Sun Safety

Sun safety for kids is very important as the temperatures rise. Children and teens are exposed to the sun a lot more in the summer due to popular outdoor activities. The key to keeping your child safe during the summer is to minimize sun exposure and remember to use sunblock with a high sun protection factor (SPF).

Minimizing sun exposure

It’s healthy and important for children to play outside. The key is keeping your child’s skin safe from the sun’s ultraviolet (UV) rays when he or she is in the sun. Here are six tips for reducing sun exposure:

  1. Do not go out in the sun during peak hours (10:00 a.m. to 4:00 p.m.).
  2. Apply sunscreen 30 minutes before going out into the sun. Reapply every two hours and after swimming or sweating.
  3. Chemicals to avoid in sunscreens: oxybenzone, octinoxate, octisalate, octocrylene and homosalate. These chemicals can cause allergic skin reactions and change hormone function in the body.
  4. Wear a hat and/or sun-protective clothing specifically designed to shield against ultraviolet rays (which can cause sunburn).
  5. Sun protective clothing provides ultraviolet protection (UPF) of 30 to 50+. This blocks 96 to 98% of the sun’s harmful rays.
  6. There’s no need for sunscreen when your child’s body is covered with UPF clothing.

Applying sunscreen

The American Academy of Dermatology recommends that everyone use sunscreen that offers broad-spectrum protection (protects against UVA and UVB rays), has a SPF of 30 or higher and is water resistant. It’s easy for families to skimp on the amount of sunblock they apply to their kids. Putting a large amount of sunblock on your child or teen just once for the whole day is not enough. Everyone needs sunscreen, except for babies less than six months old because they should not be exposed to direct sunlight. It is also important to use a lip balm that has SPF in it as well. Just like your body, lips can get sunburned as well.

When applying sunscreen to your children, even teenagers, one ounce is the proper amount. That is the same amount it takes to fill a shot glass. The amount can vary based on the size of the child but this is the general amount to follow. Apply the sunscreen to dry skin 15 minutes before going outdoors. Re-apply sunscreen every two hours or after swimming or sweating according to the directions on the bottle.

Sunscreen should be worn everyday even when it’s cloudy. Use precaution when near water, snow and sand. They reflect the damaging rays of the sun, which can increase the likelihood of sunburn. If your children are in the sun, they should wear protective clothing and stay in shady areas. It’s especially important to keep teens away from tanning beds because the ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If teens want to look tanner they should use a self-tanning product like a lotion.

Recommended sunscreens

Be sure to look for a broad-spectrum sunscreen with an SPF of at least 30 that contains zinc oxide and/or titanium dioxide. We suggest the following:

  • Alba Botanica Kids Mineral Sunscreen, SPF 30
  • Blue Lizard Australian Sunscreen, Baby, SPF 30+
  • COOLA Baby Mineral Sunscreen Unscented Moisturizer, SPF 50
  • Bare Republic Natural Mineral Sunscreen, SPF 50
  • La Roche-Posay Anthelios 50 Mineral Ultra Light Sunscreen Fluid, SPF 50
  • Beauty Counter All Over Sunscreen, SPF 30
  • Neutrogena Pure and Free Baby, SPF 60+
  • California Baby Super Sensitive Sunscreen, SPF 30+
  • Thinksport for Kids Sunscreen, SPF 50+
  • Babyganics Mineral Based Sunscreen, SPF 50+
  • Goddess Garden Kids Sport Natural Sunscreen Lotion, SPF 30
  • Kiss My Face Organics Kids Mineral Sunscreen Lotion, SPF 30

It’s important to remember that your child’s skin is more vulnerable to sun damage than your skin. By following these recommendations for sun protection, you will help protect your child from burning and other skin damage.


Hand, Foot and Mouth Disease

Hand, foot, and mouth disease (HFM) is an illness caused by coxsackievirus which is spread from person to person. It can affect anybody, but it is most commonly seen in young children. HFM tends to spread more during the spring and summer.

How do I know if my child has hand, foot and mouth disease?

