Staying Hydrated During Summer Sports and Activities

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As an emergency room physician and a pediatrician, I unfortunately see a consistent dose of summer-related injuries and all of the consequences that come along with them. During the summer, heat-related illness becomes a hazard to avoid. This term – heat-related illness – is applied to a spectrum of illness; one that ranges from mild to severe symptoms and can even result in death. With appropriate planning, heat-related illness can be prevented.  

Stay cool. Makes sense, but often requires some effort. Schedule events during cooler hours of the days. Arrange to be back in cooler environments during the hottest times. Taking frequent breaks can also be helpful.

Hydrate early and often. If children start the activity dehydrated, they are going to have a hard time becoming adequately hydrated. Even if a child thinks he is not thirsty, it’s important to drink before and during the activity.

During organized sports, this can be a coordinated effort. When children are playing outside, it often requires some reminding. It is recommended a child drink 8 to 16 ounces of fluid (water or appropriate sports drink) every 20 minutes during an activity. This may need to be adjusted for the age and size of the child. Avoid caffeinated beverages and excessively sugary drinks (like sodas).

The weight of the matter. The most ideal measure of dehydration is body weight. Knowing pre-activity weight and post-activity weight can give an indication of the actual amount of water that has been lost. Significant dehydration is noted when someone has lost 3 percent of his original weight.

Strategize to reduce risk. The American Academy of Pediatrics outlines the following strategies:

• Acclimatize slowly to the hotter weather. This may take up to two weeks.

• There should be unrestricted access to fluids during activities.

• Attempt to schedule events during cooler hours.

• Monitor for early heat-related illness symptoms, such as muscle cramps, excessive fatigue and weakness, headache, dizziness, nausea/vomiting and passing out. 

Age matters. While these strategies can help prevent heat-related illness for most children, there are special groups of kids who are at even greater risk than the rest. Infants and toddlers are particularly susceptible to heat illness, for a variety of reasons, but most importantly because they are dependent upon adults to ensure they are in appropriate environments. Additionally, those with chronic medical problems may take medications or have conditions that prevent them from adequately acclimating to the hot environments. These issues need to be considered when planning activities during the hot summer days.

— Sean M. Fox is a medical doctor and associate professor in the division of pediatric emergency medicine at Carolinas Medical Center.