How to Prevent Heat Stroke: Common Sense Guidelines

When summer heat grows intense, parents need to be mindful of their children’s health. But pediatricians at Children’s Hospital of Philadelphia (CHOP) say there’s no reason to stay indoors all day.

“Kids need outdoor time all year round,” Dr. David Pollack explains. “The activity, the sunlight, the fresh air, and the exposure to nature are all important for their health. And older kids benefit from detaching from computers and electronic devices. On the hottest summer days, parents simply need to observe some common-sense guidelines and pay close attention to how their kids are feeling.”

Recognize the signs of heat exhaustion or heat stroke

Watch for these signs of overheating and heat-related illness:

• Symptoms of heat exhaustion include: pallor (an unhealthy pale appearance), weakness, headache, nausea, muscle cramps or fainting. If you notice any of these signs, even subtle ones, cool your child off and have them drink extra fluid right away.
• Symptoms of heat stroke include: high fever, flushed skin, confusion or loss of consciousness. This condition warrants a call to 911.

Heat exhaustion and heat stroke sound scary, and they are. But your child is unlikely to experience them if you follow simple precautions.

How to prevent heat stroke and overheating

Dr. Pollack offers these precautions and suggestions to stay safe and comfortable on hot days and prevent overheating.

Avoiding heat-related illness in babies and young children

Babies and young children are at greater risk of overheating because they sweat less, which limits their ability to cool down in the heat.

• Take special care not to overdress babies when the weather is hot.
• Give them extra fluid to drink — more breast milk or formula; plenty of additional water if they are weaned. Breastfeeding mothers should drink extra water themselves on hot days.

Avoiding heat-related illness in children of all ages

When your children are old enough to understand and communicate how they’re feeling, remind them to pay attention to their bodies in the heat, and to tell an adult if they don’t feel well or need to take a break. Parents and caregivers can follow these guidelines to help keep everyone in the family cool and healthy on those steamy summer days.

• Keep them hydrated. Remind your kids to drink water regularly, all day long. Bring water with you when you go out so it’s always available. Monitor urine output. If your kids aren’t peeing, they are likely not drinking enough.
• Dress them in light clothes. Children, like adults, need light clothes in hot weather — light in weight and color. Dark colors absorb heat from sunlight, while light colors reflect it. Choose clothes made from lightweight, breathable fabrics, the type of clothing you would be comfortable in yourself when out in the heat.
• Go outside when the sun is low and the air is at its coolest, in the morning and late afternoon or evening. The hours between noon and 4 p.m. are the most dangerous for heat exposure in very hot weather. Use that hottest part of the day for your indoor activities and for resting.
• Allow extra time for rest. Heat is tiring, and especially tiring for children. Plan you day with breaks for everyone.
• Help your kids cool off. Give them a cool bath or spray them with a water mist. Run their wrists and ankles under cold water. Wipe their heads with a wet towel. If you have a place to swim, bring them, taking care to stay out of the full sun between noon and 4 p.m.
• Never leave a child unattended in the car. Cars heat up quickly to dangerous temperatures when parked in the sun, even when it isn’t hot outside. When you park, check the back seat to make sure everyone is out of the car before you leave it.
• Keep your home cool. If you don’t have air conditioning, open windows for ventilation and run a fan.
• Find air-conditioned public spaces. You might spend part of your day at the library or a mall.

Many cities and communities have "cooling centers," which may be libraries or community centers with AC that residents can utilize if they don't have AC in their homes. For example, Philadelphia has a list of local cooling centers.

How to prevent heat illness in young athletes

All the advice above still applies but there are a few extra things to keep in mind for young athletes exercising during summer months. To stay cool while playing sports in the summer and early fall, Dr. Naomi Brown, a pediatric sports medicine specialist at CHOP, offers the following tips:

• Get acclimated to the heat. If your child has been spending a lot of time in air conditioning, have them do light exercise outside for 10-15 minutes at a time, to start getting them used to the hot weather. It can take 10-14 days for young bodies to get used to exercising for extended periods of time in the heat. 
• Train in the morning or evening. If possible, have your child do outdoor training in the early morning or later in the evening, when it’s the coolest. They should avoid exercising during the hottest part of the day, specifically between 10-4.
• Stay hydrated. Water is most important but young athletes, but they can also benefit from electrolyte replacement if they are sweating more than usual. Make sure they’re staying hydrated with water and supplement with a sports drink like Gatorade.
• Use the buddy system. Tell your child the symptoms of heat illness: dizziness, headache, vomiting, unusual behavior and disorientation. This way, they can tell a parent or coach if they’ll feeling ill or see one of their teammates struggling with the heat. This is especially true if your child has sickle cell trait, as they are at increased risk of heat-related illness.
• Wear sunscreen and light-colored clothes and be aware of the medications your athlete is taking. For example, antihistamines that include diphenhydramine make you sweat less and doxycycline makes you more sun-sensitive.