Boy with brown hair drinks yellow liquid while mom sits beside.

Dehydration in Kids

We’ve all been there; your kiddo or baby is sick, loses their appetite, and isn’t motivated to drink. You may be surprised to hear that, as pediatricians, we don’t worry so much about a child not wanting to eat, even for a few days! Instead, our primary concern is preventing dehydration. Dehydration occurs when fluid intake is insufficient to meet the body’s needs or to keep up with fluid losses. Small children and babies can go a few days without eating much without any issues, but without drinking enough, they can become dehydrated fast! This is especially true if they have vomiting or diarrhea. Read on for signs of dehydration in kids, tips for preventing and treating dehydration at home, and when to bring them to see a healthcare provider. 

 

Signs your baby or child may be dehydrated:

Early signs of dehydration in kids can be subtle; look for decreased energy, dry lips, dark urine. Other more significant signs include:

  • Decreased urination or wet diapers – less than one void every 4-6 hours
  • Dry lips and mouth
  • Fussy and irritable (even after fever is treated)
  • Reduced or no tears when crying
  • Sunken eyes
  • Flattened soft spot (fontanelle) in an infant
  • Very sleepy or lethargic

When to call your healthcare provider:

  • Fever in an infant under three months of age
  • Any of the above signs not improving
  • No wet diaper or urination in 8 hours
  • Difficulty breathing or very fast breathing
  • Bluish color to the face or lips
  • Very sleepy or lethargic

How do I prevent or treat dehydration at home?

In many cases, encouraging plenty of fluids can help prevent dehydration in kids and babies. If a child has mild hydration, similarly, there are things you can do at home to increase their fluid intake. However, in some situations, it can be too challenging to manage or the dehydration may be significant enough to warrant medical help. Therefore, if your child shows signs of dehydration and is not improving or if they start to show any signs of more significant dehydration, it is best to bring them to a healthcare provider asap. In some cases, the best dehydration treatment involves IV fluids. Remember, dehydration can be life-threatening, so don’t hesitate if you are concerned.

 

Top tips to prevent dehydration babies and kids:

Think about fluid intake early and try to push those liquids before your little one gets behind. 

  • Breastfeeding and bottle-fed babies should be encouraged to eat on their regular schedule and if taking less each feed, then offer feeds more frequently.
  • Don’t give water to babies under six months.
  • Consider an oral rehydration solution such as ORS powders or Pedialyte, especially if they aren’t eating to replenish electrolytes (safe for any age.)
  • Other fluids to try:
    • Half juice/half water (sugary drinks can make diarrhea worse, but may be helpful when diluted if they are refusing other options)
    • Clear broths
    • Popsicles! These can be a great trick for kids since they taste good, and the novelty makes them extra appealing. Pedialyte pops are a pediatrician fav!
  • If your older baby or child is well enough to eat, you can offer foods with added fluids.
    • You can add breastmilk or broth to pureed foods.
    • Puree pouches contain a fair amount of liquid and are easy to eat, even if appetites are low.
    • You can try offering fruits with a high water content, like watermelon.
  • If your child has frequent vomiting, refrain from offering food until they can keep fluids down. Focus on tiny sips of clear liquids frequently. Be sure to provide drinks with electrolytes.
  • Do not give your child medicine to stop diarrhea unless your pediatrician advises.
  • Do not give Pepto Bismol to children under the age of 12 years old. 
  • In a pinch, use a medicine syringe. 
    • For young children and babies who are flat-out refusing to drink, a last-ditch effort can be to administer small amounts of fluid the same way you would medicine. 
    • Using a medicine syringe to the back of the cheek, administer 15-30ml of breastmilk, Pedialyte or ORS every 10-15 minutes.

It can be worrying and difficult when your baby or child refuses to drink, but knowing what to do and what signs to look for can help you be prepared and get help when needed. Check out the resources below for more information!

Healthychildren.org – Dehydration

Cleveland Clinic – Dehydration and your child

Kidshealth.org – Dehydration

Close up image of crying baby

RSV in babies and kids

RSV has been all over the news lately due to an early rise in cases this season. Never fear, there is no reason to panic, but it is always helpful to be informed! RSV is not new, it’s a common virus that causes cold symptoms in most of us, but we are seeing more cases and more severe symptoms in some people this season. Read on for more info about RSV in kids and babies, why it is on the rise, and what steps you can take to protect your family. 

 

What is RSV?

RSV stands for Respiratory Syncytial Virus. In most people, it is a virus that causes cold symptoms such as runny nose, cough, and sometimes fever. However, in certain groups, like babies and young kids, it can cause more severe symptoms. Most children have already been infected with RSV by the time they are preschool age. 

Which children are at increased risk for more severe RSV?

In specific populations, especially young infants, RSV can cause inflammation in the lower lungs and small airways, leading to Bronchiolitis or Pneumonia. Children at higher risk from RSV include:

  • Babies under age two, but especially infants under three months
  • Some premature infants that are low birth weight or have chronic lung disease 
  • Children with severe asthma or other chronic lung problems
  • Babies or children with certain heart defects
  • Weakened immune systems due to a condition or medications

What are the Symptoms of RSV in babies and kids?

Symptoms of RSV in the Upper respiratory tract include:

  • Fever (temperature > 100.4)
  • Cough
  • Runny nose
  • Sore throat
  • Decreased appetite
  • Fussiness 

Symptoms of Bronchiolitis or RSV in the lower respiratory tract:

  • Cold symptoms, in addition to signs of respiratory distress:
    • Wheezing
    • Rhythmic grunting with breathing
    • Fast breathing
    • Head bobbing with breaths
    • Using extra muscles to breathe, which looks like belly breathing or pulling in under the ribs and above the sternum.
    • Flaring of the nostrils

How is RSV diagnosed?

Healthcare providers diagnose RSV by asking about your child’s symptoms and performing a physical exam. There is also a nose swab test for RSV. If your child has symptoms of lung congestion or is showing signs of bronchiolitis, they may also check an oxygen level and possibly order a chest X-ray. Most of the time, since RSV is usually mild and resolves on its own, further testing isn’t necessary. However, if your child is at risk for more severe symptoms or lives with someone at higher risk, it may be worth asking your doctor about a test for RSV. 

How to treat RSV?

