June 18, 2013
With temperatures pushing triple digits around the country and kids enjoying the outdoor joys of summer, ensuring adequate hydration is a high priority. This is especially critical for children engaging in strenuous outdoor physical activity on hot and humid days when the risk of heat-related illness is most severe.
While parents, coaches, physical education teachers and recess aides should be well-versed in the importance of hydration in preventing heat-related illness, school-aged children can also take an active role in maintaining adequate hydration during the hot summer days.
Here are five tips to share with your kids to help them stay well-hydrated when it is hot outside.
- Pre-hydrate. How hydrated your child is before heading outdoors is just as important as how well-hydrated he is during exercise. In fact, kids who start activity mildly dehydrated are at increased risk of heat-related illness. Help to avoid problems by encouraging your child to drink 6 to 8 ounces of water before heading out the door.
- Bring water. Any time the kids are headed out to play, they should bring water with them. Typically, about 3 to 8 ounces of water for every 20 minutes of physical activity for nine- to 12-year olds should be appropriate. Younger kids may need a little bit less. Older kids need about 11 to 16 ounces every 20 minutes. Although water is usually sufficient to maintain adequate hydration, alternating water intake with a sodium-containing sports drink may be warranted for exercise lasting longer than one hour, multiple workouts in one day, sport participation, or other intense physical activity. (Other than the above listed situations, sports drinks are generally unnecessary and provide nothing more than excess calories.)
- Have your child sit out if he or she is feeling under the weather. Children and adolescents getting over an illness, especially one involving vomiting and/or diarrhea or fever (symptoms that contribute to dehydration), should return to activity slowly and pay special attention to hydration.
- Recognize signs of heat-related illness. If your child develops any of the following signs of heat illness during activity, he or she should know to ask to be taken out of the game and seek attention from an adult: bright-red flushing of the cheeks and face, dizziness, headache, vomiting, feeling very cold or very hot, change in mentation, heat cramps, an acute worsening of performance, or any other alarming changes in mental or physical status.
- Rehydrate. Drinking adequate fluids after exercise helps to replace fluids lost from sweat and correct any remaining fluid deficits. How much fluid your child needs depends on many factors, including his or her age, duration and intensity of exercise, amount of sweat lost, and heat and humidity levels. Your child could use several strategies to assess the amount needed and adequacy of rehydration. To be scientific, you could weigh your child before and after exercise and use the difference in weight to determine how much fluid is needed. (For example, a 1 pound weight loss = 16-ounce fluid deficit; a one-half pound weight loss = 8-ounce fluid deficit.) Your child could also use feelings of thirst to guide intake. A rough indicator of good hydration status is when urine color is faint-yellow to clear.
Heat-related illness is dangerous and can potentially lead to severe complications including organ damage or even death. The good news is that heat-related illness is highly preventable with appropriate attention to hydration and immediate action in response to signs or symptoms of heat stress. Educating children and adolescents on the importance of hydration before, during, and after exercise—especially in hot and humid conditions—helps to ensure safe and enjoyable summer fun.
By Natalie Digate Muth
Natalie Digate Muth, MD, MPH, RD, FAAPNatalie Digate Muth, MD, MPH, RD, FAAP is the Healthcare Solutions Director for the American Council on Exercise, a board-certified pediatrician and Fellow of the American Academy of Pediatrics, a Diplomat of the American Board of Obesity Medicine, registered dietitian and board-certified specialist in sports dietetics, and ACE-certified health coach. She is the author of "Eat Your Vegetables" and Other Mistakes Parents Make: Redefining How to Raise Healthy Eaters" and the upcoming textbook "Sports Nutrition for Health Professionals". She has been ACE certified since 1998.