As children begin practices for fall sports in the sweltering heat, it's important to take steps to prevent heat exhaustion.

Heat exhaustion is one of three types of heat illnesses, said Robert Kregenow, M.D., a pediatric emergency medicine physician at Washington University School of Medicine and St. Louis Children's Hospital. It occurs when the body cannot cool itself properly during periods of extreme heat and excessive sweating without adequate replacement of fluid and salt. If untreated, it can lead to heat stroke, the most severe form of heat illness. The mildest form is heat cramps.

"Heat stroke can occur in healthy individuals during strenuous exercise or those with poor temperature regulation during extreme heat, such as infants and the elderly," said Kregenow. "Even with emergency treatment, heat stroke can lead to multi-organ failure and death."

Children and teenagers adjust more slowly than adults to changes in environmental heat, produce more heat with activity than adults and sweat less. They also may not think to rest or drink enough fluids when playing sports or exercising, Kregenow said. Humidity also is a contributing factor in heat exhaustion.

Heat illnesses can affect any child, but those who have chronic health problems, take certain medications, are overweight or wear heavy clothing are more susceptible. Football players are prone to heat illness, since their uniforms cover nearly the whole body and practice often begins when daytime temperatures are at their highest.

"To prevent heat exhaustion, have children drink plenty of water and sports drinks, at least 8 ounces every 15 to 30 minutes, during outdoor activities on hot days, and teach them to take breaks to drink or spray themselves down with a hose or sprinkler," said Kregenow.

He also suggests avoiding caffeinated drinks, which can lead to dehydration. Make sure to dress the child in light-colored, lightweight, loose-fitting clothing and use sunscreen of at least 15 SPF. Never leave infants or children unattended in a parked car or other hot environment.

Some signs of heat exhaustion include:

-- muscle cramps or muscle aches
-- pale, moist skin
-- fatigue or weakness
-- nausea, vomiting and diarrhea
-- headache
-- fatigue or weakness
-- anxiety or irritability
-- feeling faint or dizzy
-- normal or slightly elevated body temperature

Some signs of heat stroke can include all of the above signs, but often have:

-- body temperature greater than 104 F
-- mental status changes
-- seizures
-- blood pressure instability and breathing problems
-- may or may not be sweating

Kregenow has several tips for those who suspect heat exhaustion in a child or teen.

"Move them to a cool place to rest and remove excess clothing," he said. "Put cool cloths, cold water or ice packs on their skin and give them a sports drink containing salt and sugar. If the child improves, let him or her rest in a cool place the rest of the day. If there is not immediate improvement, the child cannot drink the fluids or is getting worse, call 911 to activate emergency services."

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