Sun and Water Safety: Don’t take risks. Follow these tips.

Memorial Day signifies the start of summer, the opening of pools and trips to the beach. Regardless of where you’ll be outside or around water, it’s always important to be safe. Make sun and water safety a priority! Bug safety will be covered separately in a future post.

Safe in the sun!

Keep kids safe in the sun with many methods, not just sunscreen.
Keep kids safe in the sun with many methods, not just sunscreen.

Protecting your child in the sun is very important. Make sure you understand how various sunscreens work, how they should be used, and what else you can do to protect your kids from the sun.

Infants under 6 months

Babies under 6 months of age should be kept out of the direct sunlight as much as possible.

Move your baby to the shade or under a tree, umbrella or the stroller canopy. Be careful near reflective surfaces, such as water. Shade may reduce UV exposure by only 50% if there’s reflected sun.

Dress them in lightweight but long sleeved clothing and wide brimmed hats to keep the sun off their skin.

It’s okay to apply sunscreen to small areas of the body that you cannot cover with clothing, such as face and hands.

Make sure infants stay hydrated in the heat. Do not give extra water to infants until they are on solid foods. Breastfeed more often or give extra formula to prevent dehydration.

Mineral vs chemical sunscreens

The sunscreen does not have to be baby specific, but chemical sunscreens are absorbed more than mineral sunscreens. One of the concerns of young infants using sunscreen is they absorb chemicals too much, so mineral sunscreens are preferred for them.

I think most things marketed for babies are really for parent’s piece of mind. They aren’t necessarily better for baby. And they can mark up the cost just because it says it’s for Baby. But one of my favorite sunscreen brands for babies – Blue Lizard – actually prices competitively for the baby product. I like this brand because it was developed in Australia to be used safely at all ages. All of their products are mineral based.

Mineral based products use zinc oxide and titanium dioxide to reflect sun rays. There is minimal absorption. The downsides are they are not as light on the skin and they can wash off when sweating or swimming.


Chemical sunscreens, on the other hand, are absorbed into the skin. They absorb the sun rays that enter the skin. These are best for older children who are exercising outdoors and swimmers since they do not wash off as easily.

What is SPF?

SPF= Sun Protection Factor

The SPF increases the time you can spend in the sun, depending on your skin type. If you would typically burn in 1 hour, an SPF of 15 will keep you from burning for 15 hours, if you reapply every 2 hours. If you would burn in 20 minutes, an SPF of 15 used every 2 hours would protect you 15 x 20 minutes, or 5 hours. This is why fairer skinned people need higher SPF levels.

The sun protection factor (SPF) should be at least 25 and should cover both UVA and UVB rays. The sooner your skin burns, the higher the SPF you should use.

How should sunscreen be used?

For all infants and children over 6 months, be generous with sunscreen. Apply sunscreen at least 30 minutes before going outside, reapply it every 1-2 hours if sweating or swimming (even if it states it is waterproof), and use sunscreen even on cloudy days. One full ounce should be used to cover an adult.

Reapply the sun screen every 1-2 hours.

Try to keep children out of the sun between 10:00 am and 4:00 pm, when the sun’s rays are strongest.

Clouds are not sufficiently protective against the sun. UV rays on cloudy days may be reduced by only 20% to 40%.

Does sunscreen cause cancer?

I don’t know why this is a popular question these days. Well, yes, I know why people question it. The rumor that chemicals in sunscreen are dangerous is commonly circulated online. That’s why it’s questioned, but I don’t know what started this rumor.

Sun causes cancer.

Sunscreens have been studied extensively and have been shown to be safe. Use them.

What about eyes?

We often neglect our eye health, but there are ways to prevent sun damage to our eyes. This sun damage can lead to cancer, cataracts, and growths in the eye.

Sunglasses should be used to protect the eyes from sun damage. Hats with wide brims also keep sun out of the eyes.

Be sure your sunglasses are rated to protect against UVA and UVB 100%. Darker glasses don’t offer more protection necessarily. They must be rated to protect against UVA/UVB.

Bigger frames are better. Especially the ones that wrap around the sides of the face.

Higher cost doesn’t mean better protection – look for the rating! Even inexpensive sunglasses can provide protection. This is good, since most of us need several pair due to them getting misplaced or broken – especially the ones for our kids!

For more on sunscreens:

SMART SUN PROTECTION: UNDERSTANDING THE BEST SUNSCREEN OPTIONS from Dr.Michelle Ramírez at Dream Vibrant Health.

