Hey Mom! Make room in your already bulging diaper bag for one additional item, sunglasses. For your infant. The earlier children begin to wear “shades” the less likely they are to have cataracts and other eye problems when they become grandparents.
1. Any old shades won’t do. Infants’ eyes are especially susceptible to the sun. Their eyes absorb greater amounts of harmful ultraviolet (UV) radiation than do adults’. Infants’ lenses are more transparent because the lenses do not yet contain pigment that helps reduce radiation. And infants’ pupils are relatively large, allowing more light into the eyes. Infants often look directly into the bright sun – though reflexes will quickly make them blink and look away.
2. Children spend more time outdoors than adults. People get a large percentage of their lifetime sun exposure by the time they are eighteen years of age, the period during which eyes are particularly sensitive to UV radiation. While about 80% of parents realize that it’s important for children to wear sunglasses, more than half of these children seldom or never wear sunglasses.
3. Children less than six month of age should be kept out of the sun. Protect their eyes from the sun when carrying them and when they are in the back seat of a car. Note that the sun comes from different directions as you drive. (Also, sunscreens are not recommended at this age. Sunscreens have not been tested on infants. And infants have thin and permeable skin, possibly leading to excessive amounts of sunscreen chemicals being absorbed into the body.)
4. Older infants and children should be protected from the sun. Broad-brimmed hats decrease UV exposure up to 30%. Have sunshades on strollers; some sunshades specifically block UV radiation. Minimize outdoor activities between 10 AM and 2 PM when radiation is most intense. Children with fair complexions are especially vulnerable to UV radiation because their eyes and skin contain less protective pigment.
5. All shade is not created equal. Clouds are only partially protective. Being in the shade of a building but having a blue sky directly above offers little protection from UV radiation. Being under a beach umbrella protects from direct radiation but allows considerable radiation reflected from water and sand. Dirt, grass and concrete reflect comparatively little radiation.
6. Beware of “fun” or “novelty” sunglasses. These are mainly marketed for young children for entertainment but offer no UV protection. Moreover, some have large brightly colored frames that may contain lead. Such glasses were sold in 2013 and 2014 and labeled Disney, Marvel and Sears/Kmart. Buy infants’ sunglasses at reputable stores that sell eyeglasses.
7. Read labels. All sunglasses should block 99 to 100 % of UVA and UVB. For infants and young children, choose sunglasses made of shatterproof polycarbonate, not glass, to reduce the risk of injuries. Also, choose ones that have flexible frames. Such frames also reduce injuries and are less likely to be damaged when children bend or twist them or leave them where they can be stepped or sat on. Polarized lenses reduce glare. Children’s sunglasses come in various sizes. (One size fits all adults.) Labels generally state the age range for the glasses. Comfortable fit on the nose and around ears makes children less inclined to remove them.
8. Other considerations. Lenses should be large and wrap around towards the ears, and have an adjustable strap to go around the head. Straps help keep glasses in place and make it more difficult for children to remove them. Dark colored lenses are no more protective than light ones; protection results from chemicals applied to the lenses. Replace sunglasses when they become scratched. Good sunglasses need not be expensive. Cost reflects frames, not UV protection.
9. Good luck in having young children wear sunglasses. While most young children seem to enjoy wearing them – it makes everything look more colorful – some children will refuse. To encourage them, wear them yourself, and point out other children wearing them. For older toddlers, let them pick out a pair they like. Reward them with a toy but let them play with it only as long as they wear the glasses. Be persistent. Don’t let them go outside unless they wear sunglasses and bring them indoors when they take them off. Compliment them on how good they look. Take a picture and show it to them.
10. Days in snow country are as harmful for eyes as summer days at the beach. Snow is a far better reflector of UV radiation than water or sand, reflecting up to 85% of rays. Many winter activities take place in snow-covered hilly terrain, allowing evenmore reflected rays to hit children’s eyes, and from additional angles. Modern winter clothing permits children to spend more time outdoors. Altitude increases radiation; the higher the elevation, the less atmosphere to filter out harmful rays. And cold weather, light clouds, and a sun low on the horizon offer little protection.
