As we head into the warmer summer months it's important to remember our children's bodies adapt and respond to heat differently than our own. Most of the time here in Southern California we are lucky that our temperate weather doesn't shock too much as we transition between seasons. However, oftentimes our children's levels of outdoor activity do change with picking up a new sport or having more free time in the daylight spring and summer hours. In general, children respond more quickly to changes in heat than adults because they produce more heat "per mass unit" and have a greater surface to body-mass ratio. In addition, children do not sweat as much as adults and therefore may not disperse accumulated heat as well.
The American Academy of Pediatrics summary statement on "climactic heat stress and the exercising child and adolescent" tells us that at any increased level of humidity and at an outdoor temperature of ninety-five degrees or greater, children are particularly at risk to dehydrate rapidly. Unless corrected this dehydration may lead to heat exhaustion or heat stroke in cases of significant and rapid core body temperature increases. Parents must be sensitive to this susceptibility and allow children time to adjust to new humidity and temperature levels prior to expecting them to be as active or perform at the same athletic level. Guidelines suggest children gradually increase their level of activity by fifteen minute intervals over a one-to-two week time period. It is unsafe and unrealistic to think that the same workout or game should be played if the weather turns significantly warmer over a few hours or days. Parents should monitor and adjust their children's levels of strain to account for such differences.
Parents and athletes must remain vigilant about hydration. For each additional thirty-to-forty-five minutes of increased activity a child has, generally he must add another eight ounces of fluid intake to his normal daily fluid requirements. Light weight and light colored clothing should be worn to allow easy evaporation of sweat and not contribute to elevating a child's core temperature. Having a new dry shirt available can also be helpful during all day events so a change can be made when one shirt becomes saturated with sweat and does not breathe well. Parents and community members also should be advised that children with special needs may have an even greater risk of dehydration related illness. Due to illness or mental disability some children may not appropriately develop thirst or produce sweat to signal their need to hydrate. Standard requirements and health screening will help to allow these and other children to accommodate to heat stress safely, and to adjust their activity level and fluid intake to their environment.