Water and Protecting Your Child

Dehydration and Heat Illness: Protecting Your Child

With the hot days of summer come summer sports: baseball, tennis, football, both in the neighborhood and at camp. Before you send the kids out to practice -- or just for a long day of play in the sun -- learn to protect your child against the dangers of dehydration and heat illness.

1. What puts my child at risk for dehydration?

The same things that put you at risk for dehydration: prolonged exposure to high temperatures, direct sun, and high humidity, without sufficient rest and fluids. The difference is that a child's body surface area makes up a much greater proportion of his overall weight than an adult's, which means children face a much greater risk of dehydration and heat-related illness.

2. What signs of dehydration should we watch for?

Early signs of dehydration include fatigue, thirst, dry lips and tongue, lack of energy, and feeling overheated. But if kids wait to drink until they feel thirsty, they're already dehydrated. Thirst doesn't really kick in until a child has lost 2% of his or her body weight as sweat.

Untreated dehydration can lead to three worse types of heat illness:


Heat cramps: Painful cramps of the abdominal muscles, arms, or legs.
Heat exhaustion: Dizziness, nausea, vomiting, headaches, weakness, muscle pain, and sometimes unconsciousness.
Heat stroke: A temperature of 104 or higher and severe symptoms, including nausea and vomiting, seizures, disorientation or delirium, lack of sweating, shortness of breath, unconsciousness, and coma.

Both heat exhaustion and heat stroke require immediate care. Heat stroke is a medical emergency that, when untreated, can be deadly. Any child with heat stroke should be rushed to the nearest hospital.

3. What can I do to prevent dehydration in my child?

Make sure they drink cool water and sports drinks early and often. Send your child out to practice or play fully hydrated. Then, during play, make sure your child takes regular breaks to drink fluid, even if your child isn't thirsty. The American Academy of Pediatrics recommends five ounces of cold tap water or sports drink for a child weighing 88 pounds, and nine ounces for a teen weighing 132 pounds. One ounce is about two kid-size gulps.

Get them acclimatized before summer practice. "If you're going to send your kid off to tennis camp, they shouldn't be sitting around doing nothing in May and then going out to play tennis eight hours a day in June," says Hergenroeder. "They should be outdoors jogging, riding a bike, and otherwise slowly building up their fitness and ability to handle the heat." The fitter children are, the sooner their bodies will start to sweat after beginning to exercise -- and that's a good thing!

Know that dehydration is cumulative. If your child is 1% or 2% dehydrated on Monday and doesn't drink enough fluids that night, then gets 1% or 2% dehydrated again on Tuesday, that means your child is 3% or 4% dehydrated at the end of the day. "They may be gradually developing a problem, but it won't show up for several days," says Hergenroeder. "You should always monitor your child's hydration." One way to do this: weigh your child before and after practice. If his weight drops, he's not drinking enough during his workout.

A simple rule of thumb: if your child's urine is dark in color, rather than clear or light yellow, he or she may be becoming dehydrated.

4. If my child develops heat illness, what can I do to treat it?

The first thing you should do with any heat illness is get the child out of the sun into a cool, comfortable place. Have the child start drinking plenty of cool fluids. The child should also take off any excess layers of clothing or bulky equipment. You can put cool, wet cloths on overheated skin. In cases of heat cramps, gentle stretches to the affected muscle should relieve the pain.

Kids with heat exhaustion should be treated in the same way but should not be allowed back on the field the same day. Monitor your child even more carefully, Hergenroeder says. If your child doesn't improve, or can't take fluids, see a doctor.

Heat stroke is always an emergency and requires immediate medical attention.

5. Are some children more prone to dehydration or heat illness than others?

Yes, says Hergenroeder. One of the biggest risk factors: a previous episode of dehydration or heat illness. Other factors that can put your child at greater risk for heat illness include obesity, recent illness (especially if the child has been vomiting or has had diarrhea), and use of antihistamines or diuretics.

Lack of acclimatization to hot weather and exercising beyond their level of fitness can also lead to heat illness in young athletes. "If a young player isn't in shape and tries to go out and do things quickly to 'make the team,' -- or goes to summer practice or summer camp and hasn't been used to that kind of heat and humidity and duration of exercise -- that sets them up for dehydration and heat illness," Hergenroeder says.

6. Is it ever too hot for my child to practice or play sports?

A growing number of athletic programs suggest that it is sometimes too hot to practice. In fact, many are restricting outdoor practice when the National Weather Service's heat index rises above a certain temperature. The heat index, measured in degrees Fahrenheit, is an accurate measure of how hot it really feels when the relative humidity is added to the actual temperature.


SOURCE: Albert C. Hergenroeder, professor of pediatrics, Baylor College of Medicine; chief, the sports medicine clinic, Texas Children's Hospital.

Dangers of Nitrates in Your Water

Definition:
Nitrates: Inorganic compounds that can enter water supplies from fertilizer runoff and sanitary wastewater discharges. Nitrates in drinking water are associated with methemoglobinemia, or blue baby syndrome, which results from interferences in the bloods ability to carry oxygen.

Definintion:
Blue baby syndrome: a pathological condition, called methemoglobinemia, in which blood's capacity for oxygen transport is reduced, resulting in bluish skin discoloration in infants; ingestion of water contaminated with nitrates or certain other substances is a cause.

Nitrate in drinking water at levels above the national standard poses an immediate threat to young children. Excessive levels can result in a condition known as "blue baby syndrome." If untreated, the condition could be fatal.

Current EPA safe drinking water standards call for nitrate levels below 10ppm for Nitrates (measured as Nitrogen).

From the EPA (government site)

Nitrate (measured as Nitrogen)
Infants below the age of six months who drink water
containing nitrate in excess of the 10ppmCL could
become seriously ill and, if untreated, may die.
Symptoms include shortness of breath and blue-baby
syndrome.