In national parks, your family’s health and safety are your responsibility. The National Park Service (NPS) has two missions: minimizing mishaps for visitors and maintaining a pristine wilderness. All large parks have experts to monitor safety conditions. But the wilderness, by its very nature, has inherent dangers with wild animals roaming free and “land in the rough.” Planning ahead and common sense can virtually eliminate health and safety problems.
1. Go prepared. All parks have websites. Conditions in parks may be quite different from those where you live. And each park is different. Check climatic conditions, weather, altitude, pollen counts and whether pets are allowed, for example. Summertime temperatures at many parks in the Western US reach more than 100 degrees. The Grand Canyon (Arizona) is not only dry and hot but the rims are at elevations in excess of 6,000 feet (1,880m). Large parts of Yellowstone (Wyoming) are at 8,000 feet (2,440m). Altitude sickness is possible at higher elevations. See below. Insects are a big nuisance in the Everglades (Florida.). Covering up with clothing and insect repellents is essential.
2. Stop at Visitors’ Centers. Check the literature and bulletin boards for safety information and ask rangers about fun, age-appropriate, seasonal- and weather-permitting activities. Ask if cell phones are operative. The NPS has been slow in implementing service. There are ongoing, heated debates between powerful groups wanting to ban phones entirely, arguing that phones distract from the very concept of wilderness and that phone towers ruin the scenery. Others argue that phones are essential in case of emergencies and to stay in touch with relatives back home.
3. Know your family’s limitations. However far you walk, you must walk back. Leave more time for the return trip, due to heat, fatigue and other factors. Most four-year-olds can walk a mile or so, rest thirty minutes, and then walk back. Six-year-olds can walk two or three miles each way. In some places (at the Grand Canyon, for example), the outward hike is downhill into the Canyon, making the return uphill. How far can you carry your child?
4. Backpacks. Children’s backpacks should not exceed 10% of a child’s body weight for backpack beginners, going up and down hills, walking on tough terrain, and in hot weather. Backpacks that are too heavy or worn incorrectly can cause temporary aches and pains. Some backpacks, especially ones designed for small children, have long straps to fit children of various sizes. Long straps may cause tripping and become entangled in branches. Tuck them in.
5. Supervise children closely in sensitive areas. Obey signs. At higher altitudes, for example, snowfields persist all summer and are irresistible to children. However, the snow may conceal hidden cavities under the snow and collapse under the weight of a child. And falling off walkways over hot geothermal water may expose children to scalding water.
6. Keep your distance from large animals. Stay at least 100 yards (90 m) from bears and wolves and at least 25 yards (23 m) from all other large animals – bison, elk, bighorn sheep, deer, moose, and coyotes. Best to hold children’s hands. Discourage children from playfully flailing their arms at animals; animals may interpret flailing as aggressive moves.
7. But cars, not animals, are the chief cause of most serious mishaps. When driving, be prepared for a child in your car to shout, “I see a bear.” Roads are heavily traveled, hilly, often narrow and winding, and often there are families walking along the road. Expect cars in front of you to make sudden stops and children to dart into the road when they see a large animal.
8. Other mishaps involving children. Children fall (especially when walking on slippery rocks in streams), are bitten by small animals while feeding them, and drink water from lakes and streams. Feeding animals is prohibited. Report bites to park personnel. Persons bitten may require rabies vaccine. Untreated water from lakes and streams may contain organisms that cause diarrhea days or weeks later. In case of illness soon after all travel, tell health care personnel where you have been.
9. Take pictures from the distance. Many children have their own cameras and are overly zealous in taking pictures. Don’t open car windows to take pictures when animals are nearby. Leaning out is even worse. Camera-related accidents can also occur from going too close to thermal pools or cliffs to get better views.