Just like a common cold, there is no cure for RSV. However, things that can help your child feel better include what would help with any bad cold:

  • Nasal saline and suction
  • Medicine for pain or fever, like Acetaminophen (Tylenol) or Ibuprofen (Motrin, only in babies over six months)
  • Honey for cough if your child is over age one year.
  • Humidifier
  • A menthol-based chest rub may be helpful if your child is over the age of two years.
  • Plenty of fluids/frequent small feedings in infants

 

When should you call your doctor?

Call your doctor right away if your child has any of these symptoms:

  • Signs of bronchiolitis
  • Difficulty breathing or pauses in breathing
  • Bluish color around the mouth
  • Signs of significant dehydration – less than one wet diaper every eight hours, not making tears, dry mouth and lips
  • Persistent fever or symptoms not improving after seven days

Why does RSV seem so much worse this season?

RSV is not a new scary virus; it is around yearly, typically in fall to early spring. However, one reason there seems to be such a boom in cases is that the safety precautions we practiced during the height of the COVID-19 pandemic also protected us from spreading RSV and other respiratory viruses. As a result, cases of RSV and other viruses significantly decreased over the last couple of years. Since most regions began lifting requirements for masking and distancing last year, we are seeing RSV and other respiratory viruses re-emerge in full force! In addition, many children in daycare or school who typically would have already been infected are now being exposed for the first time, which can mean their symptoms are more severe. 

How can you prevent RSV?

RSV spreads in the same way a cold does, through droplets from someone who is infected with the virus. Steps to take to help protect your family from RSV include:

  • Good hand hygiene – Teach your family to wash hands well and frequently with soap and water or an alcohol-based hand sanitizer.
  • Limit exposures – If you have a young infant, avoid crowded places during the cold and flu season and keep them away from anyone with cold symptoms. Keep kids home when sick and show them how to cough and sneeze into their elbows. 
  • Immunizations – Although there is not currently a vaccine against RSV, you can help keep your child healthy by ensuring they are up to date with their other immunizations, including a yearly flu shot. In addition, if you have a newborn or young infant at home, adults who spend time in close proximity should be vaccinated against the flu and make sure their Tdap vaccine, which protects against whooping cough, is up to date.
  • Protect your child from secondhand smoke exposure.
  • Breastmilk has also been shown to decrease the frequency of particular infections by providing antibodies. 
  • There is a monoclonal antibody treatment for high-risk babies, such as very premature infants or those with chronic lung disease. 
  • In addition, trials are underway for an RSV vaccine with some promising preliminary results.

As always, if you have concerns about your child’s specific risks or symptoms, talk with your pediatrician. We wish you a happy and healthy start to the holiday season! Remember, wash your hands, stay home when sick, and get your flu shot!

 

More resources:

CDC – RSV in infants and young children

Healthychildren.org – RSV

Child stands with mouth open wide covering his eyes.

Sore throat in Kids. Is it Strep?

Sore throats are a common symptom in kids and can be a real pain. However, did you know not every sore throat is strep, and not every sore throat needs antibiotics? Fortunately, most sore throats will go away on their own. However, if your child has a sore throat, there are some things you can do in the meantime to help your little one feel better. Read on for more info about what strep throat is, how it is diagnosed and how to treat strep and other causes of sore throat!

What is a sore throat?

A sore throat refers to pain and inflammation of the throat (pharyngitis) or tonsils (tonsillitis.) Most of the time, sore throats in kids are caused by common viruses. 

What is strep throat, and is it contagious?

Strep throat pharyngitis or tonsillitis is caused by a bacteria called streptococcus. Strep throat is not common in kids under the age of two years. Strep throat is contagious and easily transmitted from bacteria present in the droplets of an infected person, so it is best to keep your child with strep away from others. As with any infection, practice good hand washing and clean shared surfaces.

What are the symptoms of strep throat?

The main symptoms of trep throat are due to inflammation in and around the tonsils. The main symptom is a sore throat, but this may not be the primary complaint in young kids. Other common symptoms of strep throat include:

  • Fever
  • Headache
  • Stomachache
  • Swollen lymph nodes (‘glands)
  • Fatigue
  • Rash

What symptoms do not usually occur with strep throat?

Strep bacteria doesn’t usually cause other upper respiratory symptoms. Therefore if your child has the following symptoms, strep throat is less likely:

  • Cough
  • Runny nose
  • Ear ache
  • Vomiting and diarrhea

How is strep throat diagnosed?

When a healthcare provider is evaluating your child for a sore throat, they will likely do the following things to determine the cause:

  • Physical exam
  • Vital signs, including temperature
  • Rapid strep test
  • Throat culture

How does a rapid strep test work?

  • With a rapid strep test, a healthcare provider swabs the back of the throat with a long cotton swab and the test gives a positive or negative result in 5 minutes or less.
  • If the test is positive, it is very reliable, and your child will likely receive antibiotics to treat strep throat. The only caveat is that some people are “carriers” of strep, meaning they have some streptococcal bacteria in their throat all the time, and it is not causing their current symptoms. Therefore, if your child continually tests positive for strep, it is worth discussing with your healthcare provider whether they could be a carrier, which may alter the treatment plan.
  • When a rapid test is negative, this either means they don’t have strep and the pain is due to a virus or that not enough bacteria were picked up by the rapid test. Often the next step would be a throat culture.

What is a throat culture?

A throat culture involves sending a swab sample from the back of the throat to the lab. In the lab, they watch the culture to see if bacteria grow. They check for growth at 24- 48 hours and can determine whether or not it is strep throat. 

How is strep throat treated?

  • Antibiotics
    • The mainstay of treatment for strep throat is an antibiotic to treat the bacteria.
    • In most cases, the infection would likely resolve eventually without antibiotics. However, if untreated, there is an increased risk for prolonged illness or other complications from strep throat, such as rheumatic fever.
    • Remember, antibiotics only treat bacterial infections, so if your child’s strep test is negative, antibiotics will not help. 
  • Pain relievers
    • Treating the inflammation and discomfort of a sore throat can help your child feel better quickly. 
    • Acetaminophen(Tylenol) and Ibuprofen (Motrin) are over-the-counter pain relievers that can help. 
  • Fluids
    • Hydration is essential during any infection. 
    • Your child may need extra encouragement to drink if swallowing is painful. One benefit of ensuring their pain is well controlled is that they will be better able to stay hydrated. 
    • Warm tea, broth, ice-cold liquids, or even popsicles are sometimes tolerated better than room-temperature fluids.
  • Other helpful tricks
    • Lozenges for older children may help keep the throat moist and provide some relief.
    • Saltwater gargles for older children who can gargle and spit may also be helpful for temporary relief.

