Ep 142: How to keep our kids safe throughout the summer, Part 1 with Dr Wendy Hunter Pediatrician

This weeks episode of Ask Dr Jessica is joined by Dr Wendy Hunter, pediatrician, for a conversation about how to keep our kids safe over the summer. We'll talk about best practices for sun protection, how to best prevent against mosquito bites, how to prevent drownings, prevention of getting overheated (heat stroke) and prevention of common summertime injuries.

Takeaways

• Sun protection is crucial for children, including the use of sunscreen, protective clothing, and sunglasses.
• DEET is a safe and effective insect repellent, while natural repellents may not be as effective.
• Water safety is of utmost importance, especially around pools. 
•  designated supervision is crucial for pool safety, as swim lessons are not foolproof.
• Having a fence around the pool is essential to prevent accidents.
• Limiting the number of children on a trampoline reduces the risk of fractures.
• Hydration and staying cool are key to preventing heatstroke in children.

Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner.

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The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

Transcript

Unknown: 0:00

Hi everybody. I'm Dr Jessica Hochman, paediatrician and mom of three. On this podcast, I like to talk about various paediatric health topics, sharing my knowledge, not only as a doctor, but also as a parent. Ultimately, my hope is that when it comes to your children's health, you feel more confident, worry less, and enjoy your parenting experience as much as possible. Hi everybody. Today we are joined by San Diego based paediatrician, Dr Wendy Hunter. Dr Hunter is also the podcast host of the paediatrician next door. On today's podcast, you'll hear us share some tips about how to best keep our kids safe over the summer. We talk about things like best practices for sun protection, how to avoid getting pesky mosquito bites, how to swim safely, how to keep our kids from getting overheated and more. I really enjoyed talking to Dr Hunter, and please stay tuned for next week's episode where we continue our conversation, reviewing what you need to know about childhood illness that we commonly see in the summer. Dr Wendy Hunter, I'm so happy to have you here. Thank you so much for coming on this podcast. Hi, Dr Jessica, you have such a lovely warmth about you. Your patients must feel so lucky that you're their paediatrician. Yeah, I think 70% of them love me, and maybe the other 30% are not so sure that's okay. That's like humanity, that's true, right? You can't you can't get along with everybody, but sometimes you can't read people. So I'll bet those 30% do love you, but they don't have a natural way of showing it. Yes, you know what they don't like about me is that I'm brutally honest, and they just shared that with you. No, I'm kidding. I think sometimes parents need that, though. Yes, I do think. I think sometimes they appreciate that, and I definitely have everyone's best interest at heart. So I thought this would be a really fun chance to have a conversation about getting ready for summer, because I think there's a lot of predictable paediatric related illnesses and issues that come up every summer. And so I thought, what a great opportunity we can chat about things that parents need to know so that they can keep their kids safe and out of trouble. I think that sounds fantastic. I can't wait to compare notes with you. Me too. Me too. I thought we could start off by talking about a topic that a lot of us, especially here in Southern California, where we both practice keeping our kids protected from sunburn. So let's first talk about that. Do you have any recommendations that you give to family? So many recommendations that I make, but I do want to start with this. I had a patient yesterday say that they were going to take their three month old on vacation in Tahiti, and didn't say anything more. And I said, Oh, what about sun protection? And then I had the opportunity to educate like, you really shouldn't use sunscreen under age six months, because the babies can absorb all the chemicals. So I kind of start there. But sunscreen so controversial right now, because there's so much in the news about the chemicals, and the truth is, the UV lights, I think, are more dangerous right to your skin than the chemicals. I think so too. And I think What's hard is that we don't really know what the bad effects of the sun are until we're much older, you know, until much more time has gone by. So for example, melanomas, we really don't see them in the in the paediatric population, but they become much more apparent as time goes on and you age so and we know that melanomas are directly related to sunburns, especially in the younger years. Yeah, it's almost like I say, and this is probably just an exaggeration, but to make the point across to my patients, I don't care what you do when you're 25 years old anymore, but as a kid, you really need to prevent sunburns, because if you get bad sun damage when you're young, you get melanoma when you're 40, and if you get bad sun damage when you're 35 you get, you know, melanoma when you're 95 and I don't care anymore, you're not my problem so, and it's, you know, I'm being facetious, but we really need to protect the young skin. It's true. I actually took my two kids to the dermatologist yesterday. I learned a lot from the dermatologist, and he gave us great reminders about how important it is to apply sunscreen and how important it is to not burn, and I learned something interesting yesterday. You