Inadequate hydration places the athlete at risk for imbalances in electrolytes (such as sodium and potassium), heat illness and compromised performance. Individual characteristics such as age, weight, gender, sweat rates and composition will all be unique. Younger children do not dissipate heat as well, so they are at higher risk for dehydration and heat illness than their teenage counterparts. Fluid replacement needs to be individualized.

We want all of our little all-stars to succeed on the field, but do so in a safe manner. As the temperature rises, be watchful for the HEAT: Hydration, Environment, Acclimatization, Treatment.

Hydration: The first step in preventing dehydration is ensuring normal hydration status before activity. For most, about 16 ounces of fluid four hours before activity is adequate. Normal hydration exists if the athlete produces clear urine. If there is dark urine or an inability to produce urine, consuming 16 ounces of fluid slowly, every one to two hours until urine is produced typically corrects the problem. For those engaging in sessions lasting longer than three hours, sport drinks may be beneficial and care should be given to determining an individualized fluid replacement schedule. Body weight changes can help determine sweat losses. The general rule is that a pound of sweat lost needs to be replaced by about 20 ounces of fluid.

Environment: Changing the environment in which the athlete participates can also prevent dehydration and heat illness. Practice and training sessions should be avoided during the hotter mid-day hours between noon and 4 p.m. Extreme temperature and humidity should prompt practices to be moved inside or cancelled altogether. Mandatory rest and water breaks ought to be encouraged. Competitions should allow for additional breaks and free substitutions. Excess equipment, especially helmets, should be removed whenever possible.

Acclimatization: Most young athletes will not be conditioned for the rigors of full intensity competition performed at stressful temperatures. A graded transition should be used. Recommendations include limiting practices to 60-90 minutes, only one session per day for the first week of conditioning and gradually increasing the amount of equipment worn. Detailed acclimatization schedules are available from youth sports organizations as well as the American College of Sports Medicine website.

Treatment: Athletes should be constantly monitored for early warning signs of heat illness. Diminished performance, fatigue, nausea, dizziness or confusion should all prompt the athlete to get to a cool place, rest and drink fluids. More worrisome symptoms such as confusion, passing out or severe headache warrant immediate medical evaluation.

For more information, or to make an appointment with one of UofL Physicians’ sports medicine physicians, contact Jonathan Becker MD or Jessica Stumbo MD, at 502-637-9313.

Editor’s Note: UofL Today reprints To Your health articles from the “UofL Physicians-Insider” newsletter. Read the entire August Issue (opens as a PDF document).