Heat waves like the one sizzling across Western Pennsylvania are dangerous for everyone’s health, but young children are markedly more susceptible to hazards associated with prolonged exposure, experts say.

“The younger the child is, the less likely they are going to be able to deal with the heat,” said Dr. Raymond Pitetti, chief of pediatric emergency medicine at UPMC Children’s Hospital. As their body’s ability to regulate temperature isn’t fully developed, they also produce more heat with activity than adults do and sweat less.

“Under 9 or 10, they take a little bit longer to generate sweat, and sweating is one way that we reduce heat. They take longer to sort of acclimatize to the weather,” he explained. “Young kids have more water in their body than older people do, so they’re much more susceptible to dehydration.”

“(Children) have less well-developed physical mechanisms for regulating body temperature, so their temperatures may rise faster in extreme heat, ” said Dr. Kate DeAntonis, a pediatrician at Allegheny Health Network. “From a developmental standpoint, they are more apt to ‘overdo it’ in the heat, and are less capable of understanding or communicating about symptoms.”

Pitetti said parents need to pay more attention to how their children are feeling during hot weather, especially because younger people may not know how to make wise decisions regarding heat safety.

“You can’t rely on the child to make an informed decision or a correct decision,” he said.

“Caregivers have to play a very proactive role anticipating their needs and interpreting any symptoms,” DeAntonis said.

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Stages of heat injury

Heat injury comes in three worsening stages, Pitetti said: heat cramps, heat exhaustion and heat stroke. Heat stroke is the worst of the three — according to the Centers for Disease Control and Prevention, and can cause permanent disability or death without emergency treatment.

Heat cramps occur in the muscles when someone doesn’t have the salt and water they need. Taking a break and getting some hydration can help, he said.

“In heat exhaustion, your body temperature rises and you’re dehydrated, but you’re still able to sweat,” he explained. “Get out of the heat, get into shade or indoor air conditioning, and hydrate.”

Heat stroke happens when the body temperature begins to climb much higher than normal, and the person loses their ability to sweat. Their skin might be hot, flushed, red and dry, and they are very dehydrated.

“Get them out of the heat, loosen (their) clothing, get them in air conditioning, put fans on them and ice packs on them under the armpits in particular, and ice water towels around the body,” he said. “Get them cooling off as best you can until you can get them to see us.”

After that, it’s time to seek medical attention, he emphasized.

“Typically, when you have heat stroke, you have an injury to one of your organs,” he said. “If your symptoms have progressed to the point where we think you have heat stroke, you need to come to the hospital.”

How to manage the heat

Children also need to drink more water, said DeAntonis. In the case of babies and infants, parents should try to increase the volume of each feeding, whether by breast milk or formula, to make sure their baby is hydrated.

“Toddlers and preschoolers, typically you would want to give them about three or four extra cups of water in addition to what they would ordinarily drink,” she said. “For kids 4 to 6 or 7, five to six cups, and 8 or 9 and above, probably seven or eight extra servings of water or something similar.”

When children are dehydrated, they may have less urine output, along with a dry mouth and sunken eyes, she said.

“Patients will feel very fatigued and look like they aren’t feeling well, and they may be markedly less active,” she noted.

More severe heat illness is marked by fatigue, fever, headache, nausea, vomiting, intense thirst and muscle aches or abdominal pain.

At Alle Kiski Pediatrics, pediatrician Dr. Kultar Shergill said his office has seen more children with heat exhaustion and dehydration over the past few weeks.

When playing outside, he recommends kids take a break every 20 to 30 minutes to get some water and return to the shade. And infants under a year old should be kept out of the sun as much as possible, he said.

“They can get sunburned within minutes,” Shergill said. “They shouldn’t be exposed to direct sunlight.”

Area emergency responders also have seen more activity in general, though not specifically with children. Cassandra Kovatch, public information officer for the Westmoreland Public Safety department, said there has been a little bit under 20% increase in overall call volume within the Westmoreland County 911 center over the past week.

Historically speaking, she said, heat waves see an increase in calls, especially on the EMS end.

The heat can affect teens, too, especially when active outdoors. According to a guide by the Harvard T.H. Chan School of Public Health, about 9,000 high school athletes are treated for heat exertion each year. Football players are especially at risk.

Changing plans

In weather this hot, sometimes it’s best to avoid the sun and being outdoors during the hottest time of the day, from about 11 a.m. to 4 p.m., DeAntonis said.

“If you can be in a place that has air conditioning, if you don’t have (it) yourself, that can be very helpful,” DeAntonis said, noting there are cooling centers available across Western Pennsylvania.

“The best way to stay safe is with prevention,” she said. “Unfortunately, sometimes that requires changing your plans or your routine, which is always sort of a bummer in the summertime.”

Jamie Falo, library director at the Greensburg Hempfield Area Library, said the library has shifted around some of its ongoing summer programs for children to avoid the sweltering heat.

“Some of the activities that were scheduled outside that we’ve had so far, we’ve moved them into the shaded areas instead of out in the open sun,” she said. “There were some games scheduled for some of the programs, and instead of the games we changed them to crafts so there wasn’t as much activity.”

Marissa Haynes, Hempfield’s parks and recreation director, said the township’s popular summer day camp has had a few changes in activities in response to the heat. The camp has 213 participants this year over the course of 10 weeks, ranging from children entering first grade to those entering sixth grade.

Leaders have reduced strenuous, cardio-based activities, and there is a greater emphasis on activities indoors and in the shade. Staff also are scheduling more water and shade breaks and reapplying sunscreen frequently.

There also has been more conversations overall about health and safety, she said.

“We’ve been very attentive to the heat and the air quality, to ensure the safety of the campers and our staff, who are out there doing some big work for our community,” Haynes said.

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