Deborah Howell (Host): Fun in the summertime sun is one of the true joys of life, but we're all more cognizant than we used to be when we were kids of what sun can do to our skin. Today, Le Bonheur General Pediatrician and Medical Director of Healthy Lifestyles Clinic, Dr. Adebowale Odulana, will talk to us about the effects of sun on kids, what precautions to take, what to look out for, and lots of other tips for staying safe outside during summertime. Welcome, Dr. Odulana.

Adebowale Odulana: Thank you so much for having me. You know, I'm thrilled to have a chance to talk to you all on this podcast today.

Host: The thrill is all ours. Now, let's just jump right in and ask how does sun exposure affect children's skin differently than adults?

Adebowale Odulana: Well, children's skin is different than adults. First off, the top layer of a child's skin is thinner in comparison to adults. And also, the type of cells that actually are helpful in protecting against the UV rays are not present as much in children. And those cells don't actually really kind of develop further until much later in childhood. So for those reasons, children are far more susceptible than adults to harms for sun exposure.

Host: Good to know. So, what times of day should direct and prolonged sun exposure be avoided?

Adebowale Odulana: Well, the time that we're thinking about for peak sun exposure is really from around 10:00 in the morning to 4:00 in the afternoon. And so, if you can, try to avoid being out during those times, if possible.

Host: All right. Say that to a pickleball player and they'll say, "Hmm, I don't know."

Adebowale Odulana: Of course.

Host: So if you do need to be out there, what type of sunscreen is most effective and where should it be applied and how often?

Adebowale Odulana: You want to be looking for your sunscreen with an SPF of at least 30. And for those of you with sensitive skin, you want to be looking for the mineral sunscreens. And those are the sunscreens with zinc oxide or titanium dioxide in them as well, because those are better for sensitive skin. Some other things to consider are hypoallergenic as well as fragrance-free sunscreens, again, for your more sensitive skin.

Host: Absolutely. And the SPF factor, we've gone over this before, but I think it bears repeating. Don't just get a hundred and think you're done for the next five hours, right?

Adebowale Odulana: Absolutely. That was so well stated, because you want to make sure that you're reapplying every like one and a half to two hours. And also, you want to be mindful for those of you who love those water activities that we encourage as well to do it safely, you want to make sure that you're reapplying, because there's no sunscreen that's actually waterproof. There are water-resistant ones, and those are the ones that we would recommend, particularly during the summer using. Because more often than not, in the heat waves that we experience here in Memphis, you're going to be sweating in some degree. So, frequent re-application in those settings would be recommended.

Host: I've heard a shot glass-full is about the amount you need for your whole body and face.

Adebowale Odulana: That is correct. And if we're thinking about where it needs to go, you want to make sure that you're putting a nice layer and rubbing it in completely on areas that are not covered by your clothes.

Host: And that goes for spray-on, too. You need to rub that in after you spray it, correct?

Adebowale Odulana: Absolutely. Again, great sound advice. No matter the type, you want to make sure that you're rubbing it in. And additionally, you want to put it on roughly 15 to 30 minutes before you actually go outside, because you want to make sure that it's absorbed already before you actually go outside.

Host: Got it. So, other than applying sunscreen, what are some other ways to protect children from the sun?

Adebowale Odulana: So, kind of like what we talked about earlier, you want to try and avoid, if possible, those peak hours of sun exposure. So if possible, doing activities in the morning or in the evenings. But if you have to be out there during that peak time, then you want to make sure that you're mindful of the clothing that you're wearing. For instance, you want to be wearing those light cotton clothing, long-sleeved, that are light that cover the areas of your skin that could be exposed.

You also want to make sure that you're mindful of the shade, because when you're out in the sun, the shade is your friend. So whether it's you're out at the beach and you have a beach umbrella, or whether it's your rain umbrella, these are ways that you can protect yourself from the sun and to use. And for those of you who are at the beach, if you see a tree, again, another area potentially for shade for you to set up with your family in a nice, shady place. And those are all considerations that can protect you in addition to sunscreen.

Host: Now, what should I do if I think my child might be dehydrated? When should I call my pediatrician about that?

Adebowale Odulana: So, the sun, heat and activity, those are all a combination for dehydration. So, it's really good that we're talking about this. One of the early signs that you can look for are cramps. And what you want to do is first get your child out of the heat. So, find a shaded area and then work on hydration. Oral hydration with an emphasis on water and/or the sports electrolyte beverages as well. And you want to be using things that are going to stay and increase your child's volume status. So, you want to stay away from those like really, really, really sugary beverages and focus more so on the water or your sports drinks.

