As summer approaches, the incidence of skin irritations increase due to insect bites and stings, poison ivy, and sunburn. In childcare programs, these irritations can cause problems ranging from minor itching to life-threatening situations. The best practice is prevention.
For most children, being bitten by a mosquito or two creates only minor discomfort, but mosquitos can also transmit encephalitis and other serious diseases. (Your local health department will probably issue a warning if there is an outbreak of encephalitis in your area.) Ticks are also the second leading insect carriers of human, including Rocky Mountain Spotted Fever and Lyme disease.
However, some children are extremely sensitive to insect bites and stings, particularly bee and wasp stings, or fire ant bites. Even a single bite or sting could cause anaphylactic shock, a life-threatening allergic response in which the airways swell and cause breathing difficulties. Make sure that the center's first aid supplies include a "bee sting shot kit," or syringe of epinephrine, and that staff knows how to administer the shot to a child or adult (the amount administered differs for child and adult) if they have a severe reaction to a bee sting.
There are steps you can take to prevent insect bites and stings in child care settings. First, remove any standing water, which can become mosquito breeding ground. Empty any cans, flower pots, or old tires that trap water. Check with your local health department for ways to deal with ditches or other areas with standing water. Also, control ants, bees, and wasps by removing their nests. When using insecticides (if using them at all) do so with the utmost caution. Some insecticides are particularly hazardous so you may want to check with your local health department or poison control center before using any products you are not familiar with.
Children in outdoor environments, such as day camps, scouting activities, church camps, or those participating in field trips or nature walk activities are more likely to be exposed to insects. The following preventive steps can help keep attraction of insects to a minimum:
- Do not wear bright colors such as yellow or red that attract insects. To a bug, that yellow shirt looks like a big flower.
- Avoid wearing perfumes, hair sprays, and other fragrances that may attract insects.
- If insect repellents are to be used, read the label carefully. Choose a repellent that contains less than 15% diethyltoluamide (DEET). Avoid products that contain ethanol. Apply the repellent sparingly and wash it off when the child comes indoors, or apply the repellent to clothing, rather than the child's skin.
- Using insect repellent on young children (under the age of two) should be questioned. There have been cases of young children developing medical problems due to the use of a repellent with 10-15% DEET. Check with your local poison control center for advice and clear any use of repellents with parents first.
- Wear light-colored clothing on hikes or nature walks. It is easier to spot ticks or other insects on light-colored fabrics.
Exposure to poison ivy, oak, and sumac can result in an itchy rash or dermatitis, and in severe cases, extreme swelling and other complications. The best prevention is to avoid these plants.
- Caregivers should check the childcare area thoroughly for toxic plants and have them removed. Check with local environmental or regulatory agencies about use of chemicals to kill plants. Salt-based products, such as "Round-Up" are generally permitted if used properly. Remember, even a dead plant may have the irritating oil, so plants should be carefully removed.
- Children participating in camps or hikes are more likely to have contact with these plants. Teach older children what these plants look like as well as how to avoid them.
- If a child touches poison ivy or some other irritating plant, wash the skin thoroughly with soap and running water as soon as possible.
- Over-the-counter products such as "Ivy Block" have been shown to be effective in reducing the effects of toxic plants. However, some of these products may contain ethanol, which is not generally recommended for use on children.
While a slightly sunburned nose is not usually considered serious, research shows that prolonged exposure to sun, repeated sunburn, and even a single severe sunburn-may lead to skin cancer later in life. Each blistering sunburn doubles the risk of developing malignant melanoma, which is the most serious type of skin cancer. Furthermore, a severe sunburn can create other serious effects in children, such as heat rash, dehydration, heat exhaustion, and heat stroke. And don't forget to protect the eyes! Years of exposure to ultraviolet light increases the risk of cataracts.
The best advice is to avoid over-exposure to the sun's rays. Children under six months old should stay out of direct sunlight at all times because their skin is thinner and more sensitive to the sun. Play time in the sun for older children should be limited to 15 minutes unless a sun block is used. Children should not be allowed to stay in the sun for extended periods of time or during the hottest part of the day (10:00 a.m.-3:00 p.m.). Playgrounds should provide adequate shade, and children should wear hats and sunglasses with UV protection.
If children will be in the sun for prolonged periods (i.e., ball games, day camps, hikes), consider these recommendations:
- Wear tightly-woven light-colored clothing. Over 30% of the sun's rays can penetrate loosely woven fabrics, such as tee-shirts, and dark colors absorb heat and increase the chance of heat-related problems.
- Use sunscreen when children will be in the sun for more than 15 minutes. Choose a sunscreen with a SPF rating of 15 or above. For water play activities, choose a sunscreen that is "waterproof." These products will provide protection in the water for about 30 minutes. Apply the sunscreen 30 minutes before going outside so it can penetrate the skin and provide protection. Completely cover exposed areas, giving special attention to the nose, ears, cheeks, and shoulders.
- Some children with sensitive skin can develop rashes or irritation from sunscreens containing the product PABA. Most sunscreens clearly say "Paba Free" so check the label before applying the product.
Sun and fun make great memories for young children but bug bites and sunburns can mar summer days. With proper care, summer can be safe as well as fun!