Heat And Light

If you think pediatricians don't make mistakes raising their own kids, think again!.  My wife and I had just had our first baby.  When our girl was 6 weeks old, my wife was getting cabin fever, stuck home breast feeding around the clock.  We lived in eastern Maryland then, and decided to take a weekend at the beach for some fresh air and sunshine.  Being a pediatrician and a pediatric nurse, we were careful about the sun- big hat, sun tent, plenty of fluids. We didn't put sunscreen on baby and unfortunately, didn't count on sunlight reflected off the sand and off the water.  Baby was lit up from below where her hat and tent didn't protect and when we brought her home, she was the color of a cooked lobster.  Some experts! Now it's summer and kids should be outdoors swimming and playing, having fun and using their brains in healthier ways than with a phone, computer, or TV.  However, kids need protection from too much heat and light from the summer sun.  The most dangerous problem is children and teens overheating. The heat-related tragedies are already making the news.  The story typically goes like this: the parent is in a rush, goes into a store and leaves the child in the car.  The parent is detained somehow and by the time he/she gets back to the car, the child is dead.  They always say, "I was only going in for a few minutes," but unfortunately anything longer than a few minutes is all it takes. Consider this: How long could you sit in a parked car in the sun, engine and A/C off?  Five minutes?  Ten, if you're strong?  It takes about 40 minutes to bake a cake, about 20 minutes to bake a cupcake.  Now if you're the cake and can only stand five minutes in the car before you are drenched with sweat and gasping and overheated, how long do you think your cupcake toddler can last?  The lesson is clear: don't leave kids in a car in the summer at all, for any length of time! Fortunately, these episodes of kids dying in hot cars is rare.  Much more common is heat injury with older kids during summer sports practice.  August is coming and with it, football practice.  I can count on seeing some kids in the Emergency Department with heat cramps, heat exhaustion or worse, heat stroke. Heat cramps are the mildest of the sports heat injuries, where the kid athlete is working out hard, not stretching enough, not drinking enough, and not resting enough between bursts of activity.  He begins to get painful muscle cramps, and this means it's time to stop, recover, stretch, and hydrate. The next level of injury is heat exhaustion.  In addition to cramps, these kids begin to have dizziness, headache, and weakness from dehydration and over-heating.  If the child-athlete doesn't take a break at this point, the next, worst, stage is heat stroke: the child becomes confused, lethargic, may stop sweating, and then is at risk for muscle and kidney and brain injury, and death. To prevent heat injury, coaches and team captains should take these precautions: First, athletes need to adapt to the heat.  Start with work-outs of lighter intensity and shorter duration.  Football players should spend the first weeks of summer practice in shorts and t-shirts only; then progressively add intensity, duration, and equipment. The second strategy is adequate hydration and recovery.  Athletes should drink before, during, and after practices.  There should never be limits on access to drink; coaches who restrict fluids are only hurting their kids, hurting their kids' performance, and should be fired. Finally, direct sun exposure should be minimized.  Teams should have a shady spot to rehydrate between work-outs.  Practices should be scheduled for earlier morning, like for 7am to 10 am instead of 8 to 11.  Afternoon practice should start at 4 or 6 pm instead of 2 pm. Finally, coaches should have an action plan to handle heat injury.  Like surveillance for concussions, coaches should be watching players for signs of cramping, sleepiness, and headaches. We all make mistakes, like when my wife and I accidentally sunburned our new baby at the beach.  Just please don't make bigger mistakes by not taking heat seriously.