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The Honolulu Advertiser

Posted on: Friday, July 23, 2004

RECREATION
Keeping kids hydrated crucial in activities

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By Leila Wai
Advertiser Staff Writer

It is one of the most preventable problems in sports. It can affect an athlete's ability to perform by causing headaches, cramps, and excessive fatigue.

Ameen Mujtabaa, 10, gets a water bottle from Kimi Imamoto at the "Defeat the Heat" tent.

Photos by Andrew Shimabuku • The Honolulu Advertiser

The cure is as easy as walking to the kitchen sink and filling up a glass of water.

Dehydration affects two of out three children, according to the National SAFE KIDS Campaign, through its "Defeat the Heat" public safety campaign.

"You have the whole gamut from heat cramps or heat stroke or death," said Billie Tang, who is a physical therapist and athletic trainer. "And it is so preventable, you just have to know about fluids."

Tang, with the Keiki Injury Prevention Coalition, was one of several volunteers at the "Defeat the Heat" tent at Waipi'o Peninsula Soccer Complex at the American Youth Soccer Association Rainbow Tournament earlier this month.

She said most parents and coaches are unaware how much fluids — both water and sports drinks — children need, especially in a hot and humid climate like Hawai'i.

"They set the example," Tang said. "If a coach isn't allowing you to drink water, what are you going to do?"

One of the best indicators of lost fluids during activity is weight loss. Tang said the 450 children who visited the "Defeat the Heat" tent were weighed before and after their games. Losing more than a pound was an indication of improper hydration.

Losing a little weight is natural, according to Dr. Spencer Chang, an orthopedic surgeon who specializes in sports medicine.

Chang, who helped out at the tent, said "replenishing is the key."

He said sports drinks help replace lost electrolytes. However, he cautioned to stay away from caffeinated soft drinks because they are diuretics and won't hydrate you.

He also said to drink cold water to try to cool your body down.

Chang, who also helps out as a team doctor at the University of Hawai'i, did his fellowship with the University of Miami football team, and said he saw first-hand some of the dangers of dehydration.

Florida is similar to Hawai'i because of its humidity, and he said some of the players became so dehydrated they needed to receive 2 to 3 liters of fluids intravenously.

If dehydration is not addressed, it can escalate to heat cramps, heat exhaustion, or exertional heat stroke, which can result in death.

Courtney Frederiksen downs a sports drink during a break in her soccer game at Waipi'o Peninsula Soccer Complex.
Treatment for dehydration includes moving a child to a shaded or air-conditioned area and giving them fluids to drink.

Heat cramps can include symptoms such as intense pain and persistent muscle contractions. Cramps can be treated with light stretching and massage.

Heat exhaustion is moderate heat illness that occurs when a child continues to be physically active even after he or she suffers from the effects of the heat, like dehydration, according to the National SAFE KIDS Campaign.

The worst-case scenario is exertional heat stroke, which occurs when a child's body creates more heat than it can release. It can lead to permanent disability or death if left untreated, according to the National SAFE KIDS Campaign.

If a child's temperature rises above 104 degrees or he or she has seizures, confusion or irrational behavior, you should seek medical treatment immediately.

Kailua Intermediate student Trey Tam, 12, said he will drink more fluids after learning what could happen if he doesn't drink enough.

His father, Ranson, of Waimanalo, was happy for the education.

"He sweats a lot, so we always tell him to drink plenty," Ranson Tam said. "This educational stuff will help out. If you see the pro football players, they have a lot of accidents. I don't think a lot of parents know about it."

According to the campaign, children with different body weight need different amounts of water.

Children under 90 pounds should drink 3 to 6 ounces one hour before an activity, 3 to 5 ounces every 20 minutes during an activity and up to eight ounces after the activity, per half pound of weight lost.

One ounce usually equals two child-size gulps.

Children over 90 pounds should drink 6 to 12 ounces one hour before an activity, 6 to 9 ounces every 20 minutes during an activity and up to 12 ounces after the activity, per half pound of weight lost.

It is something Kailua freshman Melanie Yoshida will have to take into consideration.

Yoshida, 14, said she gets dehydrated a lot, although she tries to drink Gatorade before and during games.

"I already kind of knew about it, but I didn't know how much I needed," she said. "I need to try to drink more water."

Symptoms of dehydration include the obvious, such as thirst, and a headache and dizziness, according to the National Safe Kids Campaign.

Some signs that aren't as obvious are: becoming seemingly bored or uninterested in the activity; or the child being unable to run as fast or play as usual.

King Intermediate eighth-grader Kekoa Bonds said he didn't know the symptoms of dehydration before, although he drinks a lot of water because his mother encourages him to.

"I was just drinking it before," said Bonds, 12. "But now I know why."

Reach Leila Wai at lwai@honoluluadvertiser.com or 535-2457.

• • •

WHAT TO WATCH FOR / HOW TO TREAT IT

Fluid Examples for Children

Over 90 pounds: 1 hour before activity, 6 to 12 ounces

Under 90 pounds: 1 hour before activity, 3 to 6 ounces

During activity: every 20 minutes, 3 to 5 ounces (under 90 pounds), 6 to 9 ounces (over 90 pounds)

After activity: to replace fluids, up to 8 ounces per half pound lost (under 90 pounds), up to 12 ounces per half pound lost (over 90 pounds)



Dehydration

Signs and symptoms

• Dry Mouth

• Thirst

• Being irritable or cranky

• Headache

• Seeming bored or uninterested

• Dizziness

• Cramps

• Excessive fatigue

• Child not able to run as fast or play as well as usual

Treatment

• Move child to a shaded or air-conditioned area

• Give him or her fluids to drink



Heat Cramps

Signs and symptoms

• Intense pain (not associated with pulling or straining a muscle)

• Persistent muscle contractions that continue during and after exercise

Treatment

• The child should be given a sports drink to help replace fluid and sodium losses

• Light stretching, relaxation and massage of the cramped muscles may help



Heat Exhaustion

Signs and symptoms

• Child finds it hard or impossible to keep playing

• Loss of coordination, dizziness or fainting

• Dehydration

• Profuse sweating or pale skin

• Headache, nausea, vomiting or diarrhea

• Stomach/intestinal cramps or persistent muscle cramps

Treatment

• Move child to a shaded or air-conditioned area

• Remove any extra clothing an equipment

• Cool the child with cold water, fans or cold towels (replace towels frequently)

• Have child lie comfortably with legs raised above heart level

• If the child is not nauseated or vomiting, have him or her drink chilled water or sports drink

• The child's condition should improve rapidly, but if there is little or no improvement, take the child for emergency medical treatment



Exertional Heat Stroke

Signs and symptoms

• Increase in core body temperature, usually above 104 degrees when the child falls ill

• Central nervous system dysfunction, such as altered consciousness, seizures, confusion, emotional stability, irrational behavior or decreased mental acuity

Other possible indicators include

• Nausea, vomiting or diarrhea

• Headache, dizziness or weakness

• Hot and wet or dry skin

• Increased heart rate, decreased blood pressure or fast breathing

• Dehydration

• Combativeness

Treatment

• Locate on-site medical personnel

• Remove extra clothing or equipment

If there are no on-site medical personnel

• Call emergency medical services for immediate transport to the nearest emergency medical facility. Begin cooling the child while waiting for and during transport to the emergency facility

Source: National SAFE KIDS Campaign

For more information, go to www.DefeatTheHeat.com.