How can I treat other sore throats that are caused by a virus? 

  • All of the above, except for the antibiotics! 
  • Remember, antibiotics only work on infections caused by bacteria. They do not affect viruses. 

What are other causes of a sore throat?

Other viral infections are the most common causes of sore throat. Less commonly, other types of bacterial infections can lead to sore throat as well.

  • Common cold viruses can often cause pharyngitis.
  • Coxsackie virus causes hand-foot-and-mouth disease and can lead to sores in the mouth and throat that cause pain.
  • Infectious Mononucleosis, also called “mono,” can cause various symptoms, including severe pharyngitis and tonsillitis.
  • Croup is a viral infection that causes inflammation in the upper airway leading to a barky cough, sore throat, fever, and congestion.
  • Abscesses or severe swelling are a less common result of strep throat or other bacterial throat infections that can lead to swelling in the back of the throat. These can be dangerous due to the potential to block the airway. 
    • If your child has a severe sore throat, fever, difficulty swallowing, or noisy breathing, they should be urgently evaluated by a healthcare provider. 

My child gets strep throat a lot. Do they need their tonsils out?

Tonsillectomy, or the removal of tonsils, was historically common practice for children with multiple episodes of strep throat. However, it is only recommended now in extreme cases because the procedure’s risks often outweigh the benefits. Talk with your doctor if you are concerned your child may need a tonsillectomy. 

 

More resources:

CDC – strep throat

 

Healthychildren.org – Strep throat or Sore throat

Child sleeps while parent sits aside them with a book in their lap.

Five tips to promote better sleep

Most kids are back to school now, and many of us parents are still trying to get everyone back into the swing of things! After a fun summer, sleep schedules and routines may have fallen off a bit. We know sleep is essential for overall well-being and mental health, but it can be hard to know how to get our kids and ourselves back on track. Have no fear. Here are five tips to promote better sleep to help the whole family thrive this school year! Keep in mind these tips apply to parents’ sleep too!

Timing is everything!

  • Set a consistent sleep and wake time.
  • Having a consistent wake and bedtime helps regulate circadian rhythms and promote better sleep.
  • Circadian rhythms are 24-hour cycles that are part of the body’s internal clock to carry out essential functions including sleep and wakeful periods.
  • Aim for around the same bedtime every night and get up around the same time every day +/- 20-minutes.
  • Yes, this means avoiding letting kids stay up super late and sleep late on the weekends! But you can allow a little wiggle room for the occasional weekend, vacations, or special events. 
  • The point is not to feel stressed or guilty when things fall off the schedule but to aim for consistency whenever possible, so it becomes second nature.
  • Read here for more info on how much sleep your child needs based on age. 

Fill up their cup! 

  • A big part of promoting quality sleep is getting enough daylight, activity, and good nutrition during the day!
  • There is evidence that exposure to daylight, especially before 10 am helps regulate circadian rhythm and promote better sleep. 
  • Better sleep is just one of the many reasons to ensure your kids get at least 60 minutes of active play daily! 
  • Good nutrition helps regulate blood sugar, avoid energy crashes during the day, and fills up those tummies so they can be comfy and content for sleep. Offer three meals and two snacks daily that include some protein and healthy fats in addition to fruits and veggies. 
  • If bedtime is more than 2 hours after dinner, then you may want to offer a healthy bedtime snack that includes a complex carbohydrate and protein as part of your routine—for example, whole wheat crackers and peanut butter. 

Develop a bedtime routine!

  • Bedtime routines help prime us for sleep and wind down after a busy day.
  • If having a bedtime routine sounds daunting, don’t stress. You do not have to have an elaborate ritual for this to work!
  • A few simple activities that happen every night in roughly the same order are all it takes. 
  • For example, after dinner, kids play quietly for 30 minutes, then take a bath, change into PJs, brush their teeth, read books, sing a bedtime song, and put to sleep. 
  • Did you know that there is science behind the bath part of the bedtime routine? Studies show passive warming from a shower or bath before bed promotes better sleep quality and efficiency! 

Set the scene!

  • Help create a welcoming sleep environment to optimize sleep. 
  • The key factors are darkness, temperature, and limiting ambient noise.
  • Light is one of the main factors affecting circadian sleep rhythms! 
  • A darker room promotes better sleep, so consider blackout curtains if your child has windows that let in excess light.
  • Ideal temperatures for sleep are between 68 and 72 degrees. You should also adjust PJ choices, so kids aren’t too chilly or overheating.
  • White noise, soothing music, or nature sounds can be a great way to relax and drown out ambient sounds for sleep.
  • Research studies have also shown soothing scents like lavender or chamomile to help promote sleep. 

Avoid screen time before bed!

  •  The light from screens and stimulation from shows or games can interfere with, you guessed it, circadian rhythms and make it hard to wind down for sleep. 
  • A good family rule is no screens 60 minutes before bed. For teens and adults to leave phones outside their bedrooms and use an old fashioned alarm clock as an alarm instead. 

Hope these tips help the whole family get some more zzzs! If you have concerns about your child’s sleep or possible sleep disorders, talk to your healthcare provider. Check out these resources for more info! 

Sleep Foundation – Light and sleep

Healthychildren.org – Healthy sleep habits

American Sleep Association – Get Better Sleep

Healthychildren.org – Sleep tips for mental health

Group of children walking to school.

Back-to-School: Tips for Parents

Summer break is winding down, and back-to-school is fast approaching. Transitioning from summer to the start of the school year can be tricky for everyone. Read on for a few tips and ideas to help make that back-to-school adjustment easier for the whole family! 

 

Get back on a school year schedule

Ideally, we can maintain a flexible schedule during the summer months. Naturally, though, things will have gotten a bit laxer or, in some cases, totally out of whack! Instead of waiting until school starts to get back on a consistent schedule, it’s best to ease in over the days to weeks before. If the kids have gotten used to staying up, you may have better success gradually moving up bedtimes by half an hour a day over a few days rather than shifting back all at once. And if sleeping late has become the norm, gradually moving up wake-up times simultaneously can help facilitate those earlier bedtimes. Dust off those bedtime routines and morning routines. Aim to give the kids a few days of being close to a school schedule before the first day!

