What to Do If a Spider Bites Your Child

It can often seem like spiders are everywhere, and when you consider that more than 100,000 species of spiders have been identified, they probably are.

A black widow spider is typically easy to identify because of the classic markings on its body.
A black widow spider is typically easy to identify because of the classic markings on its body. Photo by Vincent Iannelli, MD

Even with only 4,000 species of spiders in North America, that’s a lot of spiders.

And believe it or not, that’s a good thing. All of those spiders eat up to 800 million metric tons of insects each year!

Fortunately, very few of these spiders are dangerous.

In the Unites States, just two species of spiders are poisonous enough to cause harm. They include the black widow spider (Latrodectus mactans) and the brown recluse spider (Loxosceles reclusa).

Even in other parts of the world that have more of a variety of venomous spiders, like Australia, that “reputation is bigger than its bite.”

It is important to remember than even venomous black widow and brown recluse spiders aren’t wandering around your house trying to attack your kids. They usually like to live in places where they won’t be disturbed. So unless your child was crawling through boxes in a closet or attic, or some other place where they might have disturbed a spider, it is unlikely that any bites on their skin were caused by a “bad spider.”

And in most cases, any “bite marks” probably weren’t caused by a spider at all, as many experts think that spider bites are over-diagnosed. Many other conditions, including other insect bites and skin infections can mimic spider bites.

Symptoms of a Spider Bite

Surprisingly, most spider bites aren’t that painful. Although it may feel like a pin prick, many bites often go unnoticed, making it hard to know if you have been bitten.

Common spider bite symptoms can include a single bite mark with:

  • swelling
  • redness
  • itching
  • pain

In fact, most spider bites will resemble a bee sting. Your child may also develop hives and other allergy symptoms if they are allergic to the spider bite.

Symptoms of a black widow spider bite cold include severe muscle pain and cramps, which develop within a few hours of the bite. Other symptoms might include weakness, vomiting, trouble breathing, abdominal pain, and high blood pressure.

Brown recluse spider bites can be painful. In addition to pain, these spider bites might cause burning and itching. Another characteristic finding is that the spider bite may look like a bull’s eye, with a red ring around a white center that turns into an ulcer.

Was Your Child Really Bitten By a Spider?

The most obvious way to diagnose a spider bite is to see the spider biting your child.

Keep in mind that since many of us have spiders in and around our homes, simply seeing a spider and then noticing a bite on your child doesn’t necessarily mean that your child has a spider bite.

As hard as it sometimes is to tell if a child even has a spider bite, it can be even harder to determine what type of spider actually bit him. Again, seeing the spider can help, as “bad spiders” have very characteristic features.

The black widow spider is jet black, with a red hourglass marking on the underside of their abdomen. Brown recluse spiders are smaller, are yellowish-tan to dark brown, and have a violin shaped marking on their back.

Should you try to catch a spider to help your doctor identify it? Probably not, as you are more likely to bring your pediatrician a crushed spider that is impossible to identify than anything useful. And you should likely be concentrating on taking care of your child after he has been bitten, instead of chasing after the spider.

What to Do If a Spider Bites Your Child

For most spider bites, you can follow some simple home treatments, including:

  • washing the spider bite with soap and water
  • apply an ice cube to the bite for about 20 minutes
  • giving your child a pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil)
  • applying a topical antibiotic ointment to the bite two or three times a day
  • applying a topical steroid cream to help control itching and redness a few times a day
  • continuing home treatments for one or two days, the typical time that it takes a spider bite to go away

Of course, you should seek medical attention if you think your child was bitten by a black widow spider or brown recluse spider, or if any spider bite seems like it is getting infected, with increasing redness and pain after a few days.

Don’t overlook the fact that your local poison control center (1-800-222-1222) can be a good resource if you think your child was bitten by a poisonous spider.

What to Know About Spider Bites and Kids

Other things to know about spider bites include that:

  • Even the poisonous black widow spiders and brown recluse spiders rarely cause life-threatening symptoms or death.
  • In addition to seeking medical attention for a black widow spider or brown recluse spider bite, see your pediatrician if a spider bite isn’t getting better in a few days.
  • Kids may need a tetanus shot after a spider bite.
  • Spiders usually bite just once, so if a child has multiple bites, then it likely isn’t from a spider.
  • Although parents often look for the double fang marks in trying to identify a spider bite, they usually aren’t seen, and even when you see “fang marks,” it doesn’t mean that your child was bitten by a spider.
  • Instead of a black widow or brown recluse, it is more likely that you will come across a more harmless spider in or around your home, like a grass spider, wolf spider, orb weaver, or daddy-long-legs.

Most importantly, teach your kids to avoid spiders by shaking out shoes and clothing that are lying on the floor and not storing boxes or other items on the closet floor or underneath your child’s bed. You can help keep spiders out of your child’s crib or bed by making sure any bedding doesn’t touch the floor.

And remember that spiders eat insects, so might help keep your kids free of other types of bites.

More About Spiders and Spider Bites

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Don’t Skip Your RhoGAM Shot

I’m kind of shocked that I am having to write about warning folks to not skip their RhoGAM shot.

“Prophylactic anti-D immune globulin should be offered to unsensitized Rh D-negative women at 28 weeks of gestation. Following birth, if the infant is confirmed to be Rh D positive, all Rh D-negative women who are not known to be sensitized should receive anti-D immune globulin within 72 hours of delivery.”

