Until those tests are finished, the cause of death has been deferred, said Susan Siu, chief investigator for the medical examiner. She did not know how long the tests would take.

The child has been positively identified as Anuhea Paet. Her mother is a 31-year-old Kane'ohe resident.

The autopsy results are needed before police can decide on whether to file criminal charges against the baby’s mother.

"The investigation is continuing and if there needs to be an arrest, there will be one," said police homicide Lt. Bill Kato. "The investigation has to run its course and the autopsy has to come up with something that indicates an arrest is warranted."

The case is still classified as an unattended death, he said.

Kato said the baby’s mother left her in her car — which was parked in the sun in a Kane'ohe parking lot — from 7:15 to 11:30 a.m. About 11:30 a.m., the mother drove to the Windward YMCA. The baby was found about 1 p.m.

The temperature in Kailua reached 88 degrees on Monday.

"There was a long stretch of about four hours where the baby was left unattended in the car," he said.

Windward YMCA supervisor Roz Hamby said the mother, Susanna Hunt, had been teaching a physical therapy class before finding her daughter in her vehicle.

Hunt and her family declined to comment about the incident yesterday.

Kato said the mother, who lives with the baby’s father, was too distraught to be interviewed on the scene. Patrol officers took a brief statement from her, Kato said.

Hunt is not an employee at the YMCA, said Hamby, group vice president of the Honolulu YMCA.

She works for a Windward physical therapy company, Fukuji & Lum Physical Therapy Association, which has an agreement with the YMCA for the use of its swimming pool. The agreement has been in place for about three years, and the classes take place from noon to 1 p.m. Monday, Wednesday and Friday, Hamby said.

Hamby couldn’t say how long Hunt has been leading the classes but said this was the first time Hunt had brought the child. She said that she assumed Hunt had a regular baby-sitter.

"She was a wonderful instructor, great personality, great with people, someone we enjoyed having around the YMCA," she said.

Hamby said the YMCA has not been able to reach the family since the incident.

"We just want to give them our sympathy and let them know our hearts go out to them," she said.

State health officials warned yesterday that children should never be left unattended in cars.

"Children can suffer heat stroke within minutes, followed by permanent disability or death," said Therese Argoud, childhood injury prevention coordinator in the Department of Health’s Injury Prevention Program.

"Heat stroke can occur when the body temperature reaches 105 degrees Fahrenheit and death at 107 degrees Fahrenheit," said Argoud.

The temperature inside a closed car on a hot day can rise as much as 20 degrees in the first 10 minutes — and continue to rise rapidly.

Even with a window cracked open by 1› inches, the temperature inside a car can rise from the low 90s to above 125 degrees within half an hour, according to a study done by San Francisco State University’s Department of Geosciences.

Children are especially vulnerable to heat because their body temperatures rise three to five times faster than those of adults, Argoud said.

In addition, a baby has less ability to sweat and cool itself than an older child or adult, said Dr. Linda Rosen, deputy health director and a former emergency room physician.

"And their breathing can be affected by being overheated. It can slow down their breathing," Rosen said.

Health officials said there is a general lack of awareness of how easily a small child can get into trouble. "Kids should not be left unattended ever," said Argoud.

According to Janette Fennell, founder and president of the non-profit safety group Kids and Cars, 40 small children have died of hyperthermia in overheated cars this year. In the past five years, a total of 200 infants and small children have died nationally.

"In a very short period of time, a vehicle becomes an oven," said Fennell. "We’ve known of children who have succumbed to the heat in a short time on a 70-degree day when inside the vehicle it was probably 90."

Fennell said that what her organization has found in hyperthermia deaths is that children literally have been forgotten. "It could be a situation where someone really thinks that they had dropped off the baby but they hadn’t," she said. "A common thread is there’s been a change in routine. Maybe dad usually drops off the baby, and today it’s mom, or vice versa. Or usually another child is dropped off first, and there’s been a change."

"We have parents who are multi-tasking, stressed out, and they are really losing sight of the very basic things that we need to protect children," said Nancy Partika, executive director of Healthy Mothers, Healthy Babies.