Dr. Bob: I am worried about my children playing out in the summer heat. They want to be outside, and I want them to get exercise. But when the heat index is so high, I worry about them getting heatstroke. Plus, my oldest son is playing football and they practice in the intense heat sometimes. What is your advice?
Answer: You are right to be concerned. Children can be very vulnerable to heat-related injuries and should be protected. We do want our children to get exercise, so we need to practice proper safety measures when they are outside. When they are outside on a day with high temperature and high humidity, we know that there is a higher heat index and we tend not to regulate our body temperature well. Let’s review some safety measures –
- It is imperative that children maintain adequate hydration. They should be getting water or a sports drink at least every 20 minutes. Breaks should be mandatory.
- If the children are just starting strenuous activity in the heat, they should gradually increase the intensity of the activity. For example, if they are going to a camp, initial activities over the first several days should be mild before more vigorous activities are planned.
- Light-colored clothing is recommended and preferably it is fabric that is wicking (tending to take the sweat away from the skin). Remember that sweating is our body’s way of losing heat (the cool moisture tends to keep the temperature stable instead of overheating). Change shirts if they get too saturated.
- If at the beach or at the pool, please remember to adhere to the same drink guidelines. It is easy to get lulled into a false sense of security when you see the waves splashing at your feet or you are jumping in the pool. You can still get dehydrated in those settings.
- Also remember that the hot sun at the beach or at the pool can contribute to being overheated and easily dehydrated. The necessary sunscreen to protect the skin might inadvertently contribute to overheating if adequate hydration measures are not taken.
- Please remember that little children are at greater risk of heat-related injuries. Whether at the pool or at the beach, they will need water frequently. They are less likely to ask for it, and it is imperative that we are active in urging them to drink. Don’t take no for an answer.
- Whenever you leave your car, be sure that your children are not left in the car. Every year some tragic deaths occur due to this error.
- Football practices in the late summer should have adequate water breaks – every 15-20 minutes. The practices should be scheduled when the hot overhead sun is less of a factor, in the early am or late afternoon. Your son should be instructed in the signs of early heat exhaustion or heat stroke.
The signs and symptoms of heat problems include excess sweating, cool or clammy skin, nausea, headache, fatigue, lightheadedness, dizziness, rapid pulse, cramping, faintness, or lack of urination. Any of those signs should be considered a trouble sign. Stop exercise immediately. Get in a cool place. Drink fluids. Seek emergency care if any of these signs or symptoms are present. Heat-related injuries are potentially fatal and should be treated seriously.
I passed out once in the heat when I was not drinking an adequate amount of water, so I have experienced heat-related problems first-hand. Let’s not take a risk with our children.
Dr. Saul is Professor of Pediatrics (Emeritus) at Prisma Health and his website is www.mychildrenschildren.com. Contact Dr. Bob at askdrbobsaul@gmail.com with more questions.