The American Academy of Pediatrics has issued guidelines on reducing children's risk of heat illnesses.

By Gay Frankenfield
WebMD Feature

Reviewed By Michael Smith

During the dog days of summer, heat stress is a hot issue. Because children can't adapt to high temperatures as well as adults can, they're at high risk for heat exhaustion and heatstroke, according to the American Academy of Pediatrics. Experts offer advice on how to help prevent heat stress in kids, including how to avoid dehydration due to exercise.

As the mercury rises, physical exertion and inadequate fluid intake can cause heat exhaustion, with weakness, dizziness, slow pulse, and clammy skin. If sweating fails to cool the body, heat exhaustion can lead to heatstroke, with confusion, collapse, rapid pulse, and dry skin. Heatstroke, which can be accompanied by convulsions or unconsciousness, isn't necessarily fatal, but it can leave survivors with permanent brain damage.

"Because of their size and limited sweat capacity, children are at greater risk for heat-related illness," says pediatric sports medicine specialist Eric Small, MD, an instructor at New York's Mount Sinai School of Medicine and a member of the American Academy of Pediatrics Sports Medicine and Fitness Committee. "So parents and coaches should take preventive measures during the warm weather months."

In July 2000, the American Academy of Pediatrics recommended the following restrictions on activities:

At temperatures below 75ºF, all activities are allowed. However, heat stress can occur at this temperature, so parents should be alert for symptoms.
Between 75ºF and 78.6ºF, there should be longer rest periods, and children should drink adequate fluids every 15 minutes.
Between 79ºF and 84ºF, children who are not acclimatized to the heat or those who are at high risk should stop activity altogether.
Above 85ºF, all athletic activities should be cancelled.

To further reduce the risk of heat stress in children, the Academy developed these guidelines:

During hot and humid conditions, reduce the intensity of physical activity that lasts for more than 15 minutes.
Ensure that kids are well hydrated before prolonged activity.
Enforce drinking of 5 ounces of cold tap water or a flavored salted beverage every 15-20 minutes for children. For adolescents, the recommendations increase to 9 ounces. The Academy stresses that this should be enforced even if the child is not feeling thirsty.
Provide clothing that's light-colored, lightweight, and absorbent.
Replace sweaty garments with dry garments periodically.
If traveling to a warmer climate, increase activity over 10-14 days.

In keeping with the Academy's recommendations, one coach keeps a close eye on the weather. "To assess the risk of heat stress, watch the weather for both temperature and humidity," says Randy Ford, an assistant baseball coach at Penn State University. As the long-time director of baseball summer camps for kids, Ford tells WebMD that high humidity accounts for more heat stress than high temperatures.

"To prevent dehydration, keep cold water near the field and encourage children to drink often, even when they don't feel thirsty," Ford urges. "And to keep kids cool, teach them to wrap ice in a towel and apply it to their neck. Or have them run through a sprinkler between drills."

Children also need to know about the risk of heat stress. "Kids should learn how to play hard and play smart, so teach them how to recognize and prevent heat stress when they're young," Ford advises. "But in doing so, don't forget to mention the importance of three balanced meals and adequate sleep."

If kids show signs of heat stress -- especially dizziness -- time is of the essence. "To avoid heatstroke, encourage them to lie down and sip salted water or a sports beverage," Small says. "But if they become confused or disoriented, call 911 immediately."

Originally published July 19, 2000.

Medically updated May 20, 2003.

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