Hiking on a hot dayEven here in the cool Pacific Northwest the summer months can send temperatures soaring into the 80’s, 90’s and 100’s. Hot for any average adult, but potentially even more dangerous for young children. Our country is currently experiencing rolling heat waves. Thing is, children heat up faster than adults (five times faster) because they have fewer sweat glands, their body-to-surface ratio is different (their sweating would never do as much good) and this combination makes it more difficult for children to regulate internal temperatures. Couple this physiology with children’s inability to tell us they’re HOT (infants/toddlers) or the instincts of a child or teen athlete (who may not know limits or want to regulate activity) and it can sometimes lead to overheating.

Heat is different for children than adults. They are at particular risk for two reasons: their dependency and their judgment.

Frankly, I worry most about children being left or trapped in hot cars this time of year. Ten children have already died this year in the U.S. after being trapped in a car that can heat up like a cooking oven. Yesterday, with millions of Americans on heat advisories, NBC national news showed footage of bystanders this week breaking glass to save a child left in a hot car. Even though everyone seems to believe it won’t happen to them, about 3 dozen children die each year (primarily during the summer) after getting forgotten or trapped in a car that heats up. If you think you’re too smart for it to happen to you or your family read this — a piece I’ve called the most devastating article around.

The majority of these children are 2 years old or younger. Children this young have very little control over their environment, so it’s up to us to ensure that they are safe  ~ Dr Tony Woodward, Pediatric Emergency Medicine Physician

Why Children Die Quickly In Hot Cars:

  • It only takes 10 minutes for a car to reach deadly temperatures on an 80-degree day. It’s mere single minutes when temperatures outside exceed 90 degrees. Children are sometimes left in the car out of convenience or are left because adults get distracted and simply forget. Children’s unique position of dependence puts them at exceptional risk. They get stuck and can’t get out of a car seat or booster or simply don’t know how to unlock the doors from inside. This vulnerability is important to remember. It’s also important to acknowledge that it’s not only during heat waves that children overheat in cars; 57 degrees is lowest known outside temperature at which heatstroke can occur.
  • Play is led by curiosity and occasionally that curiosity plops children in harm’s way. The 3 dozen children who die from vehicular heatstroke annually die in differing circumstances. Most deaths occur in young children under age 2. But older children (> age 3 years) tend to die in hot cars while playing and getting trapped in a locked car or trunk. Broken down, 73 percent children are left in a vehicle (forgotten or left their for a parents’ convenience) and 27 percent get trapped while playing in a vehicle.

DO THIS: Keep your cars locked in the garage or driveway. Store purse or bag in backseat so you always “look (at the backseat) before you lock.” Make sure daycare or babysitters always call you if child is absent unexpectedly or gets lost. When a child goes missing check cars immediately.

The Physiology Of Heating Up:

In extreme heat our bodies heat up rapidly as our cooling mechanisms (sweating) can’t keep up. Evaporation of sweat from our skin is what cools us off so if it’s extremely humid or we’re not hydrated well sweating isn’t as productive as desired. Further movement changes the calculus on cooling. Exercising muscles produce 10 to 20 times more heat than muscles at rest. So if you or your children are in camps or exercising in the heat, take extra precautions. You need an additional 2-4 cups of water for every hour of physical exercise to stay hydrated in the heat. Children may not be as good at staying hydrated, wearing loose clothes and regulating their activity (they’re children after all) so we have to set guidelines. Keep exercise to shorter intervals (15 minutes), water breaks every 20 minutes, and ensuring they stay hydrated between sports. School-age children have been found to regulate temperature more like adults, and can often participate in activities in the heat but need guidance on moderation. This past weekend our family hiked just shy of 6 miles with lots of water and a lake swim in the middle. We can enjoy the heat but we have to be careful! Further, if coaches are pushing too hard, push back and use the heat index as a guide. Here’s the AAP policy to help guide you, too.

DO THIS: For child or teen athletes discuss need for extra hydration in heat, honest reporting on symptoms and staying out of sports if dehydrated or sick with stomach bugs/vomiting/diarrhea. Demand extra water before sports, water breaks every 20 minutes, and that sports are modified when heat index is up. Switch practice times to morning when cooler temperatures make it safer.


Knowing how to identify heat injury or heat stroke helps prevent trouble. Heat exhaustion typically develops after ongoing heat injury: a temperature of 103 degrees Fahrenheit or higher, hot skin with no sweating, rapid pulse, vomiting, and eventually unconsciousness.  If you think your child might be experiencing the beginnings of or severe heat stroke, here are a few ways to help:

  • First, call 9-1-1 and get out of the heat as best you can as fast as you can.
  • Bring their internal temperature down as quickly as possible (cool water, fans, cool shower or sponge down your child’s body).
  • Undress your child completely and lay them down in a cool area.
  • Do NOT give your child acetaminophen (Tylenol). Fever reducers like acetaminophen or even ibuprofen don’t reduce heat in our bodies brought on by the environment and can cause further health risks, especially if a child is dehydrated.

3 Things To Remember During While Parenting In The Heat

  • Act fast if you see a child left in a car. Call 911 immediately if you ever see an infant or toddler or child left in a car for help in getting them out. Seconds and minutes matter here. Don’t ever leave your precious baby or young kids alone in the car — ever! Keep your purse or bag in the backseat as a reminder to “look before you lock.”
  • Children’s bodies heat up 5x faster than adults so watch for heat exhaustion or heat stroke symptoms in children in the extreme heat. You’re not over-reacting if you ask and call for help. Use water and shade to cool overheated infants and children immediately and don’t ever hesitate to call 911 if you need help.
  • Water for prevention for child and teen athletes is key this time of year. Shape expectations, stay hydrated, optimize practice times early in day, and keep exercise intervals under control. Exercising muscle is HOT muscle.

Heat Stroke Infographic

More heat resources: