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Healthy Kids
Playing it safe in the sun

There's nothing quite like sunny summer days in Oregon. People are drawn outdoors, often for hours at a time. However, too much sun exposure can lead to painful burns and an increased risk of skin cancer.

"Everybody can get skin cancer, so it's absolutely important that kids and adults use sunscreen in the summer," says Dr. Pilar Bradshaw. "Make putting it on part of your morning routine."

Why is sunscreen so important?
The sun gives off two types of UV radiation that damages cells in our bodies. UVA rays play a big role in prematurely aging our skin, while UVB rays lead to burns. The amount of UVA radiation remains consistent throughout the year, but UVB varies depending on the season, and it's most intense during the summer.

Dr. Bradshaw recommends choosing a "broad spectrum" sunscreen with a sun protection factor (SPF) of 30 or higher. Broad spectrum protects against both UVA and UVB rays and SPF 30 or higher means it will repel more than 97 percent of the rays that burn.

"My favorite sunscreens, as a pediatrician, are the creamy ones because they go on better," Dr. Bradshaw says. "The sprays often don't go directly on the kid, or they don't go on evenly and it's hard to see that."

Be sure to reapply sunscreen at least every two hours, especially if your children are perspiring or have been in the water.

Additional sun protection tips
Wear sun-protective clothing when possible, including a hat with a wide brim and sunglasses. And be sure to monitor the time your family spends in the sun, especially children under six months old.

"Babies can easily overheat, so it's better to keep them in the shade, as much as possible. And, really, that's my recommendation for kids and adults of all ages," says Dr. Bradshaw.

The sun's rays are at their strongest between 11 a.m. and 3 p.m., so avoid sun exposure during those peak hours. While clouds do reduce some of the sun's UV rays, they don't block all of them, so be aware that you can still get sunburned on overcast days. Also, reflective surfaces, like water, intensify UVB rays and their effects on the skin.

Soothing a sunburn
If your child does get sunburned, aloe gel or moisturizing creams may provide comfort, along with cool baths or cool, wet compresses.

"Giving older children Advil or Motrin, as directed, or Tylenol to younger kids, can be helpful for pain and discomfort," Dr. Bradshaw says. "If the burn blisters, it's recommended that you see your doctor."

Be prepared for sunny days
To make sure you always have sunscreen on hand, keep it in your vehicle's glove compartment or first-aid kit. Be sure to monitor the expiration date. Once sunscreen has expired, the ingredients may be less effective.


Playing safe around water

During the summer, more kids spend time playing outside around water than any other season of the year. While it's a great way to cool off and have fun, water also can be dangerous, especially for younger kids. Drowning is the leading cause of unintentional death in children ages 1-4.

"If you've ever gone to the public pool with your child when it's busy, it's kind of like a 'Where's Waldo?' situation. It's very difficult to visually keep an eye on your kid; it takes tremendous concentration," says Dr. Pilar Bradshaw.

Make supervision a priority
To help protect your children around any body of water, keep a vigilant eye on them. Designate one adult whose sole responsibility is to supervise kids in the water.

"Put your phone away. This is not a time to be reading a book or working on your laptop. If you're with other adults, don't get distracted by conversation. The designated 'watcher' should have their eyes and attention on the water," Dr. Bradshaw says.

Never assume that a child who knows how to swim is not at risk for drowning. All kids need to be supervised in the water, no matter their swimming skills. If a child is under the age of 5, the supervising adult should be within arm's length, providing "touch supervision."

Wear life jackets
Invest in properly fitting, Coast Guard-approved life vests, and have kids wear them whenever they are near water. Pool toys, water wings and other floaties are not reliable flotation devices and may give children and parents a false sense of security.

"Do not depend on inflatable swimming aids," says Dr. Bradshaw. "The only thing that we believe really helps keep kids safe in the water is an actual life vest."