ACOG on Prevention of Rh D Alloimmunization

Unfortunately, like with the vitamin K shot, in addition to trying to scare new moms away from getting vaccines, they also tell them to skip their RhoGAM shot.

What is RhoGAM?

RhoGAM (RhIg) or anti-D immune globulin is not a vaccine.

A RhoGAM shot can help prevent hemolytic disease of the newborn and fetus.
A RhoGAM shot can help prevent hemolytic disease of the fetus and newborn.

It is a prescription immune globulin shot that is given to some pregnant and post-partum women to prevent Rh (Rhesus) immunization, which can lead to hemolytic disease of the fetus and newborn if you get pregnant again.

RhoGAM was approved by the FDA in 1968.

RhoGAM Questions and Answers

If you have been educated about RhoGAM on the Internet and are thinking about skipping your RhoGAM shot, it might be time for a little more research:

  1. What is hemolytic disease of the fetus and newborn (HDFN)? It is not to be confused with vitamin K deficiency bleeding, which can be prevented with a vitamin K shot. Also known as erythroblastosis fetalis, HDFN occurs when a mother develops antibodies against her baby’s own red blood cells and destroys them, leading to anemia, jaundice, and edema. In severe cases, this can be life-threatening and the baby can develop hydrops fetalis.
  2. Why would a mom develop these antibodies against her own baby’s blood in the first place? Since a baby’s blood type is determined by both their mom and dad’s blood type, it is easy to see how it might be different than moms. This usually isn’t a problem, after all, a mother’s immune system doesn’t usually attack any other cells of the placenta or her baby (immune tolerance of pregnancy) that might be “foreign.” Unfortunately, it is not uncommon for a baby’s blood and “foreign” red blood cells to mix with mom’s blood, which could trigger antibodies to form.
  3. How does a baby’s blood mix with mom’s blood? Doctor’s have long known that while mixing is not common during a women’s pregnancy, it can commonly occur when she gives birth, explaining how Rh disease used to kill 10,000 babies each year in the United States. It doesn’t take trauma, a procedure (amniocentesis or chorionic villus sampling), or a difficult delivery for a baby’s blood cells to leak into a mother’s bloodstream. It can just happen. Mixing can also happen after a miscarriage, an ectopic pregnancy, or an induced abortion. Simply trying to turn a baby from the breech to a head-down position before delivery (external cephalic version procedure) leads to fetal-maternal hemorrhage in 2 to 6% of cases.
  4. Who needs to get a RhoGAM shot? It is hopefully clear already that not everyone is at risk to develop Rh immunization and so not everyone needs RhoGAM. Some folks can safely skip their RhoGAM shot, but only because it would never have been recommended for them in the first place. You only need RhoGAM if your baby’s blood type might be different than yours, specifically the Rh D antigen of the blood  and if you (mom) are Rh D negative (Rh-negative). Why don’t we worry about the ABO part? While an ABO incompatibility can also cause hemolytic disease of the newborn, it is usually much more minor. Why don’t we worry if you are Rh-positive and the baby is Rh-negative? If your baby is Rh-negative, then he or she wouldn’t have any Rh antigens on their red blood cells to make antibodies against.
  5. What is the chance your baby will be Rh-positive? It depends. And is actually more complicated than people think. If dad is Rh-positive, he can be either +/- or +/+, because there are two alleles for the Rh gene and Rh-positive is dominant. So if mom is Rh-negative (she can only be -/-), then their baby could either be +/- or -/-, so has at least a 50% chance of being Rh-positive. On the other hand, if dad is definitely +/+, then there will be a 100% chance that the baby will be Rh-positive. If you are confused now, then you don’t want to think about how two Rh-positive parents can have a Rh-negative baby!
  6. When will I get my RhoGAM shot? The current guidelines are to get a RhoGAM shot at around the 28th week of pregnancy to prevent Rh sensitization for the rest of the pregnancy; within 72 hours after the delivery of an Rh-positive infant; after a miscarriage, abortion, or ectopic pregnancy; or after amniocentesis or chorionic villus sampling.
  7. Can I skip my RhoGAM shot? You can skip your RhoGAM shot if you are already Rh sensitized (because it’s too late and RhoGAM won’t help for any future pregnancies) or if you are Rh-positive.  You will know if you are already Rh sensitized because a blood test is done to check for Rh antibodies. When paternity is certain (you know who the father is), and the father is Rh-negative, you can also skip the shot you would get at 28 weeks.  You can also skip your RhoGAM shot if your baby is Rh-negative.
  8. How do you know if you are already Rh sensitized? Moms who are Rh-negative get an antibody screen to see if they have Rh antibodies when they are 28 to 29 weeks pregnant.
  9. Why do some women seem to safely skip their RhoGAM shot and have a healthy baby? Like with skipping a vitamin K shot or with skipping or delaying vaccines, the risk of a baby developing hemolytic disease of the fetus and newborn isn’t 100%, so these parents who skipped their RhoGAM shot gambled and got lucky their baby wasn’t harmed.
  10. But don’t they do it differently in other countries? Yes. In the UK, they routinely give all Rh-negative mothers either one dose of RhoGAM at 28-30 weeks or two doses, one at 28 weeks and another at 34 weeks. New mums will also get a shot after their baby is born if their baby is Rh-positive.

