The Highs and Lows of Sunshine
There's no question that sunshine makes people feel good. In areas of the country that suffer through harsh winters, the onset of warm, sunny days feels liberating. Children can go outside without wearing layers of clothing. They can run through the grass, swing in the park, and enjoy the beach and pool.
Sunshine also activates the body's production of vitamin D -- which is important for building strong bones and teeth. So your child even reaps medical benefits from getting the sun's rays. However -- as with any good thing -- too much can be a problem.
Though it's tempting to revel in the warm weather when the seasons change, be careful. When the first hot days arrive, expose your child for gradually increasing periods before letting her play outside for long amounts of time. The body needs time to adapt to heat.
Sunburn is the most obvious harmful result of catching too many rays, but the sun can also cause other problems. Here's how to make sure your child has a happy, healthy summer -- in or out of the sunshine.
Every sunburn a child experiences is not only painful but also raises her risk of getting skin cancer, so it's important to protect a baby's delicate skin. You can do so by covering her up, using sunscreen correctly and regularly, and only allowing her to be out in the sun at the safest times of the day.
The sun's rays are most punishing during the midday hours, so try to time outings and playtimes before 10 a.m. or after 3 p.m. Always put sunscreen on your infant -- even a newborn -- before heading out, paying special attention to his cheeks, the backs of his hands, and the tops of his feet.
Choose a sunscreen with an SPF (sun protection factor) of at least 15. SPF refers to the length of time a person can remain in the sun before turning red. The higher the SPF, the longer a person can stay out, but the amount of time is also influenced by skin type.
For example, if you have a medium complexion, you would multiply an SPF of 15 by a "sun factor" of 10, meaning you could stay out in the sun for about 150 minutes before burning. The sun factor will be lower if you have fairer skin, so even using the same SPF, a fair-skinned person can't stay in the sun for as long as someone with darker skin.
Children's skin is thinner and more sensitive than adults' skin, and is thus more vulnerable to the elements. So be cautious about letting your baby or toddler stay out in the sun for as long as a sunscreen's SPF number technically allows. Sunscreens made for children usually come in higher SPFs -- ranging from 30 to 50 -- because kids need more protection.
But even when they use a high SPF, parents sometimes come into my office with a sunburned child, mystified. This usually happens because they didn't use the sunscreen properly. In order for a product to work, you must apply it 30 minutes before leaving the house. Then reapply when you first arrive at the beach, park, or pool. Repeat the application after swimming and toweling off (yes, even if the sunscreen is waterproof); after perspiring; or at least every two hours. Reapplication is almost more important than the SPF level.
Also, be sure to use enough sunscreen and to rub it in well. A quarter-size dollop covers only about one toddler arm. Don't forget about often overlooked areas such as the backs of hands and the tops of ears and toes. To get a wiggly toddler to stand still, make a game out of applying it ("This is the way we put on sunscreen, put on sunscreen...").
Hats and Water Temperature
However, don't let sunscreen give you a false sense of security. Babies younger than 6 months should be kept out of direct sunlight -- even with lotion. Not only is their skin extremely sensitive to burning, but their eyes can be damaged, too. Children older than 6 months can wear sunglasses (check the label to make sure the glasses screen for UV rays).
All children should also wear hats to protect their face -- the best kinds have a wide brim and a flap that covers the ears and neck. Summer clothes don't offer a lot of protection from the sun, especially if they get wet. If your child has sensitive skin -- say, red hair and a fair complexion -- you can purchase clothes that have a built-in sunscreen.
These clothes have an Ultraviolet Protective Factor (UPF) rating on their label; a rating of 20, for instance, means that the clothing allows only one-twentieth of the sun's radiation to reach the skin. RIT, the dye manufacturer, also make a wash-in sunscreen product you can use on clothes.
If you're taking your baby into a pool, make sure the water is warm enough -- preferably 80 degrees F or more. Most ocean water is too cold, although holding your infant and letting some waves splash onto the two of you is always fun. If your baby has a hat and sunscreen on, enjoy yourselves, but only for a few minutes.
The best protection is to limit your child's time in the sun to short periods -- for instance, take your baby into the pool for 15 minutes or let your toddler run in the park for 20 minutes, then get her into the shade. Bring an umbrella to the beach and keep your infant under the stroller canopy when you can. Be aware that even under a tree or an umbrella, or in other shady spots, there is still a reflected glare of sunlight or light filtering through from above.
Have you heard people say "It's not the heat, it's the humidity"? They are correct to a certain extent. Whatever the temperature, the effect is exaggerated when the humidity is high. That's because humidity refers to the moisture in the air -- and the more moisture there is, the less perspiration can evaporate off the surface of your skin to help your body cool down in hot weather.
The heat index calculates the temperature your body feels due to the combined effect of heat and humidity. A 90-degree day, for example, is effectively 106 degrees if the humidity is 70 percent. At that level, heat exhaustion (weakness, nausea, and dizziness) and heatstroke (fainting) are possible.
Don't allow your toddler to engage in strenuous play when the heat index tops 90. The heat index may be given as part of your local weather report.
If you're going to be out in hot weather for a while, make sure your toddler or preschooler drinks several ounces of water beforehand. Children who are playing don't respond to their body's needs until they're in trouble.
By the time your child complains of thirst, he could be on the brink of dehydration. Offer your child something to drink every 30 minutes while you're out, as well. Plain water is the best -- you don't need to give sports drinks or electrolyte solutions -- but flavoring the water with a little juice may make him drink more. If your child is flushed and hot, insist that he rest in the shade. Cool off his skin with water from a wading pool, hose, spray bottle, or drinking fountain.
Also, be aware of metal that can heat up in the sun and burn your child, including slides and swings at the playground and the metal parts of car seat safety straps. Touch these surfaces with your fingers to test them before your child comes into contact with them.
A less serious heat-related condition is called prickly heat or miliaria. These tiny red bumps form when sweat glands plug up. The rash usually appears in the folds of a child's neck or on his arms, where sweat and moisture get trapped.
Prickly heat is not serious and will get better in a few days if you keep the skin cool and dry. You can also put a little talcum powder in the skin's creases to absorb moisture. Pour some into your hand first, and then pat it on the area. (Never shake the container over your baby because it's not good for him to breathe in the powder dust.)
If the rash doesn't clear up, gets worse, or spreads, call your doctor; it may be another skin problem. To prevent heat rash in the first place, keep your child's skin as cool as possible and dress her in loose, cotton clothing. Hot weather can also cause or exacerbate diaper rash. Change your baby's diaper frequently on hot days, even if she's not wet, because heat causes moisture to build up and chafe baby's delicate skin. And when possible, let your child run around without a diaper for a while.
It's better to be safe than sorry. Keeping these prevention pointers in mind will help you enjoy the long, hot summer safely with your little one.
Loraine M. Stern, MD, is a clinical professor of pediatrics at the University of California at Los Angeles and a practicing pediatrician.
Originally published in American Baby magazine, June 2004.
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.