Tag: sunscreen

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

Preventing and Treating Vitamin D Deficiency

More people seem to be getting the message that too little vitamin D in our diets can lead to health problems. In addition to being at risk of developing rickets (extreme vitamin D deficiency), children with milder forms of vitamin D deficiency can develop weak bones and muscle weakness.

Why is vitamin D so important?

Vitamin D is a hormone that helps our bodies absorb both calcium and phosphorous, two very important minerals that help keep our bones strong.

Without enough vitamin D, we absorb 85-90% less of the calcium in our diet! And then, to keep calcium levels normal, our bodies pull more calcium out of our bones, causing osteopenia and osteoporosis.

Some experts also think that a low vitamin D level is associated with other conditions that are not linked to calcium and our bones, including some psychiatric conditions. The American Academy of Pediatrics even states that “new evidence suggests that vitamin D plays a vital role in maintaining innate immunity and has been implicated in the prevention of certain disease states including infection, autoimmune diseases (multiple sclerosis, rheumatoid arthritis), some forms of cancer (breast, ovarian, colorectal, prostate), and type 2 diabetes mellitus.”

The role of vitamin D in preventing infections, cancer, or anything else beyond preventing and treating vitamin D deficiency (extraskeletal effects) is far from proven though. In fact, a 2010 investigation by the Institute of Medicine (IOM) didn’t find any evidence to support a role for vitamin D in any other health conditions besides supporting bone health.

Surprisingly to many people, the IOM report also found that most people in North America are already getting enough calcium and vitamin D in their diet and that getting too much can be harmful. They also warned that “the number of people with vitamin D deficiency in North America may be overestimated because many laboratories appear to be using cut-points that are much higher than the committee suggests is appropriate.”

Tests for Vitamin D Deficiency

Although vitamin D testing seems to becoming part of the routine screening tests that some doctors order, it is important to keep in mind that only those at risk for having low levels should be routinely tested.

Are your kids at risk for vitamin D deficiency?

These high risk children can include:

  • exclusively breastfed infants who don’t get a vitamin D supplement
  • babies born to mothers with a vitamin D deficiency, especially premature babies
  • children with chronic kidney or liver disease
  • children with malabsorption syndromes (Crohn’s disease, inflammatory bowel disease, cystic fibrosis, etc.), as vitamin D is absorbed with fats in our diet
  • obese children, because vitamin D is stored in fat tissue and is not readily available for use
  • children with dark skin, who live at high latitudes, and/or spend a lot of time indoors (less vitamin D from sun exposure)
  • children taking certain medications, including antiseizure medications and oral steroids
  • children who simply don’t get enough vitamin D – at least 400-600 IU of vitamin D each day, depending on their age. This might include vegetarians, vegans, and children who simply don’t drink vitamin D fortified cow’s milk, soy milk, or almond milk, etc., or other foods that are high in vitamin D.

If your child falls into one or more of these risk factors for vitamin D deficiency, then talk to your pediatrician about testing his vitamin D levels.

Although different tests are available, the test that is recommended by the AAP and the Endocrine Society is the serum 25(OH)D level (25-hydroxyvitamin D). This actually measures the levels of a prehormone of vitamin D, calcifediol, but is thought to give a good idea of a person’s vitamin D status.

This vitamin D test is preferred over testing 1,25(OH)2D levels, another test that is available, as those levels can be normal or even elevated when someone has a vitamin D deficiency. Similarly, measuring vitamin D levels (the active hormone) has not been found to be helpful. Instead, we use 25(OH)D levels as a marker for vitamin D levels.

Treating Vitamin D Deficiency

Is your child’s vitamin D level low?

That question is a actually a little harder to answer than you might realize. According to the IOM, in discussing cut-points for 25(OH)D levels, or what’s low and what’s normal, “At this time, there is no central body that is responsible for establishing such values for clinical use.”

The serum 25(OH)D level is typically defined as low (vitamin D deficiency) in children if it is below 20 ng/ml. Some experts think that a 25(OH)D level above 16 ng/ml is normal for infants and children though.

Experts do agree that a level below 5 ng/ml is a sign of a severe vitamin D deficiency.

Recommendations for treating children with low vitamin D levels depend on their age, and might include:

  • newborns: 1,000 IU /day vitamin D2 or D3
  • children 1 to 12 months old: 2,000 IU /day vitamin D2 or D3
  • children > 12 months old: 2,000 IU /day vitamin D2 or D3

These vitamin D supplements, together with adequate amounts of calcium, are usually continued for at least 1 to 3 months, at which time the child’s serum 25(OH)D level can be repeated to make sure it is responding to treatment.

