Signs of Heat Exhaustion and Heat Stroke in Infants and Toddlers



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With the summer heat upon us, it is important to remind ourselves of the signs of heat exhaustion and heat stroke. Infants and toddlers cannot always communicate everything they’re feeling. Knowing what to look for and how and when to get treatment can make the difference between life and death. Every year about 50 percent of people who suffer from heat stroke die from it, including babies.

What are heat stroke and heat exhaustion?

Heat stroke and heat exhaustion are two heat-related illnesses which fall under the category of hyperthermia. In hypothermia, the body cools down to dangerous levels after being exposed to cold weather conditions. Hyperthermia is the opposite, where the body temperature increases to dangerous levels as a result of exposure to hot environmental conditions.

Sometimes the terms "heat stroke" and "heat exhaustion" are used interchangeably, but that is not accurate. Heat exhaustion can turn into heat stroke if left untreated. Heat exhaustion is caused by excessive sweating in a hot environment resulting in a reduction in blood volume. Heat stroke is when a body’s core temperature rises above 105F (40.5C). At this temperature, bodily systems start to shut down and organs can suffer damage. Heat stroke is tricky because it doesn’t always appear immediately, but can build up over a few days.

Why do babies get heat stroke?

Heat disorders affect babies, toddlers and young children because, “in relation to their weight, they have a large surface area of skin through which to lose water. In addition, until about age two, children’s kidneys are not able to concentrate urine and preserve body fluids as efficiently as adult kidneys.” (Encyclopedia of Children’s Health) Adult bodies cool down by releasing excess body heat through sweat. The sweat evaporates and keeps us cool. Babies, toddlers, and young children do not sweat as well as adults because their bodies haven’t learned to regulate body heat as efficiently yet. Because of this, children can overheat quite easily.

When babies, toddlers and young children are unable to sweat enough to cool down their bodies their body temperatures rise quickly. This is why you never want to leave a child, even for a few minutes, in a vehicle. “[W]hen left in a hot vehicle, a young child’s body temperature may increase three to five times as fast as an adult” and “even with a window rolled down ... if the outside temperature is in the low 80s ... the temperature inside a vehicle can reach deadly levels in only 10 minutes.” (NHTSA)

The risk of a heat disorder increases when there is physical activity. Approximately 75 percent of every muscle action is used to keep our bodies warm. “Strenuous exercise would raise the body temperature by about 2 degrees every five minutes, reaching fatal levels in only about 20 minutes.”

Signs and Treatment of Heat Stroke in Babies and Toddlers

Heat exhaustion and heat stroke often don’t “just” appear out of the blue. There are usually beginning signs of heat stress, which, if left untreated, can lead to heat exhaustion and heat stroke. The initial signs of heat stress include:

  • Heat rash that doesn’t go away when the skin is cooled, called “prickly heat”. This rash looks like a red cluster of pimples or small blisters on or around the neck, upper chest, groin, and in elbow creases.
  • Heat cramps happen as muscles and bodily systems deplete their supply of electrolytes, particularly salt,  and water, and as a reaction to lower blood volumes. These cramps usually occur in the abdomen, arms or legs.
  • Moodiness or fussiness. If a baby, toddler or young child starts showing signs of crankiness or fussiness this can be an early indication of heat stress.
  • Watch for unusual erratic and repetitive behaviors such as repeatedly standing and sitting.

If these symptoms escalate and start to include:

  • Intense thirst
  • Highly concentrated and decreased output of deep yellow/orange urine
  • Dizziness or fainting
  • Pale skin
  • Rapid but weak heart rate
  • Headache
  • Nausea and vomiting

Then your child is becoming dehydrated and likely has heat exhaustion.

Treat early signs of heat stress and heat exhaustion by:

  • Stopping all activity
  • Moving the child to a cool environment
  • Giving him/her cool water with a teaspoon of salt per quart, or sports drink. Cold water and salt tablets can actually increase cramping symptoms.
  • Stretching or massaging muscles
  • Elevating the feet slightly if he or she wants to lie down
  • Removing or loosening his or her clothing

Rest and rehydration is usually enough, though some children may need more time to recover than others. Hospitalization is rarely needed, but you should call your family doctor.

Heat stroke indicates that a person’s body temperature is higher than 104F (40C), and possibly as high as 106F”. (Encyclopedia of Children’s Health).

Heat stroke symptoms include:

  • Mental confusion
  • Combativeness and bizarre behavior
  • Rapid, strong pulse (160-180 beats per minute)
  • Skin appears dry and flushed
  • Loss of consciousness or convulsions
  • Severe headache

If your child starts exhibiting these symptoms, call 911. In the meantime:

  • Move the child to a cool environment
  • Undress him or her
  • Sponge with cool water
  • Find something to fan him or her with

Do NOT give the child fluids. Do NOT give the child a fever reducer (acetaminophen or ibuprofen). These medicines are not effective at reducing a high body temperature caused by heat stroke.

Darlene Oakley is a freelance writer for


Heat Disorders. Encyclopedia of Children’s Health. Web. May 17, 2012.

Heat Stroke. Web. May 17, 2012.

Heatstroke. National Highway Traffic Safety Administration. Web. May 17, 2012.

Heat Illness. Web. May 17, 2012.

“Signs of Sun Stroke in a Toddler” Fleming, Sandy. Web. May 17, 2012.

Heat stroke. Web. May 17, 2012.

Related Links:

Heat Exhaustion and Heat Stroke

Cool Ideas to Beat the Heat

Keeping Your Heart Healthy in Summer Heat


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