Ask the Doctor: It’s Gettin’ Hot Out There

School is almost out – it’s time to head outdoors. Being active outside is great for your health, but you’ll need to watch out for heat-related dangers that can easily sneak up on you when temperatures rise.
Children, in particular, are at a much higher risk for dehydration and heat-related illnesses. Fortunately, there are simple precautions you can take to stay safe and still have fun in the sun.
Q: I’m concerned my 4-month-old baby could get dehydrated during the hot summer months. Should I give her some water to drink?
A: When it’s very hot, your baby may not feed as well as usual and could easily become dehydrated. It’s best not to give her too much water as her kidneys are still immature and can’t process water effectively. Instead, you can give her Pedialyte as it helps replenish the electrolytes she needs if she becomes dehydrated. As a general rule, your baby can have an ounce of water for each month of age, so your 4-month-old may drink 4 ounces of water a day. With Pedialyte, even quite young babies can safely drink 4 to 8 ounces several times a day to combat dehydration.
Keep a couple of bottles of Pedialyte at home to replenish fluids and electrolytes if your baby has diarrhea or is vomiting. And remember to take Pedialyte with you if you are traveling this summer, especially if you are headed to a hot destination.
Q: Our family is looking forward to day trips to local amusement parks and the beach this summer. How can I make sure nobody gets sick from being out in the sun all day?
A: There are a number of precautions you can take to ensure that everyone in your family enjoys your summer outings and doesn’t succumb to a heat-related illness:
• Wear clothes that are lightweight, light-colored and loose-fitting to stay cool. For sun protection, choose clothing with a built-in sun protection factor (SPF) and wear wide-brimmed hats.
• Put on and frequently reapply plenty of sunscreen with an SPF of at least 15. Even water-resistant or water-proof sunscreen formulas should be reapplied frequently.
• Make sure everyone drinks plenty of water before you set out and throughout the day. Don’t forget to drink when you are busy having fun.
• Avoid highly caffeinated drinks, such as some sodas and energy drinks. Caffeine can make you urinate more than you normally would, which in turn will make you more prone to dehydration.
• Take regular breaks in shady, cool places throughout the day.
Remember that children are at greater risk for a heat-related illness if they are overweight, have a pre-existing medical condition, were sick or had a fever recently, or are suffering from sunburn or sleep deprivation.
 Q: My 12-year-old daughter has been picked to play on a competitive softball league this summer. She’s very excited, but I’m concerned about her being out in the heat and sun for long periods during practice and games. What are the potential dangers?
A: First of all, congratulations to your daughter! The first step in keeping your young athlete safe is a pre-participation check-up. Your child’s doctor can help ensure your daughter is in good health before she joins the team and not at increased risk for medical dangers, such as heat-related illnesses.
In addition, you and your daughter’s coaches should be able to recognize the symptoms of heat-related illnesses. Here’s what to look out for:
• Heat cramps are muscle spasms that can strike if your daughter starts losing too much liquid and salt. She should stretch the affected muscle gently in the shade, ice the area and top up on fluids.
• Heat exhaustion: If your daughter is sweating a lot, has skin that feels cool and clammy, or complains of a headache, dizziness or nausea, she may be suffering from heat exhaustion. Make sure she rests in a cool place, replaces fluids and takes off any heavy sports padding or equipment. If your daughter’s symptoms don’t improve quickly or if she is vomiting and can’t rehydrate herself by drinking, take her to the emergency room promptly.
Heat stroke is the most serious heat-related illness and a life-threatening emergency. With heat stroke, the body has lost the ability to cool itself. Look for symptoms such as not sweating despite the heat; skin that is red, hot and dry; disorientation and unconsciousness. If your child has any of these symptoms, call 911 or immediately head to the nearest emergency room.
Q: I’ve signed up my 7-year-old son for a week-long, all-day outdoor sports camp this summer. The camp takes place at a field without much shade. How can I make sure he doesn’t get sick from too much sun exposure?
A: Help your son apply sun screen every morning before camp and make sure he takes extra sun screen, a hat and plenty of water with him for the day. Check with the camp leaders or coaches to make sure the schedule includes frequent water breaks in a shady spot. Find out if the coaches and camp leaders know how to recognize and respond to heat-related problems. Lastly, make sure your son’s coaches have your emergency contact information at hand.
Tracy DeAmicis McMahan, M.D., is a board-certified pediatrician at the Palo Alto Medical Foundation’s Mountain View Center. Advice is not intended to take the place of an exam or diagnosis by a physician.
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