How to keep kids safe in the heat

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With temperatures in parts of the country in the triple digits this week and forecast to continue into the weekend, summer life can feel like surviving inside a kiln.

Portions of the US population actually live under heat domes, which occur “when the atmosphere traps hot ocean air like a lid or cap,” according to the National Ocean Service.

But even super high temperatures don’t mean parents have to coddle kids in air-conditioned buildings all day, although doctors say parents should be more aware, better prepared and better prepared for signs of heat-related stress during temperature spikes.

“You can get outside and have as much fun as you can,” says Grant Lipman, emergency medicine physician and founder of GOES Health, an app that provides emergency health advice. “But know that especially with these unprecedented heat domes and extreme weather patterns, you’re thinking, ‘How are you preparing for this? And how do you recognize symptoms and signs when the fun stops and people are actually in danger?’ ”

Lipman and other doctors offered advice on protecting children of all ages from heat.

Take precautions at these temperatures

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

“When your kids are outside, especially in the heat of the day, you have to think about it because the cooling mechanisms that we normally have are starting to not work as well,” says Charles Braverman, a pediatrician at Advocate Children’s Medical Group in a suburb of Chicago.

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

“One of the things I always say to families of newborns: I say, ‘If it’s hot outside, go for a walk, but don’t dress your baby in ten outfits and five blankets,’ which a lot of people do,” Braverman said. “Because babies can overheat just as easily as they can freeze.”

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

Middle school students and teens who play sports are also at increased risk, she says, because the activities they participate in can distract them from realizing they’re overheating or dehydrated.

When measuring heat, parents also need to consider humidity, says US Soccer’s chief medical officer George Chiampas. “The humidity and the blazing heat, meaning the sun, are probably the biggest challenges for young children,” he said.

Even temperatures over 80 degrees, combined with humidity levels in excess of 75 percent, should prompt parents to “have a higher index of distrust and be willing to change their child’s activities.”

Prepare well for the heat

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

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

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

To help prevent conditions like hyponatremia, or a drop in blood sodium levels that often result from excess water intake, Lipman suggests giving kids salty snacks like nuts, popcorn, and pretzels with every bottle of water they drink. If kids participate in outdoor activities for more than 60 minutes, Chiampas says to offer them a sports drink for their electrolytes.

Chiampas, who is also executive director of the Disaster Management and Community Preparedness Initiative at Northwestern Medicine, emphasizes the importance of dressing children in lightweight, moisture-wicking clothing that can wick away heat and absorb sweat.

He adds that if possible, try to schedule most of your children’s outdoor activities during the coolest times of the day, which are usually before 11:00 am and after 6:00 pm. If your kids need to be active during the hottest part of the day, build in frequent and intentional breaks and make sure they have either access to air conditioning or shade.

He also points out that older children often transition from less indoor activity in June and July to full-fledged, school-related exercise in August.

“The risk is that children or even adolescents are not acclimatized, which means they have not been in the sun for a long time and they are exerting themselves,” Chiampas said. “And they essentially go from zero to 100 to prepare for the seasons and then we see some of the worst heat-related results.”

He says parents can help their children transition into a sporting season more confidently by encouraging them to engage in moderate physical activity seven to 10 days before starting outdoor training.

Look for signs of struggle

Heat-related illnesses have a spectrum that doctors say begins with heat exhaustion and ends with heat stroke, an emergency often associated with changes in mental status and a very high core body temperature of 104 degrees or higher that requires immediate medical attention.

According to Lipman, early warning signs of heat stroke include hot and flushed skin, decreased interaction, nausea and dizziness.

Wild says a child with swelling, cramps, nausea, fainting, or weakness in the heat should be evaluated immediately. She recommends putting the child in a shaded, cool place to rest, offering water, and taking internal body temperature with an oral or rectal thermometer (as opposed to a forehead surface temperature measurement).

The best way to cool a child down, she says, is to place wet washcloths on their skin, spray them with cold water, or give them a cool bath.

If you suspect your child is suffering from heat stroke, call a doctor and while you wait, Lipman says to immerse your child up to their shoulders in a lake, bath or pool.

“Soaking in cold water is the best way to cool off a heat stroke,” he said. “That’s the gold standard: the colder the better.”

Braverman says he wants to leave parents with “a massive” reminder: “This is so, so, so crucially important. Under no circumstances should you leave a child in the car, even with the windows open. Cars can heat up extremely quickly. Just get in the habit of always looking in the back seat of a car. Always take your child out of the car.”

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