Symptoms can include:

  • Painful mouth and throat sores, that can sometimes be hard to see
  • Drooling (caused by painful mouth and throat sores)
  • Decreased eating and drinking
  • Rash on the body consisting of small red bumps or fluid-filled blisters, appearing most commonly on hands, feet, and buttocks
  • Fever (typically less than 102 degrees)

Is hand, foot and mouth disease dangerous?

Most children with HFM get better without any complications. The main risk is dehydration as children will often refuse to drink because of the painful mouth sores, but this can usually be managed at home with over-the-counter pain medication. Serious complications, such as meningitis, are rare.

How is hand, foot and mouth disease treated?

HFM goes away on its own, and because it is a viral illness, antibiotics will not work. You can, however, treat the symptoms.

Using the over-the-counter medications acetaminophen (Tylenol®) and ibuprofen (Motrin®/Advil®) to treat and control your child’s pain can be very effective. Ibuprofen can be given to children over 6 months old every six hours, and acetaminophen can be given every four hours (only 5 doseds in 24 hours, though). Some children experience the most relief from alternating these medications every three hours (for example, give acetaminophen,  then three hours later ibuprofen, then acetaminophen three hours after that, and so on).

Do not wake your sleeping child to give medications, but if they wake up uncomfortable, treat them. It is okay if your child does not want to eat much while they are sick, but they do need plenty of fluids. Cold fluids often feel the best on sore throats.  Avoid citrus and salty foods. The rash is usually not bothersome and does not typically need any topical treatments.

When should I call my child’s primary care provider?

If you are worried, you are never wrong to call or make an appointment with your child’s provider. Call your child’s provider immediately if your child:

  • Is dehydrated: look for dry lips and mouth or decrease in urine output (your child should make urine at least every six to eight hours)
  • Is listless or you are concerned about how sick your child looks, especially if he/she does not perk up after a dose of ibuprofen or acetaminophen
  • Has a stiff neck
  • Has a fever of more than 105 degrees, a fever that lasts more than two to three days, or is under 3 months old with a fever of more than 100.3

How long is my child contagious?

Children are most contagious at the beginning of the illness. Although viruses may last longer, children can go back to childcare once the fever has been gone for 24 hours and they don’t have open sores. I typically recommend waiting to return to childcare until after the rash stops spreading, but it does not have to be completely gone. The rash will slowly fade over the course of a week or so. Hand washing and disinfecting surfaces and shared objects are the best ways to help prevent transmission.

Helping Kids Who Are Afraid of the Dark

Being afraid of the dark is a very common complaint among young children and one worth addressing. Helping a child overcome this fear can give them confidence that they can face other fears in the future. Some children develop a fear of the dark without any specific reason. Others can point to a specific event, such as hearing a scary story, watching something scary on TV or living through a difficult experience, which started the problem. Regardless of how it starts, there are a few steps that parents can take to help their child in this area.

Listen to your child

The first important step is to listen to your child. Try not to be dismissive, even when you are trying to be helpful. Simply saying, “There’s nothing there, don’t worry and go back to bed” might make your child feel as though you don’t understand or feel empathy for him. It is more helpful to ask your child to tell you what they are afraid of. Let them know that you understand it can be scary in the dark. Allow your child to talk about the experience and listen, reflecting back what you hear.

For instance, listening calmly and then saying things like, “It sounds like you are scared when you can’t see anything because you are afraid something scary will be in the corner of your room. I can imagine that doesn’t feel very good.” Listening and showing empathy demonstrates that you take your child’s fears seriously and care that he is upset.

Don’t try to explain your child’s fears away simply by looking under the bed, in the closet, etc. This emphasizes the feared object, rather than the fear itself. It’s not very productive and may even make the problem worse.

With that caring and compassion, you are then free to help your child move past this fear. The first step is to help them confront the fear. Avoidance – for example, just allowing your child to sleep with a light or television on or sleeping in the room with them – can make the fear worse and certainly won’t help it go away. This also teaches children that avoidance is a worthwhile way to deal with a fear, which is not the case.

