The Basics of Sun Safety for Kids

What’s the difference between UVA and UVB?

Ultraviolet A (UVA) rays make the skin tan; ultraviolet B (UVB) rays cause skin to burn. But don’t be fooled: A tan isn’t healthier. “Both suntans and sunburns are signs that skin cells have been damaged by radiation from the sun,” says Kavita Mariwalla, M.D., director of Mohs and Dermatologic Surgery at Continuum Health Partners in New York City. UVB used to get all of the blame for causing skin cancer, but new research shows UVA is equally damaging. This is particularly worrisome since UVA rays are 30 to 50 times more prevalent, and they penetrate deeper into skin cells.

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What does SPF stand for? Is a higher number more effective?

An SPF, or sun protection factor, indicates a sunscreen’s effectiveness at preventing sunburn. “If your child’s skin reddens in 10 minutes without sunscreen, SPF 15 multiplies that time (10 minutes) by 15, meaning she’d be protected from sunburn for approximately 150 minutes or 2 1/2 hours,” says Sancy Leachman, M.D., Ph.D., director of the Melanoma and Cutaneous Oncology Program at the University of Utah’s Huntsman Cancer Institute in Salt Lake City. Of course, this depends on an adequate application of sunscreen and is based on SPF calculations with artificial instead of natural sunlight. The American Academy of Pediatrics (AAP) recommends using sunscreens with at least an SPF of 15, which blocks 93 percent of UVB rays. Higher SPFs provide even greater protection, but only to a certain point: SPF 30 blocks 97 percent of UVB and SPF 50+ (the maximum SPF you’ll find on sunscreen labels due to new Food and Drug Administration (FDA) rules) blocks 98 percent.

What should I look for in a sunscreen? Are sunscreen sticks and sprays as effective as lotions?

As long as you’re using a sunscreen with SPF 15 or higher that’s broad-spectrum (meaning it blocks both UVA and UVB rays), it doesn’t matter whether you use a lotion, cream, gel, stick, or spray. “The problem with some of the easiest and most cosmetically acceptable products is that they often do not adequately block both UVA and UVB. You must look at the ingredients, but the best sunscreen is the one your child agrees to wear,” Dr. Leachman says. That said, sprays that contain the “right stuff” are great for on-the-go toddlers and preschoolers. Some young children are sensitive to certain sunscreen ingredients. To test for reactions, apply a small dab on the inside of your child’s upper arm and check the area in 24 hours for signs of redness or rash. Sunscreens with titanium dioxide or zinc oxide are often less irritating because the ingredients aren’t absorbed into skin. If your child is going to be in the water or getting sweaty, look for water-resistant sunscreens (the FDA has done away with waterproof and sweatproof claims). The new water-resistant labels state how long — either 40 minutes or 80 minutes — the sunscreen provides protection before you need to reapply it.

At what age is it safe to put sunscreen on a baby?

Your baby’s skin is sensitive and can easily absorb too many chemicals, so avoid sunscreens before the baby is 6 months of age, except those with zinc oxide as the only active ingredient,

and use on small areas of her body. Use clothing plus shade as the primary method of protection. Provide additional protection by keeping her out of the sun as much as pos

sible: take walks before 10 a.m. or after 4 p.m., when UVB rays aren’t as intense; use a stroller canopy; dress her in lightweight clothing that covers her arms and legs; and choose a wide-brimmed hat or bonnet that covers her face, ears, and neck.

How much sunscreen should I use on my child? How often should I reapply it?

The Skin Cancer Foundation (skincancer.org) recommends that adults use at least an ounce (that’s a shot glass) of sunscreen, but there’s no set amount for growing children. The important thing is to cover all exposed areas (especially easily overlooked places like ears, tops of feet, backs of knees, and hands) 30 minutes before your child heads outside so her skin has time to absorb it. Reapply at least every two hours, more frequently if she’s swimming, playing in water, or sweating.

Do certain products work better on certain body parts?