Host: I heard that if you put a lemon in the water, that also helps with the electrolytes. True or false?

Adebowale Odulana: Absolutely, that is true. The lemon basically provides a similar electrolyte balance that helps, again, keep things in the actual volume and increase the volume.

Host: You're answering these so well, I'm just going to keep rolling. What should I do if I think my child has heat stroke or heat exhaustion? Is there any way to prevent either one of those?

Adebowale Odulana: As we're thinking about heat stroke and heat exhaustion, those are really complications or heat-related illness. And both of those are serious, but heat stroke is the more kind of critical one. We'll first start to talk about heat exhaustion. And so, in addition to cramping that you might see, these kids are oftentimes sweating profusely and have lost a considerable amount of volume from sweating.

So, what you want to do is, again, you want to act quickly, get the child out of the heat and into either indoors or even outdoors, but cooler area. Try to get them in a cool or cold bath and/or sponge bath. And if you happen to have a thermometer around and are able to take a temperature, that would be very, very helpful to try and figure out how severe what you're dealing with is.

And as far as kind of when to activate or call your pediatrician or to see about getting additional help, as you have been doing your intervention, which may include, or will include rather, getting your child out of the heat, getting them immersed in a bath or sponge bath, then after assessing them for about an hour of doing these different things, you'll want to contact your pediatrician if you feel that they're getting worse or if symptoms continue. You want to contact your pediatrician and work on seeking additional medical care.

Host: Okay. And what sort of temperature brings alarm?

Adebowale Odulana: These kids can have temperatures as high as 103. But if you get over 103, we're getting into the heat stroke realm. And that's kind of a different process, a more severe process. If you have your thermometer, definitely use it. Rectal temperatures are preferred. But if that's not possible, definitely oral temperature.

Host: And what about if it's someone else's child? Should you still intervene?

Adebowale Odulana: Absolutely. If it's someone else's child or a child in trouble, and by intervene, I mean, I would encourage to either contact emergency services to get help for that child that you may see in trouble. But a critical step would be to get that child out of the heat and to get them hydrated.

Host: And you mentioned heat stroke. Can you tell us the symptoms of heat stroke?

Adebowale Odulana: Heat stroke. These children are in more trouble to be frank. These are children whose temperatures can get as high as 105 or even higher. And a lot of these children have actually lost the ability to sweat, which further complicates things. And so, as you're touching their skin, you can feel how hot it is. And so, if you see a child that really not is able to sweat, that is really lethargic or exhausted or even not acting like themselves, in the setting of being outside for a a long period of time, that's a child that you would need to take immediate action to have emergency services contacted. And whether that's you or someone that you're with, have someone immediately contact emergency services while you're getting that child into a much cooler environment and immersed in a cool or cold bath. Those are two critical steps.

Additionally, one thing to make sure to remember is these are kids, even though we know that they're dehydrated. We do not want you to try to offer things by mouth, and that is because these kids may not be able to protect their airway, and we could be unintentionally creating another complication, even though we're trying to help.

Host: This is such incredibly useful information. I have one last question for you. Do you have any other sun safety tips for parents and caregivers during the hot summer months?

Adebowale Odulana: When you are out for an extended period in the summer, whether it's sunny or cloudy, please put sunscreen on, and that's because a lot of harmful rays can still get through the clouds, even on those cloudy days, and we want to make sure that you're protected while you're out and about.

Host: I've heard that hats are great, especially those floppy ones that cover the ears, but I also have learned just recently that they don't do everything to protect your face that you think they might because sunshine reflects off. Let's say a tennis court surface and can hit you from below.

Adebowale Odulana: Absolutely. You brought up a great point, and it really speaks to how critical it is to apply sunscreen really all those exposed places. As you said, the UV light reflects off the water, off the sand, off the ground, and it can hit areas that we think are actually covered. So, we can be on the safe side and apply this sunscreen in areas that are exposed.

Host: Well, Dr. Odulana, I can't imagine a more pleasant and informative conversation. Thank you so much for being with us today and shining a light on protecting our kids from the effects of the sun. It's really been helpful.Adebowale Odulana: Well, again, it's been an absolute pleasure to talk to you today on this podcast and to our Le BonHeur families. We definitely want our families out active because we know how good that is for health and wellness. We just want you all to do it in as sun safe way as possible. So, please enjoy your summers, but let's do it in a sun safe way.

Host: Beautifully put. And if you'd like to learn more, please go to lebonheur.org/news-events/podcast. This is the Peds Pod by Le Bonheur Children's Hospital. I'm Deborah Howell. Thanks for listening, and have a great day.