This is “Healthy Conversations,” a podcast presented by Adventist Health.

Bill Klaproth (Host):  After a long winter, when the weather turns warm, it’s only natural to let your kids out to play and have some fun in the sun. But, what about the latest news on sunscreen safety and what are some other tips to keeping your kids healthy this summer? Let’s find out with pediatrician Dr. Michael McNerney. Dr. McNerney, thank you for your time today. So, given some of the recent news that sunscreen shows up in the bloodstream; is it safe for kids to wear sunscreen?

Michael McNerney, MD (Guest):  Thanks Bill for having me and to answer that question, yes, and there has been some recent news lately I think over the last couple of weeks where some studies have shown that people absorb some of the ingredients that are in sunscreen. Now, it’s important to remember that sunscreen wouldn’t be sunscreen without some of these chemicals that they put in there which allows them to absorb ultraviolet radiation and actually protect your skin and by and large, these compounds, these chemicals have been very safe over the last 50 years or so. 

We know that anything on your skin is going to get absorbed so, they’ve been looking into could these chemicals get absorbed in and in what concentrations. And I think recently the one that they have found is one that is called oxybenzone and they found that that gets absorbed rather quickly and can show up in your urine rather quickly after putting the sunscreen on. I’ve done a little digging and looking into this and they really don’t know if it causes any kind of problems yet. They know that it in rat models and mice models it can cause issues with their hormone regulation and whatnot. 

But in humans, they really don’t know. I believe that the American Academy of Dermatology wants everybody to continue using sunscreen with oxybenzone in it because it works very well. I believe the American Academy of Pediatrics has said you can look for that in the label and avoid that on children for now because we just don’t know. But I think everybody is still not sure about if that chemical is safe but there are other sunscreens out there that are safe, and everybody still wants you to wear sunscreen. It’s very important for sun safety. 

Host:  Okay. Got that. Stay away from oxybenzone. What should we be looking for in a sunscreen?

Dr. McNerney:  What you should be looking for is something called sun protection factor and that’s SPF. And we like you to put something of an SPF of 15 or higher on your kiddo which is about a shot glass worth and reapply. 

Host:  And how often should a parent reapply sunscreen?

Dr. McNerney:  It depends on sort of the day. If you are out in the water, if it’s not a obviously a water resistant brand; you want to reapply often. If it’s a pretty good water resistant brand; maybe two times. Put it on. I usually have my patients put it on before they go out in the sun. it give it a chance to sort of set up and then reapply it in the shade after you have been out in the sun for maybe a couple of hours. But if you are in the water, definitely every hour or so you want to reapply. And you can just reapply to the places that seem to get the most sun like your face, your shoulders, top of your ears, your hair or your head if your hair is very short. Those tend to be the places that get burned the first and the worst usually. 

Host:  Well that makes sense. So, let’s move on to insect repellents. Are insect repellents safe to use on children? And what should we use?

Dr. McNerney:  You should use them. Insect repellents, we’ve been using those a long time to keep from the biting bugs getting us like mosquitoes, ticks, some of the nuisance like biting fleas, the chigger bugs they get on the east coast. We think of diseases that these insects can carry so wearing a mosquito repellent if you are out, is a good idea too. I usually will tell folks why don’t you try to avoid the biting times which is dusk and dawn but that’s the time we usually find ourselves out there. 

As far as the agents that are used in mosquito repellants, number one, you can kind of go down the list in efficacy and two I use off the top of my head as examples. One is DEET and I think we’ve all heard of DEET. DEET just stands for – it’s a shortening of a very long chemical name that I can’t rattle off the top of my head. But it’s been around for a long, long time. It’s very effective in preventing mosquitoes from biting, as a deterrent to them and ticks and all the other biting bugs. 

But it can be neurotoxic in very high amounts. So, I believe that it’s been said an insect repellent of DEET of 25% or lower is safer for children. I tell people to make sure they don’t spray it directly on their child’s skin, but to spray it on their clothing and that way they can get some protection with lowering the absorption of that into your skin. Because again, they think in high doses it can be neurotoxic. It doesn’t cause cancer. I’ve heard that before. But it can be neurotoxic in large doses and I can’t give you a number as far as that is. So, it’s always better to go on the lower side. 

