Summer Care for Children — Clothing, Hydration, AC Use, Heat Rash and Sunscreen

Dr. Sandip Gupta

A podcast episode on summer child care — the mistakes parents make, how much water to give, whether AC and coolers are safe, common summer illnesses, heat rash, sunscreen and massage. Common summer mistakes: Overdressing. Parents put too many clothes on children fearing they will catch cold. Just as adults wear light clothes in summer, so should children. If the room temperature is high, put shorts on the child; only one extra layer is needed, not four or five, which causes sweating, leading to rash, itching and infection. Synthetic clothes. Dress the child in cotton, because air circulates inside cotton clothing, reaching the skin, keeping it dry and reducing sweating. Not giving water at the right time. Under 6 months, breastfeed frequently — no separate water is needed. Above 6 months, water is necessary. Children above one year who run about need more water, and they won't drink on their own, so give it frequently — otherwise sweating and overall heat create a risk of dehydration. Sugary drinks. People give packaged drinks and colas thinking it will maintain hydration. Do not do this. Children also start drinking cola after seeing parents drink it. For hydration give water, coconut water, chaach (buttermilk), curd lassi, fruit lassi made by blending fruit into curd, and a little natural fruit juice without sugar for slightly older children. Playing in extreme sun. Do not let children play outside in the hottest sun, particularly between 11 am and 4 pm, or heat rashes start appearing. Keeping the child in a room with no fan. It is not true that fans, AC or coolers cannot be used for small children — they can, with the right temperature and precautions. How much water: Water is started once the child completes 6 months. 6–8 months: about 120 ml a day — give 20 to 30 ml after each solid feed; four to six times gives about 100–120 ml. 9–12 months: aim for about 120–150 ml — give 30 to 50 ml after each solid feed. Above 1 year, a rule of thumb: one cup (250 ml) at one year, two cups at two years, three cups at three years. This is not a strict guideline — the requirement depends on the child's thirst and the weather, and in summer you should give a little more. Water doesn't mean only water — coconut water, lassi, chaach, fruit lassi and unsweetened juice all count towards hydration. Give water-rich fruits like watermelon. Check urine: the child should pass urine at least every four hours and the colour should be clear like water. Ice cream: Ice cream bought from outside has a very high sugar content, and it is better not to give outside things. Instead make kulfi at home — blend fruit such as mango into milk and freeze it in a mould with a stick to make popsicles, or set it in a bowl. Cold things do give children relief in the heat, but buying ice cream from outside daily is not better — it has a lot of sugar and fat. Common summer problems in children: Ghamori (heat rash) — very common as the temperature rises and the sun causes red bumps that prickle and burn, making the child irritable. Loose motions, diarrhoea and vomiting — infections are more common at this time; these are basically food poisoning, because food spoils quickly in summer. When the child eats it, the infection enters the body: reaching the stomach it causes vomiting and stomach pain, and reaching the intestine it causes loose motions. Dehydration if the child does not drink enough water, and sunstroke from long exposure to harsh sun. Preventing food poisoning: Keep clean, eat home food and avoid outside food, eat fresh food — food stored too long spoils in summer. Wash hands with soap before eating, wash your own hands well before feeding a small child, and use clean utensils. What to feed in summer: Continue normal home food for breakfast and dinner, and add seasonal fruits. Watermelon is 92% water so it naturally helps keep the child hydrated, it is sweet and children eat it easily — always remove the seeds. Grapes can be given as a purée to small children; a child above four can eat them cut. Mango is good for digestion, sweet, and contains sugar and fibre. Give coconut water frequently and curd, which cools the body and provides good bacteria — the lactobacillus in curd prevents intestinal infection because good bacteria don't let bad bacteria grow. So even if the child has loose motions, diarrhoea or vomiting, give curd: it digests easily and its good bacteria improve intestinal health and help digestion. Also give seasonal fruits like muskmelon (kharbooja), which are high in water. Heat rash (ghamori) — prevention and treatment: Ghamori is simply caused by heat in the body. Prevention: maintain hydration, keep the room temperature right, and use AC, cooler or fan with safety precautions. Bathe more often — an older child twice a day in summer, once before sleeping and once during the day; a small child once, with a sponge bath the other time. This stops heat accumulating in the body. Do not apply powder. Powder actually causes ghamori — this is a wrong concept that has been carried along. Powder blocks the skin's pores and traps moisture