As a parent, you’re dedicated to putting safety first and foremost in everything you do, and any and all activities your child gets involved with. Given there are so many factors in keeping your child safe, we’ve made it easy for you to stay informed and on top of safety topics when it comes to planning your summer, and keeping their focus on fun, so that you can also have a great time with them! 

We’re pleased to introduce a Q&A with guest contributor Dr. Harkness, a general pediatrician at the Paoli office of Nemours Outpatient Pediatrics. We sat down with Dr. Harkness to gather his “Fast Five” insights on the topic of summer safety for parents with children which you can view below. We also have an upcoming discussion on this important topic! We welcome you to join our free, upcoming webinar at 6pm on Thursday, July 25th, 2024: Smart Summer Safety: A 360-degree Overview of Summer Safety

Swimming and Water Play are some of the best ways to enjoy being outside in the summer heat, but caution is important! What are some things to keep in mind regarding swimming and water play and what can parents do to ensure that their children are staying safe while enjoying the water?

There are a couple of hidden dangers regarding water, especially for the younger kids. One is the fact that it’s not just the pool you have to be concerned about. You have to be concerned about buckets, wading pools, and even if your kids are helping wash your car. You have to be careful about kids finding any kind of source of water. Additionally, there are infections that you can get from the water – especially in bodies of water such as lakes and streams. So anytime a kid is outside around any kind of water, they have to be closely supervised.

There are some pool-specific hazards as well. We’ve all heard of the suction of the bottom of the pool trapping kids, but that’s pretty much a thing of the past. Pools are much safer these days to help avoid those situations, but you still do have to be careful with kids in the water as there is always the risk of potential injuries. It is important that they are supervised at all times, hopefully by a lifeguard, but if a lifeguard is not there, you have to be within a reasonable distance to be able to help them.

Sunscreen is thought to be the best protector against the sun for children. What are some tips you can share when it comes to picking and applying the right sunscreen and are there any other ways for parents to protect their children from the sun this summer?

There are two kinds of sunscreens – chemical and mineral. The chemical sunscreens actually get absorbed into the skin to then absorb the light rays, essentially converting them into heat before they can damage the cells. The mineral sunscreens, on the other hand, actually act almost like a mirror to block the sun from going into the skin.

I do tend to use the mineral sunscreens even though they can be a little harder to use, a little thicker, and take a little bit more time to wipe off. I just think they’re a little better than the ones that get absorbed. There are some concerns about a few of the chemicals being absorbed, although most of the ones that are out there now that have been tested are fine. Generally, it’s always better avoid having something absorbed in your skin.

The key with any sunscreen though is that you’ll want to apply it a reasonable amount and reapply fairly often (typically every 2-3 hours or after the kids are in the water or doing a lot of sweating). The SPF of sunscreens is often talked about but can be really confusing for a lot of people. An SPF of 15 protects you from about 97% of the sun’s rays and SPF 30 protects you against 98%. So, it’s almost 1.5 times as good, but it’s really not that big a difference from 97 to 98. It is important to note, however, that using a higher SPF does not mean you can stay out in the sun longer. The SPF only tells you how much sun it’ll protect you from and does not have anything to do with how long you can stay out in the sun before needing to reapply.

Also, contrary to the common misconception that you can’t use sunscreen for children under 6 months old, you actually can use sunscreen in little babies, especially the mineral sunscreens that aren’t getting absorbed. It’s just that you don’t need to. If you can keep them in the shade, that’s much more important than the sunscreen for the sun. However, once they start moving and crawling and getting all around, it’s harder to keep them in the shade and you’ll want to put a little sunscreen on at that point.

Clothing is also really important. Good protective clothing can include a big floppy hat to protect your child’s head, face, ears, and eyes (especially for little kids), sunglasses to protect kids from UVA and UVB light rays, and swim shirts to protect most of the arms, the back, and the chest.

UV Rays from the sun are harmful, but the heat as a result can be even more so. What are some signs of heat exhaustion and heat stroke that parents should be looking for, what can parents do to ensure their child does not experience these conditions, and what can parents do in the event that their child is experiencing heat exhaustion or heat stroke?

The most important thing is prevention which really involves drinking enough fluids. The body has a pretty good mechanism for getting heat down in the system, but it needs fluids to be able to send blood out to the fingers and the toes so that it can sweat and it can radiate heat off of there. So, again, the most important thing is keeping your kids well-hydrated.

The best way to tell if your child is hydrated is if the kid’s urine is kind of light yellow to clear. We always tell the kids ‘We want lemonade, not apple juice,’ so if it’s really dark and heavy, then you know that they’re not getting enough fluid.