10. Altitudes higher than 6,000 feet may cause altitude sickness. Symptoms include headaches, loss of appetite, nausea, inability to sleep, excessive shortness of breath with exercise, and, in young children, irritability. Generally, at the altitudes of National Parks, symptoms are mild and disappear after a day or two. Treatment is rarely necessary. However, young children with significant heart and lung problems should be medically cleared before traveling to higher elevations.
With your family’s health and safety in mind, find a park to visit at http://www.nps.gov.
You need not travel halfway around the world to acquire “travelers’” diarrhea. A short trip to your neighborhood recreational water facility may suffice. But if indeed someone does become ill, don’t panic. Hold off on treating. Most cases get better by themselves, while medication may cause harm – especially for children.
1. All recreational water facilities can be polluted. Such facilities include pools, hot tubs, water play areas, interactive fountains, lakes, rivers, and oceans. Most intestinal illnesses are due to swallowing water but can also be due to breathing in mist produced by water or by not washing hands after playing in sand.
2. The number of such illnesses is steadily increasing. And young children are especially susceptible, says the Centers for Disease Control (CDC). Children have little or no immunity against the causative microorganisms. Such organisms include cryptosporidium (crypto), giardia, shigella, and norovirus – some of the same organisms responsible for travelers’ diarrhea in poor countries. Crypto, for example, can survive in well-maintained chlorinated pools for several days.
3. “Don’t drink the water.” This old adage is probably more important for recreational water than for tap water. The probability of illness depends on how polluted the water is, how much is ingested, and which organism is involved. For some organisms, swallowing just a few, easily contained in a mouthful, suffices to cause illness. The younger the child, the more likely he/she will swallow water. Dunking infants’ heads to get them “used to water,” a common practice, can make them ill.
4. The chief source of intestinal-causing diseases is fecal matter. In recreational water, the fecal matter comes from people, especially infants in diapers. However, even adults’ routine toilet-related hygienic practices fail to remove all fecal matter from skin. Showering with plenty of soap and water before swimming reduces the incidence of illness. Avoid recreational water entirely while you are ill, and a few days after recovery.
5. Some recreational swimming facilities ban infants in diapers. Think twice before swimming where there are many such infants. While special swim diapers have become popular – they don’t disintegrate in water, fit snuggly around waist and thighs, and have a plastic outer lining – such diapers merely retard and decrease leakage, but do not prevent it.
6. Man-made public water facilities must be professionally maintained. Ask pool operators if free chlorine and pH levels are checked at least twice a day and more often when the pool is heavily used and the weather is hot. Some large pools now use ultraviolet ozone technology or hyperchlorination to treat recreational water. Check backyard pools yourself for adequate free chlorine (1-3 parts per million) and pH (7.2-7.8) levels. Test strips are available at local home improvement stores and pool supply stores.
7. Public beaches are generally checked for pollution. Reports are available from local health departments. Ask for the latest report. Never swim near storm drains or after heavy rain; the water draining into the beach often carries sewage from overflowing sewage treatment plants and may contain fecal material, fertilizer, pesticides, and other pollutants.
8. Most intestinal illnesses in young children need not be treated. The vast majority of cases of loose stools in this age group disappear spontaneously. If a child is happy, playful, and eating and drinking normally, medication and changes in diet are not necessary. Treatment, especially with antibiotics, alters the “good” bacteria lining the intestine and may make children more susceptible to intestinal illnesses in the future.
9. Children who have symptoms in addition to loose stools need prompt medical evaluation. Of concern are fever, blood in the stool, listlessness and not drinking, for example. Even in such cases, fluids may suffice and antibiotics may not be necessary. However, this is a decision to be made by a health professional.
10. Miscellaneous. Well-maintained facilities have no odor. A strong chemical smell of chlorine, for example, may indicate a maintenance problem, especially in hot tubs and spas. When hot tub equipment is working, pumps and filtration systems make noise and you should hear them running. Children less than five years of age should not use hot tubs. Poorly maintained recreational water can also be the source of skin rashes, eye and ear infections, and other illnesses. For additional information about recreational water, see http://www.cdc.gov/healthywater/swimming/protection/pool-user-tips-factsheet.html.