ready for this? Yeah. What'd you learn? He said, Guess where you are more likely to get a melanoma on the body, where are the most likely spots on the skin where melanomas occur? Okay? Well, it's got to be the sun exposed areas like the back of your hands, forehead. Sometimes I think about the part of your hair, because we don't protect that and the ears, okay, so that would have been my guess too. But he told me that the most common locations are actually on the chest and the back, because people take their shirts off and they get burned there, and so later on in life, that's where the melanoma show up. I had no idea, and they're not as likely to put sunscreen on. Like I put sunscreen on every day, but I only put it on my face. What about applying sunscreens? Because that, I think, is really challenging for parents, and they're always asking about how bad the sprays are, but I'm like, whatever you need to do to get that sunscreen on your kid, right? I agree with you. I think it's all a balance. And I think yes, at the end of the day, I'd much rather prevent a burn than be concerned with the chemicals. However, the zinc oxide is a barrier sunscreen, so you don't have chemical absorption into the into the body. Yeah, yeah. There are a couple of those mineral sunscreen. Beans that are much safer, and they're safer for the environment, if you're swimming in the ocean. Oh, that's a good point. Yes, you can hurt them, apparently, with the azobenzo, I can't even pronounce it, yes, yeah, that's, that's a good thing to know sticks. The sticks are good for the face, because you can, you know, it doesn't get in your kids eyes. And that's a good suggestion. I like the sticks. I agree. I think just avoiding the sprays on the face, so creams or sticks, I think are great ideas. I've heard other paediatricians talk about the recommendation about sunscreen being recommended six months and older, but I actually agree with you that I think it's better to put on sunscreen if a child needs it when they're little, if it's zinc oxide. Because what's interesting is decitin, the ingredient that we use for diaper rash creams is zinc oxide. You know, even though the official guidelines are to wait to put sunscreen on until six months and older, to me, I think it's still okay if a child's gonna be in the sun, if they're under six months to apply a zinc oxide. Yeah. And same with the titanium. Probably yes and yes. So the two mineral sunscreens are titanium dioxide and zinc oxide. So if you find a sunscreen with those ingredients, don't be afraid to put them on your children, is what I think we're both trying to say. And then, obviously, hats, T shirts, whatever clothing, UV protective clothing. I've heard some dermatologists say that clothing is probably even better than sunscreen. Oh, that's great. I've had two patients just this month have sun allergy, which interesting, seen in a while. But, yeah, if you haven't been out in the sun in a while, some kids are allergic when they first are exposed for the season. That's really interesting. I've seen solar urticaria, or hives that come from the sun. Oh, yeah, I have never seen that. That's a good one, too. Yeah, I struggle with this because I do like a little bit of sun, to be honest. I like feeling, you know, the ambient air, and a little bit of sun on my skin. Well, plus you're getting a little vitamin D. That's true, right way to get your Vitamin D, but you do technically, that's true. That's true, yes, and I so I agree with you. I think clothing is really good. Hats are really important. The other thing that dermatologist reminded me yesterday is that it's really important to wear sunglasses, which, honestly I don't wear enough. I was just going to ask you about that, because, yes, you can get melanoma in the back of your eye, right? You can. There's so much to worry about, and I should wear them more, because at least sunglasses, they look good too, right? Yes, they hide my bags. I don't see any bags. Can't see that well, probably so sunglasses. Child to wear sunglasses. Oh, Lord, that's true. That's true. I guess we can ask, we can ask, we can try. And it was good too for the dermatologist to say to my kids where it wasn't coming from me, for him to remind them to wear hats and sunglasses, especially while hiking, while in any kind of bright light, sunglasses are beneficial. He reminded me that it prevents against macular degeneration when you're older. So that's something that we don't see as paediatricians, but a good reminder, yeah, and you know, it is our role to help prevent things in the kids as they grow up. So yeah, I hadn't thought about that either. Absolutely, yes, there's endless to worry about, right? So I think at the end of the day, prevention is the key. Absolutely, do you like going out in the sun? I do. It definitely brightens my mood. You know, I'm at the coast, and we've had so much cloudy cover recently, it's depressing. So yeah, I do, yes, I agree a lot. But yeah, and I garden. I'm a big gardener. I spend a lot of time in the sun that way. That's so healthy for you. Mm, hmm, the soil, the plants Absolutely. Oh, and the other tip for parents, just something that I've made the mistake of before, is making sure when you apply sunscreen to get all the spots. So specifically, the ears are easy to miss. Behind the neck, those are tricky spots that often get forgotten. So just making sure you apply everywhere on the body. Yeah, I had a dermatologist friend suggest using sunscreen powder in your hair parts, because you can't really cover that well, can I tell you, I've never heard of sunscreen powder. That's