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How to keep kids safe in this heat


With temperatures in swaths of the country hitting triple digits this week and predicted to continue into the weekend, summer living can feel like surviving the inside of a kiln.

Parts of the U.S. population are, in fact, living under heat domes, which the National Ocean Service says occurs “when the atmosphere traps hot ocean air like a lid or a cap.”

But even super-high temps don’t mean parents need to keep kids cosseted all day inside of air-conditioned buildings, though physicians say parents should be more aware, more prepared and more attuned to signs of heat-related distress during temperature spikes.

“You can get outside and have as much fun as possible,” says Grant Lipman, an emergency medicine physician and the founder of GOES Health, an app that provides health advice for emergencies. “But be aware that especially with these outrageous heat domes we’re having and extreme weather patterns, think about, ‘How do you prepare for them? And how do you recognize symptoms and signs when the fun stops and people might actually be in harm’s way?’ ”

Lipman and other physicians offered advice for how to keep kids of all ages protected in the heat.

Take precautions at these temps

As temperatures and heat indexes climb into the 90-degree range, parents need to start paying attention to the risk of heat-related illness.

“If your kids are going to be outside, especially in the heat of day, you’ve got to start thinking about that because the cooling mechanisms that we usually have start not to function as well,” says Charles Braverman, a pediatrician with Advocate Children’s Medical Group in suburban Chicago.

Kids, especially babies, don’t sweat as well as adults because their sweat glands are still maturing.

“One of the things I always tell families of newborns: I go, ‘If it’s hot outside, go for a walk, but don’t put 10 outfits and five blankets on your baby,’ which a lot of people do,” Braverman said. “Because babies can overheat just as easily as they can get cold.”

Bridget Wild, a pediatric hospitalist at NorthShore University HealthSystem in Chicago, says younger children are more vulnerable to heat emergencies for three reasons: They may not be able to help themselves to water and salty snacks to replace sweat loss; their baseline heat production is higher than adults due to their higher metabolic rate; and they have a higher ratio of body surface area to mass, which makes them more susceptible to high temperatures.

Middle-schoolers and teens participating in sports are also at increased risk, she says, because the activities they’re engaged in can distract them from realizing they are overheating or dehydrated.

When gauging the heat, parents also need to factor in humidity, says George Chiampas, chief medical officer for U.S. Soccer. “It’s the humidity and the radiant heat, meaning the sunshine, that is probably the most challenging for young children,” he said.

Even temperatures above 80 degrees, combined with humidity higher than 75 percent, should cause parents to “have a higher index of suspicion and be prepared to modify their child’s activities.”

Prepare well for the heat

Hydrate, hydrate, hydrate. And don’t forget about salt.

“Going out is optional, but coming back is mandatory,” said Lipman, riffing off a climbing adage by mountaineer Ed Viesturs.

It’s essential to prepare for activity in the heat, whether it’s a day at the zoo or hike in the mountains, by assessing risks and exposures throughout the entire day, said Lipman, who lives in Redwood City, Calif. Ask questions like, “Is there going to be shade? Do you have ways to cool people down? Do we have enough water? Do we have salty snacks?”

To prevent conditions like hyponatremia, or a decrease in sodium levels in the blood often due to excessive water intake, Lipman suggests giving kids salty snacks like nuts, popcorn and pretzels with every bottle of water they drink. If kids participate in more than 60 minutes of outdoor activity, Chiampas says to offer a sports drink because of its electrolytes.

Chiampas, who’s also the executive director of the Disaster Management and Community Preparedness Initiative at Northwestern Medicine, stresses the importance of dressing kids in light, moisture-wicking clothes that can dissipate heat and absorb sweat.

He adds that, if possible, try to plan the most of your kids’ outdoor activities during the coolest parts of a day, which usually fall before 11 a.m. and after 6 p.m. If your kids must be active during the hottest part of the day, build in frequent and intentional breaks, and make sure they have access to either air conditioning or shade.

He also points out that older kids often go from doing less activity indoors during June and July into full-on, school-related sports practices in August.

“What the risk of that is, is that children or even adolescents are not acclimated, meaning they haven’t been out in the sun for long periods of time exerting themselves,” Chiampas said. “And they essentially go from zero to 100 to get prepared for seasons, and that’s when we see some of the worst outcomes related to heat.”

He says parents can help their kids transition more safely to a sports season by encouraging them to get moderate exercise outdoors for seven to 10 days before their practices start.

Look for signs of struggle

Heat-related illnesses have a spectrum that doctors say begin with heat exhaustion and end with heatstroke, an emergency often involving changes in mental state and a very high core body temperature of 104 degrees or higher that necessitates immediate medical attention.

Early warning signs of heat exhaustion, Lipman says, include hot and flushed skin, decreased interaction, crankiness and dizziness.

Wild says a child experiencing swelling, cramping, nausea, fainting or weakness in the heat should be assessed right away. She recommends moving the child into a shady, cool place to rest, offering water and measuring internal body temperature with an oral or rectal thermometer (as opposed to taking a surface temperature measurement via the forehead).

The best way to cool a child down, she says, is by applying wet washcloths to the skin, spraying them with cold water or giving them a chilly bath.

If you suspect your child is suffering from heatstroke, call for medical help and while waiting, Lipman says to immerse your child up to the shoulders in a lake, bath or pool.

“Cold water immersion the best way to cool down heatstroke,” he said. “That’s the gold standard: the colder, the better.”

Braverman says he wants to leave parents with “one massive” reminder: “This is so, so, so critically important. Never, under any circumstances, leave a child in a car, even if the windows are open. Cars can heat up extraordinarily quickly. Just get in the habit of always looking in the back seat of a car. Always take your kid out of the car.”

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