Which Dermatologist-Approved Sunscreen You Should Use To Keep Your Skin Safe from Dr. Dhaval Bhanusali, a medical and cosmetic dermatologist

Sunscreen Safety: Is It Worth The Hassle? from Dr. Nidhi Kukreja at The Growing Parent.

Water

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How can I protect my child around water?

All parents should take a basic CPR course! Young children can drown in only a few inches of water, even if they’ve had swimming instruction.

Children who are swimming – even in a shallow toddler’s pool – should be watched closely. Even if there’s a lifeguard at the pool, there is too much to monitor when there’s a pool full of kids. You must watch your own kids until they’re strong swimmers.

It’s recommended that infants and toddlers have an adult within arm’s reach. For young children, you should continue to pay constant attention and be free from distractions. It’s easy to be distracted when talking to another person or checking your phone. Don’t consider it watching kids if you’re pool side reading a book.

Inflatable pools should be emptied and put away after each play session. (This also reduces unwanted mosquitoes!)

Enforce safety rules – no running near the pool and no pushing others underwater.

Water wings, tubes and other floating devices are not approved flotation devices and should be used only under direct and close supervision. Because they give a false sense of security, I don’t recommend them.

Be sure the deep and shallow ends of any pool your child swims in are clearly marked. Never allow your child to dive in the shallow end.

And then there are teens…

Talk to older kids and teens often about water safety. As they gain confidence in the water, they take more risks.

Teens are especially notorious for risk taking behaviors. Let them know your expectations. Teens might roll their eyes, but studies show they do best with rules and clear expectations from parents.

Of course they should not drink alcohol ever, but risks increase around water. They should never swim alone, even if they are captain of the swim team. If they are going to a river or lake, they need to be careful of inherit risks there, such as diving into shallow waters and boat safety.

As always, be sure you know where they’re going and when to expect them home. If they’re in water they won’t have a cell phone available at all times, so you might want to schedule “check in” times.

Drowning Risks

Drowning is a real risk. Dry drowning? Not so much.

Learn what distress in the water looks like. The movie depiction of drowning with a lot of yelling and thrashing around is not what usually happens.

If someone can verbalize that they’re okay, they probably are. Drowning victims can’t ask for help. There is a video linked to this page of what to look for with drowning that shows an actual rescue. From this site, signs of drowning:

  • Head low in the water, mouth at water level
  • Head tilted back with mouth open
  • Eyes glassy and empty, unable to focus
  • Eyes closed
  • Hair over forehead or eyes
  • Not using legs – Vertical
  • Hyperventilating or gasping
  • Trying to swim in a particular direction but not making headway
  • Trying to roll over on the back
  • Appear to be climbing an invisible ladder

What about swimming lessons?

The American Academy of Pediatrics does not recommend swimming lessons for children under one year of age because they cannot really learn skills to keep them safe.

Even young children who have had swimming lessons should not be unattended at the pool because they are not able to always make safe choices.

How can I protect my child around the backyard pool?

Inflatable pools should be emptied and put away after each play session. (This also reduces unwanted mosquitoes! Who wants mosquitoes in their backyard?)

If you have a swimming pool at home, it should be completely surrounded on 4 sides with a tall fence that has a self-locking gate. The house cannot serve as one side of the barrier. Keep the gate closed and locked at all times. Be sure your child cannot manipulate the lock or climb the fence.

If your pool has a cover, remove it completely before swimming. Never allow anyone to walk on the pool cover. Your child could fall through it and become trapped underneath.

Keep a safety ring with a rope beside the pool at all times. If possible, have a phone in the pool area with emergency numbers clearly marked.

Spas and hot tubs are dangerous for young children. They can easily drown or become overheated in them. Don’t allow young children to use them at all due to these risks. If older children use them, they should be supervised. Be sure they are well hydrated. After using a hot tub, be sure everyone showers. You don’t want hot tub folliculitis!

What about at the ocean or lake?

Talk to kids about the pull of undertow if you’re wading into the ocean. (If you don’t know what this is, walk into the water without your kids first.)

Use coast guard approved life preservers correctly whenever needed. All people should wear a life preserver when riding in a boat unless they are inside a cabin. Children should wear a life preserver when they are near the water’s edge or on a dock, even if the law doesn’t require it.

A life preserver fits properly if you can’t lift it off over your child’s head after he’s been fastened into it. For the child under age five, particularly the non-swimmer, it also should have a flotation collar to keep the head upright and the face out of the water.

Adults should not drink alcohol when they are swimming or boating. They are not only at risk of dehydration from the alcohol, but they also risk lives. It presents a danger for them as well as for any children they might be supervising. Don’t ruin a fun time with a tragedy.

Keep it fun in the sun!

