I’m not talking about the eventual lifting of that metaphorical dark Covid 19 cloud, mums and dads, but the impending arrival of summer. Although summer this fateful year may not be the same as what we are used to, it will still bring heat, sunshine and UV exposure. We Aussies have one of the highest rates of skin cancer in the world and five bad sunburns in childhood more than doubles the risk of melanoma later.
So, how do we protect our children? For a start, keep them inside during the hottest part of the day when UV radiation is at its highest, and remember babies under 12 months should not be exposed to direct sunlight when UV levels are 3 or more.
The good news is that skin cancer is one of the most preventable cancers, so we must teach our kids to be SunSmart. Don’t be guided by temperature or cloud cover, it’s all about the UV index (check it out on the SunSmart phone app or with the Bureau of Meteorology website.) If it’s 3, ie. moderate, or higher, then, (speaking of SunSmart):
Slip on clothing that covers as much skin as possible, using light weight, closely woven, loose fitting clothing. Rashies and wetsuits are great at the beach.
Slop on sunscreen. Apply SPF30+ or higher on all uncovered skin, 20 minutes before going out and reapply every 2 hours. Use water resistant and broad-spectrum sunscreen.
Slap on a hat. Need to shade the face, back of your child’s neck, eyes and ears, so broad brimmed or legionnaire style is better than baseball caps.
Seek shade when you can, especially when children are playing outside, but even in the shade they still they need hats and sunscreen etc.
Slide on sunnies. Have to be rated category 2 or upwards to protect from UV rays. Wrap around is best and a rear elastic band to keep them on. Aussies are world champs at getting sun related vision threatening eye problems as well has suffering skin cancers.
More on sunscreen
Best not to use it on babies under 6 months because they tend to absorb more of the chemicals and their skin is more sensitive. It’s OK to use a little bit but the best plan is to cover them up and keep them out of the sun. Don’t let your baby get sunburnt.
There are 2 types of sunscreen, firstly the mineral ones that block or reflect UV radiation, generally containing zinc oxide and titanium dioxide. They tend to leave a whitish colour behind after application. These are the best option for children as they don’t get absorbed into the skin. Then there are the chemical ones that absorb the UV rays, which contain synthetic chemicals like salicylates, are easier to apply, are invisible when rubbed in but are not as safe for kids.
Then you need to look at the Sun Protection Factor (SPF), which tells you how much UVB (which causes most sunburn) radiation is blocked by that product. You should go for SPF 30+ or 50+ (which provides only a small amount of extra protection over the 30+). It’s best to go for a Broad Spectrum one (covers UVA radiation too) that is water resistant as well. (It’s still best to reapply sunscreen after swimming anyway.)
So, the ideal choice for children/infants is the blocking/reflective/mineral variety, at least SPF30+, broad spectrum and water resistant. If your child or baby has sensitive skin then go for hypo allergenic, low additive (fragrances and preservatives) with no parabens or oils eg Neutrogena Sheer Zinc Baby SPF 50 Sunscreen (and there are lots of others.)
And you need to use plenty. Most people use around ¼ of the amount they should. Use around a shot glass full (empty it first!) for the whole body, including ½ teaspoon on the face, and don’t forget the lips. Sure it can be messy but not as messy as melanoma.
What about side effects of sunscreens? Sometimes you can get an irritant reaction especially on the face and eyelids. This is often not a true allergy but a sensitivity and you may just need to try different one. You can also get a true allergic reaction which is usually due to a chemical, eg preservative or perfume, in the base rather than a response to the active ingredient. This is uncommon.
It’s a good idea to try a little first, ie. rub a small amount into the inside of your little one’s forearm to see whether there is any reaction. If there is then you may need to go for a hypoallergenic option. If you can’t find a suitable one, then see your GP and maybe a dermatologist will need to do some testing to find what the is the actual source of the problem.
But, I hear you ask, don’t sunscreens contain nano particles which can cause cancer? Certainly, there are nano particles in some sunscreens but there is no evidence they are carcinogenic – despite extensive testing – whereas UV radiation is a proven cause of cancer, so don’t risk it. It’s a fact that even one bad episode of sunburn in childhood increases the risk of developing skin cancers later in life.
And mums and dads, it’s best to lead by example. If children see you using sunscreen, wearing a hat etc, they will get the message. Another good idea is to set up a ‘sunscreen station’ in the house ie a designated place with a mirror, lots of sunscreen and wipes for greasy hands. By the age of 3 children can help to apply it to themselves and they should have mastered the art by preschool. And kids are more likely to use pump action dispensers, so make it user friendly.
Skin cancer checks
Parents often ask whether children need skin cancer checks. The answer is generally not – skin cancers are very rare in children. It’s normal for kids to acquire moles over time especially if mum or dad have them and this may predispose them for melanoma later in life, especially if they have too much sun. When it comes to skin cancers, sun exposure is more important than genetics. However, if junior has and odd-looking lesion on his/her skin, get it checked out.
So, what do you do if your child does suffer sunburn? Get them out of the sun, keep them well hydrated, cool their skin with cold compresses or tepid baths, give them simple painkillers eg. ibuprofen or paracetamol, use gentle bland moisturisers (oil free and don’t rub it in) and keep them inside. You can use 1% hydrocortisone cream in older children.
If your patient is under 12 months, or develops blisters, swelling and severe pain, seek medical advice, and if they get symptoms of heatstroke, ie. fever, headache, nausea and vomiting, rapid breathing or confusion then take them to the ED, ASAP, or ring the ambulance.
How do you care for infants and babies in hot weather?
One problem is that their bodies don’t adjust as well to increases in temperature, they sweat less and generate more heat during exercise, so they overheat and dehydrate quickly. And babies can’t tell you they are thirsty, so breastfeed or bottle feed your baby more often during the heat, and aim for 6-8 pale, wet nappies per 24 hours. Try to avoid too much contact with your hot skin when feeding and nursing them, so use a towel or cloth as a barrier. And of course, you breast feeding mothers need to keep your fluids up too. In infants and older children offer extra drinks, especially water and not fizzy sugary stuff.
During a really hot spell, have your baby sleeping in the coolest room in the house, close the curtains, have no liners or padding in the bassinet and surround it with damp cloths and wet towels. Fans are good but don’t point them directly at the baby (and beware of safety issues with kids and fans) and have air con on but not too cold, ie. 24 Celsius is low enough. Bathing and sponging with tepid water is a good idea too.
Don’t have babies sleeping in prams in hot weather and if out and about, cover the stroller with a light cloth and remove the back panel to allow air to circulate.
PS. Never ever leave babies and young children in cars. Even just for a minute. Remember it’s 30 degrees hotter in that hotbox than outside and they can overheat very quickly with lethal consequences.
Take home messages
Don’t let your children/babies get sunburnt. Slip, slop, slap, seek, slide. Check the UV level.
Mineral, minimal additives, broad spectrum, at least SPF30+, water resistant sunscreen.
Babies and children overheat and dehydrate quickly in hot weather.
Breastfeed or bottle feed your baby more often in hot weather.
Offer children extra drinks in hot weather.
Oh, and did I mention – never leave them in the car.