Add Lyme disease to the ever-growing list of illnesses you need to be familiar with to keep your family healthy.
1. Know where and when it occurs. The disease is most commonly seen in rural areas of the Northeast from Virginia to Maine, northern California, and the northern Midwest but can occur almost anywhere in the US and Canada. About 80% of cases occur in May through July, but can occur in any season except winter. Your local health department can tell you if you live in an area where Lyme disease precautions are indicated.
2. The cause are bacteria, but ticks are the culprits. These bacteria inhabit animals, most commonly deer and mice. Ticks transmit the bacteria from animals to humans. Only some animals and some ticks are infected. Unlike most biting insects, these ticks imbed themselves into a person’s skin and remain there. It takes ticks at least 36 hours to inject the Lyme-causing bacteria into the skin, giving you time to prevent the disease. Lyme disease is never transmitted from person to person.
3. Proper dress helps minimize tick bites. Light-colored apparel makes it easier to spot ticks crawling on clothing. Long sleeve shirts and long pants tucked into socks help keep ticks away. (Lightweight, summer-friendly clothing helps children stay comfortable outdoors in warm weather while being covered up.)
4. Use insect repellents on exposed skin. For children, use repellents containing no more than 20 to 30% DEET. Read instructions. DEET is considered safe for infants aged two months and older. Know how long DEET is effective, especially with excessive perspiration and when used simultaneously with a sunscreen. Wash off when no longer needed.
5. Apply permethrin 0.5% to clothing. While DEET can be used on clothing, it wears off in a matter of hours. Permethrin is a safe substance that kills ticks on contact and remains on clothing for extended periods, even after laundering. Read instructions. Apply especially to pants, socks, and shoes; most ticks get onto clothing by people brushing against high grass where insects are present. Permethrin can also be used on tents and some camping gear. Do not use permethrin directly on skin. Clothing pre-treated with permethrin is available on the web and from camping supply stores.
6. Check children for ticks. Have them bathe or shower soon after coming indoors. This helps wash away ticks on the skin not yet imbedded. Check for ticks under arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in the hair. Ticks can crawl around on the body.
7. Removing ticks. Use fine-tipped tweezers to grasp the tick at the surface of the skin. Pull straight, in a continuous motion. Don’t twist – this can cause the mouth parts to break off and stay in the skin. Clean the bite site and wash your hands with soap and water or rubbing alcohol. Do not use hot matches, nail polish, or petroleum jelly on the tick; these are not effective. Take your child to a medical facility if part of the tick remains in the skin.
8. Experts can identify ticks. Only certain kinds of ticks transmit Lyme disease bacteria. Ideally, place the tick in a small, sealable, transparent envelope or jar and take it to a medical facility. If they cannot identify it, they can send it to a laboratory for testing. Ticks can also be tested for the causative bacteria. Short courses of commonly used antibiotics prevent Lyme disease.
9. The symptoms of Lyme disease. Many children (and adults) who contract Lyme disease don’t recall being bitten; the ticks are small, varying in size from pinhead to apple seed, and are easily missed. Lyme disease can still be effectively treated when symptoms appear. Symptoms include a “bull’s eye” rash, fatigue, chills, fever, headaches, and muscle and joint pain. The rash appears 3 to 14 days after the bite and at the site of the bite. It is red in color, and grows larger with the center clearing, and may be several inches in diameter. In dark-skinned people it may look like a bruise.
