A child doesn’t need to be playing in the sun to develop heat stroke, sometimes even a poorly ventilated room during a power cut can be enough.
Every summer, parents face a familiar worry, how much heat is too much for their child?
More than 67,000 cases of suspected heatstroke were recorded between March and July 2024.
Indian Government
Every summer, thousands of children are rushed to emergency rooms due to heatstroke and dehydration, many of which are entirely preventable. This highlights the urgent need to prioritize summer safety for kids.
Children are particularly at risk because their bodies lose fluids more quickly and their thermoregulation systems are less efficient than those of adults. Managing heat illness and dehydration in kids during summer involves an active approach to hydration, electrolyte balance, sun protection, breathable clothing, and early detection of heat-related illness.
MedBound Times connected with Dr. Kaveri Subbiah, a developmental pediatrician, Director and clinical head of Vistara CDC, and a public health advocate.
Dr. Kaveri explains “Hydration is not only about water — it’s about balancing electrolytes. ORS works because the small intestine absorbs water far more efficiently when sodium and glucose are present together (facilitated by sodium–glucose cotransporter-1, SGLT-1).”
The World Health Organization suggests that oral rehydration fluids support the absorption of water through sodium–glucose pathways (WHO).
Daily fluid targets vary by age. The figures below are based on AAP guidelines and include all fluid sources — water, milk, and water-rich foods:
Note: These are baseline targets. Add 1–2 cups for every 30–60 minutes of outdoor activity, and more on days above 35°C. Individual needs vary — always consult your pediatrician for personalized guidance.
But hydration alone cannot prevent heat-related illness, timing and consistency matter just as much.
Until mild dehydration occurs, kids do not feel thirsty. One small preventive measure, to maintain stable circulation and body temperature, is to give fluids 15 minutes before outdoor activity.
The CDC recommends avoiding outdoor activity during peak UV and heat hours. In India, this window is typically 10:00 AM to 4:00 PM. During these hours, ambient temperature and radiation intensity can push a child's core body temperature up dangerously fast. Scheduling play before 10 AM or after 4 PM is one of the most effective single actions a parent can take.
Once outside, offer water every 15–20 minutes — even if your child feels fine. Rest in the shade between active play, and watch for signs of overheating before symptoms become serious.
But avoiding heat exposure is only one part of the equation, protecting the skin also plays a crucial role in preventing fluid loss.
Sun exposure for a long time can increase transepidermal water loss (water loss through the skin), leading to dehydration and skin irritation.
Use broad‑spectrum sunscreen (SPF 30+).
Reapply every 2–3 hours and immediately after swimming or heavy sweating — a step many parents skip
Use protective clothing
Use wide-brim hats that shade the face, ears, and back of the neck.
Seek shaded play areas.
Use mild cleansers and moisturizers after outdoor activity.
Healthy skin protects against excessive water loss and irritation during hot weather.
Even with good sun protection, early warning signs of heat illness can appear subtly and should never be ignored.
Heat exhaustion may manifest gradually in children as irritability, fatigue, dizziness, or loss of appetite.
An easy way to assess dehydration is capillary refill time. Press on a fingernail until it becomes pale and then release it, normal colour should return within two seconds.
According to Dr. Kaveri Subbiah, here are the things to look out for during summer:
Kids repeatedly asking for water
Sudden onset of dullness/ tiredness
Reduced frequency of urination
Child stops sweating
Becomes confused or unusually drowsy
Has seizures or loses consciousness
If your child shows any of the above warning signs, do not delay medical care. Heat stroke is a life-threatening condition that can worsen rapidly and requires immediate intervention. Call emergency services and begin cooling measures while waiting for help.
Heat exhaustion and heat stroke exist on a continuum, but they are not the same. UNICEF warns that once heat exhaustion sets in, a child can progress to heat stroke in under 30 minutes if not cooled down. Knowing the difference is not academic — it determines whether you manage at home or dial emergency services immediately.
The choice of clothing affects the body’s ability to cool itself. Synthetic fabrics retain heat; whereas loose-knit cotton or linen allows sweat to evaporate which is the body's natural way of cooling itself.
