“While we are ecstatic that children are finding ways to get exercise and enjoy being outside, we want to remind parents to make sure that kids are protected while having fun,” said Kara Starnes, D.O., medical director of Urgent Care at Cook Children's.

Helmets are a Must for Fun on Wheels

ATV and dirt bike crashes are a common occurrence during summer. Over Memorial Day Weekend, the emergency department in Fort Worth saw 10 injuries related to motorcycles, dirt bikes, ATVs and skating.

Always ensure your child wears a properly fitted helmet to avoid head injuries. Adult supervision is essential when a child is riding any motorized vehicle, and children should never ride on ATVs or dirt bikes designed for adults.

“Please supervise your children on motorized vehicles,” Taylor Louden, M.D., medical director of Pediatric Emergency Medicine at Cook Children’s Medical Center – Fort Worth said. “They should always be wearing their seat belt and appropriate safety gear. The start of summer is a great time to check your kids’ safety gear and make sure helmets fit appropriately and are in good condition.”

A helmet that fits correctly will feel snug but not uncomfortable. 

A few other key points:

• Helmets that passed federal safety standards in testing will say “U.S. Consumer Product Safety Commission certified” on the label.
• Helmets should be worn in a level position just above the eyebrows.
• If the helmet rocks backward and forward or side to side, adjust the straps. No more than two fingers should fit under the buckled chin strap.    
• Never ride without a helmet.

Water Safety: A Constant Vigilance

Drowning is the leading cause of accidental death for children ages 1 to 4, and the second leading cause for kids 1-14 in Texas. Drownings can happen silently and quickly. A submerged person might not attract attention or appear to be in danger. These tragedies highlight the importance of constant supervision around water.

Sharon Evans, trauma injury prevention coordinator at Cook Children's, emphasizes, "There's no off-season for drownings. A moment of inattention can be devastating."

Unplanned swim time is a major culprit, with roughly 70% of drownings at Cook Children's occurring when parents weren't expecting their child to be near water.

Layers of Protection: Keeping Curious Toddlers Safe

Multiple safety measures, known as "layers of protection," can significantly reduce drowning risks. Fencing around pools with self-latching gates, preferably 5-feet high, is crucial. Door and window alarms can alert you if a child exits the house unsupervised. Remember, young children are naturally curious, so removing pool toys and floats when not in use minimizes temptation. For above-ground pools, make sure to remove the ladder when the pool is unsupervised. Consider using a pool surface alarm for added security.

Cook Children's has developed the "Lifeguard Your Child" campaign to raise awareness about childhood injury prevention. Through this initiative, you can find resources like free swim lessons, safety videos, and loaner life jacket stations at lakes across North Texas. Visit lifeguardyourchild.org for more information.

Sun Safety: Protecting Young Skin

Sunburns are not just uncomfortable; they can increase a child's risk of skin cancer later in life. Zinc oxide-based sunscreen is best whenever your child is outdoors. Covering skin with SPF is another way to protect your child’s skin. Apply sunscreen generously 30 minutes before sun exposure and reapply every two hours, or more often after swimming or sweating. Protective clothing, hats with wide brims, and sunglasses that block UV rays offer additional defense.

Hydration: Keeping Cool and Healthy

Dehydration can lead to nausea, dizziness, headache, or even heat stroke. Encourage frequent sips of water throughout the day, even if your child doesn't feel thirsty. Avoid sugary drinks that can worsen dehydration.

Your child’s urine colors can range from clear to dark yellow to orange, depending on how hydrated they are. To tell if your child is dehydrated, read this article from Celina D. Cepeda, M.D., a nephrologist at Cook Children’s Medical Center – Prosper.

Fishing Fun Without the Hooks

Fishing is a popular summer activity, but fish hooks can pose a safety risk. Teach children to handle hooks with care and supervise them closely while fishing. Consider using barbless hooks to minimize injury if a hook snags on skin.