Read a story

Another easy place to start is to read a story or watch a video about being afraid of the dark. Since it is a common problem, there are lots of stories out there! For example, there is a good episode of “Daniel Tiger’s Neighborhood” on PBS where he learns not to be afraid of the dark, or try the book “There’s a Nightmare in My Closet” by Mercer Mayer. This gives a starting place to talk about how the things you think are scary might not be as scary as you imagine.

Problem solve

The next step is a great opportunity to teach your child problem-solving skills and ways to cope with fears. A good starting point is to ask your child what might help him feel less scared of the dark. A small (not too bright) nightlight, having a stuffed animal, a comforting bedtime routine or an object that empowers them (for example, some kids like a magic wand), are all some possible examples. You might be surprised at your child’s creative answers! Praise him for coming up with good ideas.

You can remind your child that he has a wonderfully creative imagination that helps him play, draw and tell stories. You can tell him that he should be glad he has such an imagination even though it sometimes means his mind plays some tricks on him. Help him learn to laugh at his mind’s ideas and start to tell himself what an interesting idea it is that there could be a monster under the bed. He can tell himself that even though it’s not true, his mind has done a good job thinking up an interesting story.

Praise your child

Last, but not least, praise your child for making an effort in any of these areas. Let him know you are proud of him for facing his fears. Also be sure to praise yourself for teaching your child not to feel bad when he is afraid of something, but to have the confidence and skill to learn more about it, challenge his own assumptions and come up with solutions to the problem. If you child can do that, he will be well equipped to handle many things in life!

Spring Allergies

As we welcome the warm weather of spring and watch flowers blossom in our backyards, we also understand that for some, spring is just the beginning of an uncomfortable allergy season. It can be anguish for children, who watch the weather change, and feel the daylight hours extend, only to be held back due to allergies. But there are some simple steps your family can take to help alleviate your child’s springtime allergy symptoms.

  1. Be proactive about body protection.

Prevention is the best way to avoid allergy-triggering stimuli like pollen and dust. Give your children sunglasses to prevent watery, itchy eyes, and avoid wearing clothing made of synthetic fibers, like polyester, nylon and spandex. When returning indoors for the day, take a shower to wash off anything that may trigger a reaction and to prevent pollen from lingering on clothes or in hair.

  1. Administer allergy medication in advance.

Antihistamines will be your go-to for managing allergy symptoms. Some antihistamines are short-acting, and some are on a time release, lasting up to 24 hours. They are safe for kids when administered correctly, so pay close attention to the drug facts on the back. Non-sedating antihistamines can be used during the day without causing drowsiness. Also note that:

  • It’s best to start allergy medication early before the allergy season starts. This will give the medication time to kick in, reducing your child’s discomfort.
  • Nasal sprays and eye drops also are good options. If the allergy symptoms still persist, ask your pediatrician about seeing an allergist to undergo allergy testing and discuss other options, such as prescription medication or allergy shots.
  1. Shut the windows and close the doors. 

It’s tempting to keep the doors and windows open in the springtime, but keeping doors and windows open will attract the outdoor triggers that can cause an allergic reaction. Close the doors once inside, and try to keep the windows shut to minimize indoor pollen.


Soothing a teething toddler can be a major concern for parents. Their frustrated faces, loud cries and aching gums all want relief as soon as possible.

Infants typically begin teething when they are 3 to 6 months old, but the “first year molars” usually come when children are 1 to 1 ½ years old. Because these are larger teeth than the first few that come in, they can be a bit more painful. Typical symptoms include an increase in drooling (though kids at this age drool a lot regardless), fussiness, putting things in their mouth (though again, this happens a lot regardless) and trying to chew on things. Often you can see the tooth beginning to break through.

Home remedies for teething pain

Teething tends to seem worse at night or when children are tired, as that is a time when they will be most bothered by discomfort and harder to distract. The gums can be quite sore, especially during the period when the teeth are close to erupting. My personal preference is to try non-pharmacologic remedies first before moving to medication.

What I find most effective is letting toddlers chew on a washcloth soaked in ice cold water. The cold helps with pain relief, and the texture of the washcloth is soothing on the gums. Other cold things can be helpful too – such as drinking ice water or cold fruit, but be careful of small things that could be choking hazards.

