As a Bend mom, I love summer. I love that the days are longer, the weather is finally warm, and the wide array of outdoor activities. As a pediatrician, however, summer brings its own set of challenges. Though we don’t see as many respiratory illnesses in summer, we do see a higher number of pediatric traumas, accidents, and both water and sun related injuries. I encourage families with kids to get outside as much as possible this time of year but I also advise that there are a few things you can do to ensure that your family is safe. Here are a few of my summertime tips.
Most sun damage occurs in childhood and all children should wear sunscreen when doing activities outdoors. Sun exposure is increased at higher altitudes so here in Central Oregon we must be extra careful. Many sunscreens have labels that advise parents not to use in infants younger than six months, however, pediatricians advise otherwise with caution. The reason to be cautious with sunscreen in infants is that they have a higher body surface to volume ratio so they get more chemical exposure as compared to older children and adults. Infants should also have very limited exposure to the sun because they have an impaired ability to cool and can become dehydrated quite easily.
As pediatricians, we know that parents are going to take their infants outside in the summer so we recommend this practical advice. If you are going to be outside with an infant for a prolonged period of time, it is best to use sunscreen. Do not, however, cover their entire body. You should only cover areas that could potentially be exposed including the face and backs of hands. Also, cover them with protective clothing and a hat to limit exposure. For infants, I recommend an infant formula sunscreen with an SPF of at least 30. These tend to be gentler formulas and are less likely to cause an adverse reaction. Older babies, toddlers, and children should also use a sunscreen with an SPF of at least 30. Buy sunscreens that say “broad spectrum” on the label as this ensures protection from both UVA and UVB rays. Apply the sunscreen at least one half hour before going outside and to all areas of the body, using caution around the eyes. Remember that indirect sunlight, especially when reflected off of water or sand can be just as damaging to skin. Reapply every 2 hours and after every exposure to water.
Parents frequently ask me about organic sunscreens or natural products versus traditional brands. There isn’t much data to show harm from traditional sunscreens but there is plenty of data showing the direct link between cumulative sun exposure and rates of melanoma. Organic sunscreens and natural formula sunscreens tend to be quite expensive. I advise that if parents can afford the organic sunscreen and feel better about using them, then buy them, however, don’t let fear of chemicals keep you from using traditional sunscreens. Protection from sun exposure is most important.
In the United States, drowning is the second leading cause of death in children under 12 years of age after motor vehicle accidents. This is a very sobering statistic as we gear up for summertime fun but something that we should keep in mind. All children should learn how to swim and I recommend swimming lessons for kids over the age of one. Early swimming is important however, it should not give parents false security. The best way to avoid pediatric drowning is adult supervision at all times for kids of all ages. For children under age five, touch supervision is the best way to keep them safe (they are within an arm’s reach at all times). For older children, an adult should be paying close attention and free from distractions such as cell phones, computers, etc. Most drowning victims do not display the classic signs of distress depicted in Hollywood movies and so the supervisor must be paying close attention. Be aware of small bodies of water such as ponds, ditches, watering cans, bathtubs, and buckets.
Life jackets are recommended around pools but are absolutely required for lake and boating activities. Make sure that you have the appropriate type of jacket for activity and that they fit properly. The AAP’s website, www.healthychildren.org, has information on the right type of life jacket to purchase.
Besides toddlers, the group at highest risk for drowning is adolescent males. This is because they tend to take risks and many adolescents are around water without adult supervision. Adult supervision is still recommended for adolescents and should be provided whenever possible. Remind your teenagers to take extreme caution when around water. They should avoid diving, especially in shallow water or areas of unknown depth. They should never swim while consuming alcohol and should never swim alone. It is also a good idea to have your teenagers to take a CPR class so that they can be trained in life saving skills.
One of the easiest ways to get exercise with kids in Central Oregon is to go on a family hike. When preparing for the hike, make sure to take food and at least one bottle of water for each person. If at all possible, have the kids wear long sleeves and pants in breathable materials, especially if you are going to be in wooded areas where ticks can hide. Apply sunscreen at least 30 minutes prior to exposure. If you are going on a long or secluded hike, bring a first aid kit and extra supplies. Make sure that the kids have supportive shoes or hiking boots. Flip flops and non-supportive sandals are not appropriate footwear for kids on hikes. Take plenty of breaks, especially with young children as they tend to tire more easily. Be careful around any water or other hazards on the trail and supervise the kids closely. If there are going to be a lot of bugs, it is reasonable to use insect repellent though not in infants younger than two months of age. It is also a good idea to check everyone for ticks when you return home, especially if you hiked in wooded or brush filled areas.
It was a long winter here in Bend and I hope that you all have a safe and wonderful summer!