Risk of Heat Illness in Children

Texas’ summer heat isn’t just uncomfortable: It poses serious health risks, especially for kids. Here’s why that’s the case and how to keep your child safe.

Understanding Heat Illness

Children are vulnerable to heat stress for several reasons, said Dr. Troy Smurawa, a pediatric sports medicine specialist at Children’s Health Andrews Institute for Orthopedics and Sports Medicine in Plano.

Like adults, children cool themselves by sweating, he said. But because children have a larger body surface area relative to their mass, they heat up faster and can’t cool down as efficiently. Their shorter height also puts them closer to the heat rising from concrete, asphalt and other heat-absorbing materials, which intensifies the warmth their bodies generate and feel.

“The other difference we find in children is their response to early cues for heat illness, heat injury and dehydration may not be as sensitive,” Smurawa said. “Whereas an adult who has been in the heat may recognize early signs and symptoms that they are getting hot and dehydrated — such as getting dizzy and lightheaded — children may not recognize those early signs. They may continue to play until [heat exposure] becomes more advanced. They may not have the trigger or desire to drink fluids until they have that thirst mechanism.”

When the body’s ability to regulate its temperature is overwhelmed, heat-related illness can result.

Emergency room visits for heat-related illnesses among children in Dallas and Plano surged 170% between 2012 and 2023, according to a recent study from UT Southwestern Medical Center. These visits were more common during the hottest months of the year, underscoring the seasonal risk.

Related:Dallas-area children hospitalized for heat-related illnesses soars 170% since 2012

Tessa Partida, 3, is held by her mother Lorraine Partida of Harlingen, Texas, they wait in the shade in Arlington, Texas, Sunday, July 27, 2025.

LM Otero / AP

Stages of Heat Illness

The first stage of heat illness is cramping, when muscles begin to spasm from excessive heat, Smurawa said. Next is heat syncope, where a person may faint from overheating. Beyond that comes a range of symptoms from exhaustion, where the body can no longer cool itself effectively. If left untreated, heat exhaustion can escalate to the most dangerous stage: heat stroke.

Heat stroke differs from heat exhaustion in two major ways, Smurawa said. Heat stroke involves a dangerously high core body temperature — typically 104 F or more — and can impair the central nervous system. This means a person may become disoriented, confused or, in severe cases, experience seizures or even coma.

“Heat exhaustion can be extreme, but it’s not quite as life-threatening, whereas heat stroke is life-threatening,” Smurawa added. “As the core body temperature gets above 104, it can start to affect the function of a person’s internal organs.”

Tips for Staying Safe

Smurawa said it’s essential for parents to recognize the signs of too much heat exposure in their children before heat illness strikes. These include:

• Pale, moist or flushed skin.
• Dizziness.
• Nausea and vomiting.
• Fatigue or tiredness.
• Disorientation.

He recommends that parents plan outings during cooler times of the day — early morning or evening — while ensuring children stay hydrated and take frequent breaks in the shade, especially during physical activity.

Miles Kraai, of Zeeland, drinks water while watching the Detroit Lions practice during an NFL football practice Monday, July 28, 2025, in Allen Park, Mich.

Ryan Sun / AP

Choosing the Right Clothing

Although cotton clothing is breathable, it traps moisture and doesn’t help with cooling. Garments that are light-colored, loose-fitting and wicking are preferable.

It’s also important to use sunscreen, Smurawa said. “Sunburn or sun exposure can increase the risk of heat illness and continues the risk of exposure to heat.”

Risk Factors for Heat Illness

Being overweight or obese can increase a child’s risk of heat illness, as can certain medications for colds, allergies or attention deficit, Smurawa said. A 2009 study from Pennsylvania State University comparing seven obese and seven lean boys, ages 9 to 12 years old, found the obese children started with higher core body temperatures and adapted to heat more slowly during summer exercise. In Texas, 21% of children ages 6 to 17 were classified as obese, according to the State of Childhood Obesity report from the Robert Wood Johnson Foundation, higher than the national average of 17%. The study used data from the National Survey of Children’s Health in 2022 and 2023.