 

Talk about feelings and what to expect

Back-to-school season can bring up many feelings, including worry, apprehension, and excitement about the new year.

  • Normalize feelings: Check-in with the kids about how they’re feeling. Reflect and share how you felt in the past when you had first days! Normalizing feeling nervous can help kids feel less alone.
  • Talk about what will happen: With younger kids, it can be helpful to talk through what will happen on the first day of school as a sort of mental dress rehearsal. With all the changes surrounding COVID 19 precautions it is also helpful if you’re up to speed on the current protocols so you can go over them with your child.
  • New year, new start! If the previous school year had some tricky social or academic challenges, take the opportunity to discuss and address associated worries or questions. Then, make a plan together to help avoid the same struggles. Emphasize that a new year is a fresh start and set a positive tone!

No matter what, make sure kids know it is normal to feel lots of different things and ok to be nervous! Remind them that new things are always a little scary, but things will become familiar and more comfortable in no time!

 

Review school year routines, safety and rules

Day to day routines and rules will likely change when school starts.

  • Review school day ground rules: Some family rules may apply specifically to the school year, like screen time limits, when friends can come over, designated homework time, bedtimes, etc. Routines around bedtime and mornings getting out of the house will likely change when school starts too. Be sure to review expectations and set clear boundaries ahead of time, so everyone is on the same page! Some families find it helpful to write down core household rules and routines as a reminder and put them somewhere everyone can see.
  • Go over logistics and safety around how kiddos are getting to and from school. Whether they will be taking the school bus, joining a car pool or walking to school, it is important to talk about the plan so kids know what to do and how to stay safe. It is a good time to review general safety topics as well. Make sure kids know the designated people that may pick them up from school or from the bus stop and emphasize not talking to or going with strangers. One idea is to have a special safety code word that the kids know not to share and only designated grownups that are allowed to pick them up will use.

 

Start fresh and do a clean-out before back-to-school shopping

A lot of emphasis gets put on back-to-school shopping every year, but it is just as important to take that time to clean out unneeded items and start fresh!

  • Out with the old! Get kids involved with pulling out clothes that don’t fit or don’t wear for the donation pile. It’s a good time to do a toy clean out too. Kids’ interests change quickly, so try to periodically go through toys and donate what they don’t use. This can help keep toy storage more manageable and help facilitate valuable lessons in gratitude and giving.
  • Don’t feel pressured to buy too much! If you need to hear this, you do not have to buy the kids a new wardrobe at the start of every school year! Buying a ton of clothes, they may grow out of before they can wear them feels wasteful. Plus, many of their summer clothes may transition well to fall with layers. That said, growth spurts happen, and some kids are harder on clothes, so you may need to replace more of their wardrobe after all. Try to focus on the specific things they need, a few versatile pieces and layers they can wear in different weather, and maybe something just for fun in the mix. Secondhand is an excellent option for kids’ clothes if you want to limit spending or use a more eco-minded approach. Since kids often do outgrow things before wearing them, many secondhand items can be as good as new!

 

Get organized

In addition to getting rid of old or unused items, help your child start the year off right by helping them organize their spaces.

  • Have kids help set up their work space and organize supplies: It helps bring a sense of control and calm when a space is free from clutter, and things are easy to find. For example, help set up an inviting school work area, get the kids involved in the process, and get their input on how they want it to look and where things should go. Also, help to organize their backpacks and school supplies.
  • Get yourself and the family organized too! If you’re given a school year calendar, add important dates to your personal or family calendar right away. A family calendar placed somewhere visible with necessary logistics like who is doing school pick-up, extracurriculars, and important events can help keep everyone on the same page. Don’t forget about any paperwork due at the start of school. If kids are due for annual health check-ups, dental visits, or need vaccines, get those scheduled asap. 

 

Reach out to teachers

  • Establish a collaborative relationship with teachers: When fall rolls around, it’s nice to finally put a face to the names who will spend so much time teaching and guiding your children during the year. So often, due to frustrations that arise when raising small humans, parents and teachers find themselves pitted against each other when they actually share the same goals. Teachers work incredibly hard under less than ideal conditions to help educate our children, and we owe them respect and kindness! If you get the chance, try to introduce yourself and your child ahead of time. This helps set a collaborative tone and may ease some nerves for your kiddo.
  • Discuss concerns or unique needs your child has ahead of time: It is especially important to communicate early and often if your child has behavioral challenges, unique traits, or special learning needs you feel teachers should know. Being upfront about your concerns or potential challenges helps set expectations. It also may provide an opportunity to troubleshoot and collaborate before challenging situations arise. If you think your child may need special accommodations it is best to start discussions early so there is plenty of time to organize any supports or resources that are needed.

 

For more info on educational resource programs go here.

 

Catch up on rest and family time

Summer break can be a mix of long stretches of downtime and jam-packed activities. Consider not scheduling much the week before going back to school so kids can relax, catch up on rest and get organized for the year. Instead, take the opportunity to set aside some extra family time together before school starts, and everyone gets busy.

 

Start a back-to-school tradition

  • Start an annual end of summer ritual! Kids thrive with routines and traditions, and who doesn’t love an excuse for a sweet little celebration? We love the idea of a back-to-school ritual that helps mark the transition in kids’ minds and is something to look forward to. This practice doesn’t have to be anything elaborate! It can be as simple as a special dinner the night before school starts or having one last outing as a family to a favorite summer spot. It’s also a great time to discuss the upcoming school year and set goals or hopes for the year. As part of the tradition, you can even have them write the goals down so they can look back and see whether they made progress in achieving them. These hopes don’t have to be strictly academic aspirations. Goals can be about new skills or social development, like making one new friend, learning to tie shoes, etc.

 

Transitions and first days will always come with challenges. Still, with a little help, your child can start school knowing all of their feelings are valid and give them the confidence that they have all the tools they need to have a great school year! 

 

Here are some more helpful resources for back-to-school tips to get you and your kiddos off to a great start!

