Beat The Heat—and Heat-Related Illnesses

by Heidi Green
July 18, 2012

Staying cool can be a real challenge during the dog days of summer. As temperatures soar, as humidity rises, and we engage in vigorous outdoor activity, the risk of heat-related illness—heat cramps, heat exhaustion, or heatstroke—rises too. The risk is even greater for children, whose bodies overheat 3–5 times more quickly than adults. Children may not understand cautions to “stay hydrated,” and they may be more susceptible to conditions that typically wouldn’t cause health problems at other times of the year.

To keep your family safe from heat-related illnesses, you need to know what they are and what causes them. Read on to learn more about how to identify these illnesses, what you can do if your child is affected, and what you can do to keep them from happening in the first place.

Heat-related illnesses
Heat cramps. Children may experience painful cramps throughout their body as a result of high activity in extreme heat. Sweating causes a loss of fluid and electrolytes. If the fluids and salts are not replaced, children develop muscle cramps. Fortunately, heat cramps can be easily treated, by moving your child to a cool, shaded place to rest and giving him fluids.

Heat exhaustion. Also the result of a lack of fluids, heat exhaustion is a more serious heat-related illness. Symptoms can include: dehydration; fatigue; weakness; clammy skin; headache; nausea; vomiting; rapid breathing; and irritability. Heat exhaustion should be treated promptly; if left untreated, it can quickly escalate into heatstroke. Get your child indoors or, if that’s not possible, into the shade. Loosen or remove your child’s clothing, and give him something to drink and eat. Bathe your child in cool (not cold) water. You will want to monitor your child’s body temperature; cooling strategies should continue until his body temperature reaches about 101 degrees F. Your child may need to go to the hospital if he is so affected by heat exhaustion that he is unable to eat or drink; rehydration is essential, and IV fluids may be necessary.

Heatstroke. Heatstroke is a life-threatening medical emergency in which the body is unable to regulate its temperature. Symptoms include: flushed, hot, dry skin without sweating; temperature of 104 degrees F or higher; severe, throbbing headache; weakness, dizziness, or confusion; fatigue; seizure; unresponsiveness; loss of consciousness. If your child shows signs of heatstroke, call 911 immediately. While waiting for help, get your child indoors or into the shade. Remove your child’s clothing, and douse him with cool or tepid water (such as from a garden hose). Fan him, to promote sweating and evaporation. If available, place ice packs around the groin, neck, and armpits—areas where large blood vessels are close to the skin surface. Do not immerse your child in an ice bath. There is a high risk of choking if you give your child fluids, but if you can safely do so, sit him up and try to give him small sips.

Preventing heat-related illness
It is impossible to know the full extent of heat-related illness, since many cases go unreported. Heat cramps and heat exhaustion, for example, are typically treated at home. But given the influence of climate change, some experts have suggested that the incidence of heatstroke and related fatalities will become more prevalent.

To prevent heat-related illness in your children:

• Never leave your child alone in a hot car, even for a few minutes. In 2010, 49 U.S. children between the ages of 2 months and 6 years died from car-related heatstroke. Temperatures inside a car can climb quickly, even with the windows open. Young children are unable to regulate their body temperature effectively, so it must be controlled through their environment and with fluids.
• Think “Where’s baby? Look before you lock.” The theme of a new campaign by the National Highway Traffic Safety Administration (NHTSA) and Safe Kids Worldwide to help prevent child deaths from heatstroke encourages parents to get in the habit of looking in their whole vehicle—front and back—before locking the door and walking away. Another good tip: place something you will need at your last stop (i.e., a cell phone, a briefcase, a purse) next to the child or under his feet, so that you must check the back seat before you leave the car. Since car-related heatstroke tends to happen when parents or caregivers change their routine and forget a child, ask someone to phone you after drop-off if your child doesn’t arrive where they should (i.e., a child care provider, a partner, a parent).
• Always lock your car when it is not in use. Thirty percent of all recorded heatstroke deaths in the U.S. occur when an unattended child gets into an unlocked vehicle (such as when playing Hide-and-Seek). Always thoroughly check your car before locking it and lock it when it’s not in use.
• Remind kids to drink plenty of fluids. Children should drink enough liquid to replace lost fluids and salt, even if they don’t feel thirsty, approximately every 20–30 minutes. A child weighing about 88 pounds should consume about 5 oz of water or sports drinks (not soda, juice, or other fruit drinks) at a time. In addition to thirst, other signs of dehydration include dizziness, dry mouth, irritability, lethargy, fatigue, dark yellow urine, sunken eyes, and lack of sweat, tears, or urine. Breastfed infants will have their needs met through their mother’s milk, which is roughly 88 percent water. Since giving water to your baby can reduce the amount of milk your body makes, and since excess water can cause hyponatremia, a rare but serious condition, it is best to avoid giving your baby any water for at least six months and up to 1 year of age. Once babies are consuming a variety of foods in addition to breast milk or formula, giving your baby small sips of water in a cup is likely safe. Since there is no evidence to show a safe, upper limit, however, it is best to stick with sips of water rather than ounces of water.
• Dress children for the weather. Light-colored, loose-fitting clothing and hats are the best protection against the sun and heat. Even indoors (in cribs), infants may be susceptible to heatstroke if they are overbundled. Indoor temperatures between 68 and 72 are ideal for infants. When dressing your infant or child, use your own comfort as a gauge of what’s appropriate, and add no more than one additional layer.
• Avoid the sun during the hottest part of the day. Skip vigorous outside activity during the hours of 10 a.m. to 2 p.m. Stay in the shade, when possible, and pack healthy snacks that include plenty of fluids.
• Teach kids to be aware of how they feel. Tell your children why it’s important to recognize when they feel overheated. Remind them that if they feel overheated, they should take a break, come indoors or find shade, and get a drink right away.

Heidi Green has been researching and writing about women’s and children health since she moved to Pittsburgh more than 10 years ago. She is also a children’s book reviewer in her spare time. She is mom to Ben, Katie, Sam, and Max.