Children’s Health Andrew’s Institute Director of Sports Medicine Shares Tips to Help Children Avoid Heat Illnesses This Summer

Fort Worth mom of three Lauren Cain loves taking her kids to local parks and being outside as much as possible-but once the heat hits, they head indoors. "We don't spend a lot of time outside if it's above probably 90," she says.

Like Cain, most people look to the temperature or heat index when deciding how hot is too hot, but there are other factors that matter just as much, says Dr. Troy Smurawa, director of pediatric sports medicine at the Andrews Institute at Children's Health.

Kids don't always respond to heat the same way from day to day, so it's important to watch for signs of heat stress-even if they've handled similar conditions before. Children can react differently to the same heat stress depending on the surface they are playing on, the clothes they are wearing, how hydrated they are and even if they took medication that day or not.

What Affects a Child's Risk of Overheating

Heat Acclimation: First, are you acclimated to the heat? If you're from a cooler climate and new to DFW, or even if you've been vacationing somewhere else cooler, your body will be more sensitive until it adjusts-usually over about two weeks.

Conditioning and Activity Level: Conditioning matters, too. If your child is heading into a sports camp or practice without recent activity in the heat, they'll feel the effects much more quickly.

Hydration is another key factor, but it's not as simple as drinking when you're thirsty. By the time kids feel thirsty, they may already be behind. Instead, they need to be consistently drinking fluids throughout the day, especially in the hours leading up to outdoor activity.

Kids can be more vulnerable than adults to dehydration in the heat-not because their bodies work differently, but because they may not recognize early warning signs or stop to hydrate on their own. As Smurawa notes, kids may feel things like thirst or fatigue without understanding they're warning signs.

Once dehydration sets in, it becomes harder for the body to cool itself through sweating, increasing the risk of heat illness. One simple way to monitor hydration is urine color. Hydrated kids will sweat and cool themselves more effectively. Urine should be pale yellow to clear in a well-hydrated child; darker yellow is a warning sign, and an apple-juice color signals severe dehydration.

Medical Conditions and Medications: Some kids are more vulnerable to heat than others. Medical conditions like diabetes, asthma, and sickle-cell trait or disease can increase heat sensitivity. Even common medications like antihistamines can raise the risk of heat illness.

Understanding the Types of Heat Illness

There are four types of heat illness: heat cramps, heat exhaustion, heat stroke, and heat syncope.

Heat cramps are the mildest and can affect one muscle or the whole body. "That's basically a combination of dehydration, low sodium, exercise, and the heat," says Smurawa.

Heat exhaustion and heat stroke share many symptoms, including headache, lightheadedness, and extreme fatigue. "They may feel clumsy, have goosebumps, those types of things."

The key difference is severity-heat stroke involves a dangerously high body temperature (above 105 degrees) and can affect mental status.

"It could be very subtle, just altered behavior. They're just acting funny. They're talking funny. They're in a soccer game, and they're talking about chasing butterflies or something. They could be dry, not sweating at all. That's because they lost their ability to sweat."

Heat syncope is a serious progression, when a child may faint after experiencing symptoms like nausea, dizziness, or extreme fatigue.

"They might start to get a little lightheaded and slow down. They might feel nauseated. They actually might throw up, and they have extreme fatigue."

Kids can move from mild symptoms to more serious heat illness quickly, which is why regular breaks-ideally every 15 to 20 minutes in the shade with water-are critical in hot weather.

Heat Illness Symptoms Age by Age: What Parents Should Watch For

Symptoms can also look different depending on age. Babies and young children may not be able to communicate what they're feeling and might seem unusually fussy, lethargic, or hard to wake, while older kids and teens are more likely to recognize symptoms-but ignore them and push through.

Young Kids:

• Are less aware of what they're feeling
• May not say they're hot, dizzy or nauseated
• Signs often show up as behavior changes:
  • Irritability
  • Lethargy
  • Sudden meltdowns or withdrawal
  • Refusing to keep playing

Older Kids:

• Can recognize symptoms
• But may ignore them or delay speaking up
• Often push through discomfort during play or sports

Teens:

• Are most physically aware of symptoms
• But most likely to override warning signs
• May push through due to peer pressure, competition or coach expectations

To lessen your chance of heat illness, start with these everyday habits.

Plus, we share more ideas on where to go when it's too hot for the playground and how to tell whether your kid's summer camp is taking heat safety seriously.