Medications and teething toys

There are two main types of teething medication – topical and oral. The topical medicine most used is benzocaine (Orajel). My feeling about this medication is that it is effective but only for a very short period of time. Topical gels can also be dangerous to use because they come with serious risks, such as local reactions or seizures with overdose. Also, benzocaine-containing teething gels should not be used in infants or children under two years of age. For a toddler who is really uncomfortable a teething gel can be a good temporary fix until the immediate pain passes.

Oral medications such as acetaminophen or Ibuprofen are longer acting and can also provide pain relief.

Teething toys can be effective, but are not really necessary. I think the best teething toys are those that you can freeze. If you decide to use teething toys, it’s important to make sure that they really are designed for young children to chew on, without small parts or materials that could break off and become choking hazards.

The most important thing is to remember that the pain and discomfort are only temporary!

True or False?

It is that time of year again. It is cold and flu season and based on TV reports it’s a doozy.

In our home that means hand sanitizers for the kids’ backpacks and lunchboxes. I prefer the ones that hook on the outside so I know my kids see them. Hopefully, they actually use them.

We also make sure that everyone in the family gets their flu vaccine. Oh, and ask my kids about the hand washing lecture. (Insert image of them rolling their eyes and say, “We know. We know” here.) That’s how we arm ourselves in the Horn household. Cold and flu season means helping arm my patients and their families. Sometimes that means I spend a lot of time helping families sort fact from fiction. I’m sharing a little behind the scenes peek at what I tell parents about what is true and what is false.

Greenish mucus means your child has something worse than a cold.
FALSE. It’s just the body doing it’s work. Even though green mucus appears when a child is ill, it does not mean things are getting worse and does not determine the type of infection.

Colds and flu are most contagious before symptoms appear.
FALSE. It’s not that people are more contagious, they’re just spreading illness before they know that they’re sick. A person is just as contagious the day before symptoms appear as they are when the first symptoms arrive.

Colds cause ear infections. 
FALSE. You have something called a Eustachian tube that connects the sinuses with the nasal passages and the middle ear, and colds and congestions can cause that tube to fill and bacteria to grow. The reason kids get more ear infections is because that tube is longer when you’re younger and the angle makes it more likely to get an infection, but when you’re older, it changes so the fluid can drain better.

Not taking care of a cold leads to the flu.
FALSE. The bug that causes a cold is not the same as the bug that causes the flu. Flu is caused by the influenza virus; a cold is caused by a rhinovirus.

Don’t get a flu shot, it will give you the flu.
FALSE. Each year, the influenza vaccine protects against three different strands of influenza as determined by researchers based on the prior year’s outbreak. It is possible to become infected by a strand not covered by the vaccine, even if you get a shot.

Breathing the same air as a sick person, will make you sick.
FALSE. Illness is spread through droplets, not through breathing the same air. Those droplets need to be shared from someone through an act like sneezing or coughing, this is why it’s important to wash hands regularly and use proper hygiene.

Hand Washing!

Handwashing: Best Defense Against Illness

Colds, viruses, and flu abound during this time of year. Keeping hands clean may be one of the most important things you and your child can do for disease prevention.

Hand washing regularly is one of the best ways to prevent the spread of illness and infection.

To help head off avoidable illnesses, you and your children wash your hands:

  • After using the bathroom
  • After sneezing, coughing, or blowing your nose
  • After changing a child’s diaper or cleaning a child who has used the bathroom
  • Before, during, and after preparing food
  • Before eating food
  • Before and after touching someone who is sick
  • Before and after treating a cut or wound
  • After working and playing with your hands

In terms of how long, the longer the better when it comes to washing.

Cover your palms with soap and water, rub your hands together and scrub. It can take 15 to 30 seconds to scrub. To help a child remember to scrub for awhile encourage them to hum the Happy Birthday song or the ABC song twice.

The right way to is to make a lather and scrub, making sure children scrub the back of their hands, between fingers and under their nails.