“The upper limit for vitamin D is 1,000 to 1,500 IU/day for infants, 2,500 to 3,000 IU/day for children 1-8 years, and 4,000 IU/day for children 9 years and older, adults, and pregnant and lactating teens and women. Vitamin D toxicity almost always occurs from overuse of supplements.”

NIH Vitamin D Fact Sheet for Consumers

The Endocrine Society also advises that some children can take 50,000 IU of vitamin D2 once a week as an alternative treatment for vitamin D deficiency. Since you can definitely get too much vitamin D, be sure to talk to your pediatrician and make sure your child is getting the right dose before starting a treatment regimen for vitamin D deficiency.

Preventing Vitamin D Deficiency

Once you get your child’s vitamin D levels back into a normal range, it is important to take steps so that they don’t drop again.

To prevent vitamin D deficiency, the American Academy of Pediatrics recommends that healthy infants get at least 400 IU of vitamin D each day, while older children – toddlers to teens – get at least 600 IU. This vitamin D should come from some combination of:

  • foods that are naturally rich in vitamin D – salmon, tuna, shitake mushrooms, etc.
  • foods that are fortified with vitamin D – vitamin D fortified milk, orange juice, cheese, yogurt, margarine, and cereal, etc.
  • a vitamin D supplement – with just vitamin D, vitamin D plus calcium, or a children’s multivitamin

What about sunlight? Can’t your kids just spend more time in the sun to boost their vitamin D levels?

Although we all have the ability to make vitamin D when we are out in the sun, it isn’t considered a good source of vitamin D. Intentional, unprotected (no sunscreen) exposure to the sun has risks of sunburn and skin cancer. And it is very hard to judge how much sun exposure is necessary to get adequate amounts of vitamin D. The intensity of the sun’s radiation varies greatly in different parts of the world and at different times of year and will also affect how much vitamin D your body makes.

Other Things To Know about Vitamin D Deficiency

  • Raw milk, in addition to being unprocessed and unpasteurized, is unfortified and has very little vitamin D.
  • Although other foods may be fortified with vitamin D, in the United States, only milk, margarine, infant formula, and “fortified-plant based beverages” are mandated by the FDA to be vitamin D fortified.
  • In addition to low 25(OH)D levels, children with vitamin D deficiency will often have low phosphorous, high alkaline phosphatase, and high parathyroid hormone levels. These levels might be checked and monitored when kids are treated for vitamin D deficiency.
  • Vitamin D2 (ergocalciferol, derived from plants) and vitamin D3 (cholecalciferol, derived from animals) are two major forms of vitamin D. Some experts think that vitamin D3 is more potent than vitamin D2, especially at higher doses. Still, these prohormones are converted to the same active form of vitamin D (calcitriol) in the liver and kidney.
  • Some experts think that 25(OH)D levels between 21 and 30 ng/ml are a sign of vitamin D insufficiency in children, as in adults, and are a sign that the child needs more vitamin D in their diet.
  • Although the use of sunscreen can block the synthesis of vitamin D by blocking UVB radiation and has been blamed for lower vitamin D levels in recent years, many people likely don’t use sunscreen properly and don’t use it consistently enough and so “sunscreen use may not actually diminish vitamin D synthesis in real world use.”
  • Taking high doses of vitamin D is yet another nutrition fad which has been linked to serious consequences. Mega doses of vitamin D have been linked to kidney problems and tissue damage. That makes it important to stay below the upper limit that your child can likely take each day without causing harm, which ranges from 2,500 IU/day for toddlers to 4,000 IU/day for teenagers. Most only need 400 to 600 IU/day though.

Children with severe vitamin D deficiency are often managed by a pediatric endocrinologist or a pediatric nephrologist.

More Information on Treating Vitamin D Deficiency

  • AAP – Vitamin D: On the Double
  • The rise and inevitable fall of Vitamin D
  • Help Your Child Build Healthy Bones
  • NIH Vitamin D Fact Sheet for Consumers
  • Study – American Academy of Pediatrics Clinical Report. Optimizing Bone Health in Children and Adolescents. Pediatrics. Pediatrics Oct 2014, 134 (4) e1229-e1243
  • Study – Institute of Medicine Report. Dietary Reference Intakes for Calcium and Vitamin D. Released: November 30, 2010.
  • Study – The Endocrine Society. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism, July 2011, 96(7):1911–1930.
  • Study – Misra, M. Vitamin D Deficiency in Children and Its Management. Pediatrics, Aug 2008; 122: 398 – 417.