RELATED:

• A Cautionary Tale: The Misadventures of Summer & Top Injuries Seen at Cook Children’s
• Should My Child Ride ATVs? Cook Children's Experts Weigh In 
• Sunburn Relief at Home, When to See a Pediatrician 
• Pediatrician Shares Top Beach Vacation Health Tips 
• Heads Up: Helmet Tips for Safer Bicycling 
• Teen Driver? What to Know Before They Go This Summer 

Burns are common during the hot summer days because the sun and its UV rays are a common source of sunburn that can develop quickly on exposed skin that is not protected by clothes or sunscreen.

Sun exposure is not the only source of burns in children, other culprits include thermal heat from hot appliances, stoves or hot liquids among others. Knowing the different types of burns that can occur can help determine the kind of care that is necessary.

• 1st-degree burns occur when skin turns red/pink but there is NO blistering. An example is a mild sunburn.
• 2nd-degree burns are when the outer layer of skin is burned and some of the dermis (deeper layer of skin) is damaged. This burn usually causes blistering and is painful.
• 3rd-degree burns are when skin appears charred or white. Both the epidermis and dermis layers are damaged usually with irreversible damage.

For minor burns care at home including the following is appropriate:

• Cool the burn by using cool water over the burn for a few minutes. Do not put ice directly over the burn and do not rub or break blistering as this can increase the risk of infection and worsen the injury.
• Cover the burned area with a clean bandage that will not stick to the burned skin. Do not apply anything to the burn site before discussing this with your pediatrician.

If a burn is blistered and swollen or covers a large portion of skin (larger than the size of a child’s hand) or involves the skin of the hand, feet, genitals or over a joint (elbow/knee/ankle) then a child should be seen by their pediatrician or in the emergency room.

When it comes to sunburns, prevention is key. Zinc oxide-based sunscreen is best for exposed skin and re-application if outside and exposed to the sun for a prolonged time is usually the best way to prevent sunburn. Covering skin with SPF clothes is another way to protect your child’s skin.

If you are worried about any burn, even if it seems minor then consulting your child’s pediatrician is always a good idea. 

As your family travels to the beach this summer, remember to include health and safety measures to ensure you and your children have the best vacation possible. 

Sunscreen often comes to mind, however, there are some other precautions to consider. Cook Children’s Medical Advisor for Digital Health, Dr. Diane Arnaout, M.D., shared helpful tips when preparing for the beach. She sees a variety of beach-related medical conditions each year and offers tips to avoid trouble.

Dr. Arnaout reminds us it only takes 15-20 minutes for a sunburn to form. Hence, it’s essential to apply and reapply sunscreen routinely and ensure all body parts are covered.

“Don’t forget the top of the ears -- that’s where I tend to see the most sun damage, especially in boys because they don’t have that hair covering their ears. I see lots of freckling and burned skin here,” Dr. Arnaout said.

Dr. Arnaout also talked about using shade and clothing, such as longer swim shorts and shirts to avoid harmful, cancer-causing ultraviolet (UV) rays. By doing so, we can protect our kids from day one. 

“Try to keep kids, especially under 6 months, completely covered with an umbrella or some kind of shade because they can burn much more easily,” she said. Parents should know, according to Dr. Arnaout, that you CAN put sunscreen on your child at that age, but doctors prefer an umbrella, with exceptions for their feet. 

Lifejackets & Riptides

When taking your child to the lake, lifejackets are commonly used for children. However, Dr. Arnaout observed that many parents do not think to bring a lifejacket to the beach.

“When we go to the beach, people will assume the kids will be playing in the sand without any danger, but kids can wander off and get swept into the water very easily,” Dr. Arnaout said.

Although riptides are not ordinary on the Texas coast, it is important to keep them in mind. Dr. Arnaout shares some tips in the event your child runs into riptides. 

“Especially older kids, if it’s dragging them, do not fight it, but let it take you in the direction it needs to,” Dr. Arnaout said. “You can tire out easily trying to fight a riptide.”

Skincare & Jellyfish Stings

We’ve all seen it in the movies, TV shows or heard stories of someone peeing on a jellyfish sting, so surely that’s the way to cure one, right? Contrary to popular belief, that is false, according to Dr. Arnaout. 