brilliant. Yeah, you can keep it in your purse and just reapply in the afternoon, like if you put on sun, if you put on sun protection every morning with your moisturiser, yeah, good way to put it on the afternoon, a little bronze or with sunscreen. That's a good tip from her. Yeah, all right, so we got some good some good groundwork, reminding parents how important sunscreen is, being in the shade, wearing clothing and being mindful to protect our kids against sunburns. Perfect. Anything else that we didn't cover, I think that was a pretty good summary. No, we covered it all. Or, Jesus, we covered it all. Okay, so the next question is, insect bites. Every summer, the mosquitoes are here in full force. Let's talk about how we can keep our kids best protected from mosquito bites and insect bites. I did a lot of research on this. You did was writing a blog post about it? Yeah, so it's a little embarrassing how much I once knew what I've probably forgotten most of it, but I was my big takeaway was I was shy. Shocked to learn that DEET is quite safe, and isn't that true? I mean, I don't know where I got the idea that it was a dangerous chemical, but it is completely safe, and it is a fantastic insect repellent, and it should be our go to I love that you said that, because it's been around forever, forever. Yeah, and they've never found a link to it causing anything damaging, no, and you can put it on a really young child. I mean, I think it's down to, like, two months or something. I agree. I think at first blush, it sounds like something you want to avoid, because it is a chemical, but it's so much better to use an insect repellent that works rather than deal with the mosquito bite on the other end, yeah, because a lot of these biting insects do carry diseases, and we need to, we do, honestly need to protect our kids, not just from the itch, but from potential diseases. The other thing is, I know it sounds nice to you the natural product. I'll hear things about peppermint oil and essential oils. I've tried them myself. I've tried them on my kids, the stickers, but genuinely, I find they don't work very well. They don't and even in studies, it shows that they don't work well. So the top ones, I guess, are picaridin and DEET and then permethrin that you can put on your clothes directly. Oh, interesting. My recommendation probably is to get treated clothes for your kids. Oh, I like that. That's a great suggestion on the uncovered parts, like ankles, wrists, so spray the clothes directly. Yeah. So you can buy a repellent that you wash your clothes with, and I think it lasts somewhere around seven washes. Or you can buy clothing that's already impregnated with the bug repellent. Or you can send your own clothes off to a couple of companies that will do it, and those last like 40 washes. Okay, that's great to know. That's great to know. Andrew, I did my crazy research. I like it. No, thank you. I love learning more about preventing mosquito bites. Because honestly, yes, of course, number one, you want to prevent against the potential that the mosquitoes carrying a disease. But also, I just find mosquito bites to be so uncomfortable, they're such a nuisance, they're miserable, and kids scratch them and they get infected. So yes, so then bug zappers around your house are probably fine clothing. Also, for sure, keeping covered. I think keeping covered makes a big difference. We have these ankle biters. I don't know if you notice them as much in San Diego. I'm sure they're there, but we have a lot of ankle biter mosquitoes, so I really think it helps to wear high socks pants. I think that's a great way to deter mosquito bites as well. You know, what's funny is, at the beginning of the season, we don't see a lot of bugs, like through the winter here, well, in every anywhere, and parents come in with these mysterious rashes, right? And it turns out to be bug bites, but the way I usually identify it is from those ankle biters, because they bite in a row. So they usually have that pattern of, like, breakfast, lunch dinner, where the same bug bit you a couple of times. So parents can look for that if they're worried about what a weird, mysterious rash is. That's such a great tip. I always look for the three in a row, but saying it as breakfast, lunch, dinner, I really like that. I'm gonna be borrowing that sometimes a couple of snacks, right? Sometimes a couple of snacks. Yes. And then, do you have recommendations for people to apply it to their face? Because I know a lot of people feel uncomfortable spraying it directly on the face or applying it on the face. What do you do have them spray it in the hands and then rub it on their face? Yes, I was gonna say spraying in the hands and then rubbing it directly on the face. Yeah, it's tough, too, because you want to make sure that you get the bug repellent off your kids palms, because you don't want them to eat it. Yes, you spray it in your hands and rub it in their face. There's so much to think about. Yeah, you do want to wash their hands, the kids hands, if it's on there, before they eat Yes, and and also, even though it's been shown to be safe, on our children, when they come back into the home. I have them take a shower, take their clothes off, and clean their bodies before going to before going to bed. Yeah, I think that's a really good plan. Yes, it saves your bed sheets from being oily. Yes, that's true. That's true. So do you just keep some Do you just keep some deed around the house? Just in case? You know what? I don't have any bug spray at all. Yeah, I like the wipes. I usually take those camping or travelling, the bug