Summer and Child Health

by Beril Bayrak Bulucu, MD - June 2009

As summer approaches children are getting ready for months of fun and excitement. There are few things to keep in  mind to enjoy summer without any problems

1-Sun and Beach
Beach is a very important part of summer fun for children but sun rays are getting more and more dangerous with the added affect of global warming. Why is the sun dangerous for kids? Skin cancer risk is increased with unprotected sun exposure at any age but childrens` skin is a a lot more vulnerable to the cancerogenic affects of the sun. We know that unprotected childhood exposure to sunlight is one of the major risk factors for skin cancer.(The incidence of which is increasing markedly in the recent years especially malignant melanomas) Sunburns not only multiply the risk of skin cancer but also is very painful and disturbing and can cause secondary infections. Sunburns can be first grade, second grade or third grade burns. Sunburns can be managed with cool compresses and creams like bepanthene. If they are severe though a medical consultation might be necessary.

What to do to protect children from the harmful sun rays?
1-Keep kids away from the sun between 10 am and 4 pm
2-Make sure they use a sunscreen 50 factor and up, which should be applied 30 minutes before going under the sun.
3-Make sure they wear a hat. T-shirts are a lot more protective than sunscreen. Nowadays sunglasses are recommended for babies to prevent future cataracts (not so easy to use though)
4-Babies and children need 5-10 minutes of sun exposure for vitamin D synthesis, preferably around 8 am or 5-6 pm

Babies above 3 months of age can swim in the sea (if it is clean and moderate temperature)Seawater is a lot healtier for children than pools. Chlorine in the pools can be irritating for some children who have allergies,they might need to rinse their nose with normal saline and take showers right away.

2-Health Problems
a-Foodborne illness
Food poisoning is a lot more common in summer than any other time of the year. Because of the heat food might ro easier. Food poisoning can be caused by bacteria and viruses (like norovirus) Food poisoning usually presents with vomiting (some children might vomit 10-15 times or more) which might or not be followed by diarrhea.Usually there is no fever unless the offender is norovirus. Food poisoning usually effects many people who have eaten the same food but the picture is not always the same. Poor hand washing during picnics or at home or poor food hygiene might be the cause.

If food poisoning is severe a physician should be consulted. Fluid intake is very important. When the losses through vomiting and diarrhea is great fluids should include salt and sugar in addition to water. Children should be carefully watched for signs of dehydration. These signs include  fatigue, decreased amount of urination, sunken eyelids.

If there are signs of dehydration a physician should be consulted immediately. Rarely intravenous fluids might be necessary.

b-Skin problems
Insect bites are the major skin problems encountered by children. Even fly bites may not be as easy as they sound. Bites cause itching and itching commonly irritates the skin and causes secondary skin infections.Using antihistamine or antiinflammatory creams on insect bites might be a good idea to help alleviate inflammation and scratching as well as consequent skin irritation. If there is secondary infection (which should most often times be assessed by a physician) local antibiotic creams or ointments might need to be used.

Bee stings are particularly problematic for allergic children. Avoiding bright colors in summer outings or avoiding to picnic close to bee nests might be a good idea. If a child has a bee sting the needle should be removed with gentle scraping motion. Applying cool compresses and antiinflammatory/antihistamine creams helps relieve the pain/swelling/itching. If there is signs of allergy however a doctor should be consulted right away. Antihistamine medications (for severe cases other meds such as epi and steroids as well) might be necessary. For children who have a known bee allergy an epi pen must be kept handy as well antihistamine medications.

Ticks have been a problem in Turkey during the past few years as well as some other countries. The tick related fears in Turkey have been due to Kirim Kongo Hemorrhagic Fever  as opposed to FSMBE that is prevalent in some European countries. In the past years cases of Kirim Kongo Hemorrhagic Fever have been in the northern, northeastern and middle Anatolian cities. In Istanbul there were some reports of lyme disease which is also tickborne but the incidence seems to be very low.

Avoiding ticks might be difficult as that might mean not spending time in the nature.

It is very important though to check kids bodies` every night to investigate signs of a tick.

Usually the only visible part is a black pin size  round head. The belly button is a very favorite hiding place for ticks! If you see a tick it is best to have it removed by a physician or medical personell and have it tested. If this is not possible you can remove the tick with a tweezer, trying the make sure the head does not remain in the body.Using chemicals or ice might cause a stress response in the tick and can go deeper down in the skin.It is important to try to take the tick for testing in the closest laboratory.

Hopefully all kids will have a joyful and healthy summer.

Dr.Beril Bayrak Bulucu - Pediatrician

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