Don’t skip your RhoGAM shot if it has been recommended. If you do, you will have a 13-16% chance of becoming Rh sensitized, which can affect your next pregnancy.

RhoGAM Myths

But your OB/Gyn doctor gives you RhoGAM, so why is a pediatrician writing about it?

Because getting RhoGAM prevents hemolytic disease of the fetus and newborn. If you ever see, or hopefully just read about a baby with hydrops fetalis, you will understand why pediatricians don’t want you to skip anything just because of something you read on the Internet, especially myths like:

  • RhoGAM is a vaccine – not true. RhoGAM is made of antibodies. And while it is a blood product, it is extensively screened and tested for infections. Of course, you shouldn’t skip any of your pregnancy vaccines either, like your flu or Tdap vaccines.
  • RhoGAM contains mercury – not true. RhoGAM is thimerosal free.
  • You only need RhoGAM if you have been in a car accident – not true, at all. Again, even in a normal pregnancy, with a “gentle birth,” there can be mixing of blood. And it doesn’t take a lot of blood mixing. As little as 0.1ml of blood (keep in mind that a teaspoon is 5ml) can trigger Rh sensitization.
  • hemolytic disease of the fetus and newborn is easily treatable – not true. While it might be true for more minor ABO blood incompatibilities, it is not true for Rh disease. If a baby develops hydrops fetalis, they might need intrauterine fetal blood transfusions and an early delivery. After they are born, babies with hydrops fetalis will likely need blood transfusions (because of severe anemia), exchange transfusions (because of extreme levels of jaundice), medicines to manage heart failure, phototherapy, and will likely be on a ventilator to help them breath. And even in a modern NICU, babies with hydrops fetalis still die.
  • everyone is offered a RhoGAM shot as part of a Big Pharma profit ploy – not true. RhoGAM is only given to moms who are Rh-negative, and since 85% of people are Rh-positive, most are never offered RhoGAM.
  • you can just wait to see if you want to get the shot later – not true. If you are Rh-negative and skip the pregnancy dose, waiting until your baby is born to see if they are Rh-positive, you may have already become sensitized. Mixing of blood occurs during pregnancy in at least 12% of cases and that is not just with car accidents, procedures, or trauma. Before RhoGAM started to be used during pregnancy, instead of just after, almost 2% of moms still became sensitized. Although that might seem like a small number, when you consider that almost 4 million babies are born in the United States each year, it ends up being a lot of babies at risk for HDFN if moms start skipping their RhoGAM shots.
  • you can just skip the shot if you don’t want any more kids – not true. Want if you change your mind and decide you do want more kids or have a “happy accident.”
  • there are natural ways to prevent Rh-sensitization – not true.
  • Rhogam causes serious side effects – not true. Rhogam is safe and doesn’t cause autism or any of the other serious side effects that you might see listed on sites trying to scare you away from getting your shot.
  • “First time mothers do not need it. A dose at 28 weeks is unnecessary unless a test shows sensitization has already occurred.” – ridiculously untrue, but I included it to show what kind of advice you will find on some websites. First time mothers definitely could need it, if they are Rh-negative, so that they don’t become sensitized, and if they are already sensitized, a dose isn’t going to help them!

Again, don’t skip your RhoGAM shot.

What To Know About Getting a RhoGAM Shot

There is no reason to skip your RhoGAM shot if it has been recommended for you during or after your pregnancy.

More About Deciding To Get A RhoGAM Shot

That Black Box Warning on Vitamin K Shots

Vitamin K is not a vaccine, but some parents who plan on skipping or delaying their baby’s vaccines, also choose to skip this shot.

Vitamin K Shots

Given soon after a baby is born, a vitamin K shot is the most effective way to prevent both early onset and late onset vitamin K deficiency bleeding.

“The vitamin K injection is also a supposed safeguard in case your car is involved in a car wreck on the way home from the hospital or birthing center with newborn in tow.”

The Healthy Home Economist on why you should Skip that Newborn Vitamin K Shot

Although vitamin K deficiency bleeding has never been very common, it is often fatal, and it has been known for almost 125 years that it is caused by a temporary lack of vitamin K in newborns and younger infants.

Can’t you just give babies oral vitamin K to prevent this bleeding?

While oral vitamin K can prevent early onset vitamin K deficiency bleeding, which might start from birth to when a baby is about two weeks old, it won’t prevent late onset bleeding, even if you give the recommend three doses on schedule over two months (as they do in some countries). Babies with late onset vitamin K deficiency bleeding might not have symptoms until after they are two weeks old, or as late as 5 or 6 months old, and it can only be prevented with a vitamin K shot.

Can’t you just avoid dropping your baby or getting into a car wreck if you skip the vitamin K shot?

While you will hopefully do that anyway, the truth is that we don’t know why some infants with vitamin K deficiency bleeding develop bleeding in their brains, as it usually isn’t any kind of big trauma.

In 2013, seven babies over a period of eight months had early and late vitamin K deficiency bleeding at the Monroe Carell Jr. Children’s Hospital at Vanderbilt University in Nashville.

Three of them required surgery to remove clots “out of their head” and may “have issues with seizure disorders and will have long-term neurological symptoms related to seizures and developmental delays.”

I don’t think any of them were dropped or were involved in car accidents on the way home from the hospital or birthing center.

All had refused to get their baby a vitamin K shot.

Why Do Parents Refuse Vitamin K???