One that has been used for a long time that’s a lot safer than DEET is an ingredient called picaridin depending on how you want to say that. It’s not thought to be neurotoxic or toxic at all unless in very, very high doses. But it’s been used in Australia, in Europe. It can be found in some products in the United States and so I usually will tell people look for that ingredient in a spray or a insect repellent. And again, I tell everybody just to be on the safe side, spray it clothing and not directly on your child. 

Host:  All right. So I have my checklist here. Avoid the biting times as you say which is dusk and dawn. Look for DEET 25% or lower or picaridin which is even better and don’t spray it directly on the kid’s skin, spray it on their clothing. Really good advice. All right Dr. McNerney, let’s turn to water now. What is the number one water safety rule?

Dr. McNerney:  The number one rule I tell my parents is direct active observation or monitoring supervision I guess is the way to say it. Eyes on you kid at all times near water. If you are in a pool area, if you are at a party, it just makes no sense for you to trust in others to be watching. You need to be actively looking within arms distance or shortly not too far away. But really participating in the direct observation. And so if you are there with your family, and you are with your partner, and you are watching your kiddo, I say that it can be exhausting, so tag team it. 

Take turns and when it’s your turn, you put your cocktail down and you watch your kiddo. And that includes at the beach. I think you need to have your magazine down if you are in your chair, you need to be up out of your chair and close to the water if your children are close to the water. If you are near a lake, same goes there. It’s just important number one to just have active direct observation. 

Host:  Direct active observation. Such good advice. And keep your eyes on your kiddo as you say at all times. And it can be exhausting so great idea to tag team it with your significant other. Are there any other tips or things we should do to protect our children from drowning Dr. McNerney?

Dr. McNerney:  Well, I think as pediatricians we recommend that children from three and above start getting into swim lessons. We try to advise people not to put their complete faith in personal flotation devices meaning that a life vest and floaties are not any kind of substitute for eyes on your child and in fact, it can sort of give you a false sense of security that can lead to injury. And then two other things at home. Get rid of any standing water, buckets of water, toilet seats need to latch or have a bathroom lock. If you have irrigation like we do tend to have here on the West Coast, you don’t want to let the kiddos have access to that. If you have a pool; it’s really important to have it gated on all four sides or at least fenced in all four sides with a self-locking gate. Just prevention is the most important thing. 

Host:  Last question Dr. McNerney. So, what is dry drowning?

Dr. McNerney:  Dry drowning is kind of a – it’s word that doesn’t – it’s not really one that we use in medical parlance. I guess the way to look at it is what is drowning. Drowning is submersion in a liquid medium where the fluid goes into your lungs and causes death. Then there is nonfatal drowning which is when you survive at least temporarily from a drowning event or a submersion. And dry drowning is what happens I believe when your larynx or your airway spasms and closes and water doesn’t get down into your lungs, but you can become unconscious from asphyxiation or lack of air from things closing down. 

And that can lead to some problems that don’t show up right away and can happen down the road. So, I try not to use that word. It’s not one that we use very often. I think it’s more important to just call it what it is drowning or nonfatal drowning. It’s all in that kind of category. 

Host:  Right, so we should stay away from that term dry drowning. 

Dr. McNerney:  Yeah, I think it gets a lot of – it’s got a little bit of a hype to it lately. I think some things happen. Kids fall in the water, mom grabs them, everybody thinks they are okay and then they have some coughing and problems breathing later and I think it’s important to just if anybody goes in the water and they cough and they sputter, keep eyes on them for a few hours afterwards to make sure that they didn’t damage anything. 

Host:  So, the main thing is as a parent, if they are sputtering, coughing, choking, just make sure you watch your child for several hours afterwards. 

Dr. McNerney:  Yes, absolutely. 

Host:  Well Dr. McNerney, this has been great advice and thank you for your time. And if you like what you’ve heard, please share it on your social channels. Let’s keep those kiddos safe. And be sure to check out our full podcast library for topics of interest to you. I’m Bill Klaproth. Thanks for listening. 

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