Dr. Arnaout shares that peeing on a jellyfish sting is only a myth. It might make the sting worse. The most effective treatment is vinegar. However, there are other things you can do if your child is stung by a jellyfish. 

“The tentacles of jellyfish have these little stingers that can get stuck in your skin. One of the best and immediate things you can do is go back in the water and a lot of them will wash off. You don’t want to rub it off, but you can take a credit card and gently scrape the stingers off, ” she added. 

Last but not least, it’s time to talk about skincare and gentle clothing at the beach. Be aware of mesh lining and life vest straps, which they can harm the skin.  Dr. Arnaout says she has seen many instances where the mesh lining or buckles from lifejackets irritate private parts, especially for boys. It is important to be aware of the materials inside your children’s swimsuits. 

“I think it’s not well known that the mesh lining of these suits or even the straps that go down in that area can be super abrasive and can cause a lot of chafing and a lot of pain,” Dr. Arnaout explained.

Summer is nearly here! Let's quickly hit some of the most common questions I get around this time of year - about sunscreen, DEET, and life jackets.

1. Sunscreen:

Use it! Even on a cloudy, not-very-hot day! 80% of the sun's rays penetrate clouds! And bounce off sand and snow!

Start using it at age 6 months. Prior to 6 months, do not have your baby in direct sunlight - put them under heavy shade and put a hat on them. If you can't find shade, use sunscreen on small amounts of their skin and try to cover skin with clothing.

Go with SPF 30-50 for your kids. I don't care about brand.

Zinc oxide (the stuff that won't disappear when you rub it in) is the best. It physically blocks the harmful rays. Great for nose, ears, cheeks, tops of shoulders.

Put it on 15-30 min BEFORE YOU GO OUT.

Reapply every 2 HOURS.

PUT ON MORE THAN YOU THINK YOU NEED. 1 teaspoon per limb is about right. 1 tsp for back, 1 tsp for chest. 1/2 tsp for face.

I don't like the sprays. They miss spots and can be inhaled. If you have to use them, spray a ton on your hands and rub it it in good.

More good info about sunscreen here: https://www.checkupnewsroom.com/5-tips-to-protect-your-chi…/

2. DEET:

DON'T BE SCARED OF IT. It is not "DDT"! It is safe down to age 2 months. It is the BEST way to prevent insect bites and this has been proven time and again in medical studies.

Read a ton about this in another article I wrote here:

https://www.checkupnewsroom.com/the-deets-on-deet/

If you absolutely don't want to use DEET, go with Picaridin.

Those wrist bands ain't gonna do anything.

3. Life jackets!

Use only life jackets that are approved by the US Coast Guard.

Here are the types (compliments of the AAP Healthy Children website):

TYPE 1: This jacket floats the best. It is designed to turn most people who are unconscious in the water from the face-down position to an upright and slightly backward position. This jacket helps the person to stay in that position for a long time. It is to be used in open water and oceans. It is available in only 2 sizes: 1 size for adults more than 90 pounds and 1 size for children less than 90 pounds. (Type 1 is the most bulky but has the greatest ability to turn a child "face-up".)

TYPE 2: This jacket can turn a person upright and slightly backward but not as much as the Type 1 jacket. It may not always help an unconscious person to float face up. It is comfortable and comes in many sizes for children. (More comfy but will only turn SOME children "face-up".)

TYPE 3: This jacket is designed for conscious users in calm, inland water. It is very comfortable and comes in many styles. This life jacket is often used for water sports and should be used only when it is expected that the rescue can be done quickly. (Least bulky, most comfortable. Good support for children who have some swimming skills.)

This summer, I will be using Type 1 lifejackets for my kids when we go to the ocean or are at the lake. I will be using Type 2 when we are in the wading pool. My kids are 2 and 4 and I will be within a few feet of them at all times when they are in/around water.

WATCH YOUR CHILDREN AT ALL TIMES WHEN THEY ARE IN OR AROUND WATER. DROWNING IS SILENT.

Let me say that again: DROWNING IS SILENT.

Cook Children's has a great drowning prevention resource page. Click here to learn more.