So why do some parents choose to skip their baby’s vitamin K shot?

There are no toxic ingredients in your baby's vitamin K shot.
There are no toxic ingredients in your baby’s vitamin K shot.

Some parents simply think their baby doesn’t need it, especially if they have an uncomplicated, “gentle birth” at home. Of course that has nothing to do with whether or not your baby develops vitamin K deficiency bleeding days or weeks later. It also doesn’t matter whether or not you plan on getting your baby boy circumcised, although your pediatrician probably won’t do the circumcision if you skip the shot.

Other parents are worried about a possible link to leukemia and childhood cancer, an improbable link that was refuted way back in the 1990s.

And still others are worried about the mercury content of vitamin K shots. Or they are worried about other supposed “toxins” in the shot, that it is a synthetic version of vitamin K, or that the dose is too high.

“There is no evidence to suggest that the small amount of benzyl alcohol contained in Vitamin K1 Injection (Phytonadione Injectable Emulsion, USP), when used as recommended, is associated with toxicity.”

Vitamin K Package Insert

Why are they worried about these things?

Mostly because someone on the Internet told them to be worried about them, even though vitamin K shots are safe, are free of mercury and any other toxins you might really need to be concerned about, and the dose of synthetic vitamin K your baby gets in the shot will not cause an overdose.

Or they might be worried that their baby might get up to 100mcg/L of aluminum with each shot. Of course, since they are only getting 0.5ml with the shot, that only equals about 0.05mcg of aluminum! Although it is an extremely tiny amount, why is it even in there? It is not working as an adjuvant as some would propose (again, vitamin K is not a vaccine), but rather is likely just a byproduct of the manufacturing process. And you can be assured that your baby can quickly, and safely eliminate the small amount from their body.

“…several countries have reported a resurgence of late VKDB coincident with policies promoting the use of orally administered prophylaxis, even with multiple-dose regimens.”

AAP on Controversies Concerning Vitamin K and the Newborn

The shot (which works) is certainly safer than going to a compounding pharmacy for oral vitamin K (which won’t work to prevent all cases of late-onset vitamin K deficiency bleeding).

That’s right – oral vitamin K for babies isn’t even available in the United States.

That Black Box Warning on Vitamin K Shots

And then there is the black box warning in the package insert for vitamin K.

The package insert for vitamin K does include a black box warning, although these severe reactions are extremely rare in newborns who get a vitamin K shot to prevent vitamin K deficiency bleeding.
The package insert for vitamin K does include a black box warning, although these severe reactions are extremely rare in newborns who get a vitamin K shot to prevent vitamin K deficiency bleeding.

Why is it there?

It was found that people could have severe, life-threatening allergic reactions (anaphylaxis) if they got a large dose of vitamin K too rapidly through an IV. This type of dose would usually be given to patients with significant bleeding who were being treated with anticoagulants (anticoagulant reversal).

“Based on a review of the literature, use of parenteral vitamin K1 may result in severe hypotension, bradycardia or tachycardia, dyspnea, bronchospasm, cardiac arrest, and death. These reactions are most consistent with a nonimmune-mediated anaphylactoid mechanism. It appears that intravenous administration is more frequently associated with these reactions and occurs at an incidence of 3 per 10 000 doses of intravenous vitamin K1.”

Jamie N Brown on Characterizing the Severe Reactions of Parenteral Vitamin K1

This is not what happens when babies get their vitamin K shot though, although there is one non-fatal case report of anaphylaxis after a baby in Turkey got a vitamin K shot in 2014.

There are nearly 4 million births in the United States each year.

Almost all of them get a vitamin K shot very soon after they are born.

And yet there are no reports of anaphylaxis in the United States.

There are isolated case reports of anaphylaxis in newborns to other things, including antibiotics, hepatitis B immunoglobulin, total parenteral nutrition (TPN), and atracurium (used in anesthesia) – but not to vitamin K shots.

“Therefore the INTRAVENOUS and INTRAMUSCULAR routes should be restricted to those situations where the subcutaneous route is not feasible and the serious risk involved is considered justified.”

Vitamin K Black Box Warning

That’s why most parents don’t skip getting their baby a vitamin K shot. Or they come to regret the decision if they do.

“What it comes down to is that giving your child a shot of Vitamin K at birth is a small price to pay, especially when the cost of rejecting the shot can be severe brain injury and death. I can’t change what happened to Olive, but I can try to prevent it from happening to another baby.”

Olive’s Story

For most parents, avoiding the serious risk of vitamin K deficiency bleeding justifies their baby getting a vitamin K shot.

And that’s why vitamin K deficiency bleeding is so rare these days – at least among those babies whose parents didn’t choose to skip their vitamin K shot.

What To Know About That Black Box Warning on Vitamin K Shots

For most parents, avoiding the serious risk of vitamin K deficiency bleeding easily justifies their decision to get their baby a vitamin K shot, despite the presence of a black box warning.

More About That Black Box Warning on Vitamin K Shots

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Reducing the Risk of Hot Car Deaths

Good Samaritan laws can offer protection if you help a child in a hot car in an emergency. Call 911 and get the child out of the hot car if you need to.
Good Samaritan laws can offer protection if you help a child in a hot car in an emergency. Call 911 and get the child out of the hot car if you need to.

In the United States, about 37 children die each year in hot cars.

Few are left in the car intentionally.

