It's All About the Children

As I cringed hearing the thermostat would be reaching 100° F this upcoming week, I thought of all the children who will be outside, whether it be at summer camps, the local parks, or even just in the backyard by the pool.  And while children may not realize the perils of the summer sun, it is important that all caregivers understand that a child's internal thermostat is very sensitive to the extreme heat and the following list of conditions:

1. Heat Rash: I see this all the time although it can appear rather unremarkable. Think of it as a skin irritation secondary to the increased sweating on a hot day. No real treatment other than trying to keep the area dry and maintain a cool environment.
2. Heat Cramps: This often occurs on hot days while performing strenuous activity (although it can even occur a few hours later). With the sweating and loss of salt through the skin, the muscles often begin cramping. Treatment usually involves rehydration with electrolyte based fluids. Of note, this can also be a symptom of heat exhaustion.
3. Heat Exhaustion: Although the elderly are most prone to this condition, athletes training hard during hot days may be susceptible as well. It often develops after several days of exposure to high temperatures and imbalances of the body's fluids and electrolytes. Among others, symptoms include heat cramps, headache, nausea, dizziness, and a mild elevation of body temperature. It is very important to get the individual into a cool environment and lay him down with feet and legs slightly elevated, to drink cool water, and even spray him down with cool water.
4. Heat Stroke: An extremely concerning condition where the body is unable to regulate its temperature. The core temperature rises rapidly and with the child unable to sweat, the body is unable to cool down. This is when temperatures can get to levels (above 106° F) with disastrous consequences. Symptoms which may occur include delirium, seizures, and loss of consciousness. If heat stroke is suspected, contact 911 immediately and/or transfer to your local emergency room for further care.
5. Heat-Related Deaths: This follows when the body is unable to handle the high temperatures. Very young children or those with chronic medical conditions are at highest risk.

So how do we prevent these potentially life-threatening heat related illnesses? With thanks to the CDC and the AAP and a few thoughts of my own, here is a list of a few things that can be done:

1. As babies are extremely sensitive to the effects of the heat, it's best to avoid sun exposure altogether. However, if outside, use of lightweight long pants and shirts and brimmed hats that cover the neck are recommended. But if this is not available, it's ok to use sunscreen with at least a 15 SPF (I usually recommend a higher SPF and will use it down to my 2 month old infants I care for if they will be in the sun). If a sunburn occurs, use cold compresses on the affected areas. And best to apply the sunscreen at least 30 minutes before going outside and reapply every couple of hours.
2. Avoid sun at peak times which is usually between 10:00am and 4:00pm.
3. Hydration (as with most things) is key. Water and non-caffeinated drinks are best and if it is a prolonged activity, 5 oz. of cold water or a "sports" drink for a 90 lb. child or 9 oz. for a 130 lb. child is recommended each 20 minutes, regardless of the thirst factor.
4. For the older child/adolescent, light-colored and lightweight clothing and only one layer of absorbent material should be used.
5. Close monitoring for signs and symptoms of heat stroke and exhaustion (see above).
6. AND NEVER EVER LEAVE YOUR CHILD ALONE IN A CAR. The temperature inside a car can rise 20 degrees within 10 minutes.

So enjoy the fun summertime brings but watch out for the heat that often ensues.

Dr. Jeremy