Sun and water safety are not only important, but if you’re not careful, it can ruin a vacation. Practice sun and water safety every day!

 

Weight is Weighing on My Mind

Too much sugar is causing an epidemic of obesity in our kids. Even the ones who aren’t overweight are often less healthy due to food choices. Excess sugar consumption over time is linked to many health issues such as high cholesterol, diabetes, metabolic syndrome, and it can trigger earlier puberty – leading to overall shorter adult height. Not to mention the psychological and social implications of bullying, depression, eating disorders, and more.

Back in the day…

Why is weight so much more of a problem now than it was years ago?

As a child I did not have a perfect diet, yet I was not overweight (and neither were my classmates) because we spent most waking moments outside if we weren’t in school.

My mother packed a dessert in every lunch box. We ate red meat most days. My mother usually put white bread and butter on the table at dinner. I drank 2% milk and ate ice cream every night.

But we walked to school– without a parent by the time I was in 1st grade. (gasp!)

There were only a couple tv channels, and Saturday morning was the only time we could watch tv.

We were able to ride bikes, go to a wooded area, play on a nearby playground, dig in the dirt, you name it – we found something to make it fun!

Update: I just read a fantastic blog from Dr. Alison Escalante that shows beautifully how she and her siblings were able to explore and learn as kids. Take a look at The Summer of No TV: Why Boredom Breeds Creativity Part 1.

Why is weight so much more of a problem now than it was years ago?
unhealthy foods
Childhood obesity is a growing problem. Kids need to eat healthy and move daily.

I think it’s a combination of what they’re eating and what they’re doing.

Today’s kids are shut up in the house after school watching one of many tv channels or playing video games.

Even those who are shuttled to activities get overall less exercise because it is structured differently than free play. They ride in the car to practice or class, then sit and wait for things to start. They might sit or stand while others are getting instruction.

Simply put: They eat a lot of processed and junk food and they don’t get to do active things at their own pace with their own creativity for as long as they want.

Shouldn’t we worry about them getting hurt?

I know parents are worried that their kids will get hurt or abducted if they play outside with friends, especially if they go out of sight from a parent. But I think in some ways we’re killing our kids slowly by allowing unhealthy habits to kick in.

The reality is that most kids won’t get hurt if they’re playing. Yes, some will. But if they play video games all day, they won’t get injured. They are likely to have long term problems though.

I’m seeing adult problems in young kids, such as Type 2 diabetes, high cholesterol, non-alcoholic fatty liver disease, hip/knee problems, and more. The poor kids who are overweight have the potential to suffer long term consequences.

What to do???

On one hand kids need to learn to make healthy choices to maintain a healthy body weight for height, but on the other hand you don’t want to focus so much on weight that they develop eating disorders. I think this is possible if we focus on the word “healthy” – not “weight”.

Starting at school age I ask kids at well visits if they think they are too heavy, too skinny, too short, or too tall. If they have a concern, I follow up with something along the line of, “How would you change that?” I’m often surprised by the answers, but I can use this very important information to guide how I approach their weight, height, and BMI. We talk about where they are on the graph, and healthy ways to either stay in a good place or how to get to a better BMI.

I focus on 3 things we all need to be healthy (not healthy weight, but healthy):

  1. Healthy eating (eat a plant and protein each meal and snack)
  2. Exercise (with proper safety equipment but that’s another topic!)
  3. Sleep (again, another topic entirely!)
Food is a part of our daily needs, but much more than that.

It’s a huge part of our lifestyle.

We have special meals for celebrations but on a day to day basis it tends to be more repetitive.

We all get into ruts of what our kids will eat, so that is what we prepare. The typical kid likes pizza, nuggets, fries, PB&J, burgers, mac and cheese, and a few other select meals.

If we’re lucky our kids like one or two vegetables and some fruits. We might even be able to sneak a whole grain bread in the mix.

If our family is busy we eat on the run– often prepared foods that are low in nutrition, high in fat and added sugars, and things our kids think taste good (ie things we won’t hear whining about).

We want our kids to be happy and we don’t want to hear they are hungry 30 minutes after the meal is over because they didn’t like what was served and chose not to eat, so we tend to cave in and give them what they want.

We as parents need to learn to stop trying to make our kids happy for the moment, but healthy for a lifetime.

There’s often a discrepancy between the child’s BMI (body mass index) and the parent’s perception of healthy.