About half are accidents. Parents who forgot that the child was still in the car.

Many of the deaths are kids who got into the car and couldn’t get out.

All are tragic.

Kids in Hot Cars

How can you forget a child in a car?

Especially a car that might heat up to the point that a child can quickly die inside?

Although many people find it unbelievable that it can happen, it happens just the same.

People, once they are out of their very rigid routine, forget to drop a child off at daycare or that their child is still in the car.

“On days when the ambient temperature was 72°F, we showed that the internal vehicle temperature can reach 117°F within 60 minutes, with 80% of the temperature rise occurring in the first 30 minutes.”

Catherine McLaren on Heat Stress From Enclosed Vehicles

And remember, it doesn’t even have to be that hot outside for a car to quickly heat up.

How Hot Car Deaths Happen

It’s easy to see how some hot car deaths happen.

These are the deaths that are borne out of parental negligence. The kids who are left in a car while their parents party or shop.

But then you have the story of the mom who forgot to drop off her 7-month-old – dad usually drops her off – and doesn’t notice that she is still in the car until she picks up her son at daycare after work.

Or the child forgotten in a car after a family returns home.

Some deaths occur at daycare – kids left on a bus or van.

And sometimes kids get trapped in a car that had been unlocked.

Reducing the Risk of Hot Car Deaths

To help reduce the risk of these tragic hot car deaths, it might help to:

  • never leave your child alone in any vehicle, not even for a minute
  • lock your car and secure the keys so that your kids can’t get into your car and play by themselves
  • check the inside (after checking nearby bodies of water) of nearby vehicles, including their trunks, when a child goes missing
  • make sure your daycare provider alerts you if your child doesn’t show up
  • place reminders in the back seat with your child, so that even if you forget to drop off your child on the way to work, you will notice once you get to work and gather your things
  • bring your kids inside the house before anything else, so that you are less likely to get distracted and forget them outside
  • have a designated watcher if you have a lot of kids, especially if they are in multiple cars, to make sure everyone gets inside and no one is left in the car
  • call 911 if you see a child alone in any vehicle and get them out as soon as possible if they are not responsive or they are in distress
  • push for automakers to include standard devices in all cars to prevent hot car deaths

Most importantly, remember that it can happen to anyone, so be extra careful when you break your routine and always “look before you leave” or lock your car.

What To Know About Hot Car Deaths

Look before you lock and learn other way to reduce your child’s risk of a hot car death.

More About Hot Car Deaths

Safe and Effective Sun Screens for Kids

One of the cardinal rules of summer is that you don’t let your kids get a sunburn.

While a really great rule, it misses that you also shouldn’t let them get a tan either, and the rule doesn’t just apply to summer.

How do they do it in Australia? Slip (on some sleeves) - Slop (on a lot of sunscreen) - Slap (on a hat) - Seek (shade) - and Slide (on your sunglasses).
How do they do it in Australia? Slip (on some sleeves) – Slop (on a lot of sunscreen) – Slap (on a hat) – Seek (shade) – and Slide (on your sunglasses).

That’s were sunscreen comes in. Slop it on.

Sunscreens for Kids

Are sunscreens safe for kids?

As with insect repellents, despite all of the warning about chemicals and toxins that you might read on the internet, the answer is of course they are. In fact, most sunscreens can even be used on infants as young as age six months. And it is certainly better than letting your kids get sunburned!

You do have to use them correctly though.

Choosing a Safe and Effective Sunscreen

Which sunscreen should you use?

This Blue Lizard sunscreen includes Titanium Dioxide and Zinc Oxide, providing broad spectrum UVA and UVB protection.
This Blue Lizard sunscreen includes Titanium Dioxide and Zinc Oxide, providing broad spectrum UVA and UVB protection.

Many parents are surprised that there are actually a lot of different ingredients in sunscreens, from Aminobenzoic acid and Octocrylene to Zinc Oxide.

While some are physical sunscreens (Titanium Dioxide and Zinc Oxide), others are chemical sunscreens. Some provide UVA protection, some UVB protection, and some offer both. And not surprisingly, some have become controversial, especially retinyl palmitate (vitamin A) and oxybenzone.

All are thought to be safe though.

Which is best?

When choosing a sunscreen, start with the fact that none should usually be used on infants under six months of age. Otherwise, choose the product (whatever the brand, to be honest, whether it is Banana Boat, Blue Lizard, Coppertone, Hawaiian Tropic, Neutrogena, or Target) best suited to your child’s needs, especially considering that:

  • sun tan lotion and tanning oil should be avoided
  • SPF 8 only blocks 87 percent of UVB rays and should be avoided
  • SPF 15 blocks 93 percent of UVB rays (minimum you should use)
  • SPF 30 blocks 97 percent of UVB rays (good for daily use)
  • SPF 50 blocks 98 percent of UVB rays (good for daily use)
  • SPF 50+ don’t offer much more UVB protection and may encourage folks to stay in the sun longer than they should, putting them at even more risk from UVA rays
  • a broad-spectrum sunscreen provides both UVA and UVB protection
  • even if your kids don’t go in the water, a sunscreen that is water-resistant might stay on better if they are sweating or get sprayed with water

In addition to the active ingredient and it’s SPF, you can now decide if you want a sunscreen that is in a spray, mist, cream, lotion, or stick. You can then pick one that is fragrance free, PABA free (of course), tear free, oil free (important if your kids have acne), for your baby or your kid playing sports, for someone with sensitive skin, or goes on dry.

