Use care in the sun with your infants and children

Summer is in full swing and, along with fun in the sun, is the risk of unwanted sunburns, especially in infants and young children.

While there are many options to prevent sunburn, including sunscreen, UPF (ultraviolet protective factor) clothing, umbrellas, covers on strollers, wide-brim hats, and sunglasses for infants and children, there are additional precautions for newborns up to four months.

“Any infant under four months old should not be exposed to direct sunlight,” said Jacqueline Sloan, MD, a Cape Cod Healthcare pediatrician with Seaside Pediatrics in West Yarmouth and Orleans. “They should always be in the shade when outside.”

There is also much discussion about the warning not to use sunscreen on infants under six months of age.

“Parents talk to me about this all the time,” said Dr. Sloan. “My resources tell me that it is safe to use a small amount of sunscreen on infants four months and older on the back of their hands and face.”

Infant and Child Sunburn Prevention

Dr. Sloan recommends the following tips to prevent sunburn while enjoying the outdoors or a day at the beach for infants older than six months and children:

• Apply SPF (sun protective factor) sunscreen: SPF measures how much solar energy it takes to cause a sunburn on skin protected by sunscreen, according to the U.S. Food and Drug Administration. Dr. Sloan recommends sunscreen with an SPF of 30 or greater that contains physical blockers such as titanium dioxide or zinc dioxide rather than chemical blockers such as avobenzone, oxybenzone, or octinoxate. Infants and young children can be sensitive to chemical ingredients.
• UPF (ultraviolet protection factor) bathing suits: UPF measures the amount of UV (ultraviolet) radiation that penetrates fabric to reach your skin, according to the Skin Cancer Foundation. Dr. Sloan recommends UPF swimsuits for infants older than six months and children. She advises parents to check the material and if it begins to wear, it won’t provide as much protection and should be replaced with a new UPF swimsuit.
• UV sunglasses to protect infants’ and children’s eyes when out in the sun for any length of time.
• Sandals, water shoes or sneakers can prevent sunburn on the top of the feet and burns from walking in the hot sand.
• Keep yourself, children and infants hydrated. Breast milk if nursing, formula if your infant is on a regular formula and/or Pedialyte. Water, Pedialyte or Gatorade are good for children.

Sunburn Treatment

• If your infant or child gets a sunburn, Dr. Sloan gives this advice for treatment:
• An infant under the age of four months should be seen right away by a physician for any sun damage to their skin.
• First-degree sunburns in older infants and children, when the skin is pink with no blisters, can be treated with an aloe-based lotion or Aquaphor. Hydrocortisone cream is not recommended, as it has not been proven to be effective.
• The sunburn may peel and if it does, let it peel naturally. Cool wet compresses, cool showers, or baths can relieve the sting and inflammation of a sunburn.
• Second-degree sunburn will develop blisters and infants at four to six months of age need to be seen in the emergency department (ED) at the hospital immediately.
• Older infants and children need to be seen in the ED if they develop a fever, have a change in mental status, episodes of vomiting, or have pain that can’t be managed with Tylenol or Motrin, and if there is swelling around the sunburn.
• Older children need to be seen in the ED if they develop dizziness, extreme thirst, fast heart rate, or reduced urine output.
• Third-degree sunburn, which is rare, damages all the layers of the skin and is a definite emergency needing treatment right away. It can destroy nerve endings around the burn which is why they are not painful.

Dr. Sloan also recommended planning a short day at the beach instead of an all-day stay when the temperature is above 85 degrees.