With some sources projecting the heat index (what temperature it feels like) to be as high as 115 degrees in Baltimore this weekend, it’s important to protect your family’s skin and stay hydrated.
Dr. Thomas Jomy Mathew, a Columbia resident, has served as the chief medical officer at UnitedHealthcare Community Plan for Maryland and Washington, D.C. for two years. As an internal medicine physician, he offers his expertise in understanding the relationship between hydration, skin and health in the Q&A below.
Responses are bulleted below each question, edited for style and clarity.
Hydration
Water makes up 50%-60% of our bodies, so we need lots of it to function properly. The best way to hydrate is with water, as many artificial exercise drinks can have additives and sugar, Mathew says.
Q: What does water do for us?
- Lubricates joints
- Supports healthy organs and cells
- Aids digestion
- Regulates body temperature
- Maintains sodium balance
Q: What foods or beverages contribute most to dehydration?
- High-protein diets and foods with high salt content can contribute to dehydration.
- Sugary drinks such as soda and sports drinks can also increase fluid loss.
Q: How can parents encourage children to drink water?
- To make sure that kids are staying hydrated, parents can follow the “4 Gulps of Water” rule, which says for every 15 minutes of outdoor activity, parents should have children drink 4 ounces of water (about 4 gulps). That’s around 16 ounces of water per hour, or more depending on the activity level.
- Fun ways to increase hydration in children is to make homemade popsicles with real fruit, providing a fresh fruit smoothie made with coconut water, milk or milk substitute, or yogurt after some time outside.
- Another tip is to put a pee chart in the bathroom. By color coding a chart from clear to light yellow to dark yellow, parents can teach children what a healthy level of hydration looks like. Many of these can be found online and printed off at home.
Q: How can parents tell if their children are dehydrated?
- Some of the most common signs of dehydration in children include:
- A dry or sticky mouth
- Few or no tears when crying
- Eyes that look sunken
- In babies, the soft spot (fontanelle) on top of the head looks sunken
- Urinating less, or fewer wet diapers than usual
- Dry, cool skin
- Irritability
- Drowsiness or dizziness
- Not sweating (seek emergency care immediately)
Q: Is it possible for kids to drink too much water?
- Not many people realize that drinking more water than you need can actually cause a number of health issues, from feeling ill to causing hyponatremia or “water intoxication,” a condition that can lead to seizures, coma and even death.
- Our bodies do a good job of letting us know when they need a drink. For parents, it’s best to follow tips like the 4 Gulps Rule and keep an eye out for any signs of dehydration in kids.
Q: Are sports drinks good for hydration? Ex: Gatorade, Powerade
- You’ll often see sports drinks touting the importance of replenishing electrolytes but unless someone is doing an intense workout in the heat, or [has] vomiting and diarrhea, you really don’t need to consistently replenish them. Most people get all of the electrolytes they need from eating healthy food.
- For children especially, it’s recommended to stay away from sugary name-brand sports drinks which were developed with an adult’s body in mind. Carbonated water mixed with fruit juice is a great alternative.
Q: What are some snacks that can help kids stay hydrated?
- It’s recommended that every 30-45 minutes [you] give the child a small snack with salt and potassium to help protect against electrolyte loss and promote hydration. Pretzels or goldfish or a cheese stick with some oranges, bananas or strawberries are good options.
Q: What are some things you think might surprise parents when it comes to staying hydrated?
- Some prescription medications can be dangerous with excessive exposure to sunlight or may speed up dehydration. Make sure you research any medications your child is taking to see if additional precautions should be taken in excessive heat.
Sun Protection
Sun protection is an everyday job, and according to Mathew, the long-term sun damage that occurs by inadequate protective strategies starts when you are very young so it’s vital to be proactive!
Q: How do you decide which sunscreen to use?
The main things to look for in sunscreen are:
- Broad spectrum: This protects your skin from both ultraviolet A (UVA) and ultraviolet B (UVB) rays.