Using a whipped sunscreen is just one of the newer ways to protect your kids from the sun's harmful rays.
Using a whipped sunscreen is just one of the newer ways to protect your kids in the sun.

Or would you like your child’s sunscreen whipped???

While parents and kids often seem to prefer spray sunscreens, do keep in mind the warnings about inhaling the spray and that some experts are concerned that they make it harder to apply a generous amount on your child. How much of the spray goes off in the wind? How much end up in an oily spot on the floor? If you use a spray sunscreen, follow the directions, rub it in, and don’t spray it in your child’s face. Also, don’t spray sunscreen on your child near an open flame.

Most importantly, you want to choose a sunscreen that will help you get in a good routine of using properly and using all of the time. Personally, I like all of the newer non-greasy lotions for kids and adults that have come out in the last few years. They are easy to apply, even in generous amounts, and work well.

Using Sunscreens on Kids

Now that you have chosen your sunscreen, be sure to use it properly.

“An average-sized adult or child needs at least one ounce of sunscreen (about the amount it takes to fill a shot glass) to evenly cover the body from head to toe.”

FDA

Do your kids still get burned or tanned despite using sunscreen? They aren’t immune to sunscreen. You are probably just making one or more common sunscreen mistakes, like not using enough sunscreen (start using a lot more), waiting until you’re already outside before applying it on your kids (you want to apply sunscreen at least 15 minutes before you go outside so that it has time to get absorbed into their skin), or not reapplying it often enough (sunscreen should be reapplied every few hours or more often if your kids are swimming or sweating a lot).

How long does a 6 or 8 ounce container of sunscreen last you? Remember that if you are applying an ounce before your kids go outside, reapplying it every few hours, and using it on most days (not just in the summer), then it shouldn’t last very long at all.

A layered approach to sun protection can help keep your kids safe in the sun.
A layered approach to sun protection can help keep your kids safe in the sun.

For the best protection and to avoid mistakes, be sure to read the label and follow your sunscreen’s instructions carefully, and also:

  • encourage your kids to seek shade and wear protective clothing (especially hats, sunglasses, and UPF sun-safe clothing), in addition to wearing sun screen for extra sun protection
  • use sunscreen every time they go outside, even when it’s cloudy
  • reduce or limit your child’s sun exposure when UV rays are strongest, which is usually from about 10 a.m. to 2 p.m. (and all of the way to 4 p.m. in most areas), especially on days when the UV index is moderate or high and/or when there is a UV Alert in your area.

If you forget something, remember slip, slop, slap, seek, and slide.

Facts about Sunscreens and Sun Protection for Kids

Other things to know about sunscreen and sun protection for kids include that:

  • Waiting for improvements to sunscreen labels and new requirements for sunscreens? The FDA made their ‘big changes’ to sunscreens back in 2011. The main things that got left were the SPF cap and the rating system for UVA protection.
  • Tanning beds are not a safe alternative to getting a tan outside in the sun.
  • It is not safe to get a base tan. It won’t protect you from a sunburn and it increases your chance of future melanoma.
  • Still confused about how much sunscreen to use? Another handy rule is that a handful of sunscreen (fill to cover the palm of their cupped hand) should be a generous amount that’s enough to cover your child’s entire body. Since bigger kids have bigger hands, that should help you adjust the amount for different-size kids and as they get older.
  • Avoid combination sunscreen/insect repellent products. Use separate products instead, applying the sunscreen first and reapplying the sunscreen every few hours as necessary. Since you don’t typically reapply insect repellents (unless you are going to be outside for a really long time), if your child starts to get bitten, next time, you will likely need to consider using an insect repellent with a different active ingredient or at least one with a stronger concentration that might last longer.
  • SPF is only a measure of the sunscreen’s level of protection against UVB rays, but does say anything about UVA protection. A sunscreen that is labeled as being broad spectrum should protect against both UVA and UVB radiation.
  • According to the FDA, “SPF is not directly related to time of solar exposure but to amount of solar exposure.” What does that mean? While you can stay in the sun longer when protected with a sunscreen, no matter the SPF, it doesn’t tell you how long. Other factors, including the time of day, weather conditions, and even your location will help determine how quickly your skin will burn.
  • Sunscreens should be stored in a cool place and be thrown away after they expire. While it might be convenient, your car is not a good place to store your sunscreen.

Ready for some fun in the sun now? You sure you won’t come home with a sunburn or a dark tan?

What To Know About Sunscreens for Kids

Applying a generous amount of a water-resistant sunscreen that provides broad-spectrum SPF 15 to 30 sun protection at least 15 to 30 minutes before your child is going to be in the sun, reapplying every few hours, can help keep your kids safe in the sun.

More About Sunscreens for Kids

Get Control of Your Child’s Allergy Triggers

What’s triggering your child’s allergies and asthma?

Is it the cat?

The roses she loves to smell?

The dust on all of the stuffed animals in her room?

The Cottonwood tree blooming in the yard next door?

How do you know?

Identifying Allergy Triggers

Roses are not a common allergy trigger.
Roses are not a common allergy trigger.

If your other kids are dog lovers, they are probably voting for the cat, but depending on the time of year, her pattern of symptoms, and where you live, there could be plenty of candidates.