Additional safety around pools, spas and hot tubs
From Memorial Day through Labor Day 2017, at least 163 children younger than age 15 drowned in swimming pools or spas, according to media reports compiled by the USA Swimming Foundation. Of the 163 reports, nearly 70 percent were children younger than age 5. If your family has a pool, spa or hot tub, or will be spending any time around one, follow these safety tips.

Boating and open-water safety
Lakes, rivers and the ocean are also popular destinations for family fun. If you and your children will be boating or swimming in open water, the American Academy of Pediatrics provides these safety recommendations.

Other sources of standing water
Young children can drown in less than 2 inches of water. That means even small sources of standing water can pose a risk.

"A toddler's head is large; it will tend to fall in first. Their face and airways are small, so even in just an inch or two of water, they can drown quickly," says Dr. Bradshaw. "That means, your pond, your wheelbarrow, buckets full of water from the winter, anything that has water in it is a hazard to small kids."

What to do in a drowning emergency
While you hope it never happens, it's important to know what to do in an emergency. Familiarize yourself with these tips to help you prepare. For more information on local CPR training and swim classes, click here.


Interpreting toddler behavior

Toddlers often behave in ways that baffle their parents. Does your child insist on watching the same movie or TV show a gazillion times in a row? Or insist you read him or her the same book over and over? There's a method to your little person's madness, and it's developmentally normal.

No means no
Like many children, 16-month-old Carter Davis loves to play outside. He's active, and he keeps his mom, Ashley, on her toes.

"He's all boy, and he's always on the go," Ashley says. "He loves to play in the dirt. And he likes to eat the dirt occasionally, too. He's always putting things in his mouth."

As Carter's language skills develop, he's exerting himself more and more vocally, and Ashley knows it won't be long before he picks up and latches onto the word "No!"

As frustrating as this word can be for parents to hear over and over, Dr. Pilar Bradshaw says toddlers are not trying to be negative. Developmentally, they're trying to establish their independence and gain some control in a world where they have very little. She says one way moms and dads can work around the constant barrage of "no" is to give toddlers choices whenever possible.

"For example, say 'You choose—do you want to wear the red shirt or the blue shirt?' That's a good way to do it," Dr. Bradshaw says. "Don't ask them if they want to get in their car seat, because that's not a choice. Don't present a choice when there isn't one. That way, your child will feel like they do have some choices, but they will be less likely to fight you about the things that are important."

Creatures of repetition
Another typical toddler trait is a thirst for repetition. This fascination with repeating tasks and activities is likely why your child wants to watch Moana on a continuous loop, while the last 49 showings were plenty for you.

"Carter always wants down, so he can go back up the steps. It's just constant, up and down, up and down," Ashley says. "Or he wants his shoes on, and then he wants to take them off so he can put them back on."

While repetition can wear parents down, it's comforting for your toddler. They rely on repetitive behavior to know what's coming next—and it's fun to them. Dr. Bradshaw says parents can use repetition to their advantage by creating routines.

"Bedtime routine, dressing routines, eating routines. As many things for your 2-, 3- and 4-year-old that you can make similar, from one day to the next, will increase the likelihood that they're going to cooperate and help you."

Socially embarrassing behavior
It's not uncommon for toddlers to exhibit behavior in public that is, shall we say, cringe-worthy for parents: like nose-picking, eating food off the ground or striping down to their diaper and running around naked.

This, too, is normal exploration for your child. Toddlers are not well-versed in social rules, and they're likely to do these things whenever and wherever the mood strikes them, even at a birthday party or in the grocery store.

"Parents can get freaked out or upset with their toddler for doing something that, to the child, seems really natural, like picking their nose or rubbing their rear end. The reason these behaviors are perfectly acceptable to a toddler is because they haven't yet been taught otherwise," says Dr. Bradshaw.

Self-soothing behaviors
Toddlers often engage in some rather odd self-soothing behaviors before naptime or bedtime, including banging their heads against the wall, rocking back and forth or tugging on their hair. Check out this list of common behaviors and ways parents can best address them.

In most cases, the "strange behaviors" your child displays from time to time are normal and in line with their development. But if you have concerns, talk with your pediatrician.

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