Commonwealth Pediatrics - Helping Families Raise Healthy Children

News & Information on Child Safety

Exercise-Related Heat Illness

Exercise-related heat illness (ERHI) or “heat injury” happens when exercise is done in high temperature and high humidity. Unlike sports injuries, mainly caused by physical contact, ERHI is a type of injury often preventable with proper attention to safety and common sense.

About body temperature

  •  Human bodies try to keep a constant body temperature of around 98.6°F by balancing heat gain with heat loss.
  • Exercising muscles create 10 to 20 times more heat than resting muscles.
  • Sweating is the main way the body gets rid of excess heat.
  • As humidity rises, sweating becomes less effective at cooling the body.
  • Body temperature will rise if the body is unable to get rid of excessive heat, resulting in heat illness.

Signs of ERHI

  • Heat (fatigue) cramps—painful muscle contractions (most often in leg muscles), normal temperature
  • Heat exhaustion—body temperature up to 104°F; fatigue; nausea; vomiting; dizziness; fainting; flushed, moist skin
  • Heat stroke (life-threatening)—body temperature greater than 104°F, confusion, combativeness, seizures and/or stroke, shock, coma (unresponsive), and/or heart failure/cardiac arrest

Facts about heat illness

  • Even the best-trained athlete can develop a heat illness when it is hot and humid.
  • Early recognition is the key to successful treatment of heat illness.
  • For most athletes, drinking cold water is as good as sports drinks in preventing heat illness and maintaining performance.
  • Dripping sweat does not cool the body and prevent heat illness; sweat that evaporates does.
  • Children may be at greater risk than adults for developing heat illness.
  • Heat stroke is a serious medical emergency.
  • Plans should be in place to cancel, postpone, or change events if it’s too hot and humid.
  • Both temperature and humidity (heat index) must be measured to accurately assess environmental heat stress. Athletes who have had heat illness before are at higher risk for another episode.

Tips to help prevent heat illness

  • Schedule activities during the coolest parts of the day (early morning or late afternoon/evening); consider cancelling or delaying an activity under extreme conditions.
  • Allow athletes to gradually adjust to exercising in hot, humid weather by increasing activities slowly over the first 2 weeks of practice.
  • Avoid the use of excessive clothing and equipment.
  • Schedule breaks every 10 to 15 minutes during any activity that lasts longer than 1 hour.
  • Weigh athletes before and after each activity. Athletes should replace all of their weight lost during any exercise period prior to the next exercise period.

Know the signs and symptoms of ERHI

  • Make sure plenty of cold water and sports drinks are available before, during, and after each activity.
  • Encourage athletes to drink 4 to 8 ounces every 15 to 20 minutes during any activity period.
  • Encourage athletes to eat a balanced diet that provides the necessary vitamins and minerals.
  • Identify athletes at high risk, such as athletes who are obese, are poorly conditioned, are not acclimated, have a current illness, are taking certain medicines, or have a history of previous heat-related problems.
  • Plan for emergencies—measure body temperature, call 911, cool immediately.

What Kids Should Know When Bike Riding

When a child receives his or her first tricycle or bicycle, a lifelong pattern of vehicle operation is begun. A bike is not just a toy, but a vehicle that is a speedy means of transportation, subject to the same laws as motor vehicles.

Training Children in Proper Use of Their Bicycles

  • Parents should set limits on where children may ride, depending on their age and maturity. Most serious injuries occur when the bicyclist is hit by a motor vehicle.
    • Young children should ride only with adult supervision and off the street.
    • The decision to allow older children to ride in the street should depend on traffic patterns, individual maturity, and an adequate knowledge and ability to follow the “Rules of the Road.”
  • Children must be provided with helmets (approved by the Consumer Product Safety Commission [CPSC]) and taught to wear them properly on every ride, starting when they get their first bike or tricycle.
  • The most important “Rules of the Road” for them to learn are
    • Ride with traffic.
    • Stop and look both ways before entering the street.
    • Stop at all intersections, marked and unmarked.
    • Before turning, use hand signals and look all ways.
  • Children should never ride at dusk or in the dark. This is extremely risky for children and adults. Your child should be told to call home for a ride rather than ride a bike. Night riding requires special skills and special equipment. Few youngsters are equipped with either.
  • Children should receive training in bicycle riding, including “Rules of the Road,” and should have their privilege with the bike withheld if they ignore safety rules or don’t wear a helmet.
    Children should learn how to keep their bikes in good repair, with parents checking the tires, brakes, and seat and handlebar height annually.

Swimming Pool Safety

What is the best way to keep my child safe around swimming pools?

An adult should actively watch children at all times while they are in a pool. For infants and toddlers, an adult should be in the water and within arm’s reach, providing “touch supervision.”  For older children, an adult should be paying constant attention and free from distractions, like talking on the phone, socializing, tending household chores, or drinking alcohol. The supervising adult must know how to swim.

Pool Rules

If you have a pool, insist that the following rules are followed:

  • Keep toys away from the pool when the pool is not in use.
  • Empty blow-up pools after each use.
  • No tricycles or other riding toys at poolside.
  • No electrical appliances near the pool.
  • No diving in a pool that is not deep enough.
  • No running on the pool deck.

Pool Fences

Children can climb out a window, though a doggy door, or sneak out a door to get to the back yard and the pool. To prevent small children from entering the pool area on their own, there should be a fence that completely surrounds the pool or spa. Combined with the watchful eyes of an adult, a fence is the best way to protect your child and other children who may visit or live nearby.

Pool fences should:

  • Be climb-resistant and should not have anything alongside it (such as lawn furniture) that can be used to climb it.
  • Be at least 4 feet high and have no footholds or handholds that could help a child climb it.
  • Have no more than 4 inches between vertical slats. Chain-link fences are very easy to climb and are not recommended as pool fences. If they must be used, the diamond shape should not be bigger than 1¾ inches.
  • Have a gate that is well maintained and is self-closing and self-latching. It should only open away from the pool. The latches should be higher than a child can reach – 54 inches from the bottom of the gate.
  • For above-ground pools, always keep children away from steps or ladders. When the pool is not in use, lock or remove the ladders to prevent access by children.

Other protection products, when used with an “isolation” fence, may be of some benefit; however, these are not substitutes for adequate fencing. These may include the following:

  • Automatic pool covers (motorized covers operated by a switch). Pool covers should cover the entire pool so that a child can’t slip under them. Make sure there is no standing water on top of the pool cover. Be aware that floating solar covers are not safety covers.
  • Door alarms
  • Doors to the house that are self-closing/self-latching
  • Window guards
  • Pool alarms

Swimming Lessons

Children need to learn to swim. The AAP supports swimming lessons for most children 4 years and older. Because of recent research, the AAP no longer advises against swimming lessons for children 1 to 4 years of age. Keep in mind that because children develop at different rates, each child will be ready to swim at his own rate. Other factors parents may consider before starting swimming lessons for younger children include frequency of exposure to water, emotional maturity, physical limitations, and health concerns related to swimming pools (i.e.,swallowing water, infections, pool chemicals).


Serious spinal cord injuries, permanent brain damage, and death can occur to swimmers who dive into shallow water or spring upward on the diving board and hit it on the way down.

  • Keep safe by following these simple common-sense diving rules.
  • Check how deep the water is. Enter the water feet first, especially when going in for the first time.
  • Never dive into above-ground pools; they are usually not deep enough.
  • Never dive into the shallow end of a pool.
  • Never dive through inner tubes or other pool toys.
  • Learn how to dive properly by taking classes.