One thing you can check off your list – the roses.

Allergies are typically caused by pollen from trees, grasses, and weeds – not other types of flowering plants, like roses, geraniums, or begonias, etc. These “allergy-friendly” plants don’t produce much pollen. Other plants with flowers that are said to be fairly non-allergenic include orchids, pansies, petunias, snapdragons, and zinnias, etc.

“Brightly colored flowers that attract bees and other insects or humming birds are generally not allergenic.”

Michael J. Schumacher, MB, FRACP, The University of Arizona

In general, plants with wind-borne pollen can trigger allergies.

Are your child’s allergies better after it rains? Since heavy rains can lower pollen counts in the air, that could be a hint to a seasonal allergy trigger.

What about when it is dry and windy? Does that make your child’s allergies worse? Since pollen is carried by the wind, a dry, windy day will likely mean that there is more pollen in the air, which is another hint to a seasonal allergy trigger.

Do your child’s year round allergies quickly get better when he is away from home for a few days or weeks? That could be a hint to something inside your house being a trigger, although if he traveled far away, to another area of the country, it could simply mean that he wasn’t exposed to the same pollen in the air.

Understanding Allergy Triggers

Year round, or perennial allergy symptoms, are likely caused by things inside your home.

If your child’s allergies only seem to be bad at very specific times of the year, then pollen from grasses, trees, or weeds could be the trigger. Which pollen is high in your area when your child’s allergy symptoms are acting up?

Allergy testing is always an option if your child’s allergies are hard to control, either skin testing or a blood test.

Indoor Allergens That Trigger Allergy Symptoms

Year round allergy symptoms can often be caused by things in your home:

  • Cat and dog dander
  • Dermatophagoides farinae and pteronyssinus (dust mites)
  • Mice (mouse allergens/mouse urine proteins)
  • Cockroach saliva, feces, and body parts (cockroach allergens)

While allergy testing can help you figure out which to blame, if you don’t have any indoor pets and can eliminate mold in the house, then maybe you can blame dust mites.

Weeds That Trigger Allergy Symptoms

Most people think of ragweed as the classic weed that can trigger seasonal allergies. Often described as being “packed with pollen,” each ragweed plant produces up to one billion pollen grains each season! These ragweed pollen grains are carried by the wind and can trigger allergy symptoms from early to mid-August through September and October – fall allergy season.

Others weeds that commonly trigger allergies include:

  • nettle
  • mugwort
  • Russian thistle (tumbleweed)
  • plantain
  • Rough marsh elder
  • Rough pigweed
  • Sheep sorrel

Again, if necessary, allergy testing can help you figure out to which weed your child is allergic, but if their allergies peak in the fall, it is likely triggered by weeds.

Trees That Trigger Allergy Symptoms

Which trees are most likely to trigger allergy symptoms?

It depends on where you live, but in the spring, mountain cedar, pecan, elm, maple, birch, ash, oak, and cottonwood, are common offenders.

If you are allergic to tree pollen, you can expect symptoms in late winter to early spring.

Grasses That Trigger Allergy Symptoms

While many people don’t think of summer as a typical allergy season, that is actually when grass pollen is in the air.

Do you know which grasses are commonly grown in your area?

Bermuda grass, Timothy, Kentucky Blue, Johnson, Rye, or Fescue? Are your kids allergic to any of them? If so, their allergy symptoms will probably act up in the late spring and early summer.

Molds That Trigger Allergy Symptoms

Depending on where you live, molds can either cause seasonal symptoms (colder climates) or they can be a cause of year round symptoms.

And you can expect outdoor mold spore counts to be extra high when it is warm and humid.

Inside, mold grows best in parts of the house that are cool and damp, with common suspects including:

  • Cladosporium herbarum
  • Penicillium notatum
  • Alternaria alternata
  • Aspergillus fumigatus

Have you seen any of these names on your child’s allergy test results? Although it is considered part of our natural environment, you can keep mold from growing inside your home.

What To Know About Allergy Triggers

Identifying your child’s allergy trigger or allergy season won’t make them  away. It can help you learn to avoid or control them though, or at least help get prepared by starting your child’s allergy medicines before he is exposed.

More Information about Allergy Triggers

Safe and Effective Insect Repellents for Kids

While other measures are important too, insect repellents are typically the best way to protect your kids from biting insects and ticks.
While other measures are important too, insect repellents are typically the best way to protect your kids from biting insects and ticks. Photo by James Gathany.

As we become more and more aware of diseases that can spread from the bites of insects and ticks, it becomes important that we learn to protect our kids. Plus, itchy bites can turn into nasty scabs that your kids pick at over and over, leaving scars that might even get infected.

What should you do?

Insect Repellents for Kids

In addition to simply trying to avoid mosquitoes and ticks, which can be difficult, especially as your kids get older and spend more time outside, you should learn to protect them with insect repellents.

Are insect repellents safe for kids?

Despite all of the warning about chemicals and toxic pesticides that you might read on the internet, the answer is of course they are. In fact, many insect repellents can even be used on infants as young as age two months. And it is certainly better than your kids getting Chikungunya, Dengue, Lyme disease, Rocky Mountain Spotted Fever, West Nile, or Zika. Or MRSA from an infected bite.

You do have to use them correctly though.

