| Posted June 9, 2015 | By Allen Peabody, M.D. | Categorized under Families |

As parents, we spend a good bit of the school year focused on flu prevention. Now that it's summertime and your kids are out of school, you can take the summer off from worrying about your kids coming home with the dreaded flu virus.

With summer, though, comes a host of other things that should be on your radar as a parent.

There are the obvious dangers like sunburn or poison ivy that are troublesome during the summer, but we can't overlook the more subtle things such as too much screen time or radically altered sleep patterns, especially in older children.

While any pediatrician, myself included, will strongly recommend that children need to be outside during the summer months versus being entertained by an iPad, there are a few risk factors that cause children to come to our office during the summer.

Two of the most prominent things we see during the summer months are sunburn and swimmer's ear.

FUN IN THE SUN

Let's start with sunburn. If you are going to be outside during the peak hours of 10 a.m. and 2 p.m., even in Tennessee and even on a cloudy day, I recommend a broad spectrum sunscreen. If sunscreen is broad spectrum, it will be labeled that way and it will protect against both types of ultraviolet light (UVA and UVB).

Once you find a broad spectrum sunscreen, you need to look at the SPF, or sun protection factor. What's important to note is that a 30 SPF isn't twice as strong as a 15 SPF. The higher the SPF, the more protection you get, but they all need to be reapplied frequently to be effective.

People generally don't use enough sunscreen. The recommendation is an ounce of sunscreen for an adult. While that is hard to measure, just make a mental note to use more than you think you should. I tell patients and their parents to apply liberally and apply often.

For babies under six months of age, avoidance of sunlight is the best course of action. If they are going to be in the sun, I recommend big hats and long sleeves. If that is unavoidable, using a small amount of zinc oxide on their nose and cheeks would be acceptable.

I hear from parents a lot that it can be hard to get a younger child to cooperate when it comes time to apply sunscreen. But leaving them unprotected is not an option. I say to keep in mind the child will be a lot more miserable with a sunburn than they will be while you are applying sunscreen.

Also important to note is that no sunscreen is waterproof and now the labeling has changed to reflect that. It will either be labeled water resistant, which means it needs to be reapplied after 40 minutes of swimming or sweating, or very water resistant, which means it needs to be reapplied after 80 minutes of sweating or swimming. The best policy is just to reapply every time your child exits the water.

If your child still gets a sunburn and has redness and pain, I recommend treating the area with topical aloe lotions. If your child develops a fever or severe pain or itching, call your doctor for an appointment.

WATER WORLD

The second most prominent issue we see during the summer in our office is probably swimmer's ear. This is a condition that develops when water remains in the ear canal. It can change the Ph balance in the ear canal and foster bacteria growth.

It causes a painful outer ear infection of the ear canal. The ear can be painful to the touch and can be red. It's easily treated with antibiotic ear drops, but it is important to see a physician if you think your child has swimmer's ear.

For extreme cases, sometimes an ear wick needs to be placed in the child's ear canal. It's a small, absorbent sponge that expands and keeps the infected areas in contact with the medication for longer durations.

If your child has a tendency to get frequent cases, earplugs can be a good way to keep water out of the ear. Also, drying agents such as alcohol-based drops can help dry up the ear. For most, though, drying the ear with your towel after swimming will do the trick.

Some other things to be aware of this summer as your kids play outdoors are bug and tick bites and poison ivy.

INTO THE WOODS

Playing in the backyard or wooded areas can be fun, but it also comes with some risks. The concern with a tick bite is illnesses that can be associated. In this area we might see Rocky Mountain Spotted Fever from a tick bite, but we rarely see Lyme disease. Most times we find Lyme disease is imported from a vacation up north.

Typically a tick has to be attached for 24 to 48 hours to spread these diseases. We can remove ticks in our office, but you can also remove them at home. We recommend that you pull with gentle traction and don't twist. Pull straight out so it doesn't leave the tick's head attached. Tweezers work best but don't squeeze too hard or you can separate the body from the head.

All tick bites look like a bug bite. They will get red and they might itch. What concerns me is if there's fever, headache, vomiting, a red ring around tick bite or any rash. Call your doctor if any of these happen.

The best way to prevent unwanted insects is a good insect repellant with 10 percent to 30 percent DEET.  Most of the commercial insect repellants with this DEET content is safe for children older than 2 months if you follow the recommended usage instructions. 

AVOID THE VINE

With poison ivy, the best prevention is to learn what it looks like and just avoid it. You've heard the saying "leaves of three, let it be." That's a good way for kids to remember what to stay away from. A good rule of thumb is to tell your children to stay away from all vines, just as a precaution.

If your child does come in contact with poison ivy, the best home treatment options are topical steroids and oral Benadryl.  Most small patches do not need to be seen by a doctor, but if the lesions begin to look infected an oral and/or topical antibiotic might be necessary.  For significant reactions especially for lesions near the eye, mouth, or genitals, a course of oral steroids is indicated. 

One misnomer about poison ivy is that it will spread if you scratch it. That isn't true. It can spread, but it's from the oil from the plant that gets on whatever it touches, not from touching the actual rash. The oil can get on your hands and then anything you touch can cause more of a rash. The oil can remain on shoes or clothing, so it's important to wash everything if you think you've come in contact.

SCREEN IT

So those are the obvious outdoor triggers to watch for this summer. The more subtle one that can sneak up on you is how much time your child spends in front of a screen. That's an all-encompassing term that includes television, computers, phones, iPads and so on.

It happens before you know it. It's a rainy day and your child has been on your iPad all morning playing games. The recommendation from the American Association of Pediatrics is a max screen time of two hours a day. That doesn't change for summertime when kids have more free time on their hands. Two hours is still the max even though you might have more boredom to combat.

I recommend finding ways to be creative and have summertime rainy day activities lined up.  It can be a struggle, but habits shouldn't drastically change just because it's summer. Most school-aged kids have some kind of summertime reading they should be doing and if they don't, I'd incentivize them to do some reading anyway.

Check your local library. Most libraries will have great summertime programs that are a great way to get your kid's mind working.

Parents from time to time ask me about the importance of sleep patterns in the summer months as well. Smaller children tend to stay pretty much on their school schedule and if they deviate a little bit, that's OK. Older children tend to want to stay up later and sleep in longer. My main recommendation is to start reverting back to their school schedule two to three weeks before school starts so it isn't a big shock to their system on the first day of school.