Sunscreen lotions, gels, creams, and sprays all provide good protection from the neck down. “It’s really a matter of which one is easiest to put on your child,” Dr. Leachman says. There’s less chance of sunscreen sticks getting into a child’s eyes, so they’re great for foreheads, noses, cheeks, chins, and even ears, but use only sunscreen sticks with components that include zinc oxide and titanium dioxide. A lip balm with an SPF is also recommended. Ultimately, though, Dr. Leachman says “the best sunscreen,” is clothing (especially with SPF protection), followed by the lotions, gels, creams, and sticks.

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Winter Health

  • If your child suffers from winter nosebleeds, try using a cold air humidifier in the child’s room at night. Saline nose drops or petrolatum jelly may help keep nasal tissues moist. If bleeding is severe or recurrent, consult your pediatrician.
  • Many pediatricians feel that bathing two or three times a week is enough for an infant’s first year. More frequent baths may dry out the skin, especially during the winter.
  • Cold weather does not cause colds or flu. But the viruses that cause colds and flu tend to be more common in the winter, when children are in school and are in closer contact with each other. Frequent hand washing and teaching your child to sneeze or cough into the bend of her elbow may help reduce the spread of colds and flu.
  • Children 6 months of age and up should get the influenza vaccine to reduce their risk of catching the flu. It’s not too late to get the vaccine! Around 80% of all influenza illness generally occurs in January, February, and March.

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Hypothermia
  • Hypothermia develops when a child’s temperature falls below normal due to exposure to colder temperatures. It often happens when a youngster is playing outdoors in extremely cold weather without wearing proper clothing or when clothes get wet. It can occur more quickly in children than in adults.
  • As hypothermia sets in, the child may shiver and become lethargic and clumsy.  Speech may become slurred and body temperature will decline in more severe cases.
  • If you suspect your child is hypothermic, call 911 at once. Until help arrives, take the child indoors, remove any wet clothing, and wrap him in blankets or warm clothes.
Frostbite
  • Frostbite happens when the skin and outer tissues become frozen.  This condition tends to happen on extremities like the fingers, toes, ears and nose. They may become pale, gray and blistered. At the same time, the child may complain that his/her skin burns or has become numb.
  • If frostbite occurs, bring the child indoors and place the frostbitten parts of her body in warm (not hot) water. 104° Fahrenheit (about the temperature of most hot tubs) is recommended. Warm washcloths may be applied to frostbitten nose, ears and lips.
  • Do not rub the frozen areas.
  • After a few minutes, dry and cover the child with clothing or blankets. Give him/her something warm to drink.
  • If the numbness continues for more than a few minutes, call your doctor.

Winter Sports and Activities

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  • Set reasonable time limits on outdoor play to prevent hypothermia and frostbite. Have children come inside periodically to warm up.
  • Using alcohol or drugs before any winter activity, like snowmobiling or skiing, is dangerous and should not be permitted in any situation.
Ice Skating
  • Allow children to skate only on approved surfaces. Check for signs posted by local police or recreation departments, or call your local police department to find out which areas have been approved.
  • Advise your child to:
    • Skate in the same direction as the crowd
    • Avoid darting across the ice
    • Never skate alone
    • Not chew gum or eat candy while skating.
    • Consider having your child wear a helmet, knee pads and elbow pads, especially while learning to skate.

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What to Wear this Winter

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  • Dress infants and children warmly for outdoor activities.  Several thin layers will keep them dry and warm. Don’t forget warm boots, gloves or mittens, and a hat.
  • The rule of thumb for older babies and young children is to dress them in one more layer of clothing than an adult would wear in the same conditions.
  • When riding in the car, babies and children should wear thin, snug layers rather than thick, bulky coats or snowsuits.
  • Blankets, quilts, pillows, bumpers, sheepskins and other loose bedding should be kept out of an infant’s sleeping enviroment because they are associated with suffocation deaths and may contribute to Sudden Infant Death Syndrome (SIDS). It is better to use sleep clothing like one-piece sleepers or wearable blankets is preferred.
  • If a blanket must be used to keep a sleeping infant warm, it should be thin and tucked under the crib mattress, reaching only as far as the baby’s chest, so the infant’s face is less likely to become covered by bedding materials.