The perception of calorie needs and actual calorie needs can be very mismatched. I have seen a number of parents who worry that their toddler or child won’t eat, so they encourage unhealthy eating unintentionally in a variety of ways:

  • turn on the tv and feed the child while the child is distracted
  • reward eating with dessert
  • refuse to let the child leave the table until the plate is empty
  • allow excessive milk “since at least it’s healthy”
  • allow snacking throughout the day
  • legitimize that a “healthy” snack of goldfish is better than cookies
Any of these are problematic on several levels.  Kids don’t learn to respond to their own hunger cues if they are forced to eat.  
If offered a choice between a favorite low-nutrition/high fat food and a healthy meal that includes a vegetable, lean protein, whole grain, and low fat milk, which do you think any self-respecting kid would choose?
If they’re only offered the healthy meal or no food at all, most kids will eventually eat because they’re hungry.
No kid will starve to death after 1-2 days of not eating.  
They can, however, over time slowly kill themselves with unhealthy habits.  

So what does your child need to eat?

Think of the calories used in your child’s life and how many they really need.  Calorie needs are based on age, weight, activity level, growing patterns, and more.
It’s too hard to count calories for most of us though.
If kids fill up on healthy options, they won’t be hungry for the junk.
Offer a plant and a protein for each meal and snack. Plants are fruits and vegetables. Proteins are in meats, nuts, eggs and dairy.
Don’t think that your child needs to eat outside of regular meal and snack times.
One of my personal pet peeves is the practice of giving treats during and after athletic games. It’s not uncommon for kids to get a treat at half time and after every game. Most teams have a schedule of which parent will bring treats for after the game.
Do parents realize how damaging this can be?  
  • A 50 pound child playing 15 minutes of basketball burns 39 calories.  Think about how many minutes your child actually plays in a game. Most do not play a full hour, which would burn 158 calories in that 50 pound child.
  • A 50 pound child burns 23 calories playing 15 minutes of t-ball, softball, or baseball.  They burn 90 calories in an hour.
  • A non-competitive 50 pound soccer player burns 34 calories in 15 min/135 per hour. A competitive player burns 51 calories in 15 min/ 203 in an hour.
  • Find your own child’s calories burned (must be at least 50 pounds) at CalorieLab.
Now consider those famous treats at games.
Many teams have a half time snack AND an after game treat.  Calories found on brand company websites or NutritionData:
  • Typical flavored drinks or juice range 50-90 calories per 6 ounce serving.
  • Potato chips (1 ounce) 158 calories (A common bag size is 2 oz… which is 316 calories and has 1/3 of the child’s DAILY recommended fat intake!)
  • Fruit roll up (28g) 104 calories
  • 1 medium chocolate chip cookie: 48 calories
  • Orange slices (1 cup): 85 calories
  • Grapes (1 cup): 62 calories
  • Apple slices (1 cup): 65 calories

So…Let’s say the kids get orange slices (a lot of calories but also good vitamin C, low in fat, and high in fiber) at half time, then a fruit drink and cookie after the game. That totals about 200 calories.

The typical 50 pound soccer player burned 135 calories in a one hour game. They took in more calories than they used.

They did get some nutrition out of the orange, but they also ate the cookie and fruit drink.

The cookie has fewer calories than other options but no nutritional value and a lot of added sugars.

The kids end up taking in many more calories than they consumed during play.

Water

What’s wrong with WATER? That’s what we should give kids to drink at games.

They should eat real food after the game if only they’re hungry.  Snacks are likely to decrease appetite for the next meal, so if they’re hungry give a mini-meal, not a sugar-filled, empty calorie treat every game.

There are many resources on the web to learn about healthy foods for both kids and parents. Rethink the way you look at how your family eats.

Simple suggestions:

      • Offer a fruit and vegetable with a protein at every meal and snack. Fill the plate with various colors! (As I tell the kids: eat a plant and a protein every time you eat ~ meals and snacks!)
      • Picky kids? Hide the vegetable in sauces, offer dips of yogurt or cheese, let kids eat in fun new ways – like with a toothpick. Don’t forget to lead by example and eat your veggies!
      • Buy whole grains.
      • Choose lean proteins.
      • Don’t skip meals.
      • Make time for sleep.
      • Get at least 60 minutes of exercise a day!
      • Eat together as a family as often as possible.
      • Turn off the tv during meals. Don’t use distracted eating!
      • Encourage the “taste a bite without a fight” rule for kids over 3 years. But don’t force more than one bite.
      • Don’t buy foods and drinks with a lot of empty calories. Save them for special treats. If they aren’t in the home, they can’t be eaten!
      • Drink water instead of juice, flavored drinks, or sodas.
      • Limit portions on the plate to fist sized. Keep the serving platters off the table.
      • Eat small healthy snacks between meals. Think of fruit, vegetable slices, cheese, and nuts for snacks. I tell kids all the time: eat a plant and a protein every time you eat – both meals and snacks. Think of snacks as mini-meals!

