A pediatrician's 3 tips for keeping kids cool in the extreme heat

Most heat illness is attributable to humidity. Here's how to beat it.

A pediatrician's 3 tips for keeping kids cool in the extreme heat

I walked outside this morning to bring my two boys to camp, and when I stepped outside couldn’t tell if I was outdoors, or still in my bathroom with the shower on hot and the door closed! I was sweating within seconds of stepping outside. It was a scorcher—with temps reaching nearly 100F and humidity of 60% here in NYC.


When the temps are this hot, especially with such high humidity, it's important to know what we do to prevent heat-related illness for ourselves and for our children.

Kids' body surface area make up a greater proportion of their overall weight (compared to an adult) which makes them sweat more (proportionally) so they lose more electrolytes and become more at risk for dehydration. They are also less likely to recognize the early signs of heat effects on their bodies or, even if they do, they are less likely to act appropriately. These factor put them at high risk to suffer from heat-related illness.

Most heat illness is attributable to humidity. When humidity is high, our sweat can’t evaporate and cool us as quickly as it normally does, and this can lead to an increased body temperature and the need for more fluids. The heat index, takes into account humidity and temperature and is easily obtainable at NOAA.

As with many things in pediatric healthcare, the best “cure” is prevention. I'm sharing three essential tips to keep your child cool and comfortable—and avoid heat-related illness—during times of extreme heat:

1) Keep kids hydrated. If you wait until your child is thirsty it is too late, he is already dehydrated! Get your kids drinking before thirst develops and consume additional fluids even after thirst is quenched.

Babies under the age of 6 months should not get pure water—however, they may need to nurse (or have bottles) more frequently in order to stay hydrated. Babies over 6 months can be offered a few ounces of water throughout the day. Offer water in a sippy cup or a few extra ounces of breastmilk/bottle every 20mins that you are outside in the heat. For older kids that are in camp or participating in other outdoor activities—scheduled hydration breaks with strong encouragement for drinking is very important! For kids exercising more than 45 minutes, fluids with electrolytes should be provided (eg: Gatorade or other sports drinks; coconut water is also a great natural source of most needed electrolytes.)

Keep track of how many trips to the bathroom you make with your child—babies and children should be urinating at least every 6-8 hours—and their urine should be a pale yellow color.

Some fun ways to get fluids in your child—ice pops (make your own!); watermelon and flavored waters.

2) Restrict outdoor activities. When possible, plan for vigorous exercise to occur early or late in the day, and limit your little one's outdoor exercise during the peak sun hours of 11am-3pm.

Talk to your child’s camp counselors or coaches, and ask them what their plan is for the hot days: Are there extra water breaks? Will they encourage drinking during those breaks? Will they allow children to rest if they look fatigued?

Older children who are athletes often face pressure to continue to participate, so educate your child to listen to his/her body and to take breaks when needed. (It is much “cooler” to make it through the day at sports camp then it is to get carted off to the Emergency Room for intravenous fluids!)

Choose outdoor activities that are in the shade and/or in cool water—pools and water sprinklers are great ways to stay cool.

And remember, if your child has recently had a gastrointestinal (GI) illness or fever, they are more likely to be susceptible to the effects of heat and will dehydrate more quickly. Limit their activity during the hot days.

3) Dress appropriately! Dress your child in a single layer of light-colored, loose-fitted breathable clothing (less sun absorption from the bright colors and the loose fit enables your child to sweat (it's the body’s natural way to let off extra heat). And please do not forget to protect your and your children's skin: ALWAYSUSE SUNSCREEN!

If despite your best efforts, the summer heat still gets the best of your children, it's important to recognize signs of heat exhaustion:

  • Tachycardia (fast heart rate)
  • Sweating
  • Nausea, vomiting
  • Headache
  • Fatigue
  • Weakness
  • Dizziness
  • Thirst
  • Confusion
  • Fainting
  • Muscle cramps
  • Irritability
  • Cool-clammy skin

If your child is exhibiting any of these signs of heat-illness, cool them off as quickly as possible… remove them from their activity, bring them into the shade or indoor air conditioning; remove layers of clothes; let them sit/play in a kiddy pool filled with cool water/ice; apply cold/ice towels to the neck, armpits and groin—these areas have large blood vessels and can help cool the body off more quickly.

'Here comes the sun. Here comes the sun, and I say It's all right.' – The Beatles

Tiffany Otto Knipe, MD, is a pediatrician, a mother and the founder of Washington Market Pediatrics in Manhattan.

*All content in this article is provided for information purposes only and does not constitute medical advice, diagnosis or treatment. Neither this article nor your transmission to the author of any personal medical information creates a physician/patient relationship. You should always seek the advice of your own physician regarding any medical condition you may have. More information.

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