Hope this helps answer your burning hot summer questions!

Hugs,

Dr. Diane Arnaout

In our area, MayFest is this weekend! But before you go out, be sure to pull out the sunscreen as you head out for the fun!

Here are a few things to remember:

1. We recommend sunscreen for all children 6 months of age and older, regardless of skin type. There are several explanations for not using sunscreen on young infants:

• Their skin may be more permeable, resulting in more absorption of the chemicals in the sunscreen.
• They have a larger surface area of skin, so are more likely to absorb the sunscreen.
• They are also more likely to get dehydrated and suffer negative effects of sun exposure, so we really want you to keep them in the shade.
• I usually tell patients if sun exposure is unavoidable, sun block in better than a sunburn, but the best bet is to use lightweight clothes that cover them and stay in the shade.

2. Use sunscreen rated at least SPF 30.

3. We find lotion more effective than spray products.

4. Apply sunscreen 15 to 30 minutes prior to sun exposure.

5. Plan to use about 45 mL or 9 teaspoons of sunscreen for older children and adults. Estimate 1 teaspoon for the face and neck, 1 teaspoon for each arm, 2 teaspoons for the torso and back and 2 teaspoons for each leg. Reapply every two hours.

6. Stay hydrated and have a great time.

Skin cancer is a serious problem in the United States. Did you know this information from the Skin Cancer Foundation?

• One in five American will develop skin cancer in the course of a lifetime.
• Over the past three decades, more people have had skin cancer than all other cancers combined.
• About 5.5 million Americans nonmelanoma skin cancer each year.
• Melanoma accounts for up 3 percent of all pediatric cancers.

Children who are overexposed and under protected are at greater risk for developing skin cancer as they age.

“The majority of skin cancer is preventable,” said Jenica Rose-Stine, D.O., a pediatrician at Cook Children’s Willow Park office. “Protecting your child from the sun at an early age is key.”

A new study in JAMA Dermatology found that 40 percent of the most popular sunscreens sold on Amazon didn’t provide proper protection. The American Academy of Dermatology looks for these three requirements:

• A sunscreen should have a Sun Protection Factor of at least 30.
• Protect skin against both UVA and UVB rays.
• Resistant to water, including sweat.

Dr. Rose-Stine recommends:

• Using sunscreen labeled “broad spectrum,” which protects against both UVA and UVB rays. Choose a sunscreen that has a Sun Protection Factor (SPF) of at least 30, preferably 50, and apply enough of the sunscreen to cover all exposed areas including the ears, back of the neck, hands, feet, lips and top of the head for children with fine hair. Reapply at least every two hours or after swimming or participating in activities that produce sweat.
• Liquid sunscreens that are “physical blockers.” They physically deflect or block the sun’s rays. Look for the words “zinc oxide” or “titanium dioxide” listed first in the ingredients (Blue Lizzard is a good brand.)
• Purchasing sunglasses for children that block 100 percent of UVA and UVB rays, as sun exposure can increase the risk of intraocular melanoma developing in the eyes – particularly those that are light-colored.
• Avoiding the sun during its peak summer hours between 10 a.m. and 4 p.m.
• Have your child wear a swim shirt to minimize sun exposure to chest, shoulders, and back.

Recent studies suggested that many children are now deficient in vitamin D, a vitamin necessary for healthy bone growth and development. Children only need 15 minutes of sun exposure a day to absorb their daily dose of vitamin D.

“Children should get vitamin D from a diet rich in eggs and fortified foods, such as milk, cereal, orange juice and yogurt,” Dr. Rose-Stine said. “Sun exposure triggers the skin to produce vitamin D, but parents shouldn’t rely solely on sun exposure because of the associated risks.”

Click to read the JAMA study.

About the author

Jenica Rose-Stine, DO is a pediatrician at Cook Children's Willow Park pediatrics - 136 El Chico Trail, Ste. 102 Willow Park, Texas 76087. Dr. Rose Stine is enthusiastic about several areas of pediatrics including development, safety and prevention, and nutrition and she thoroughly enjoys her interactions with first-time parents and their newborns.

