimming pool. After all, you maintain the water chemistry and it is your family using the hot tub, therefore your germs (if any) that are around the hot tub. Some children are prone to ear infections. If this is the case, you are likely to discourage your child from putting their ears underwater in the bath. I would suggest this should be the same for the hot tub and swimming pool. There are ear plugs and ear covers that can be used when in the hot tub, so they might be a good investment.


Enjoy the time in your hot tub together as a family away from technology & relax your aching body when pregnant in the soothing waters, but be cautious & avoid getting too hot. Hot tubs are amazing memory makers and if used with a little common sense can be great for all the family.

If you have any questions, please let me know - but most of all enjoy!

*source Moretti, et al 2005 Hyperthermia & the risk of Neural Tube Defects in Offspring: Review and Meta-Analysis. Epidemiology 16(2): 216-219

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