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As a mother of two and a physician who specializes in working with newborns, Mattie Wolf understands that it can be tempting for parents to look upon their children and regard them as a “mini-me.”

But when it comes to high summer temperatures, Wolf cautions, that may be one of the worst things that a parent can do.

“Children are not little adults,” said Wolf, a neonatologist at Emory University’s School of Medicine and Children’s Healthcare of Atlanta. “Children and infants, especially the way that their bodies work, is different. Infants do not have the same ability to sweat. The way that their lungs work, the way that their heart pumps blood, all of those things—their bodies respond in a different way to heat. So it’s especially important that we try to protect them from heat waves and elevated temperatures to the best of our ability.”

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As the nation steams toward what’s expected to be yet another summer of record-breaking temperatures, public health experts are reminding parents to practice caution when it comes to managing how children are exposed to extreme heat.

Over the past year, researchers have expanded what we know about how heat affects young people, noting that extreme heat exposure in childhood can have lasting effects on learning and sleep quality; high temperature can make children more sedentary, which can impact health in later life; and that heat is linked to an increase in mood and anxiety disorders in children and higher use of emergency mental health services.

And while many parents and caregivers may not understand precisely how a young child’s body is affected by heat, experts say it is wise to keep Wolfe’s admonition in mind—they are not miniature adults, and the toll of hot weather on their health could be greater than what is apparent at first glance.

Among the suggestions public health experts offer to help children cope with high temperatures are those ensuring that children are properly hydrated, making sure that they are wearing loose clothing, not covering car seats and strollers in an attempt to block the sun and not leaving children alone inside hot vehicles. 

With the planet having marked 12 consecutive months of record-breaking temperatures and a range of studies over the past year, public health experts are increasingly concerned about the risks of heat-related health problems to infants, toddlers, tweens and teens.

Roughly 1,300 Americans die each year from extreme heat, including about three dozen children, many of whom are victims of what’s known as vehicular heat stroke, from sitting in poorly ventilated cars and trucks.

Jan Null, a meteorologist and an adjunct professor at San José State University, has been studying pediatric vehicular heat stroke for more than 20 years. In a study Null co-wrote in 2005, he and researchers found that car temperatures go up 19 degrees in 10 minutes and increase by 34 degrees within half an hour. Null said there have been two so far this year.

Since 1998, he said 971 children have died in hot cars in this country. “God, I’m hoping we don’t get to, you know, get to a thousand this year,” he added. 

As temperatures rise, experts say, it’s essential that parents rethink how—and how often—they allow their children to be exposed to the heat.

“Summer used to be a time where you’d send your kids outside and you’d be like, ‘Go outside, have a wonderful time. You know, have fun,’” said Claudia Benitez-Nelson, a professor in the Earth Ocean and Environment department at the University of South Carolina. “And now with the climate that we’re in, when you send your child outside and it’s 110 degrees, you’re like, ‘No, no, no, come back in. Maybe let’s not play outside all day today.’ I mean, we as parents have to fundamentally change.”

Summer officially doesn’t start until June 20, but outdoor temperatures are already starting to rise. And as a heat wave blankets much of the U.S. this week and states hit record highs, doctors and researchers urge parents, guardians and caregivers across the country to keep children in mind when it comes to heat.

Benitez-Nelson, who is also a member of Science Moms, a nonpartisan group of climate scientists who are also parents, said it’s even hotter than it was 10 or even five summers ago. And because of climate change and our warming planet, she said summers will continue to get hotter and hotter, and the summer vacations of children today will change more and more too. 

“They’re going to be a lot more inside,” she said. “They’re going to be getting up early or staying up later to kind of take advantage of those cool periods of time. I mean, it’s where we’re going to have to change how we kind of do all these things.”

Young children cannot regulate their body temperatures in the same way as adults and exposure to high temperatures can lead to “muscle breakdown, kidney failure, seizure, coma or even death in extreme cases,” according to a working paper from the Center on the Developing Child at Harvard.

Children’s bodies are smaller and heat up more quickly, according to researchers. They have less of a capacity to sweat, or in the case of infants, they don’t sweat at all.

And the risks continue while children continue to grow, Wolf said.

“Obviously, infants are the most susceptible,” she said. “But over the course of their childhood, into their early teenage years, their physiology, the way that their body works is definitely different. And so as they near their teenage years and into early adulthood, obviously the way that their body works mimics the way adults’ bodies work. But it’s a slow process that changes throughout their entire childhood.”

Heat can also hurt the lungs of young children. It’s something Carmen Vélez Vega, a public health professor at the University of Puerto Rico, thinks about constantly. “It also exacerbates respiratory symptoms more so than in adults, like asthma. And they breathe more than adults,” she said.

Vélez Vega said after Hurricane Maria, power was out in Puerto Rico for nearly a year in some areas, and with rising temperatures, the health of children was seriously impacted.

“What happened to us in 2017, in Puerto Rico, was terrible because the whole health system collapsed,” she said in an interview. “For kids that were asthmatic, they didn’t have the resources they needed.” 

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And federal health officials have been diligent about spreading the word about the dangers to young people.

Grace M. Robiou, director of the Environmental Protection Agency’s Office of Children’s Health Protection, led a Spanish-language webinar last week on how air quality and extreme heat affect children’s health.

“There are significant risks to children that we need to be aware of,” Robiou said. “And we’re trying to raise awareness of these risks so that people can take precautions. Every summer, over the past several years, we have increasingly experienced more days of extreme heat. So we want parents and caregivers to practice prevention as the best defense for managing heat and avoiding heat exhaustion or even heat stroke in children.”

“We need to remember,” Robiou said, “that children are reliant on others to support them.”

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