Choose loose-fitting cotton or linen.
Opt for light-colored fabric that doesn't absorb sunlight.
Avoid tight synthetic clothing.
Here's everything at a glance:
Keeping children safe during summer requires a combination of hydration, timely outdoor activity, sun protection, and early recognition of warning signs. In countries like India, where heatwaves, school schedules, and power cuts can increase risk, these precautions become even more important.
Implementing these evidence-based strategies can significantly reduce the risk of heat-related illness and help children stay safe and healthy during hot weather. If you are unsure about your child's specific hydration needs, always consult your pediatrician before peak summer months.
What is the best drink for a child playing in the hot weather?
Dr. Kaveri explains “Oral Rehydration Solution (ORS) is the recommended fluid to maintain osmotic balance.”
What to do if my kid refuses to drink ORS?
If kids refuse to drink even small sips and they do not show signs of dehydration, parents can offer
Tender coconut water
Buttermilk
Lemon water with a pinch of salt and sugar
Watermelon (fruit contains 92% water)
These homemade fluids are intended to help maintain fluid balance rather than treat dehydration” says Dr. Kaveri.
How can I check if my child is dehydrated?
“Use the Capillary Refill Time test. Press on your kid’s fingernail until it turns pale (loses pink colour), the release. The pink colour should return within two seconds. If it takes longer your child may be dehydrated” explains Dr. Kaveri.
If my child’s urine is clear does it mean there is no dehydration?
“Parents often assume clear urine equates to no dehydration, but some children may inherently have light coloured urine. Hence, a better indicator would be frequency of urination or number of diapers used in infants” clarifies Dr. Kaveri.
What are the common mistakes that parents make regarding hydration?
One of the worst mistakes would be to give sports drinks or sodas to the child, as the high glucose would worsen the dehydration cautions Dr. Kaveri.
Can I give water before play to prevent dehydration?
Dr. Kaveri Subbiah recommends the following:
Offer small sips of water before play. There is no need to force the child to drink.
Banana or yogurt can help meet carbohydrate (energy) needs before activity.”
How do I find out if my kid suffers from heat exhaustion?
“If a child is repeatedly asking for water, acting unusually fatigued or has reduced frequency of urination, they could suffer from heat exhaustion” explains Dr. Kaveri.
What to do if my child has heat exhaustion?
• Move your child immediately to shade or an air-conditioned space
• Remove extra clothing and apply cool (not ice-cold) damp cloths to neck, armpits, and groin
• Offer sips of ORS or plain water — do not force large amounts at once
• Have your child lie down with legs slightly elevated
• If symptoms do not improve within 15–20 minutes, seek medical attention
Can heat stroke occur indoors?
Yes. Poorly ventilated rooms, power cuts, and hot parked cars can all trigger heat stroke in children — even without direct sun exposure. If a room feels uncomfortably hot to an adult, it is unsafe for a child. Watch for the same warning signs: hot dry skin, confusion, and reduced urination.
Note: Heat Stroke — This Is a Medical Emergency If your child has hot dry skin, confusion, seizures, or loses consciousness — do NOT wait. Call 112 immediately. While waiting, apply cool water to the entire body and fan them actively. Do not give anything by mouth if they are not fully alert. Heat stroke can cause permanent organ damage or death if not treated within minutes.
World Health Organization. Oral Rehydration Salts: Production of the New ORS. Geneva: World Health Organization. https://www.who.int/publications/i/item/WHO-FCH-CAH-06.1
Centers for Disease Control and Prevention. “Heat and Children Safety.” https://www.cdc.gov/disasters/extremeheat/children.html
UNICEF. “The Climate Crisis Is a Child Rights Crisis: Introducing the Children’s Climate Risk Index.” https://www.unicef.org/reports/climate-crisis-child-rights-crisis
National Centre for Disease Control (NCDC), Government of India. “National Action Plan on Heat-Related Illnesses.” https://ncdc.mohfw.gov.in/index1.php?lang=1&level=1&sublinkid=693&lid=550
