From the Desk of Dr Stutts

Heat & dehydration*

With the warmer weather and sunshine, it’s necessary to keep the risks of overheating and dehydration in mind. Here, we will provide essential tips for caregivers to help your pediatric patients stay safe in the summer heat.

Understanding Dehydration

Dehydration occurs when the body loses fluids to the point that it doesn’t have enough water and electrolytes to function properly.¹ Infants and children can get mildly to moderately dehydrated for many reasons, including fever, diarrhea, vomiting, or being in heat. They are especially susceptible to getting dehydrated, which can be very dangerous for them.²

Because their bodies aren’t as efficient at thermoregulation as adults, infants and children are at greater risk of heat-induced adverse health outcomes. For example, children don’t sweat as much as adults, and sweat is one of the main ways the body cools itself.³ Furthermore, very young children may not be able to communicate that they are feeling overheated or unwell, so caregivers need to know how to keep them safe.

The following are some common signs of dehydration^* for infants and young children⁴:

• Dry mouth and tongue
• Crying without tears
• No wet diapers for 3 hours or more
• Fever
• Unusual sleepiness or drowsiness
• Irritability
• Eyes that look sunken

* Mild to moderate dehydration.

Dehydration and Oral Rehydration Solutions

If a patient becomes mildly to moderately dehydrated, they may need to drink an oral rehydration solution (ORS), like Pedialyte^®, to help replace lost fluids and electrolytes.² Since heat affects children differently than adults, children may have a greater need for interventions like an ORS.³ Similarly, lactating mothers need to be aware of the increased importance of hydration before and during breastfeeding. The Institute of Medicine (IOM) recommends that pregnant women consume 3 liters of water daily, while breastfeeding women should increase their intake to 3.3 liters per day. In comparison, the daily water intake for non-pregnant, non-breastfeeding adult women is 2.7 liters.⁵ If no contraindications exist, Pedialyte can help replenish needed fluids and electrolytes.

Note:

Infants under the age of 1 should only be given an ORS under medical supervision. Remind caregivers to ask for your input if they are ever concerned about their infant or child’s hydration levels.

Summer Heat Tips for Caregivers With Infants or Children

1. Check the local heat index before taking an infant or child outdoors, and avoid being outside during the hottest parts of the day. The American Academy of Pediatrics (AAP) suggests avoiding taking babies outside for long periods if the heat index is greater than 90 ºF.⁶
2. Take a break from the heat at least every 15–20 minutes, depending on the child's response to being in the heat. Time in the heat can cause infants and children to feel tired, so it can also be helpful to plan rest times or naps following being outside.
3. Find shade on hot days and dress infants or children in loose, lightly colored, breathable material. Make sure they have a hat, head covering, or umbrella.
4. Provide liquids to help infants and children stay hydrated. Offer young infants breast milk or formula to keep them hydrated. If the child is over 1 year of age, they can be given water. If children 1 year and older show signs of mild to moderate dehydration, drinks like Pedialyte and other ORSs can be purchased in the baby or pharmacy aisle at the store to help replace much-needed electrolytes.²
5. Remind caregivers to hydrate themselves! Caregivers may need to be reminded to drink fluids to keep themselves safe and hydrated during the heat as well. ORSs like Pedialyte are not just for children, but can be great solutions for adults to rehydrate and feel better fast.

You Can Help Patients Avoid Dehydration*

Dehydration in infants and children caused by heat can be dangerous. Healthcare professionals can assist caregivers by educating them about dehydration, identifying its warning signs, and offering tips for summer heat preparedness. This can help families enjoy the summer months safely and to the fullest.

* Mild to moderate dehydration.

References: 1. Daley SF, et al. Pediatric Dehydration. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK436022/ 2. Nationwide Children’s. Dehydration: Giving Liquids at Home. https://www.nationwidechildrens.org/conditions/dehydration#:~:text=Dehydration%20means%20that%20your%20child,the%20main%20causes%20in%20babies 3. US EPA. Climate Change and Children’s Health and Well-Being in the United States. https://www.epa.gov/system/files/documents/2023-04/CLiME_Final%20Report.pdf 4. MedlinePlus. Dehydration. https://medlineplus.gov/dehydration.html 5. Medicine IO. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Nutrition MD. 2004;30(6):73-185. 6. American Academy of Pediatrics. Extreme Temperatures: Disaster Management Resources. American Academy of Pediatrics website. https://www.aap.org/en/patient-care/disasters-and-children/disaster-management-resources-by-topic/extreme-temperatures/