there, which causes rash and heat rash. Small children do not need powder at all. If ghamori has already appeared: do cold sponging — use lightly cool water (not chilled), soak a cloth and apply it to different parts of the body, which gives relief. Applying an aloe vera lotion normalises the skin; if there is a lot of burning or itching, calamine lotion can be applied. Maintain hydration and ventilation so normal air reaches the child. With this, ghamori settles within about a week. Do not let the child scratch it, because scratching over heat rash causes infection. If it is severe, a doctor may need to give an antihistaminic syrup, but that is usually not needed. Sunscreen for children: Many people think sunscreen is not for children — that is not true. Children under 6 months do not need sunscreen; they mostly stay indoors and should be kept indoors. If you do go outdoors, use proper covering — a hat or cap, and cover the stroller. Children above 6 months can use sunscreen, with some specific guidance: use a broad spectrum sunscreen that protects against both UVA and UVB rays, with SPF above 30, and it should be mineral based, not chemical based. Mineral based sunscreen forms a coating over the skin so the child's skin is not damaged and stays healthy, and it stays effective longer. Apply sunscreen whenever taking the child out in the sun between 10 am and 3 pm, 15 to 30 minutes before going out, especially on the face and exposed body parts. Massage in summer: You can massage daily or on alternate days. As per the guidelines, massage before the bath and then bathe the child. Coconut oil is best for summer massage because it provides some cooling and maintains the skin's moisture. Do not massage children with mustard oil or olive oil. Bathe the child with lightly cool or normal water, not hot water, otherwise the skin can get damaged and rashes can appear. Using AC, fan and cooler safely: Parents often endure the heat themselves fearing the child will catch a cold or cough. That is not the case — India gets very hot and children suffer from it just as adults do, so AC, cooler and fan can be used with these precautions: Maintain 24 to 27 degrees on the AC. The air from the AC, cooler or fan should not fall directly on the child — keep the child to the side. Do not run the fan or cooler at maximum speed; only as much as makes the room comfortable. AC, cooler and fan dry the room out, so keep a humidifier or a vessel of water so the air does not get too dry. Dry air blocks children's noses, so put non-medicated saline nasal drops in the nose frequently — about once every two to four hours — so dried mucus doesn't block the nose. Avoid sudden temperature changes — don't take the child straight out of a cool room into the heat, or straight from outside into the AC; bring them in first and then switch the AC on. Open windows a little in the morning and evening for ventilation. Child not sleeping because of heat: Maintain good ventilation and use AC, cooler or fan as above. Give the child a light bath before sleeping — a sponge bath for a small child, a full bath for an older one, within about five minutes, then dry them well. This cleans off sweat, the child feels relaxed and sleeps comfortably. If you open windows, fit nets, because summer brings dengue mosquitoes that can bite children — dengue, chikungunya and other mosquito diseases are a risk. Use a mosquito net over a small child. Final message: Give food that provides good hydration, keep track of water intake, give water-rich fruits like watermelon and muskmelon, give coconut water frequently, and make different kinds of lassi so the child gets variety. Maintain cleanliness, especially handwashing, since summer food poisoning causes loose motions, diarrhoea, vomiting and stomach pain. Don't give outside food, as food spoils quickly in summer. Use AC, cooler and fan safely. When going out, apply sunscreen for children above 6 months and cover smaller children, and avoid taking the child out between 11 am and 4 pm. Relevant for: parents asking how to dress a baby in summer and whether cotton matters; parents asking how much water a 6–8 month, 9–12 month or older child needs; parents giving packaged drinks or colas for hydration; parents asking whether ice cream is okay and what to make at home instead; parents whose child has heat rash, loose motions, vomiting or dehydration in summer; parents asking whether baby powder prevents or causes ghamori; parents asking whether AC, cooler or fan is safe for a baby and at what temperature; parents whose child gets a blocked nose in AC; parents asking about sunscreen for babies — what age, what SPF and what type; parents asking which oil to use for summer massage; parents whose child can't sleep in the heat; and parents concerned about mosquitoes and dengue. Disclaimer: This video is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Every child is different — please consult your pediatrician before using any lotion, sunscreen or medicine on your child, and seek medical attention if your child has persistent loose motions, vomiting, signs of dehydration, high fever, or a rash that worsens or becomes infected.