 

American Academy of Pediatrics – Back to School Tips

 

American Psychology Association – Back to School Blues

Two girls lie in the grass holding cups to their ears and mouth.

Common Summer Rashes in Kids

Summer is full of outdoor adventures, lots of water time, and, unfortunately all of this fun can lead to a multitude of skin woes. Here is some info about five common summer rashes in kids, ways to prevent them, and how to treat them. 

Insect bites and stings

Pesky insects can be unwelcome guests during time outdoors, especially the ones that bite or sting! The more common culprits include mosquitos, ticks, and bees or wasps. In most children, these bites and stings can cause itching and pain. However, in some cases, they can cause a severe allergic reaction called Anaphylaxis which can cause symptoms that include hives, swelling, and difficulty breathing and is a medical emergency. If your child has a known allergy to a particular insect bite or sting, make sure to make a plan with your doctor and always carry an epi-pen if it has been prescribed. In addition to causing discomfort, insect bites may also spread certain diseases that can make your child ill, so preventing them as much as possible is a good idea. 

How to prevent it:

  • Avoid sweet-smelling lotions, soaps, and bright clothing if you don’t want to attract insects.
  • Wear long pants/sleeves, hiking socks, and close-toed shoes in areas where ticks and mosquitos are a concern.
  • Insect repellants with DEET up to 30% are safe and effective.

What to do about it:

  • Always do a tick check after time spent outside.
  • Remove stingers and ticks immediately and wash the area with soap, water, or alcohol.
  • Treat inflammation and itch with a cool compress and consider using a soothing topical treatment such as hydrocortisone cream or calamine lotion.

Poison Ivy/Plant rashes

Depending on where you live, certain plants can cause an uncomfortable, itchy, painful rash due to a substance called Urushiol coming in contact with the skin. These are common and rather unpleasant summer rashes but can happen any time of year if someone comes in contact with the particular plants. The typical plants that cause this are poison ivy, oak, and sumac. 

How to prevent it:

  • The best way to prevent plant rashes is to be familiar with which of these plants are in your area and be able to recognize them.
  • Wearing closed-toed shoes, high socks, and long pants and sleeves is also helpful in preventing skin from coming in contact with the plants.

What to do about it:

  • Remove all of the child’s clothing as the oil can remain and continue to cause symptoms.
  • Bathe your child with soap and water for at least ten minutes to remove residual oil.
  • Discourage scratching and trim nails to avoid causing small openings in the skin that can get infected.
  • Apply a cool compress or a soothing topical treatment such as hydrocortisone cream or calamine lotion.
  • Call your doctor to discuss other treatment options if the rash is severe or does not resolve in a few days.

Heat rash

Heat rash is a common summer or warm weather rash caused by clogged sweat glands and happens most often in babies and young children with smaller sweat ducts and a more challenging time regulating their temperature. It causes small reddish bumps.

How to prevent it:

  • Keep little ones cool by avoiding over-dressing them, choosing light, breathable fabrics, and using fans or AC if needed.
  • If you notice hot spots that are red and sweaty, reposition your baby or adjust clothing to allow air to flow.
  •  Wipe hot, sweaty areas with a cool wash cloth.

What to do about it:

  • Gently wipe down affected areas with a cool wash cloth and leave them open to the air.
  • Do not apply lotions or ointments, as these further clog the sweat ducts and potentially worsen the rash.

Eczema

Eczema is a chronic itchy rash that causes dry, red, scaly areas of the skin. We often think of cold, dry winter as a time that exacerbates this rash. However, dry air from air-conditioners and irritants like chlorine from swimming pools make this a common summer rash as well.

How to prevent it:

  • Eczema is a chronic condition, but some things can help keep symptoms from flaring.
  • Moisturize liberally and regularly with hypoallergenic, unscented, emollient lotions. Lotions containing colloidal oatmeal have been shown to help eczema.
  • Avoid irritants like scented soaps, lotions, or detergents.
  • Avoid bathing too frequently, but be sure to at least rinse briefly after swimming in pools with chlorine or sweating. 
  • Cool, breathable clothing fabrics are a good choice when possible.

What to do about it:

  • If the above measures don’t prevent an eczema flare, talk to your physician about other treatment options.
  • Many children with eczema may need a steroid cream like hydrocortisone from time to time to manage exacerbations.

Tinea

Tinea is a rash that is also often called “ringworm.” However, don’t fear, a worm is not the culprit! This common skin infection is caused by a fungus! It’s often called ringworm because the rash can form round or oval spots that become smooth in the center as they grow, leaving a red scaly ring. Similar fungal infections caused by tinea include athlete’s foot and jock itch. Fungal infections are more likely in areas where skin touches or stays damp from sweat but can occur anywhere. 

How to prevent it: 

  • Make sure to change socks and sports gear that is in contact with the skin and gets sweaty frequently to prevent athlete’s foot or jock itch. 
  • Tinea can spread quickly, so treat pets and family members as soon as it is recognized.

What to do about it:

  • Anti-fungal treatment is usually needed to treat tinea.
  • In mild cases, over-the-counter treatment for athletes’ foot or jock itch can be sufficient. It is also important to continue to preventive measures mentioned above that help keep skin dry.
  • Ringworm, however, can be more challenging to treat, and you should talk with your physician about whether you need a prescription anti-fungal medication. 

We hope these tips help you prevent and treat these common summer rashes in kids! Now spray on your insect repellant and head out for a hike! 

 

Healthchildren.org – 12 Common Summertime Skin Rashes

American Academy of Dermatology – 12 Summer Skin Problems You Can Prevent

child in a hat rides in a toy car through a grove of trees

Road tripping with kids

The summer is a great time to travel with the family, but with airline prices and pandemic worries, flights may not seem the most appealing way to journey at the moment. Instead, a good old road trip can be a great way to get a change of scenery without as much hassle. Road tripping as a family can be a great way to travel. You get to go at your own pace and avoid the stress of air travel. However, hitting the road with kids can come with its own complications! So here are some useful tips to help you plan a fun and easy road trip with the kids this summer! 

Set expectations ahead of time! 

