The long-awaited, glorious days of poolside lounging, dripping ice cream cones, beach walks and giggles under the stars are finally here. The memories you make with your children this summer are sure to last a lifetime. During your vacation adventures, keep these practical safety tips in mind.
Beat the Heat
Kids (and adults) need protection for all outdoor activities, whether poolside or not. Even one sunburn can increase your child’s risk of skin cancer later in life. Infants and children under four years of age are most vulnerable to the powerful effects of the sun. Try to schedule activities for early morning and late afternoon, avoiding the peak sun intensity between the hours of 10 A.M. and 4 P.M.
Practice the “shadow rule.” When your shadow is shorter than you are, ultraviolet (UV) rays are high and you need sunscreen. If you are out in the heat, seek shade under a tree, an umbrella or a pop-up tent. Dress your kids in lightweight, light-colored clothing to stay cool. Long-sleeved swimwear offers better protection from UV rays. Wide-brimmed hats are easy and provide great protection and shade. It is a good idea to get your children into the habit of wearing sunglasses early to protect their eyes from UV rays, which can cause cataracts later in life. Look for sunglasses that block both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Never leave your kids in a parked car, even if the windows are open.
Recognize the early signs of dehydration: a dry or sticky mouth, no wet diapers in a 6- to 8-hour period for infants or a 12-hour period for older children, dark yellow urine, lethargy or irritability, fatigue or dizziness and eyes that look sunken into the head. Thirst is usually a late sign of dehydration. Muscle cramping can be the first sign of a more serious heat-related illness. Go to an emergency room or urgent care facility if your child shows any symptoms of heat-related illness (nausea, vomiting, weakness, fainting or rapid pulse). Move to a cooler location, apply cool, wet cloths and sip water while awaiting care. The best way to prevent dehydration is to make sure kids consume more fluids than they lose. Encourage them to drink water at regular 20-minute intervals during activities. Kids should drink water or sports drinks specially designed for rehydration during exercise. Avoid sugary drinks such as fruit juice and soda, which can cause cramping.
Selecting among all the sunscreen products lining the shelves can be overwhelming. Spray or lotion? Water-resistant or sweat-resistant? Sunscreen or sunblock? What is sun protection factor (SPF)?
The most important consideration is how well the products protect your skin from UV rays. The American Academy of Pediatrics (AAP) recommends that all children wear sunscreen with an SPF of 30 or higher, regardless of skintone. You will also want to choose a product with coverage for both UVA and UVB rays.
Apply sunscreen generously 30 minutes before going outdoors. Don’t forget to cover ears, the nose, lips and the tops of feet. Sunscreen sprays are temptingly convenient, but use them with caution. The vapors are easily inhaled and can cause lung irritation. Some sprays can be flammable, so do not apply around open flames, such as a heated grill or a fire pit. Sprays also make it more difficult to see if you have adequately covered an area, increasing the risk of sunburn.
Sunscreen can be safely used in babies aged six months and above. You should apply sunscreen whenever your child will be doing any activity in the sun, not just swimming or water activities. Protect tender lips with an SPF 30 lipbalm. Dermatologists recommend a generous application of one ounce (enough to fill a shot glass). Reapply every two hours, no matter what the label says. Water intensifies the sun’s rays, so be sure to reapply every 60 to 80 minutes during activity. Toss out sunscreen if it is past its expiration date or if you have had it for three years or longer. Also, be a good example to your kids by wearing and reapplying sunscreen consistently. Avoid sunscreen with para-aminobenzoic acid (PABA) and benzephenones, chemicals that can easily irritate young skin. Products with titanium dioxide or zinc are good choices for sensitive skin. Avoid combination bug repellents and sunscreens. Bug repellent doesn’t need to be applied as often as sunscreen.
Up to 30 percent of teens use indoor tanning or tanning beds to achieve a tan/base tan. The American Academy of Dermatology has taken a stance against the use of such devices. In addition, the World Health Organization and the United States Department of Health have declared these devices known to cause cancer, with perhaps up to 400,000 cases of skin cancer each year. Even one indoor tanning session can increase your risk of skin cancer by up to 67 percent. It is possible for teens to become addicted to indoor tanning. Many states have laws against children younger than 14 years using tanning facilities, although the Food and Drug Administration advocates for a ban on kids 18 years and younger.
Water activities are fun and healthy. Studies even have shown that water-based exercise can improve the health of mothers and their unborn children. It decreases anxiety and improves mood in addition to promoting physical health.
Safety is key when engaging in water activities. According to the Centers for Disease Control, drowning is the leading cause of death by injury for children ages 1 to 4 and the second leading cause of death in children ages 1 to 19, with toddlers and teens being most at risk. A lifeguard or a responsible adult should always supervise children in or around water. Be a “water watcher.” Adults must devote 100-percent attention 100 percent of the time. Do not supervise children with a cell or mobile phone nearby, as this can be distracting and give you a reason to leave the area.
