Whether your child plays organized sports or just loves being active outdoors, hot weather can pose serious health concerns. As temperatures in all parts of the U.S. trend upward, kids face a rising risk of weather-related illness, such as heat exhaustion and heat stroke. This includes exertional heat stroke (EHS), linked with intense exercise in hot weather. EHS is a leading cause of sudden death in high-school athletes, particularly football players.

Kids who are active in sports aren't the only ones at risk for weather-related illness when it's hot out. So are those who perform in marching bands, work at amusement parks, or handle lawn and garden tasks. Heat illness is also not unique to the outdoors as it can affect kids who work or exercise in uncooled indoor spaces such as field houses, barns or enclosed swimming pools.

If they don't take a break to hydrate enough, cool off and rest, kids might experience muscle cramps, dizziness, headache, nausea or vomiting, excessive sweating, loss of coordination, drowsiness and confusion.

Symptoms like these may point to heat exhaustion, which means it is time to stop playing. When kids don't get immediate attention, body temperature can continue to rise above 104 degrees, causing a heat stroke. At this point, they may faint, suffer seizures or even die. Heat stroke is a medical emergency.

Even modest temperatures of 75 to 80 degrees can be dangerous if the heat index reaches 90 degrees — the threshold for caution when playing or working outdoors. A heat index of 105 or above indicates a "danger day" when kids and families should limit time outside.

Children and teens with asthma, heart and kidney conditions will be more vulnerable to the heat when the heat index soars. Medications, in particular those commonly used for ADHD, can make a difference as well, since they change the way a child's body functions.

The AAP has several recommendations for keeping kids safe while they enjoy their outdoor activities all year round.

Most importantly, keep a close eye on small children who need extra protection and supervision. Toddlers and preschoolers love being outside, but they may not remember to drink water or take shade breaks. Encouraging regular water and snack breaks is a helpful strategy to avoid dehydration. Since small children are more sensitive to heat than older kids, it's wise to limit outdoor play. Keeping little ones in the shade during peak UV hours, roughly 10 a.m. to 3 p.m., reduces risks for heat illness and sunburn.

Help older kids tune into their bodies and what they need. When children and teens play outside, they may ignore signals that point to heat stress. Make sure they know what to watch for — and teach them to check in with a responsible adult right away if there are concerns. Explain that while grownups who know the signs of heat illness will be watching over them, kids can protect themselves by being their own "first responders."

Getting your child involved in sports and outdoor activities can create a learning and bonding opportunity. Before heading out, ask kids to help you with a few simple steps. Check the weather report, put on sweat-proof sunscreen and hydrate together. Carry chilled or frozen water bottles with you, with backup bottles in the car or bike holder. If your child isn't wearing a uniform, help them choose light-colored, loose, breathable clothing. As your child grows, encourage them to take responsibility for these steps so they become lifelong practices.

Make young athletes feel comfortable speaking up. Many young athletes hesitate to opt out when it's hot. Peer or coaching pressure might drive them to keep moving on hot days, even when their bodies warn them to stop. Surprisingly, many athletic programs don't have specific guidelines for preventing heat illness, so adults should also be ready to speak up.

Ask coaches and athletic coordinators what heat safety precautions are in place — and if the heat index reaches the high 90s, consider having your child sit out for the day. Missed games and meets can cause serious disappointment, but they are never worth risking a child's health.

Since no two kids respond to the heat in exactly the same way, it can be helpful to ask your child's doctor for pointers. Pediatricians can offer specific advice and a personalized plan for kids with health conditions, those who take medications or those who live in hotter parts of the country. Write down any questions you have — and mention any regular sports or activities that will expose your child to high temperatures.

Having a plan for preventing heat illness in active kids is smart, no matter where your family lives. Having an emergency action plan is also smart, as it is important to treat the symptoms of heat illness immediately. Pediatricians are ready to join the conversation, helping you make the case that when it is dangerously hot, keeping cool makes healthy sense.

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Samuel Schimelpfenig, MD, FAAP, FACSM, is board-certified in general pediatrics and primary care sports medicine. He is a member of the American Academy of Pediatrics Council on Sports Medicine and Fitness, as well as the American College of Sports Medicine. Dr. Schimelpfenig is an associate professor at the University of South Dakota Sanford School of Medicine and serves as the medical director of his health care system's sports medicine department.

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