Latest American Academy of Pediatrics Recommendations (2011) for Limiting Sun Exposure in Children & its relevance to indian children

Specific recommendations for pediatricians for Limiting Sun Exposure in Children include the following:

• Health-supervision practices should include advice about UVR exposure, such as avoiding sunburn and suntan, wearing clothing and hats with brims, using sunglasses, and applying sunscreen. If possible, outdoor activities should be scheduled to limit exposure to peak-intensity midday sun (10 AM to 4 PM).
• When a child or adolescent might sunburn, he or she should use sunscreen to reduce the known risks for sun exposure and sunburn, including the increased risk for skin cancer. Sunscreen with a sun-protection factor (SPF) of at least 15 should be applied every 2 hours and after swimming, sweating, or drying off with a towel. People may prefer avoiding sunscreens containing oxybenzone, as these may have weak estrogenic effects when absorbed through the skin.
• Although all children need counseling about UVR exposure, this is particularly true for children at high risk for the development of skin cancer, including those with light skin, nevi, and/or freckling; and/or a family history of melanoma.
• Skin cancer prevention is a lifelong effort, and beginning in infancy, at least 1 health maintenance visit per year should include advice about UVR exposure. All children are at risk for adverse effects of UVR exposure on the eyes and immune system, although not all children sunburn. Especially appropriate times for counseling about UVR exposure include during the spring and summer in northern states, before anticipated sunny vacations, and during visits for sunburns.
• Because outdoor physical activity should be strongly encouraged, this should be promoted in a sun-safe manner.
• Sun-protection practices tend to wane in early childhood. Beginning at age 9 or 10 years, it may be helpful for pediatricians to discuss sun protection with children, together with parents, to encourage joint responsibility for the child's sun protection.
• Infants younger than 6 months should be kept out of direct sunlight and covered with protective clothing and hats. When sun avoidance is impossible, parents may apply sunscreen only on exposed areas. Absorption of sunscreen ingredients may be higher in preterm infants.
• Pediatricians should become familiar with chemical photosensitizing agents. People using these oral or topical agents should limit sun exposure and avoid all UVA from artificial sources. When sun exposure is inevitable, they should wear fully protective clothing and high SPF sunscreen that also blocks UVA wavelengths.
• Breast-fed and formula-fed infants and other children should receive vitamin D supplementation in accordance with guidelines, for a total intake of at least 400 IU of vitamin D daily. Children at risk for hypovitaminosis D may need laboratory testing of 25-hydroxyvitamin D concentration.
• Deliberate UVR exposure to artificial sources and overexposure to sun with the goal of increasing vitamin D concentrations or for other reasons should be avoided.
• Pediatricians should advocate for adoption of sun-protective policies (eg, shaded playgrounds, outdoor time before 10 AM, and allowing hats at schools and child care facilities).
• Pediatricians should support and advocate for legislation banning use of tanning parlors by children younger than 18 years.

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Comments:

These are impressively detailed and well thought out recommendations. Being a tropical country we have a very high rate of UV exposure via sunlight in our children in India. The good news is that being dark-skinned we are naturally protected against high rates of skin cancer by the high melanin content in our skin. However there are a few important points regarding sunscreen usage that should be of interest to everyone.

Sunscreens of around SPF 15 are generally as effective as the higher SPF (& more expensive) ones. However liberal use 15-30 minutes before and repeated use after every 2 hours, swimming, bathing, toweling etc is important.

Avoid Sunscreens below 6 months if possible (though they can be used in sun exposed areas if needed), and avoiding Sunscreens with oxybenzone if possible. The US FDA approves Zinc Oxide and Titanium Dioxide for usage in Sunscreens.

For more information about sunscreens and children safety & UV radiation hazard read theAAP policy statement here

An excellent online toy resource for your child in India

Many parents ask about safe and interesting toys for their toddlers and children.

While a bewildering variety of toys are available in the toy shelfs nowadays in India, choosing the best for our children can be confusing and intimidating.

Many of us try to go for the tried and tested imported brands like Fisher-Price etc.

Doing online search for toys for my daughter, I stumbled upon an excellent company - Early Learning Centre (ELC). This is a Britain based toys manufacturing company creating interesting and somewhat unique toys for children of various age-groups. While as of now, their website does not show any Indian Center, the fact is that these excellent toys are available online at Shoppers Stop website.

Also they seem to be in the process of setting shops in India, and have an outlet in Terminal 3 of Indira Gandhi Airport, New Delhi. The toys are very good build (my daugther's & her cousin's rough handling have not made a dent yet!) and are colorful, musical and quite interesting, I must say.

I would recommend that parents flying out from T3 in Delhi certainly take time out to visit this shop. Others can browse through the online collection at Shoppers Stop. This adds to my costs of flying in & out of Delhi :)

Full Disclosure: I am NOT associated with any of the websites mentioned above. I do not have any financial relationship with them either.

Best Diaper Brands in India - A Pediatrician's Personal Choice

Many parents of young children, especially NRIs (Non Resident Indians) are worried when they come over to India for vacations. They are not aware of what diaper brands are available, and whether the available brands would "suit" the sensitive skin of their toddler/ infant.

A whole range of good quality diaper brands are now available in India. Here is a small selection (in no particular order)

• Pampers
• Pampers (Active) - Imported from Saudi Arabia!
• Huggies
• Momy Poko Pants (Can be worn like an underwear - no need to fasten adhesive strips)
• Wipro Baby Soft - Cloth like feel

Many of the upscale pharmacies in bigger cities also have a wide range of Imported Diapers. Hence I rarely advise parents to carry diapers in from abroad, unless the skin of the child is very sensitive, and allergic to a large number of available brands.

My personal favorite is surprisingly an Indian Brand - Wipro's Baby Soft Diapers. There are two reasons for the same...

1. It actually has a cloth like feel and is thus probably less likely to cause a contact dermatitis / allergic rash.
2. Its drying power is phenomenal, and the diaper remains significantly drier for longer than with other brands.

Full Disclosure: I use this brand for my daughter. I have NO financial relationship with the manufacturers of any diaper brands, including the ones that I am recommending. I have to buy them just like the rest of us :)