Anytime children or adolescents play sports or get physically active in hot weather, they’re at risk of heat-related illnesses. Understand how heat-related problems happen and what steps you can take to prevent them.
Your child might be vulnerable to dehydration and other heat-related illnesses if he or she:
- Wears clothing or protective gear that contributes to excessive heat retention
- Rarely exercises
- Is overweight or obese
- Is sick or had a recent illness, especially involving diarrhea, vomiting or a fever
- Is taking certain supplements or medications, such as cold medicine
- Has a chronic condition, such as diabetes
- Isn’t well-rested
Regardless of the weather or what climate you live in, children and dehydration is an important topic for parents. Excessive sweating and low fluid intake can put young athletes at risk for dehydration.
As children return to school over the months of August and September you will find many young athletes outside, practicing and playing sports. Baseball players stand out in the hot sun, track athletes are rigorously training and soccer players hit the field.
What do they all have in common? They are all at risk for dehydration.
Children as a rule can become dehydrated during the weeks leading up to sports activities. They may feel they are drinking enough, but in fact are only meeting the minimum requirements, and over time accumulate a negative fluid balance. On the day of the sporting event it is not uncommon to see a reaction due to dehydration.
According to a research study from the University of South Carolina, over 75 percent of young athletes ages 7 to 18 come to practice already dehydrated. The main culprits of dehydration are excessive sweating and low fluid intake with the young athlete.
Athletes see significant decline in their athletic performance from dehydration. Dehydrated muscles are not able to react and contract as quickly and efficiently as a well-hydrated muscle. Dehydrated muscles can also get stuck in a contracted state, otherwise known as a cramp. Additionally, the brain may become confused and decision-making more difficult. The heart has to work more to pump blood throughout the body, causing an increased pulse and faster breathing.
In children, 100% dehydration, equivalent to a half- to one-pound weight loss in a 100 pound athlete, can impair athletic performance by cutting down endurance. In teens, a two percent dehydration (a two pound weight loss after exercise in a 100 pound athlete) may cause decreased endurance and impair alertness and cognitive function.
A condition where children are not thirsty anymore because they have been drinking, but they haven’t consumed enough to cover their hydration needs. Children are at the highest risk for voluntary dehydration, as well as those who have been exercising in hot, humid climates.
Sweating is the body’s way of cooling itself, releasing heat that builds up with exercise. If you couldn’t cool yourself, you would cook your internal organs. In addition to letting off heat, the body also loses sodium, chloride and potassium in sweat. Every person sweats differently. Some lose lots of fluid also known as dripping sweat, while others may hardly break a sweat. Children, in general, sweat less than adults, but once puberty hits, sweating becomes similar. Sweating is good, but you need to make sure to replace the fluid and electrolytes that are lost.
Staying hydrated is a constant effort for any athlete, but being young has its own set of challenges.
Developmentally, children and teens need reminders to drink fluids, as they get distracted. They also may not drink enough due to logistics of practice such as inadequate breaks for rehydrating. It is critical to schedule drinking around exercise and continuously checking for signs of dehydration.
The risk of heat-related problems is greater within the first few days of activity in a hot environment. That’s why it’s best to take it easy at first, gradually increasing the amount of activity — and the amount of protective equipment — as the days pass. Young athletes might need up to two weeks to safely acclimate to the heat.
During sports activities coaches are encouraged to:
- Require young athletes to drink plenty of fluids before practice and during regular beverage breaks — even if they aren’t thirsty
- Make sure clothing is light colored, lightweight and loosefitting, or exposes as much of the skin as possible
- Limit activity at midday, when the temperature is hottest
- Decrease or stop practices or competitions if necessary, or move them indoors or to a shady area
- Ensure that fluid is available at all times
Experts and the science point to the importance of drinking fluids during practice, especially if muscles are to perform their best and the body can endure the demands of a long, hot practice.
The American Academy of Pediatrics (AAP) set guidelines for fluid consumption during exercise for youth as follows:
- Children should have appropriate fluid replacement available.
- Children should consume fluids at intervals before, during and after exercise.
- Children who are 9 to 12-year old should replenish fluids every 20 minutes
Even mild dehydration can affect your child’s athletic performance and make him or her lethargic and irritable. Left untreated, dehydration increases the risk of other heat-related illnesses, including heat cramps, heat exhaustion and heatstroke.
Encourage your child to pay attention to early signs and symptoms of dehydration, including:
- Dry or sticky mouth
- Excessive fatigue
- Disinterest in the game
- Inability to run as fast or play as well as usual
Remind your child that he or she should report signs and symptoms to the coach right away. Don’t let embarrassment keep your child on the field.
If dehydration is detected early, fluids and rest might be all that’s needed. If your child seems confused or loses consciousness, seek emergency care.
Here is a simple and easy to following guideline for children of all ages:
Child athletes should drink a percentage per pound of body weight per hour (a 100 pound child needs 20 ounces per hour). Starting 2-3 hours before and during exercise.
Young athletes should drink 2 ml per pound of body weight per hour (a 100 pound child swimmer needs 200 ml per hour or approximately 7 ounces, per hour). Drink this amount 1-2 hours after exercise, as it promotes adequate hydration status for the next exercise session.
DRINK OF CHOICE:
Water. For one-hour sessions of exercise or less, young athletes can drink and stay hydrated with plain water.
SAFE SPORTS DRINKS:
When exercise sessions last more than an hour, young athletes should replace the primary sweat nutrients, sodium and chloride, as well as consume some carbohydrate to improve endurance and keep muscles fueled. This can be accomplished with a sports drink that is high in electrolytes but low in sugars.
Fitness waters and enhanced waters don’t provide enough carbohydrate for a long workout, but could be fine for shorter exercises of less than one hour. Soda and other sugary beverages such as juice drinks, sweet tea, or lemonade are not allowed under any circumstances.
If you feel thirsty, you’re already dehydrated is true. The mechanism of thirst is complicated and can be associated with the level of dehydration.
Although the Institute of Medicine (IOM) supports the use of thirst as a gauge for when to drink, more recent studies have shown that young athletes may not be good measures of their own hydration status. They may not recognize thirst, or may deny it, being distracted by other events. For this reason, it is important for parents and coaches to remind children to drink fluids.
Thirst: Using a scale of one to nine, with one being not thirsty at all to a nine being very, very thirsty, researchers have found that young athletes falling between a three and five likely had a 1 to 2 percent dehydration.
Urine Color: Urine color charts have been developed to help young athletes know when they are dehydrated. Ideally, young athletes want their urine color to be a pale yellow,like fresh-squeezed lemonade or lemon juice, indicating adequate hydration. A strong yellow, orangey-yellow or brownish green color Mellow Yellow or Mountain Dew means the athlete is dehydrated and drinking needs to begin as soon as possible. A great tool to use are urine color charts in locker rooms to educate about hydration.
Weight: A pre- and post-exercise body weight is another method for identifying dehydration. For every pound lost after exercise, 16 ounces of fluid should be consumed to replenish hydration status. For example, if a child’s weight is 110 pounds before practice and 108 pounds after practice, there is a two-pound loss of water weight and the athlete would need to drink 32 ounces of fluid.
If your child plays, encourage him or her to drink plenty of fluids before, during and after practices and games. Teach your child the signs and symptoms of dehydration, as well as the importance of speaking up if they occur.
Involve your child’s coach, too. Talk to the coach about adjusting the intensity of practice depending on the temperature and humidity on the field. Support the coach’s decision to cancel games and practices when it’s dangerously hot outside.
Making your child a part of the awareness of the dangers of dehydration makes sense and guarantees a winning season all around.