Causes:
Runoff from fertilizer use; leaching from septic
tanks, sewage; erosion of natural deposits

Excerpt from the EPA guide titled:
Water On Tap: What You Need To Know

The United States enjoys one of the best supplies of
drinking water in the world. Nevertheless, many of
us who once gave little or no thought to the water
that comes from our taps are now asking the question:
“Is my water safe to drink?” While tap water
that meets federal and state standards is generally
safe to drink, threats to drinking water are increasing.
Short-term disease outbreaks and water restrictions
during droughts have demonstrated that we can no
longer take our drinking water for granted.

Nitrate in drinking water at levels above 10 ppm is a health risk for infants less than six months old. High nitrate levels in drinking water can cause blue baby syndrome. Nitrate levels may rise quickly for short periods of time because of rainfall or agricultural activity.

Excessive levels of nitrates can cause “blue baby syndrome,”
which can be fatal without immediate medical attention.

Nitrate, a chemical most commonly used as a fertilizer,
poses an immediate threat to infants when it is
found in drinking water at levels above the national
standard. Nitrates are converted to nitrites in the
intestines. Once absorbed into the bloodstream,
nitrites prevent hemoglobin from transporting oxygen.
(Older children have an enzyme that restores
hemoglobin.) Excessive levels can cause “blue baby
syndrome,” which can be fatal without immediate
medical attention. Infants most at risk for blue baby
syndrome are those who are already sick, and while
they are sick, consume food that is high in nitrates
or drink water or formula mixed with water that is
high in nitrates. Avoid using water with high nitrate
levels for drinking. This is especially important for
infants and young children, nursing mothers, pregnant
women and certain elderly people.

Boil Water Notice
Do NOT boil water to attempt to reduce nitrates.
Boiling water contaminated with nitrates
increases its concentration and potential risk.

If you are concerned about nitrates, talk to
your health care provider about alternatives to
boiling water for baby formula.

more about Nitrates...

From Colorado State University

Nitrates in Drinking Water
by J.R. Self and R.M. Waskom

Quick Facts...
-Nitrate is a colorless, odorless, and tasteless compound that is present in some groundwater in Colorado.
-Nitrate can be expressed as either NO3 (nitrate) or NO3-N (nitrate-nitrogen).
-Nitrate levels above the EPA Maximum Contaminant Level of 10mg/l NO3- N or 45 mg/l NO3 may cause methemoglobinemia in infants.
-Proper management of fertilizers, manures, and other nitrogen sources can minimize contamination of drinking water supplies.
-Nitrate (NO3) is a naturally occurring form of nitrogen found in soil. Nitrogen is essential to all life. Most crop plants require large quantities to sustain high yields.

The formation of nitrates is an integral part of the nitrogen cycle in our environment. In moderate amounts, nitrate is a harmless constituent of food and water. Plants use nitrates from the soil to satisfy nutrient requirements and may accumulate nitrate in their leaves and stems. Due to its high mobility, nitrate also can leach into groundwater. If people or animals drink water high in nitrate, it may cause methemoglobinemia, an illness found especially in infants.

Nitrates form when microorganisms break down fertilizers, decaying plants, manures or other organic residues. Usually plants take up these nitrates, but sometimes rain or irrigation water can leach them into groundwater. Although nitrate occurs naturally in some groundwater, in most cases higher levels are thought to result from human activities.

Common sources of nitrate include:
fertilizers and manure,
animal feedlots,
municipal wastewater and sludge,
septic systems, and
N-fixation from atmosphere by legumes, bacteria and lightning.

Health Effect of Nitrates

People
High nitrate levels in water can cause methemoglobinemia or blue baby syndrome, a condition found especially in infants under six months. The stomach acid of an infant is not as strong as in older children and adults. This causes an increase in bacteria that can readily convert nitrate to nitrite (NO2). Do not let infants drink water that exceeds 10 mg/l NO3-N. This includes formula preparation.

Nitrite is absorbed in the blood, and hemoglobin (the oxygen-carrying component of blood) is converted to methemoglobin. Methemoglobin does not carry oxygen efficiently. This results in a reduced oxygen supply to vital tissues such as the brain. Methemoglobin in infant blood cannot change back to hemoglobin, which normally occurs in adults. Severe methemoglobinemia can result in brain damage and death.

Pregnant women, adults with reduced stomach acidity, and people deficient in the enzyme that changes methemoglobin back to normal hemoglobin are all susceptible to nitrite-induced methemoglobinemia. The most obvious symptom of methemoglobinemia is a bluish color of the skin, particularly around the eyes and mouth. Other symptoms include headache, dizziness, weakness or difficulty in breathing. Take babies with the above symptoms to the hospital emergency room immediately. If recognized in time, methemoglobinemia is treated easily with an injection of methylene blue.

Healthy adults can consume fairly large amounts of nitrate with few known health effects. In fact, most of the nitrate we consume is from our diets, particularly from raw or cooked vegetables. This nitrate is readily absorbed and excreted in the urine. However, prolonged intake of high levels of nitrate are linked to gastric problems due to the formations of nitrosamines. N-nitrosamine compounds have been shown to cause cancer in test animals. Studies of people exposed to high levels of nitrate or nitrite have not provided convincing evidence of an increased risk of cancer.

Distillation boils the water, catches the resulting steam, and condenses the steam on a cold surface (a condenser). Nitrates and other minerals remain behind in the boiling tank.

Boiling nitrate-contaminated water does not make it safe to drink and actually increases the concentration of nitrates.

Aqua Di Vita Water is made using pure distilled water as the base and is considered to be nitrate free. In addition, no additives of any kind are used.

Read more about Aqua Di Vita Here