Now, even with adequate hydration, the higher the temperature gets and the higher the humidity, the harder it is for kids to actually avoid heat problems. The first heat problem that you usually see is heat exhaustion. Signs of heat exhaustion include crankiness, tiredness, simply not feeling well, and excessive sweating. When you see them start to get really tired and not feeling great, you’ll want to get them out of the heat and try to get a fan, cold fluids to drink, and some ice bags to put in the underarms or the lower abdomen as that can sometimes help. It can also help to move them to an area where there’s wind blowing on them because that air blowing on them will help to facilitate the evaporation of sweat, which helps to cool them off.The more wind you have, the more sweat you evaporate, the cooler you get.

Now if internal temperatures continue to increase without any remedies, heat exhaustion can turn into heat stroke. This is where the body’s mechanism doesn’t work anymore because they don’t have enough fluid. Kids suffering from heat stroke can tend to visually look really look sick, will stop sweating and actually look dry, become really lethargic and out of it and experience internal temperatures go up to 107 or 108, which becomes a medical emergency with the potential of real organ damage or even worse. So if you get to that point where the kids are really looking sick, are not sweating, or are not able to answer you, that’s a 911 call.That’s a medical emergency that has to be dealt with right away.

Environmental hazards are some of the lesser obvious threats to a child’s safety during the summer. For bug safety specifically, what are some tips you can share for parents trying to protect their children from bugs so that they can enjoy being outside?

I’m not a big fan of using bug sprays on children because the neurological side effects that we’ve seen. So you definitely want to be careful with bug sprays. However, if you do plan to use bug spray, find one with DEET in it. In under 30% concentrations, there’s pretty good evidence that it’s safe but I’ve just never been thrilled with using absorbing bug sprays on kids. Most bugs in this area are really not much of an issue. So even though the kids get bitten a lot, I will often tell parents that I’d rather have them get bug bites than get the bug spray. In the rare case that I do use a bug repellent, I actually only use them on the clothes instead of directly on the skin.

Also, you definitely don’t want to use a bug spray that’s mixed with sunscreen. You only want to use bug spray once a day, and if you have the bug spray mixed with the sunscreen you may end up using it in excessive amounts.

Ticks are also something to be on the lookout for as they are all around. Ticks generally come in two sizes. One is the bigger size, the dog tick, which looks more like a sesame seed, and the other is the deer tick, which looks like a poppy seed. The smaller ones are the ones that can give you Lyme disease. Getting bitten by a dog tick or finding an engorged dog tick is not a big deal, but the smaller ones are really the ones we worry about.

If the tick has been on the skin and engorged for more than a day or so, we’ll sometimes treat those kids with a single dose of antibiotics. Most of the time you can just clean it up and cover it with a little Band-Aid and some antibacterial ointment and you’re OK.

The summer is the perfect time play outside and enjoy the weather, but even everyday play items can pose risks. What are some potential hidden hazards when it comes to everyday play items and games that children typically enjoy?

The biggest hazard by far is trampolines. Everybody loves trampolines as they are a wonderful outlet to keep kids active and away from staying inside playing video games, but they can really be a source of injury (even if you have the sides up). Every couple of years we see serious trampoline injuries such as a neck injuries that leave children paralyzed. That’s why you really have to be careful with trampolines. So, even though I’m not a big fan of them, I’d much rather kids play on trampolines than sit around and play on their iPads all day as long as they are being supervised.

I also think that riding bikes and scooters is great, but parents need to ensure that their kids are wearing a helmet. It is also important to wear shoes when riding bikes. I can’t tell you the number of times I’ve seen kids riding bikes in flip flops or bare feet who get caught in the spoke. I don’t worry about the elbow pads and knee pads and all that. You’re going to fall. You’re going to scrape your knee. That’s OK. But again, helmets and shoes are really important for kids when they’re on bikes, scooters, or anything else like them.

When it comes to playgrounds, you have to be careful around swings. Kids have this tendency to walk out in front of somebody swinging and get kicked in the head. This is especially true the younger they are. Additionally, you have to be careful with playground slides and the heat. Slides can burn kids if they get too hot. I mean, all of us old people always talk about the fact that we used to have these two-story, all-metal, slides that we would ride down where you could just feel your thighs burning the whole way, but you still have to be careful with the heat on these new slides as well

Closing Words

I always tell kids, especially school-age kids, that their job in the summer is to come home every day and have their parents ask them ‘How did you get so filthy?’ Every day they should be out there getting sweaty, getting dirty, and staying active! Let them enjoy the summertime. Keep them away from the screens, the iPads, and the video games. Let them go out there and run around and play. It’s the best time of year for them to do that and I really love to see them get out there and play. That’s their job.

About Dr. Harkness

Dr. Michael Harkness is a general pediatrician at the Paoli office of Nemours Outpatient Pediatrics. He has been a general pediatrician for over 35 years and enjoys working with parents to help children grow up to be their best selves. He has a special interest in sports medicine and child development. He also has a passion for teaching medical students how to care for children of all ages.