To conncet with Cook Children's Willow Park pediatrics, please follow them on facebook https://www.facebook.com/ccwillowpark

Back to Sleep, Tummy to Play - Check

Rear Facing Car Seat Until 2 Years- Check

Sunscreen Every Time- Ch….Well, most of the time, amiright?

You can click the link above to read the detail on sun safety, but I'll summarize them here:

Under 6 Months:

• Keep in the shade under an umbrella or stroller canopy - Dads, it's a good excuse for you to stay inside when it's hot and watch the World Cup this summer.
• It's OK to put sunscreen on small areas of the body (i.e. face) if shade is not available.

Over 6 Months:

• Sunscreen, sunscreen and then sunscreen again. If your child isn't annoyed by your frequency of sunscreen applications, you're not doing it right. Re-apply at least every 2 hours and listen to the chorus of, “But mom, not again.” It’s a beautiful sound.
• Pick a sunscreen with the highest SPF you can find-At least 15 but preferably higher; if you find 1000, let me know, because my wife loves you!
• Limit sun exposure between 10 AM to 4PM-Feel free to use the classic lunch, no swimming for 2 hours because of cramps wives tail, it's been working for generations.

OK, super-parents who would never forget above facts can stop reading…now.

And, for the rest of us.

3 Tips to Treat a Sunburn:

1. Use an aloe vera based gel or cool wet rag for comfort.
2. Treat with oral ibuprofen at the onset of pain and for 24-48 hours.
3. Neither of these are miracle workers so prevention is by far the best strategy.

3 Reasons To Seek Medical Attention:

1. Severe blistering.
2. Severe pain.
3. Other symptoms such as fever, vomiting, headache or signs of dehydration (no urine output for >6 hours or dry lips and mouth).

Let’s all keep our kids sunburn free this summer!  

Sunburn is not only very painful for your kids it is very dangerous for their future health as well. The incidence of melanoma (the most fatal form of skin cancer) is on the rise in the United States. Studies have shown that a sunburn in childhood or adolescence almost doubles your risk of developing melanoma as an adult.

Moisturizing children’s skin during the winter is important and that includes wearing protective lip balm.

“When children get chapped lips, they tend to scratch their lips with their tongues, which can lead to infection if there are germs on the skin,” said Frank McGehee, M.D., a Cook Children’s pediatrician. “Children should apply lip balm two to three times per day.”

Dr. McGehee recommends parents purchase an inexpensive variety of lip balm because many children are prone to lose small items like lip balm frequently. He also suggests the lip balm have sunscreen in it.

Speaking of sunscreen, people in warmer climates are especially susceptible to winter sunburn because it’s tempting to stay outdoors longer when the stifling heat of summer passes and the temperature is milder. Dr. McGehee said children should wear and reapply sunscreen every 60 to 90 minutes when they’re outside.

That information should last until next year, when we’ll probably forget again. After all, who wants to get used to this cold weather.

About the source

Frank McGehee, M.D., continues a Cook Children's legacy that began more than 70 years when took over the office at 1129 Sixth Avenue in Fort Worth, near the medical center. For an appointment, visit here or call 817-347-6859. 

That’s the advice from the Food and Drug Administration and Consumer Reports. The FDA has launched an investigation into the potential risks of spray sunscreen.

The concern is that people, especially children, will breathe in the ingredients of the sunscreen. Consumer Reports followed the report by asking that spray sunscreen “should generally not be used by or on children.”

Justin Smith, M.D., a Cook Children’s pediatrician, understands the thought process of this call to action. Dr. Smith says children with asthma may be at greater risk by breathing in the ingredients in the sunscreen.

"Any aerosol product that forms a spray makes particles small enough to get into the lungs if inhaled,” Dr. Smith said. “For some children, this could cause irritation that could lead to difficulty breathing. It is especially important to be cautious in children with asthma and other problems with their lungs."

For more information click here:

• Dr. Smith’s blog on the importance of sunscreen
• The Consumer Reports tips on sunscreen
• The FDA’s full report