  • If you haven’t done many long car rides with the kids before, you can help them mentally prepare by discussing the plan and what it’ll be like in advance. 
  • Make it something to look forward to! Keep it positive and highlight some planned stops along the way or the fun final destination!
  • Be sure to emphasize any challenging situations you anticipate or road trip rules like using the potty before leaving and at stops, keeping hands to ourselves (if you have siblings that tend to bicker), etc. 
  • Let the kids help choose and pack their car supplies depending on their age! What toys do they want to bring? What snacks?
    • Obviously, you get the final say and should give them parameters, so you don’t end up bringing a gallon-sized tub of gummy bears and every toy car they own!
    • For example, “Pick 2 activities and 3 toys you would like to bring.” “Do you want to bring apples or oranges?” “Cheese sticks or peanut butter crackers?”

Strategies for planning departure time and stops:

  • Best time to leave:
    • One strategy is to either leave early when the kids might fall back to sleep for a bit or to leave just before nap time. 
    • This can backfire if kids get over tired, though. 
    • For tricks to help your kiddo sleep in the car, check out “How to encourage car naps” below. 
    • If you opt not to leave early in the morning, try to plan some active time before hitting the road to use up some of that energy!
  • Planning pit-stops:
    • Every kid and every drive is different. Sometimes it is better to keep going if kids are happy or sleeping and see how many miles you can get under your belt. Other times, it may be more important to stop frequently to keep spirits up, get the wiggles out and prevent major meltdowns. 
    • As a general rule of thumb, it is best to stop every 2-3 hours at least to give your little ones a break from the car seat. If you have a newborn or young infant in the mix, you won’t have much choice as you’ll have to stop every couple of hours to feed them.
    • It’s helpful to scope out potential stops beforehand and choose scenic spots with space for kids to run around or playgrounds.

Prepare for messes!

  • Car messes are the worst, but they will happen when road tripping with kids despite your best efforts! Between spills, potty accidents, and bouts of car sickness, the possibilities are endless. 
  • Bring basic cleaning supplies: paper towels or extra wipes, spray cleaner, garbage bags, and at least one handy change of clothes, maybe more if you have an infant! 

Keep them busy!

  • Even though we all hope the littles will just sleep, it doesn’t always work out that way.
  • Pack a few different activities to keep them entertained and avoid the dreaded chorus of “I’m boooored!” 
  • If your family uses screens/tablets occasionally, road trips are a great time to bust them out. Download some kid-friendly movies or educational shows and games. 
  • Other screen-free ideas are books, playdough or silly putty, water wow coloring books, busy books, magnet puzzles/games, simple crafts for older kids, etc. 
  • You might want to invest in an organizational tray that attaches to the car seat, so kiddos have a place to set their activities and snacks.

Snacks!

  • Have we mentioned snacks? Snacks are always a good idea, but can make or break the experience when road tripping with kids!
  • Not only does hunger tend to strike at inconvenient times, but snacks also occupy little hands and keep spirits up! 
  • Pack a variety of healthy snack options and beverages. Maybe don’t go overboard on drinks if you want to avoid excessive potty stops, though! 
  • For snacks, think healthy and satisfying like fruit, cheese, nuts (if your child is over 4 because of choking risk,) crackers, etc.

How to encourage car naps:

Car naps are not guaranteed, but they are definitely appreciated!

  • Incorporate as much of your child’s naptime routine as you can:
    • Sing the same songs,
    • Bring their lovey or blanket,
    • Use a portable white noise machine if they’re used to one at home. And if you don’t typically use one, consider trying it! White noise can greatly help initiate and maintain sleep and also helps with sleeping in different environments. 
  • Make sure the car temperature is comfortable and on the cooler side.
  • Dress them comfortably; consider putting them in lightweight PJs for the drive, take shoes off, etc. 

 

Dealing with Car Sickness:

Car sickness is very common and a frustrating problem for many parents. If your child gets car sickness, try these tips:

  • Give them a light bland snack before the trip.
  • Distract them with stories or music. Screens or books may not be the best choice for children who get car sick.
  • Encourage them to look out the window. For babies, window stickers or toys that suction to the window may encourage them to look outside.
  • Take frequent breaks and allow older children to sit or lie down, give babies a break from the car seat.
  • Talk with your healthcare provider about medications like diphenhydramine (benadryl,) or dramamine that may help. They may cause drowsiness and other side effects so be sure to discuss with your healthcare provider prior to use.

Car seat safety:

Proper car seat safety is always essential, but road tripping with kids is an excellent excuse to ensure yours is up to snuff.

  • Does your child still fit within the weight and/or height requirements? 
  • Has the seat been involved in a crash, even minor? If so, it should be replaced. 
  • Remember, rear-facing is the safest so keep them in this position as long as possible. Kids are flexible, so even if their legs are bent, it is not as uncomfortable as it looks!
  • Go here for more information and tips on car seat use and safety. 

 

Woman hiking with baby in hiking carrier looking out at half dome in yosemite.

Hiking with babies and kids

Hiking with kids is a great way to spend time in nature, get some exercise and have fun together. Time outdoors has physical and emotional health benefits and is good for the whole family! You might decide this is the summer to explore your local hiking trails, or perhaps you’re planning a family vacation and want to get the whole crew out on the trails. Great! Hiking with kids might sound daunting, though. What do you need to bring? How far can they go? What if they hate it? Don’t fear! Read on for our best tips and gear list for hiking with kids, whether you’re a hiking pro or brand new! 

What gear do you need?

Fortunately, you don’t need much for hiking, especially when you’re starting out. Still, it is good to have some essentials and consider additional back country supplies if you start to get into bigger adventures.

Dress for the weather and bring layers!

Remember, there is no bad weather – only bad gear! 

  • Invest in quality outdoor clothing and accessories for kiddos, especially when it comes to cold-weather gear – if they’re comfortable, they’ll enjoy it more!
  • In warmer months, lightweight but full-coverage UV clothing is a great way to protect little ones’ from sunburns and bug bites! 
    • There are many options for stretchy, lightweight footy PJs that work great for babies. 
  • Don’t forget hats and sunglasses for added sun protection!
  • Especially for little ones, it’s a good idea to throw a backup outfit in the pack and maybe an extra shirt for you! Spit-ups and blowouts are always only a hiccup away!

