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Pediatricenter of Greater Cleveland

Seasonal Updates

Summer Updates

POOL SAFETY

Swimming is synonymous with summer, but can pose a safety hazard for children.  Below are some basic tips for pool safety, but please click on the following link for a detailed list of pool safety tips:    HealthyChildren.org Pool Safety

Pool rules

Never leave children unsupervised around water 
Keep children within arm’s reach at all times when in the water 
Never leave toys inside the pool after use – these are tempting for young children to reach for these and fall in
Never dive in backyard pools, as these are not often deep enough; especially never dive in the shallow end of the pool   

Pool fences
Fences – a 4-foot high 4-sided fence is recommended around any body of water, with a lock high enough where small children cannot reach it.  Inflatable pools pose a drowning risk as well, as these often aren’t fenced off.  Deflating inflatable pools when not in use is recommended.  

Swimming lessons
The AAP recommends swim lessons for all children over the age of 4, and from the ages of 1-4 when showing interest of developmental readiness.   

SUNSCREEN
To prevent burns, it is recommended that infants under the age of 6 months have no direct exposure to sunlight.  After 6 months, “broad spectrum” sunscreen (which protects against both UVA and UVB rays) with an SPF of 15 and above is recommended.  It’s best to apply 15-30 minutes prior to sun exposure, with reapplication after 2 hours, or after swimming/sweating.  Experts recommend trying to avoid sunscreen containing the ingredient oxybenzone because of concerns of mild hormonal properties.  Instead, try sunscreens with zinc oxide or titanium dioxide.    

Lightweight long-sleeve shirts and pants with a tight weave, along with wide-brimmed hats, are recommended when children are outdoors. 
Sunglasses with at least 99% UV protection are also important.
Try to avoid sun between the hours of 10am – 4pm when the sun is most intense. 

INSECT REPELLANT
Tips to avoid bites  
Avoid the use of scented soaps, perfumes or hair sprays
Avoid areas with stagnant water, uncovered foods and gardens where flowers are in bloom
Avoid dressing your child in clothing with bright colors or flowery prints
The CDC has good advice on prevention of mosquito bites: https://www.cdc.gov/zika/prevention/prevent-mosquito-bites.html
This New York Times article also has some helpful information about preventing mosquito and tick prevention as well:  https://www.nytimes.com/2018/05/01/well/mosquitoes-ticks-lyme-disease-protection.html

DEET
Insect repellants that contain DEET are the most effective against ticks (which can transmit Lyme Disease – see below) and mosquitos (which can transmit West Nile virus and other viruses)
The current CDC and AAP recommendations for children over 2 months of age is to use 30 percent DEET (no bug repellant is recommended under the age of 2 months)
The concentration of DEET in products ranges from 10 percent to 30 percent 
Ten percent DEET only protects for about 30 minutes, which is inadequate for most outings
Combination sunscreen/bug spray products should be avoided, as sunscreen should be reapplied every 2 hours whereas insect repellant should not be reapplied that frequently 
Wash off the areas you applied bug spray on your children bug spray when coming indoors 

TICKS/LYME DISEASE
Transmitted by the deer tick - usually small (3-10mm), and red/brown or brown
Mainly in NE states, as well as MN/WI/MI – Lyme disease is not endemic in Ohio
Diagnosis – usually by symptoms; bloodwork is not helpful in confirming or ruling out Lyme disease

Stages of Lyme disease
1. Early localized disease:
  Flu-like illness  - fatigue, decreased appetite, headache, neck stiffness, muscle aches, joint aches, enlarged lymph nodes, fever
  Cough/cold symptoms, or vomiting/diarrhea are uncommon
  Rash called erythema migrans - usually happens within one month of tick bite
  Most often 1-2 weeks after bite
  Most often on head and neck in younger children, arms/legs on older kids
  Classically looks like a target or bull’s eye, but can be uniformly red; rarely perfectly round
2. Early disseminated disease: multiple rash lesions, neurologic and/or cardiac findings
3. Late Lyme disease: intermittent/persistent joint pain, other neurologic manifestations

Prevention:

  • Avoid shady, grassy and brushy areas frequented by animals and humans
  • Wear long sleeves and pants when in said areas
  • Use tick repellent (20-30 percent DEET – up to 30 percent DEET safe for kids >2mo age)
  • Thorough check of skin and clothes after being outdoors in a known area for ticks, particularly scalp, armpits, waist, groin, and backs of knees
  • Shower within 2 hours of being outdoors in a known area for ticks
  • Try to reduce deer and/or mice exposure

Treatment – there are antibiotics that treat Lyme disease, and also antibiotics that prevent someone from getting Lyme disease.  In order to be put on these medications, certain criteria need to be met.  If your child has the above symptoms with a recent known tick bite, please call and schedule an appointment to discuss need for treatment. 

 
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