For parents, keeping kids safe is part of summer's challenge
By Steve Herring
Published in News on July 1, 2012 1:50 AM
Ashley Och applies sunscreen to her daughter Jane's, 4, face, while Mary, 6, and Lily, 9, look on. Mrs. Och applies sunscreen on the children once every hour.
Children may view summer as time to be spent outside playing, on trips to the beach and swimming, but for parents, it is a time to be concerned about sunburn, bug bites, poison ivy and other potential health problems.
However, a little preparation, planning and common sense can help ease those concerns and hopefully avoid some of those problems.
"The sun is terribly important because if you look at those of us who are a little bit older, skin cancer is the fastest-growing form of cancer," said Dr. David Tayloe of Goldsboro Pediatrics. "Most of that is not malignant melanoma, it is basil cell carcinoma, but it is directly related to how much sun you have been exposed to in your life. We know that if a child has one blistering sunburn that it increases the risk significantly of skin cancer in adulthood. The real gold standard is to not let your child sustain a sunburn that results in peeling of the skin. That is a tall order because we live in a hot place.
"The rules are try to avoid direct sun exposure between the hours of 10 a.m. and 4 p.m. We know the sun is more overhead and hotter. Go on the side of protection that is in the form of umbrellas, hats and sunglasses and long-sleeve shirts and pants."
And don't trust sunscreen if it is necessary to be out with nothing but a bathing suit, he said -- there is varying advice about what strength of sunscreen to use.
"But I think most people agree it should be a 30 or more," he said. "Realize that it has to be applied after each time you go in the water because even though a lot of them say they are waterproof, they invariably wash off.
"Of course you rely on observation of family and friends if they tell you that you are really getting red. You need to get out of the sun all together."
Tick-borne Rocky Mountain spotted fever is a year-around concern in North Carolina, Tayloe said.
"In 50 percent of the cases, nobody saw a tick," he said. "Our antennas are up all of the time for any child with unexplained fever, who acts like they are sick. Children with Rocky Mountain spotted fever are sick. They are not smiling and playing and shooting the breeze with you in the exam room. When I see a child who is laying around just like they feel bad and they have fever, I begin thinking Rocky Mountain spotted fever.
"The real hook on Rocky Mountain spotted fever is that penicillin is worthless. Cipro is worthless. You have got to use a tetracycline and we don't use tetracycline very much in pediatrics except for acme. Then it is every day as a preventive kind of thing. That is why people die from Rocky Mountain spotted fever, if somebody just selects any antibiotic to give you because you are sick they are not likely to choose tetracycline."
Typically 90 percent of people with Rocky Mountain spotted fever have a rash, usually on the extremities, the hands and feet, he said. Also, 70 percent are vomiting.
Lyme disease, on the other hand, is still rare in the area, he said.
"It is a good idea whenever your children come in and take their baths in the evening to look in their hair or behind their ears. The kids will normally find the ones on their arms and legs so they can see them and feel them and remove them."
Gentle traction with tweezers should be used to remove the tick, he said.
"This thing about the head staying in, that is not an issue," he said. "The body will expel the head. You don't have to worry about that. You want to grab it firmly and pull slow and easy until the tick releases."
Fire ants are in the same family as wasps and other insects whose stings can send people into shock, Tayloe said. People who are allergic to the stings break out in hives and pass out, while a person who is not allergic will experience local swelling.
Over-the-counter creams or rubbing alcohol can be used on the stings, he said.
"If they break out in hives, they need medical attention because they can go into shock," he said.
Spiders, including black widows or brown recluses, also are among common problems, he said.
People bitten by a black widow are probably as "sick as a dog," throwing up, experiencing chills and muscle spasms within 30 minutes of being bitten, he said.
Brown recluse spider bites typically result in a blistery swollen area that gets bigger and ugly, he said. The person often runs a fever. Dr. Tayloe said he is familiar with the brown recluse, but has never treated anyone bitten by one.
"The treatment for that is surgical incision of the lesion," he said.
People should not be afraid of using over-the-counter insect repellents that have DEET as an active ingredient, but it should only be used once a day on children and should not be used on children under 2 months of age.
Poison ivy is another hazard in eastern North Carolina, he said.
"Once you get poison ivy that is it," he said. "You are just going to be itching for a couple of weeks."
His advice is learn to recognize three leaves on the end of stem.
"If you think you have been in contact, wash clothes as soon as you get home, take a long shower and put on clean clothes," he said. "The amount of time resin stays on skin determines how likely you are to break out or not."
It is important to teach children how to swim, Dr. Tayloe said. However, a common problem associated with water is swimmer's ear -- an infection of the ear canal.
"Parents need to know that if their child is complaining about their ear and it hurts to wiggle the outer ear then it is probably swimmer's ear and they need to immediately keep them out of the water," he said. "Then if they will start using an antibiotic drop and we can prescribe those when we see the children here."
Summer camp counselors use a half-and-half mixture of vinegar and alcohol that is squirted into the ear, he said.
Flushing ears out after swimming replaces water with a weak acid that cuts down on overgrowth of bacteria that causes swimmer's ear, he said.