Protecting Children from Heat Waves in Hyderabad: A Paediatrician's Complete Guide

Hyderabad regularly records summer temperatures of 40–44°C from March to June. For adults, this is uncomfortable but manageable. For infants and young children, it can be life-threatening in a matter of hours. Heat illness in children is preventable — but it requires parents to understand the signs, act quickly, and know when home treatment is not enough.

Why Children Are More Vulnerable to Heat Than Adults

Children's bodies handle heat less efficiently than adults for three fundamental reasons:

1. Higher surface area to body weight ratio: Children absorb more heat from the environment relative to their body mass
2. Less efficient sweating: Especially infants — their sweat glands are not fully developed. Sweating is the body's primary cooling mechanism
3. Cannot self-regulate: Infants and young toddlers cannot tell you they are hot, cannot remove clothing, cannot seek shade or water independently. They are entirely dependent on their caregivers

Three Levels of Heat Illness — Know the Difference

Heat Cramps (Mild)

Painful muscle cramps — usually in the legs — during or after exercise or outdoor activity in heat. The child is alert and not confused.

Treatment: Move to shade/cool area. Give cool water or oral rehydration solution (ORS). Rest. Gently stretch and massage cramped muscles. No need for hospital if the child is alert, drinking, and cramps resolve within 30 minutes.

Heat Exhaustion (Moderate) — Act Promptly

Symptoms:

• Profuse sweating
• Pale, cool, clammy skin
• Fast, weak pulse
• Nausea or vomiting
• Headache and dizziness
• Fatigue and weakness — child wants to lie down
• Temperature elevated but below 40°C

Treatment: Move to a cool, air-conditioned space immediately. Remove excess clothing. Apply cool wet cloths to the neck, armpits, and groin. Give oral fluids if the child is alert enough to swallow — ORS, coconut water, or plain cool water. If no improvement within 30 minutes or the child is vomiting and cannot keep fluids down — take to hospital for IV fluids.

Heat Stroke (Emergency) — Call 108 Immediately

Heat stroke is a life-threatening emergency. Body temperature rises above 40°C and the brain is involved.

Warning signs of heat stroke in a child:

• High fever above 40°C combined with hot, red, dry OR moist skin
• Confusion, strange behaviour, agitation, or loss of consciousness
• Seizures
• Rapid, strong pulse that becomes weak
• Stopped sweating (in classic heat stroke) despite extreme heat

Emergency action while waiting for ambulance: Move the child to the coolest possible environment. Immerse in cool (not ice cold) water or apply cool wet sheets to the entire body. Fan continuously. Do NOT give fluids to an unconscious or confused child — risk of aspiration. Call 108 and say "paediatric heat stroke."

The Most Dangerous Mistake: Leaving Children in Parked Cars

The interior of a parked car in Hyderabad summer can reach 60–70°C within 10 minutes of parking — even with windows cracked. A child's temperature can rise 3–5 times faster than an adult's. Heatstroke can occur within minutes. Never leave a child in a parked car for any duration, regardless of how brief.

Practical Prevention Tips for Hyderabad Parents

• Timing outdoor activities: Keep children indoors between 11 AM and 4 PM during April–June. Plan outdoor play for early morning (before 9 AM) or evening (after 5 PM)
• Hydration: Offer fluids every 20–30 minutes during outdoor activity — do not wait for the child to ask. ORS, coconut water, nimbu pani (lime water), or plain water all work
• Clothing: Loose, light-coloured, breathable cotton. Avoid dark colours that absorb heat. Hats or caps outdoors
• School bags and auto travel: Children travelling in autos or open vehicles with heavy bags are at significant heat exposure risk — check on children after long commutes on hot days
• Fever in summer: A child with a fever above 38°C during a heat wave can deteriorate quickly — seek medical assessment earlier than you normally would

Infants Under 6 Months — Special Risk

Babies under 6 months cannot sweat effectively and should not be given water (exclusive breastfeeding provides sufficient hydration). Signs of overheating in infants: hot to touch, flushed face, rapid breathing, restlessness or unusual lethargy. Air-condition the room or use a fan (not directly on the baby). If temperature rises above 38°C in a baby under 3 months — attend hospital immediately.

For paediatric assessment and heat illness management: Dr. Sushma B at Sri Anand CNC, Chanda Nagar, Hyderabad. Call +91 90633 66983.