repellent wipes, really convenient. Yes, I am. I actually dropped my kids off for camp this morning. They're going to be gone for quite a while. My two oldest kids are going to be gone for a month, and so I made sure to send them with enough sunscreen and bug repellent. Wow, that's amazing. Good for you. For you know, changing them to be independent. Thank you. Thank you. So I did give them some of the spiel this morning, making sure that they cover their bodies with both sunscreen and bug repellent. You took them to camp this morning. This morning. Yes, you're doing okay. I am okay. Actually, maybe too good, right? Some free time. Yes, yes, I know you're gonna clean out closets, right? I already started this morning. How did you know I already started? I have a goodwill pile. You read my mind. You read my mind. I'm so excited for you. Thank you very much. That's so funny that you say that, because literally, this morning, I was thinking I should be made. Making them a really nice send off breakfast, and instead I was showing them papers. Do you still need this? Do you still need that? So you read my mind after my own heart, yeah. Okay. And the other thing about mosquito bites, I think being mindful of where to find mosquitoes. I think that's helpful. So you know when to be more cautious. So they love to come out at dusk and dawn. They love to be by stagnant water, water that's not moving. So I think that's also helpful just to be aware where mosquitoes like to be. Yeah, that's a really good point. And the time of day, most of our mosquitoes come out around 5pm so if you can just go in for that little brief period of time, like 536 they're gone, and so are though. That's the perfect time of day to be out. If it's not too sunny, they know too. It's the most beautiful time of day. They know it Okay, so, so that was very helpful. Now this is also something just the paediatricians and us. I think this is a very worthwhile topic to bring up. But preventing swim accidents being safe around water. Do you have any suggestions you'd like to start? Start the floor with? Okay, pools are in my top three scariest things for a paediatrician, right? I agree, maybe Top Scariest thing besides maybe cars or something, but just the most devastating injuries to children can happen so quickly. Yeah. I mean, you and I both know we've seen four year olds who drowned, and I, you know, I think my biggest warning, and we can get all into swim practices and safety, is that those those classes for the young, young kids, they actually don't prevent drowning. I did do the early swim lessons with my son under 18 months, where they're supposed to teach him how to float, but then I looked at the data, it doesn't make a difference. So that was really disheartening to me. So you just have to be super vigilant all the time around pools, especially when you're away from home, like if you're at grandparents house and they have a pool, or, you know, you're travelling, Airbnb, whatever you're at, I think those are the times I'd be most vigilant, because at home, you're going to have a fence, right? So I don't know that we can just start there. It's true. I always say that it's so important for somebody to be in charge, because all too often, there'll be a party, or you'll be at your grandparents home, as you mentioned, and people aren't paying attention. You think you think that you're paying attention, but it's easy to get distracted. So I like having a handoff where, for example, you say to your husband, you're in charge right now and then, if he has to, you know, leave the pool, go to the restroom, he does a handoff to you. Now you're in charge. I'm going inside to use the restroom or whatever, for whatever reason that I was talking about the crazy hat. So you just have, like, the ugliest hat around, and whoever's wearing the hat is in charge of watching the pool for all the kids. That's a good one, because then you, like, literally have something too handoff. I did pull a kid at a party. We were at a baby shower. I pulled a six year old out of the pool. I just happened to glance at the pool and I saw this arm just flailing, and I just jumped in and my clothes and grabbed her. Just becomes like she was six years old. Thank goodness you were paying attention. I mean, it could have happened in front of a party of 40 people, wow, yeah. Wow, yeah. I can think of two drowning accidents that have been terrible, where they happen during a party when people just weren't paying attention. Oh, my God, devastating, yes. So yeah, the hat trick is my my big tip. I like it. I'm picturing a big, colourful, fun hat, like the ugliest thing you can find. Yet. I'm gonna get one. I'm gonna look for one. What other aspects do you have about pool safety? Okay, so a couple things. And number one, I think, is just supervision. Swim lessons, of course, are important, but as you mentioned, they're not foolproof, because I think about how often and how easy it is for kids to fall into the pool with clothing on. If you ever try to swim in a pool with clothing on, it's really difficult. That's a good point. So for little kids, that's such a risk for them. So even though, even though you might think that your kid is pool safe in certain situations, they might not be as safe as you think, yeah, yeah, that's a big point we want to drive home. Oh, and then the other thing is, I think it's just really important to have a fence. I have a lot of families that have fences, but then a good amount don't. And I don't know if they're worried about the aesthetics, but it's so important to have a fence. I can't stress that enough, right? Like