Don’t overestimate your child’s swimming ability. The AAP recommends swimming lessons for children ages four and up. Adults should practice touch supervision for infants, toddlers and weak swimmers; that means having your child within arm’s length. Install a pool safety fence at least four feet high around home pools and make sure the gate is self-closing.
Many states require children to wear flotation devices when present on watercraft. Look for U.S. Coast Guard-approved life jackets. The AAP discourages the use of inflatable swimming aids. These “floaties” are not an appropriate substitute for life vests, as they can deflate, slip off and are not designed to keep children safe.
Kids should never swim alone. Even great swimmers should have buddies. Advise children never to dive into oceans, lakes or rivers. No one should ever dive in water less than nine feet deep. Do not allow children younger than 14 years to operate a personal watercraft.
Recreational water illnesses (RWIs) are germs that are present in swimming pools, hot tubs, water play areas, lakes and rivers. Swallowing just a small amount of water can make your child sick. Contrary to popular belief, chlorine does not kill all bacteria. Prevention is the best protection. Do not allow your child to swim if he has diarrhea. Shower before entering the pool. Take your kids on frequent bathroom breaks to avoid having them urinate in the pool. Change diapers in a bathroom or diaper-changing area, not poolside, to keep germs away from the pool. Check your pool’s chlorine levels (1 to 3 mg/L or parts per million) and pH (7.2-7.8) to maximize germ-killing power.
Children can get swimmer’s ear (otitis externa), an infection of the outer ear canal that can cause pain. To prevent swimmer’s ear, use a bathing cap, earplugs or custom-fitted ear molds to keep water out of the ears. Dry your child’s ears thoroughly with a towel after water activities. Pull the earlobe in different directions and tilt the head at different angles to drain water from the canal. You should never use cotton-swabbed tips to clean your child’s ears, as they can be abrasive, increase inflammation and pack wax tightly enough to cause an obstruction and temporary hearing loss. Ask your healthcare provider about using drops to prevent swimmer’s ear. These can be appropriate for use in some kids, but not in cases of children who have ear tubes, ear infections or damaged eardrums.
Protect yourself and your family from bugborne illnesses such as West Nile virus, Lyme disease and the newly identified Zika virus. Use an effective insect repellent when playing outdoors. Insect repellents with diethyl-meta-toluamide (DEET) are very effective but should be used with caution. Look for the concentration of DEET on the label, which ranges from 10 to 30 percent. Lower concentrations work well, but not for as long as higher ones. A ten-percent concentration can repel insects for about two hours. Do not apply bug spray more than once a day. Some non-DEET alternatives such as lemon eucalyptus are safe, but potentially ineffective.
If you are in a wooded area, be on the lookout for ticks. Tuck in your clothes and remain covered. If you need to remove a tick, use fine-tipped tweezers to grasp it as close to the skin’s surface as possible. Don’t twist or jerk it, but pull straight up. After removal, clean the bite area and your hands with rubbing alcohol. Dispose of a live tick by submerging it in alcohol, placing it in a sealed bag/container or flushing it down the toilet. Never crush it with your fingers. Consult your provider if your child has a tick bite. Avoid remedies such as painting the tick with nail polish or using heat to remove it.
You may encounter a jellyfish at the beach. Experts recommend rinsing the area with seawater. Using freshwater can prompt the stingers to release more venom so don’t pour a water bottle over the area. Do not rub the stingers off. Use a credit card to scrape any remaining stingers. If available, apply a paste of baking soda and seawater. Call 911 if your child is having trouble breathing, has a swollen tongue or lips or experiences nausea or vomiting, muscle spasms or a sting in the eye or mouth. Try to swim at guarded beaches that have warning flags to alert visitors of jellyfish.
Play It Safe
Do not make bicycle helmets optional for anyone in your family — and that includes you. In many states, wearing a helmet is the law. According to the CDC, about 500,000 kids are seriously injured in bike accidents annually, and many of these injuries are preventable by wearing helmets. Wearing a helmet can reduce the risk of injury by as much as 85 percent. Choose a well-ventilated helmet that has bright colors visible to drivers, and that fits correctly and can be adjusted. Make sure the helmet has a Consumer Product Safety Commission (CPSC) sticker on the inside. If your child has a bike crash, replace the helmet, as it can lose the capacity to absorb shock after a big hit. Kids also should wear helmets when using scooters, roller blades, skateboards or other motorized toys.
The Fourth of July can make great memories, but the best way to enjoy it safely is to attend public fireworks displays, and leave the lighting to professionals. Lighting fireworks is illegal in many areas, especially within city limits. Kids should never play with fireworks, even sparklers or firecrackers. Sparklers can reach a temperature hot enough to melt gold. Don’t let your kids pick up pieces of fireworks after a show. They may still be ignited and have the potential to explode. If your child has a fireworks-related injury, seek immediate medical attention, no matter how minor the injury may seem.
With just a little care and planning, you and your family can safely enjoy all the adventures summer can hold.
Jessica Peck, DNP, RN, CPNP-PC, CNE, CNL, is an Associate Professor at the University of Texas who has been practicing in pediatrics for more than 20 years. She is currently the secretary for NAPNAP.