 

 

New Juice Guidelines!

Juice that comes from fruit is not the same thing as eating fruit. It’s missing the fiber and even the feeling of fullness that comes from eating foods rather than drinking. Too many kids drink excessive juice, which fills them with empty calories and can contribute to obesity and tooth decay. The American Academy of Pediatrics has updated their juice guidelines to help families limit juice intake to more appropriate amounts.

How much juice should kids have?

  • Juice is not recommended at all under 1 year of age in the new guidelines.
  • Toddlers from 1-3 years can have up to 4 ounces of 100% juice a day.
  • Children ages 4-6 years can have 4-6 ounces (half to three-quarters of a cup).
  • Children ages 7-18 years can have up to 8 ounces (1 cup) of 100% fruit juice as part of the recommended 2 to 2 ½ cups of fruit servings per day.

General tips and tricks:

100% juice

Offer only 100% juice if you’re giving juice at all. Fruit flavored drinks are not the same thing as juice.

Water

Water is always healthy!

If your kids want it flavored, cut up fruit and put it in the water.

There are many recipes online to get ideas, but kids don’t need anything fancy – just put cut up pieces of their favorite fruit with water in a glass container. Put the container in the refrigerator for 2-4 hours and then pour the infused water into their cup without the fruit (which could pose a choking risk). The infused water will stay fresh in the refrigerator for up to 2 days.

Water bottles

Some kids like to start the day with a frozen water bottle. Simply put a 1/2 to 3/4 full water bottle in the freezer overnight – don’t fill it too much because ice expands! Add a bit of water in the morning to help it start melting so it’s drinkable when they want a sip. Adjust the amount of water to freeze as needed depending on how insulated your water bottle is.

water it down

If your kids demand more than the recommended amount of juice for their age per day, water it down. By mixing water (or sparkling water for a bit of zip) with juice, you decrease the amount of sugar in every serving. You can give 1/2 the recommended daily maximum amount of juice with water twice and still stay within the daily limit.

Never let kids drink juice out of a bottle

Kids tend to drink more volume when it’s in a bottle. Infants who take bottles are too young for juice anyway. As they get into the toddler years, transition onto cups.

Bedtime!

Never put kids to bed with juice. They should brush teeth before bed and be allowed only water until morning.

Pasteurization

Offer only pasteurized juice. Unpasteurized juice can cause severe illness.

Real fruit

Give kids real fruits and/or vegetables with every meal and snack.

Make smoothies!

Putting fruits and vegetables in a blender to make a smoothie is a great way to give the full fruit or vegetable instead of juice.

Consider adding plain yogurt**, chia, flax, oats, nuts, and other healthy additions to increase the nutritional components of the smoothie! **Flavored yogurts often have added sugars. Look for just milk and cultures in your yogurt.

Juice box: not recommended!

Most juice boxes have more than a day’s supply of juice. Don’t use juice boxes. Offer juice in cups so you can limit to the age appropriate amount.

What about organic?

Organic juice is not healthier than other juice. Many parents presume it has less sugar or more nutrients, but it doesn’t.

Vegetable juice

Vegetable juices may have less sugar and fewer calories than in the fruit juice, but are often mixed with fruit juices so you must read ingredients. They also lack the fiber of the actual vegetable, so eating the vegetable (or pureeing veggies into a smoothie) is healthier.

Read labels

Beware of labels that look like juice but aren’t 100% juice.

The label might say “juice cocktail,” “juice-flavored beverage” or “juice drink.”

Most of these have only small amounts of real juice. Their main ingredients are usually water, small amounts of juice, and some type of sweetener, such as high-fructose corn syrup.

Nutritionally, these drinks are similar to most soft drinks: rich in sugar and calories, but low in nutrients. Avoid them.

Sports drinks?

Sports drinks are not healthy substitutes for water.

They are sugar-sweetened beverages that contain sodium and other electrolytes. Unless one is doing high intensity exercise for over an hour (such as running a marathon, not playing in a baseball tournament), water and a regular healthy diet provide all the calories and electrolytes we need.

water (again)

Water’s the best drink for our bodies.

Buy fun reusable water bottles and challenge your kids to empty them throughout the day.

The old rule of “8 cups a day” is outdated, but we should get enough water (from the water content in foods + drinks) to keep our urine pale.

We need more water when it’s hot, when we exercise, when we’re sick and when the air’s really dry.

Once we feel thirsty we’re already mildly dehydrated, so drink water to prevent dehydration.

juice guidelines
The AAP’s 2017 Juice Guidelines