- Sun Protection Factor (SPF) number: This number tells you the level of protection against UVB rays which are the main cause of sunburn. The American Academy of Dermatology recommends SPF 30 or higher. Keep in mind that while a higher SPF blocks more UVB rays (SPF 30 blocks 97%), it doesn’t last longer than a sunscreen with lower SPF. All sunscreens should be reapplied about every 2 hours, or after swimming or sweating.
- Water resistant: While no sunscreen is waterproof, water-resistant sunscreens typically last up to 40 minutes of swimming or intense exercise.
Q: Do children need different sunscreen?
- No, children can use the same sunscreen as adults.
Q: When should people wear sunscreen?
- It’s best to wear sunscreen whenever you’re outside. The Skin Cancer Foundation recommends wearing it every day, even when it’s cloudy, as your skin can still burn.
- It’s also important for people of color to be aware that although their skin may be less prone to burning, they are just as high risk for skin cancer and should use sunscreen daily.
Q: Other than using sunscreen, what can people do to keep cool?
- Covering up with lightweight, tightly woven shirts and pants adds an extra layer of protection. There are many companies that offer sun-protective clothing to help block UV rays. Look for clothing with the UV Protection Factor (UPF) labe,l which will tell you the level of protection on a scale from 15 to 50+. A higher number means more UV protection.
- You can also use UV-blocking sunglasses and wear hats to protect your eyes.
- To stay cool, take breaks from the sun and spend time in the shade or indoors.
Q: How hot is too hot for playing outside?
- A heat index of 90 degrees Fahrenheit and above can pose health risks for children and lead to heat-related illnesses including heat exhaustion and heat stroke (which is a medical emergency).
- Symptoms of heat exhaustion include:
- Nausea
- Headache
- Dizziness
- Irritability
- Weakness
- Thirst
- Increased body temperature
- Heavy sweating
- Decreased urination
- Heat stroke is a medical emergency, and you should call 911 right away. Symptoms include:
- Very high body temperature
- Change in mental state
- Confusion
- Slurred speech
- Loss of consciousness
- Seizure
- Hot, dry skin
- Profuse sweating
Q: What are the most common areas people “miss” with sun protection?
- Some of the most common areas that are easy to miss are the tops of ears, back of neck, and the part line on the scalp.
Q: When does a sunburn require medical attention?
- Common sunburn symptoms include reddening, peeling skin and blisters.
- Symptoms of overexposure, also known as sun poisoning, include chills, rash, nausea or fever. While these symptoms are usually temporary, it’s best to speak with a medical professional.
Q: What immediate steps can parents take if they notice their child starting to burn?
- Take the child out of the sun.
- Have them bathe in cool water or use a cool cloth.
- Use lotion to soothe the skin, specifically products with aloe vera.
- When they go outside again, make sure they wear protective clothing that covers the burn.
Q: Is tanning dangerous?
- Sun tanning is not a safe activity and can increase your risk of developing skin cancer, according to the FDA. Long periods of time tanning can prematurely age the skin and cause leathery, wrinkled skin and dark spots.
- According to the Skin Cancer Foundation, indoor tanning devices are especially harmful and can emit UV radiation in amounts 10 to 15 times higher than the sun at its peak intensity. Indoor tanning can increase the risk of being diagnosed with melanoma. Twenty states, including Maryland, prohibit people younger than 18 from using indoor tanning devices.
Q: Is there anything else you’d like to share on the topics of sun protection or hydration that you don’t feel these questions have covered?
It’s very important for parents who have children on certain medications to ask their providers about the impact to factors in hydration or sun exposure. For example, certain antibiotics or treatments for acne have increased sensitivity in prolonged sun exposure moments. Make it a routine point to ask your providers during an annual well-child visit or sick visit to address any concerns surrounding medications and strategies with proper hydration and/or sun protection.