Footwear: 

  • Comfortable shoes with good grippy bottoms and protection from stubbing toes on rocks will do the trick! 
  • It is worth looking into hiking-specific shoes if you are doing more rugged hikes.
  • Hiking sandals are a great option if you plan to hike somewhere warm with lots of water. The kids can tromp around in streams and puddles, and you don’t have to worry about shoes getting wet.

Hiking carriers:

  • For babies and toddlers, it is worth looking into a hiking carrier to carry them more comfortably. 
  • When they are very young a soft carrier or regular infant carrier is fine, but as they get more weight and you do longer hikes you’ll want something with more support.
  • Even if your child is an older toddler and walking, it’s not a bad idea to have a carrier in case they get tired, and you need to carry them out.
  • There are tons of good options these days for every price bracket. 
  • We recommend heading to your local outdoor gear shop and trying some out! 
  • Look for packs that are comfortable and will grow with your child. Comfortable back straps, a waist strap, and a chest clip provide extra comfort and support. 
  • Bonus if they have a removable shade cover and a generous storage pocket or two.

First aid kit/safety supplies:

  • Building a simple hiking first aid kit is a smart investment; bandages, ointment, pain medicines (acetaminophen or ibuprofen,) tweezers. 
  • You can add to it if you decide to do more extensive hikes or overnights like backpacking.
  • Don’t forget sunscreen and bug spray!
  • Baby wipes can serve a variety of purposes so also a good thing to have on hand!

Consider these items for longer or more adventurous hikes!

  • Headlamp
  • Extra layers
  • An emergency blanket and/or shelter
  • Compass
  • GPS device (many have satellite capabilities for use out of cell range)
  • Quick shelter
  • Matches
  • Water filter tabs or filter straw

Tips for hiking with kids!

Start small!

  • Whether you’re getting started hiking with a baby in a pack or older child hiking on their own, it is a good idea to start with shorter hikes to keep it positive and build confidence!
  • How far can kids go? 
    • This depends on many factors, but a general rule of thumb is a mile per year of age. That being said, some kids can do more, especially if you work up to it! 
    • Start with shorter hikes and incorporate lots of snack breaks!

Bring lots of snacks and water!

  • Seriously, you can’t have too many snacks and bring plenty of water.
  • It’s best to bring more than you think you’ll need!
  • Pack various healthy options to fuel your little hikers; fruit, nuts, cheese, crackers, fruit pouches and maybe some special treats for when they (or you) need a little extra motivation to get to the finish line.

Think like a kid and let the little ones lead sometimes!

  • For bigger kiddos doing some walking, it is great to let them set a pace and explore! 
  • Don’t forget, it is not just about a certain distance or destination after all, but the joy of the journey! 
  • Kids are naturally curious and want to check out their surroundings, look at bugs and plants and find the perfect walking stick. Instead of rushing them, follow their lead! 
  • Incorporate games like “I spy,” or nature treasure hunts to keep everyone engaged and happy! 

Be flexible and have fun!

Do not, I repeat, do not get it in your head that you will complete the entire hike that you have envisioned every time. If you do, fantastic, major win! If not, you get credit for just getting out and trying, and there is always a next time!

  • Embrace the chaos – try not to sweat the small stuff!
    • You’re bound to forget things, messes, and cranky kids and parents will happen. 
  • Some adventures will inevitably be cut short, but you’ll learn something every time. 
  • Try to end on a high note if you can and call it a day before everyone is overtired and you’re out of snacks. 

For more great info on hiking as a family and tips on supplies check out these resources:

REI – Hiking with kids

National Park Service – Hiking with kids

toddler smiling in an innertube floatie in a swimming pool

Water safety with kids

It’s hard to imagine summer fun without playing in and around the water! Kids of all ages love it. It’s a great way to stay cool and burn off excess energy. But as much as we hate to think of it, the truth is drowning is a real risk. The risk is highest amongst children ages 1-4 making water safety with kids a major public health issue. In fact, according to the CDC, More children ages 1–4 die from drowning than any other cause of death except congenital disabilities. For children ages 1–14, drowning is the second leading cause of unintentional injury or death after motor vehicle crashes. 

Now that we’ve sufficiently ruined your day, we’ll try to boost your mood with some of our top tips for water safety with kids and ideas to enjoy the water in a fun and safe way!

Got a pool? Use layers of protection!

The key to childproofing a pool at home is to use more than one water safety barrier!

  • Secure your pool with fencing at least 4 feet high that surrounds all four sides and doesn’t have gaps. 
  • Consider a tight cover or netting.
  • Use safety locks on doors that lead to yards with bodies of water. 
  • Consider a pool alarm as well if you have young mobile kids. 
  • Remove all pool toys from the pool when done swimming.
  • Empty or securely cover baby pools after use 
  • Consider a water submersion device, especially if staying at a vacation rental or accommodation without barriers around the pool.

Assign a water watcher in group swim situations

  • Group swimming situations can be loud and chaotic, and drowning can sadly be silent and subtle.
  • Always assign a designated water safety watcher because if “everyone” is watching, often it means no one is watching.
  • Even better is a physical item to identify the water watcher, like a baton or lanyard that can then be handed off when the next water watcher takes over.

Swim lessons early! 

The skill of swimming is the most important step for water safety with kids.

  • It is never too early to start!
  • Teaching kids to swim does not increase the risk of drowning; it reduces it!
  • Consider infant survival swim courses if available in your area.

Floaties are a great safety tool but not a substitute for swim safety skills.

  • Floaties/coast guard certified life jackets should be used in open water situations like the beach or a boat or can be helpful if you are managing more than one little one who can’t swim.
  • Floaties keep kids in head-up feet down position that doesn’t facilitate swimming and can give them a false sense of confidence.

CPR training

  • Even with optimal safety measures, accidents can happen. CPR training is an excellent skill that may save a life one day. 
  • Find courses in your area here

Don’t forget small bodies of water.

Safety around pools and open water is more obvious, but it is just as important to consider other water hazards at home.

  • Block off pet water bowls.
  • Empty buckets and other standing water after use.
  • Secure bathrooms and toilets with child safety latches.
  • Empty the bath and remove all bath toys after use.

Talk to your kids about water safety. 

  • Talk to your kids about being safe around the water as soon as possible. 
  • Establish rules and expectations around water that you remind them of often. 
  • Set boundaries for where they can go and reinforce that they should never go in the water without a supervising adult. 

Ideas for water fun if you don’t have a pool nearby!