Choosing a Safe and Effective Insect Repellent

If they are using the new EPA label, your insect repellent will tell you how long it will protect your kids against mosquitoes and ticks.
If using the new EPA label, your insect repellent will tell you how long it will protect your kids against mosquitoes and ticks.

Which insect repellent should you use?

Although traditionally insect repellents with DEET have long been “considered the best defense against biting insects,” the CDC has now said that some other DEET-free alternative insect repellents may work as well as lower dose DEET, including those with 2-undecanone, Picaridin, IR3535, oil of lemon eucalyptus, and 2% soybean oil.

Of course, that has led to a lot of new insect repellents on store shelves these days. And to a lot of confused parents trying to decide which is the best for their kids.

Don’t be one of them.

When choosing one of these insect repellents, start with the fact that none should be used on infants under two months of age and products containing oil of lemon eucalyptus should not be used on children under age three years. Otherwise, choose the product best suited to your child’s needs, especially considering that:

  • no protection insect repellents should be avoided (garlic, vitamin B1, bug zappers, insect repellent wristbands)
  • shorter protection insect repellents last about two hours (less than 10% DEET, essential oils, 2-undecanone)
  • medium protection insect repellents last about 3 to 4 hours (20% DEET, 7% Picaridin)
  • longer protection insect repellents last about 5 hours or more (24% DEET, 15% Picaridin)

In addition to the active ingredient and it’s strength (how long it lasts), you can now decide if you want an insect repellent that sprays on smooth and dry and isn’t greasy, has a light, tropical scent, or is unscented. Or instead of a spray (pump or aerosol), you can even choose insect repellent wipes or a lotion.

Do keep in mind that the CDC advises that products above 30% DEET reportedly do not provide any extra protection, although it doesn’t keep stores from selling sprays with as much as 100% DEET. For other products, those with higher concentrations of DEET aren’t necessarily stronger, they simply provide longer protection.

So if you are going for a walk around the neighborhood with your preschoolers, some good choices might be:

  • Avon Skin-So-Soft Bug Guard Plus Towelettes (IR3535)
  • BioUD Spray (2-undecanone)
  • Buzz Away Spray (Citronella oil)
  • Cutter All Family Spray (7% DEET)
  • Cutter Lemon Eucalyptus Spray
  • Cutter Natural Spray
  • Cutter Skinsations  (7% DEET)
  • OFF! FamilyCare II (5% Picaridin)
  • OFF! FamilyCare III (5% DEET)
  • OFF! FamilyCare IV (7% DEET)

There are many other brands too, including Sawyer, Repel, and discounted store brands from CVS, Target, and Walgreens, etc.

Using Insect Repellents on Kids

Now that you have chosen your insect repellent, be sure to use it safely.

That means reading the label and following the instructions carefully, being sure to:

  • only apply the proper amount of insect repellent to exposed skin or clothing
  • avoid applying insect repellent near your child’s eyes and mouth, on cuts, irritated skin, or under your child’s clothing
  • wash off the insect repellent when you return indoors
  • avoid spraying insect repellent inside your home or car, directly on your child’s face (apply to your own hands and then rub it on their face) and hands (they might rub their eyes or put their hands in their mouth), or allowing them to spray it on themselves
  • instead of insect repellent, consider using mosquito netting to cover your infant’s stroller or carrier when outside, and especially when in high risk parts of the world, using insecticide treated bed nets

It can also help to mosquito-proof your home and work to control mosquitoes and ticks where your child plays. And of course, have your child cover up and dress to avoid getting bit when possible, with long socks and clothing that covers their arms and legs.

Facts About Insect Repellents for Kids

Other things to know about insect repellents for kids include that:

  • Protect times can be different for protection against mosquitoes vs ticks.
  • IR3535, also known as Insect Repellent 3535, is a synthetic biopesticide (ethyl butylacetylaminopropionate). It was once only found in Avon Skin So Soft products, but can now be found in other brands too.
  • It is the chemical in oil of lemon eucalyptus, PMD or para-menthane-3,8-diol, that gives it pesticidal properties.
  • Avoid combination sunscreen/insect repellent products. Use separate products instead, applying the sunscreen first and reapplying the sunscreen every few hours as necessary. Since you don’t typically reapply insect repellents (unless you are going to be outside for a really long time), if your child starts  to get bitten, next time, you will likely need to consider using an insect repellent with a different active ingredient or at least one with a stronger concentration that might last longer.
  • Although available, insect repellent lotions are often harder to find in stores.
  • In addition more standard insect repellents, permethrin treated clothing is available.
  • Don’t be fooled by natural insect repellents that ‘smell amazing’ and say that they aren’t “full of chemicals.” They likely contain para-menthane-3,8-diol, ethyl butylacetylaminopropionate, or other chemicals. While they are DEET-free and some may be natural, they aren’t free of chemicals. And keep in mind that many natural insect repellents are non-EPA registered.
  • Call poison control (1-800-222-1222) if your child gets the insect repellent in their mouth or eyes or has a reaction.

Although they are the best protection, since insect repellents aren’t perfect, you should also learn how to remove ticks and the symptoms of mosquito and tickborne diseases.

Yet more protection options include the Dengue vaccine (not available in the US yet though) and preventative medications for malaria.

What to Know About Insect Repellents for Kids

When used properly, insect repellents are safe and effective and the best way to help your kids avoid getting eaten up by mosquitoes, chiggers, ticks and other things that like to bite kids.

More About Insect Repellents for Kids