Summer is a wonderful time for kids.  They are free from school to spend time playing, swimming, and going to camp.  Unfortunately it is also the right time for heat related problems. The worst of these is heat stroke.  But let’s start with the mildest.

Heat Rash.

This is the little red bumpy rash that babies tend to get when it’s hot and they’re sweating.  It mostly occurs on the neck, chest, groin, and elbow creases. Like many baby rashes this one won’t hurt the baby.  However, it does indicate the baby is a little warm, so taking them into a cool place and changing out their sweaty clothes can help.  

Sunburn.

Already discussed sunburn along with sunscreen a few weeks ago.  I will note, however, that if you have a sunburn, it makes it harder for your body to regulate its temperature.  

Heat Cramps.

This is muscle pain or spasms – especially in the belly, legs, or arms – that can happen when active and sweaty in a hot environment.  The amount of sweat leads to dehydration and loss of salt, which leads to the cramps. These can also be part of the signs of heat exhaustion, so it is important to pay attention to them.  

If your child starts to get these, have them go sit in a cool place and rest.  Give them water or a (low sugar) sports drink. Wait a few hours before going back to the activity.  If the pain lasts longer than an hour consider having them seen by a doctor.

Heat Exhaustion.

This is not as bad as heat stroke, but still a significant heat related illness.  It can happen when someone is spending a lot of time out in the heat without enough to drink or enough time to cool down, and especially when they are being active.  Symptoms include heavy sweating, muscle cramps, weakness, nausea and vomiting, fainting. The skin can be cool, the heart rate fast, and breathing fast and shallow. 

Treatment for heat exhaustion starts similarly to heat cramps – move the child to a cool place and have them rest and slowly drink cool drinks.  However, you need to be a bit more aggressive with cooling including moving them to air conditioning, cooling them with cool cloths, or even having them take a cool bath.  If not improving within an hour, or getting worse, get medical help. 

If heat exhaustion is not treated, it can continue to get worse and become heat stroke.  Even if it’s treated on time, I have seen the weakness last for a few days.  

Heat Stroke.

Heat stroke is when the body is unable to control its temperature so much that its internal temperature can rise to up to 106F within minutes.  This can cause damage to the brain as well as the other organs. If not treated quickly it can lead to death. 

Similar to heat exhaustion, someone with heat stroke may have a headache, dizziness, nausea, and passing out.  Their pulse will also be fast, but in heat stroke it will be strong and not weak. Instead of cold, pale, and clammy skin of heat exhaustion, someone with heat stroke will have skin that’s hot and red.  They can be confused. With heat stroke, their temperature will be 103F or higher.  

Heat stroke is an emergency, so call 911 immediately.  Then move the person to a cool place, and do your best to get their temperature down as soon as you can.  If possible, remove the clothing and place in a cold or ice water bath. If that’s not available, then put ice packs at the armpits, groin, and neck until help comes.  Do not give them anything to drink.  

How to help your child be safe in the heat.

As with many other illnesses those most at risk are the very young and the very old, although anyone can get heat exhaustion or heat stroke.  People who are ill or have recently been ill, the overweight, those on certain medications, and those who are very active are also at risk. Wearing heavy padding or other protective gear, or dark clothing can decrease the body’s ability to release heat.  Humidity slows the cooling the body can get from sweating.    

Basic heat safety is common sense.  Stay under the shade or in a cool building, schedule activities during the morning or evening, and pay attention to how your body is feeling.  A wide-brim hat, sunscreen, and loose-fitting clothing can also help.  

Drink plenty of fluids.  Kids should start drinking before any activities, drink occasionally during, and continue after.  Don’t let them wait until they are thirsty to drink. The AAP suggests an adequate amount is 3-8 oz every 20 minutes from 9-12 years old, and 34-50 oz per hour for older kids.  A good way to check hydration is urine color – light colored or clear urine is best. For the most part water is the best fluid to drink. If, however, the activity is over an hour of hard work, or several episodes a day, an electrolyte drink that has sodium might be called for.  For those over 21, alcohol is not a good choice as it makes it harder for the body to regulate temperature.  

Children can be acclimated to being active in hot temperatures by allowing them them gradually increase the time and intensity of the activity.  In other words, three hours of wind sprints isn’t a good choice for the first day out. Also, giving at least a two hour break in between sessions allows the child’s body to cool down and be rehydrated before another round of heat stress.  The coach or other person responsible for the children should be educated enough to recognize the signs of heat stress and what to do when they see them; all children tolerate heat differently, and even the same child can have a different reaction to heat at different times.  

The child themselves should be taught to pay attention to how their body is functioning and if they are getting too hot.  This, of course, assumes the coach has made sure the kids feel comfortable enough to speak up.  

Bottom Line.

Too much heat can cause illness.  Pay attention to how you are your child are tolerating the heat.  Drink plenty of fluids, and go get cool when needed.

Links.

Tips for preventing heat-related illness.