As temperatures get higher and kids get bored, a pool can sound like the perfect solution. But a lot of us don’t have one and may not have easy access to one in our town. Here are some other fun water activities to stay cool and have fun! And don’t forget sun protection! Read about the best tips for sun protection in babies and kids here.

  • Sprinklers – old school, but always fun.
  • Water table, or fill a bin with water and assorted bowls and cups
  • Splash pad – your town may have a public splash pad in a nearby park, or there are affordable versions that attach to a hose you can buy for yourself.
  • Slip and slide
  • Check out more fun ideas here!
  • And here are some great ideas specifically for toddlers.

For more info and resources about water safety, check out these helpful sites.

AAP drowning prevention

Healthychildren.org water safety and young children

 

two children on the beach put sunscreen on eachother's faces

What is the best sunscreen for kids?

What is the best sunscreen for kids? Whatever you have handy! Any sunscreen in addition to other sun protective measures is better than none. Not only are sunburns uncomfortable, but exposure to UV rays also increases our risk of skin cancers and expedites signs of aging. For young ones, this is particularly important. They are outside more and rely on grownups to cover and protect them adequately. They also have thinner, more sensitive skin, and sun damage is cumulative! Although we are discussing sun safety for kids, these tips apply to all of us! It is never too late to start implementing adequate sun protection. Read on for more specific tips about the safest and most effective sun protection!

Sun Protection for Babies:

You may have heard that you can’t use sunscreen in babies under six months, but that is not true! Read on for how best sun protection for your littlest humans.

  • Babies under six months should be kept out of direct sunlight as much as possible. 
  • This doesn’t mean you shouldn’t take them outside, but it does mean keeping them covered and protecting them with shade as much as you can. 
  • Limit time in the sun during peak hours, between 10 am and 2 pm.
  • If shade isn’t available, you can use shade tents, umbrellas at the beach and park, and lightweight sun covers over strollers or carriers. 
  • Cover as much of their skin as possible with lightweight, long-sleeved shirts, pants, and sun hats. 
  • If there are small areas exposed like hands, feet, and face, it is ok and recommended to use sunscreen in these areas.

What is the best sunscreen for babies?

We recommend physical sunscreens using mineral-based ingredients like zinc oxide or titanium dioxide as the best sunscreen options for babies. This is because there is less risk of skin irritation, and the ingredients are generally safer and better for the environment.

Sun Protection for Kids:

The best sun protection for kids includes a combination of sunscreen and barriers!

  • Over six months, apply a broad-spectrum sunscreen to any exposed skin areas. 
  • Apply everywhere generously! 
  • It is also best to use 15-30 minutes before sun exposure so it has time to dry.
  • Reapply every 2 hours or after swimming, sweating, or wiping with a towel.
  • The tips above about shade and protective clothing for babies also apply to older kids and their grownups!
  • Apply sunscreen whenever you and your kiddo go outside, even on cloudy or rainy days!

What are Physical versus Chemical sunscreens?

  • Chemical Sunscreens work like a sponge and absorb UV rays.
  • Physical Sunscreens work like a shield deflecting damaging UV rays away from your skin. These are also called mineral sunscreens. 

What to look for in a sunscreen

The best sunscreens have the following characteristics:

  • Broad-spectrum.
  • SPF 30 or higher.
  • Paraben and phthalate free
  • Environmentally friendly (no Oxybenzone)
  • We prefer mineral sunscreens (Zinc Oxide and Titanium Dioxide) due to less risk of skin irritation, a better safety profile, and they tend to be more environmentally friendly. 
  • Still, ANY sunscreen, including chemical sunscreen, is safe and better than none!

What is the best sunscreen for sensitive skin?

Just like for babies, physical (mineral) sunscreens are your best bet for those with sensitive skin. Also, look for fragrance-free, hypoallergenic, phthalate, and paraben-free. Of course, you may also opt for sunscreens marketed for sensitive skin, but check the label to make sure!

Can sunscreen make you Vitamin D deficient?

Vitamin D is a nutrient that helps keep our bones strong and healthy and may play a role in muscle and immune function. When your skin is exposed to sunlight, your body produces Vitamin D. Some people are under the impression that you shouldn’t wear sunscreen all the time to get enough vitamin D. However, this is not true! You can still maintain your Vitamin D levels without putting yourself at risk for skin cancers!

  • There is no link between daily sunscreen use and Vitamin D deficiency.
  • It doesn’t take much sun exposure for your body to produce Vitamin D! 
  • No sunscreen is perfect, and we usually don’t apply it perfectly, allowing enough UV exposure to produce Vitamin D. 
  • You can consider putting sunscreen on after a brief period outside, 10-15 minutes, to allow for some direct sun exposure for vitamin D production while avoiding prolonged risk.
  • The risks of skin cancer from sun exposure far outweigh any risk of daily sunscreen use and potential vitamin D deficiency.
  • You can also get vitamin D in your diet! Foods containing vitamin D include fatty fish, egg yolks, fortified milk, and OJ. 
  • You can also take a supplement with vitamin D, but check with your physician for your correct dose! 

Are Sunscreens Safe?

Yes, consistent sunscreen use is safe and recommended!

  • The safety of certain sunscreen ingredients is a hot topic currently, but don’t let misinformation scare you out of using it!
  • The FDA is advocating for more safety data on several chemical sunscreen ingredients to determine how much they are absorbed into the skin and whether or not it is harmful if they do.
  • However, their recommendation is NOT to STOP using these sunscreens. 
  • The FDA has reported enough data on two sunscreen ingredients to consider them “generally safe and effective;” Zinc Oxide and Titanium Dioxide (aka. Mineral sunscreens.)
  • Some ingredients in chemical sunscreens are harmful to the environment, particularly the coral reefs, namely Oxybenzone.

Take-Aways

  • Sun protection is super important for little ones and ourselves!
  • It is best to use a combination of physical barriers like shade, clothing, and hats in addition to sunscreen.
  • For babies under six months, focus on avoiding prolonged exposure to direct sunlight by keeping them in the shade or covered as much as possible. Use a mineral sunscreen on areas that are not covered. 
  • For the rest of us, in addition to physical barriers, liberally apply a broad-spectrum sunscreen with SPF 30 or higher! And don’t forget to reapply!