On Call for All Kids - How to Keep Kids Hydrated

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The summer heat in Florida can create problems for kids who don’t stay hydrated. On this week’s On Call for All Kids, Patrick Mularoni, M.D., medical director of the Pediatric Sports Medicine program at Johns Hopkins All Children’s Hospital, discusses how important it is for kids to drink plenty of water.

Why should kids drink water rather than other beverages?

I know that kids think that water is a boring choice, but it’s the perfect beverage when compared to the alternatives. Many people think that they need bottled water, but tap water is just fine and the good news is that it is readily available. Many kids want to drink sports drinks in the summer, but these often contain too much sugar. These drinks were formulated for use in athletes who are performing intense workouts and losing electrolytes. There are definitely times where these beverages can help to replace lost electrolytes, but I would save sports drinks for sports. In fact, even in sports situations I would alternate sports drinks with water when drinking on the sideline or at halftime.

Many kids want to drink juice or juice drinks throughout the day. What about juice? Should kids be drinking it?

I think of juice as a treat. Although juice comes from fruit, and we should be eating more fruit, it is missing the important fiber and pulp of the fruit, which is a really important component. These drinks are very high in sugar, and although many fruit juices contain vitamins and antioxidants, this benefit needs to be weighed against the extra sugar calories that are present in these drinks. Many juices that are marketed to children are really sugar water with added juice. So, parents should think twice before they reach for a pouch or a box with a straw when their child is thirsty. These drinks should be thought of as treats because that is what they are, they represent drinkable calories, and with the obesity epidemic affecting one in five children, these are often calories that kids don’t need.

Energy drinks are increasingly popular. Should kids be drinking them?

The answer is no for many reasons. The biggest reason is the extra sugar and all of the caffeine. Many high school age kids increase their caffeine consumption in the summer and this can become a problem when it’s time to go back to school if their body has become accustomed to multiple caffeinated beverages per day throughout the summer. This can lead to problems with caffeine withdrawal, which includes sleep issues and headaches. With summer starting, parents of middle and high schoolers should have a conversation about caffeine and caffeinated beverages because many kids in this age group are skipping meals in exchange for energy drinks and caffeinated beverages.

How can you tell if your child is getting enough water each day?

The current recommendations are for children to drink their age in 8-ounce glasses until they reach the age of 8. Children 8 and older should drink eight 8-ounce glasses of water per day. If you have a 6-year old, he or she should be getting six 8-ounce glasses per day. Although this seems like a lot when thinking about a 10-year old who should be drinking eight 8-ounce glasses a day, this can easily be accomplished by drinking water with meals as most cups that families use are between 12 and 16 ounces.

Are there any other tricks we can teach kids to help them know if they are drinking enough water?

The best thing to teach them is to look at their urine. Many kids will find this funny at first but the color of the urine can help let a child learn about hydration status. Urine should be clear to straw color. If it is dark yellow or looks like apple juice then your child is dehydrated and needs to drink more water. I tell kids that they want to have urine that hardly colors the water in the bottom of the toilet when they start to pee. Early morning urine is usually the most concentrated so kids should try to get their urine to become clearer throughout the day.

With the hot and humid Florida weather we definitely want kids to get out and play outside, and when they come in sweaty and happy, the best thing to do is offer them a cold glass of water.