The most important part of your child’s sport practice or outdoor play this summer isn’t his batting average or how many goals he scores, but rather how well he stays hydrated. Young kids and teens have special fluid needs that differ from adults, and parents and coaches must take precautions to prevent dehydration.

“Children in general are at higher risk for becoming a heat casualty compared to adults for several reasons,” says Matthew Beekley, PhD, RD, associate professor of the Exercise Science Program, Department of Kinesiology at the University of Indianapolis.

First, they have a higher body surface to mass ratio and so absorb heat from the environment more than adults. Next, they sweat less than adults, resulting in a higher core temperature. And finally, they take longer to adjust to the heat compared to adults.

As kids exercise, their muscles generate heat, raising body temperature. When the body gets too hot, it sweats, and evaporating sweat works to cool the body back down. When kids don’t replace the water lost through sweating by drinking and rehydrating, the body can overheat.

“Becoming dehydrated during sports practice is actually a normal occurrence; it’s the amount of dehydration that can be dangerous,” says Brendon McDermott, PhD, ATC, assistant professor/clinical coordinator and athletic trainer at the University of Arkansas in the Department of Health, Human Performance and Recreation.

Dehydration compromises our ability to sweat and get rid of the heat. Signs and symptoms can progress slowly, or can come on quickly. The symptoms of dehydration typically include thirst, fatigue, headache, nausea, and lightheadedness. Dehydration is not the only cause of other heat-related illness, such as heat exhaustion or heat stroke, but proper hydration helps to prevent these from occurring.

Heat illnesses include:

• Heat cramps (abdominal cramping)
• Heat exhaustion (child sweats and experiences exhaustion, nausea and dizziness)
• Heat stroke (child stops sweating, though this may be difficult to notice, and has a worsening of heat exhaustion symptoms. The condition is life-threatening and requires immediate cooling and medical attention.

“Unfortunately there is overlap in signs and symptoms for these illnesses,” says Beekley.

Warning signs that kids are getting dehydrated are the same for adults: Thirst and fatigue. “One of the issues with dehydration is that not many of us pay attention to the symptoms of thirst and fatigue and attribute them to dehydration,” says McDermott. Everyone should pay attention to urine color as an easy check. Teach kids that urine color should be the color of lemonade. Urine that is the color of apple juice or iced tea indicates dehydration. And although thirst is a symptom of dehydration, it also occurs normally when someone is already 1-3 percent dehydrated.

KEEPING KIDS HYDRATED

The sports medicine community has moved away from blanket amounts of fluid recommendations for athletes in general.  “The simplest way to monitor if someone is drinking enough fluid is monitor their weight (bring along a portable scale that runs on a battery to practices/games,” says Beekley.  Any weight lost during practice or game can be assumed to be fluid loss.

Beekley cautions, “Even a 1-2 percent body weight loss can affect performance and put one at risk for becoming a heat casualty.”

How much to drink? Enough fluids should be offered to prevent weight loss but not in an amount that causes weight gain. Kids can drink too much fluid, which is a rare but life-threatening condition called hyponatremia.

McDermott says fluid needs for kids and adults are individual. There is no set amount that works to keep everyone equally hydrated. “This is because our sweat rate (how much sweat we lose) is individualized, and based on genetics, clothing, physical fitness, as well as a host of other factors.”

The more we lose in sweat, the more we should replace. Likewise, kids who lose less in sweat don’t need to drink as much.

The recommendations are simple:

• Kids should begin sport participation well-hydrated, making sure to check urine color beforehand and should drink fluids prior to exercise.
• During exercise, they should have regular access to fluids with adequate time to drink.
•  Following exercise, they should be encouraged to drink fluids to replace what they lost during activity.

Water, Water, Water!

In an ideal world, kids would drink water to rehydrate.  But because they generally prefer sweetened beverages more than water, things like Gatorade or other sports drinks should be available in flavors they like to get them to actually drink. 

Sport drinks offer an advantage of supplying carbohydrates and electrolytes, both of which encourage more fluid consumption. “Sport drinks do not replace everything that we lose, however, and should not be considered completely preventive,” says McDermott.

A good indicator that a sport drink may be beneficial is when exercise lasts longer than two hours. If this is the case, a sport drink can help improve energy stores and replace some of the electrolytes athletes lose, all while encouraging thirst and increasing fluid consumption at the same time. Other drinks (fruit juices or carbonated sodas) are not good during exercise as they can increase gastrointestinal cramping or stomach upset.

Because a child is more susceptible to heat illness, they should have more frequent fluid breaks (every 10-15 minutes), practice or games should not be held in the heat of the day, weight should be monitored before and after sports, and kids should be encouraged to drink up (often there is too much excitement and things going on for young kids to remember their thirst– especially during competition).

Coaches and parents should make sure that exercise intensity and duration is kept to a minimum when humidity and temperature are very high. This will help decrease dehydration and other heat related illness risks so kids can enjoy healthy play.