10. Miscellaneous. If untreated, Lyme disease can damage joints, the heart and nervous system. In tick-infested areas, wash and dry clothing at a high temperature. Avoid areas preferred by ticks: wooded and bushy areas with high grass and a lot of leaf litter. An informative, illustrated 12-page booklet on Lyme disease is available at http://www.cdc.gov/lyme/resources/brochure/lymediseasebrochure.pdf
At home, putting infants to sleep is a no-brainer. You place them in their crib – and pray they’ll sleep all night. But when traveling, there are many do’s and don’ts regarding sleep safety and getting infants to sleep in new surroundings, the latter often a real hassle.
1. Never “co-sleep,” even for a night or two. Infants in the same bed with adults have been injured when adults rolled onto them or the infant fell off the bed – no matter how ingeniously adults tried to prevent problems. Breathing issues may occur when infants bury their heads into pillows, comforters and loose bed linen. Additionally, co-sleeping may make it difficult to get infants to sleep alone upon returning home.
2. Car seats are not for overnight sleeping. Infants sleep well in car seats but should never be left unattended in them. Problems that have occurred include compromised airways when the infant’s head flops onto their chest, entanglement in straps wrongly applied, and falling out of seats. Many car seats are unstable unless properly strapped into cars. (Also, infants should not sleep unattended on sofas, recliners, bouncy chairs or swings.)
3. Check hotel cribs for safety. Cribs should look new, have firm and tight-fitting mattresses (two fingers should not fit between the edge of the mattress and the side of the crib; a 12-ounce soda can should not fit between slats). Cribs should not have protruding parts, screws, bolts or cutouts in the head or footboard, which can trap an infant’s head or limb. Cribs with sides that slide up and down are no longer considered safe.
4. “Heirloom” cribs and cradles may not meet current safety specifications. Stringent upgrades in crib design went into effect in 1970 and again in 2000. Very old cribs may have been painted with lead-containing paints. Cradles are popular overseas. While they are quaint, infants in cradles can roll so far to one side that the cradle fails to rock back in the other direction and topples over. Most cradles have pins to prevent this but the pins may be broken or missing.
5. Place cribs in safe locations. For older infants, avoid areas near window blinds, shades and drapes to prevent strangulation, and away from furniture that can make it easier for older infants to climb out. Place cribs either flush against the wall or several feet from the wall so if infants do climb out they will not become wedged between the wall and the crib. Place pillows on the floor around the crib, just in case. Cribs wheels should be secured.
6. On flights, try not to fall asleep with an infant on your lap. Infants have slipped off laps, landing on the floor and, very rarely, suffocated when a parent’s sleeping body rested over the child’s face. Safety officials recommend using an airline-approved safety seat for infants. Some car seats serve the purpose but few parents use them. The seats are clumsy to carry and may require paying an extra fare.
7. Buy a portable travel crib. They’re very handy for car trips and can also be used outdoors. Numerous types are available. Such cribs are lightweight, fold easily and compactly, are easy to clean, and have not been used by others. Some are specific for infants of certain heights and weights and constructed so that older infants cannot easily climb out. Learn how to assemble and disassemble it.
8. Jetlag affects infants, too. Infants seem to be less affected than adults. Generally, jetlag begins occurring after crossing three or four time zones. For trips of a few days, try to keep your infant’s sleeping, napping and feeding schedules on home time. For longer trips, keep your infant outdoors in daylight as much as possible for the first few days and in dim indoor light after sundown.
9. Having well-established schedules at home helps sleeping when traveling. While travel necessitates change, infants seem to sleep best when their everyday feeding/napping/going outdoors/bathing schedules remains close to those at home. Resist well-meaning adults’ requests for keeping infants awake for evening get-togethers and snacks at inappropriate times of the day. Have infants sleep in a portable crib for a week before leaving home, for example.
10. Miscellaneous. Don’t medicate. Some sedating medications (antihistamines, for example) may make infants sleep less, as well as having other side effects. Take along infants’ blankets, sheets and pajamas. Familiar textures and odors seem to make infants more comfortable. Don’t overdress infants and keep the room on the cool side. Air conditioning does not cause illness. Ask hosts not to smoke around infants.