to get your pool approved, you have to have a fence when they give you your permits, but everyone takes them out. Is that right? Yes, yes. Or alarms on your doors that will also pass inspection, but you can just take them right off because they're annoying. Wow. Yeah. I What do you think about pool cover? Some people want pool covers because they're not as visually distracting as a fence. Yeah. My brother in law has one, and his wife is literally a paediatrician, so that was their solution too. Yeah? So you guess you fall on the pool cover. I that's probably not a bad option. Yeah, I've heard, you know, from what I read, it's not a bad option, but there is the possibility of, let's say, a heavy rainstorm, where it accumulates some water on top, and kids can drown in a very small amount of water. So while it's. Unlikely. That's just something to keep in mind. Oh god, that's terrifying. It's all terrifying, right? We have a patient who they were at their grandparents home, and the little child crawled through the doggy door and drowned. Oh gosh, I know we had an OB doctor, like a doctor mom, their four year old. They were at Grandma's house getting ready for her father's funeral, and no one was paying attention. The four year old wandered into the backyard and drowned. Oh, my goodness. I mean, honestly, I think there's, there's nothing sadder and so preventable. So here, I didn't have a pool until my kids were over, like, seven or eight years old, so we purposely bought a house that had no pool, really, when they were a young Yeah, because I was an ER doctor at the time, and freaked out. And then, yeah, we didn't put a pool until much, much later. I think these are the, these are the problems that come with being a paediatrician, being a paediatric ER doctor. Yeah, we know too much afraid of so trampolines, same thing. I'm a little nervous about trampolines. Really, not going to die on a trampoline, but yeah, you're gonna break something. Yes, yes, I actually have a trampoline. My husband's really into the kids moving and getting exercise, and it's a fun way to do it. So we have a trampoline, but we have rules around it. We have to have a net around that, around the rim, and we also have a limit to how many kids can be on the trampoline at once. Number one best tip, yes. So good for you for having the rules, but yeah, the number of children on the trampoline is directly correlated with increased fracture risk. Okay, thank you. Good to know. I don't, I don't know that we enforce it well enough. So this is a good reminder for me. Yeah. And last, in terms of prevention of problems during the summer, for our kids, being in the hot sun. I know for my kids, I can't, for example, I'm concerned that they're going to be in hot sun for a lot of the day. What are some ways that we can prevent our kids from getting overheated, or, worst case scenario, heat stroke? Oh my gosh, that's so that's so tough. My My only tip is hydration, you know, so give them a water bottle, and maybe might make a mark on the water bottle, so that you remember to look and see like that they drink all the way down to that mark by, you know, an hour outside or something. That's a great tip, because it's true, it is easy to forget to drink and bring along some fruit. Fruit is a great hydration source. Popsicles, I'm trying. That's really fun. I don't really have any other tips except to stay hydrated, you know? I'll tell my kids too, to look at their urine to make sure it's not too concentrated, to make sure they're going enough and that it's clear, because I think that's a good indicator if they're drinking enough. It's also sort of a fun game to play kids. We'll look at the colour of their urine and report it right. Hey, my urine is clear. Guys, which one's the pediatrician's kid? That's right, I literally reminded them this this morning. They all nodded. They acted like they understood what I was saying. So hopefully that's okay. My kids used to jump on the bed and yell, I'm not gonna break my arm. Our poor kids. Thanks, guys, yes, yes. And then just reminding them to stay cool, I think sometimes you know you can tell when you're getting overheated. And so just being mindful to look for shade, staying cool, bring fans, drinking enough water. I think all of that's really important, especially in these hot summer months, they need to tell us that they have a headache, which they may not notice. That's truly a first sign of heat illness. That's true. And when we talk about heat stroke, that's actually when you get so hot that the body temperature actually is elevated, you can feel confused, you can feel really fatigued, you can have a very bad headache. And I think if you are concerned that a child has heat stroke, or anybody's had heat stroke, you actually want to call 911, yeah, that's a good point, too, and it's not a fever, if you take the temperature and it's high, it's hyperthermia, it's heat stroke. It's not a fever. That's dangerous. It's a good reminder. Gosh, all right, so I think that's a really good summary of things to think about in terms of preventing getting into trouble over the summer for our kids, it's perfect. And I really appreciate all your tips. I'm going to keep thinking about breakfast, lunch, dinner. Thanks, Jessica. Thank you for listening, and I hope you enjoyed this week's episode of Ask Dr Jessica. Also, if you could take a moment and leave a five star review wherever it is you listen to podcasts, I would greatly appreciate it. It really makes a difference to help this podcast grow. You can also follow me on Instagram at ask Dr Jessica, see you next Monday. You.