Protecting your kids from a dozen or so nasty childhood diseases has become a no-brainer. You take them regularly to where they get their shots and you can relax. Available vaccines are extremely safe and effective.
Protecting your kids from rabies is different – it’s up to you.
1. Rabies is caused by a virus. The virus is present in the saliva of infected animals. When a rabid animal bites, the virus is introduced into the wound, and then travels via nerve fibres to the brain, causing irreversible brain damage. Rarely, rabies spreads from the scratch of an infected animal when the paw is contaminated with that animal’s saliva.
2. Rabies leaves no room for error. Rabies is virtually 100% fatal if untreated. Optimum, prompt treatment is 100% effective. About 40,000 Americans, a majority of them, children need anti-rabies injections each year. The number of deaths from rabies in the US is down to one or two a year. For a possible exposure to a known animal – a pet cat or dog, for example – make sure that the animal’s rabies vaccination record is current.
3. Young children may be more at risk of rabies than adults. Children are attracted to animals and animals often seem to be attracted to children. Children may not report encounters with animals and, due to their size, are more likely than adults to be bitten around the head and neck. Skin in this area has numerous nerve endings, providing the virus with more pathways to the brain.
4. Instruct children to keep their distance from unknown animals. They should not pet, feed or photograph them. Hikers and bicyclers may be at increased risk. Never eat around monkeys; they may jump for food in your hands and bite/scratch you in the process.
5. Bats can cause rabies. Bat bites usually occur when victims are sleeping and in some cases victims are unaware of having been bitten. Bites are mildly painful and leave marks that may be easily overlooked. Seeing a bat in a bedroom – if you are unable to capture the bat – is sufficient reason to treat.
6. You must recognize when your child may have been exposed. Suspect all animal bites, licks and scratches until proven otherwise. Be suspicious if you find a bat inside your house or tent. Immediately report a possible exposure to rabies to your doctor, local health department or E.R. If exposure occurs overseas, especially in developing countries, check that the appropriate vaccines are available (see below).
7. Clean all bite wounds immediately and thoroughly. Wash for five minutes using plenty of soap and water. This reduces or eliminates viruses before they can enter nerve fibres. Then take the child to the nearest medical facility.
8. Experts must decide if vaccination is essential. Any mammal can be rabid. Generally, vaccination is NOT necessary if the biting animal is vaccinated, does not run wild, and is available for testing. Rabies from dogs has been virtually eliminated in the US, Canada and western Europe due to effective vaccination programs. Don’t overlook cats as a source of rabies (see kidstraveldoc.com). Check with a veterinarian before adopting stray animals. See list below of wild animals that may be rabid.
9. Optimum treatment requires two types of injections: rabies immunoglobulin (IG) and rabies vaccine. Both should be started immediately. One dose of IG provides immediate antibodies to neutralize the virus but is effective for only about a week. The vaccine requires a week to take effect. Three more doses of vaccine, given over a month, provide optimum protection.
10. Rabies treatment is safe and no more painful than other vaccines. Years ago, horse serum-derived vaccines were used. These required numerous injections, usually into the abdominal wall, were painful, and frequently caused side reactions, sometimes severe ones. In some developing countries such vaccines may still be used.
11. Rabies remains a serious problem in many developing countries. About 50,000 victims worldwide die each year, mostly in Africa, Asia, and South America. In these countries dogs are the most common source. Travellers to areas where rabies is prevalent, especially if they plan to stay for long periods or they are hikers or bicyclists, can receive preventive vaccination prior to traveling: this eliminates the need for IG, should exposure occur. In many poor countries IG is unavailable or of inferior quality. Check with your Embassy, if necessary.
Most common animals to be rabid in the US and Canada: •Racoons •Skunks •Foxes •Coyotes •Bats
Animals almost never rabid and not known to have caused human rabies in the US and Canada: •Squirrels •Rats •Mice •Hamsters •Guinea pigs •Gerbils •Chipmunks •Rabbits •Hares