My bed time reading last pm was the newest Pediatric Annals 30(4), April
2001. The focus was topical therapy in children (in other words - what to
use on derm). Dr Altemeier summed up his article with the following:
"Best practice for Melanoma Protection. We lack sufficient evidence to
finalize methods for optimal protection now. However, considering the
above [more melanoma with use of sunscreen!] perhaps anticipatory guidance
should teach parents to focus on preventing sunburns in their children.
[article discusses fact that parents are equating more sunscreen
use-properly or improperly applied -as being synonymous with staying in sun
as long as you want.] They should understand that sunscreen is important,
but that overreliance on sunscreens can increase the risk of melanoma.
They should limit their child's UV exposure by decreasing time in the sun
during peak intensity (9am to 3pm). Children should use shade and wear a
brimmed hat, shirt and pants, and eyeglasses with a UV protective coating,
as well as use sunscreens. [ ***( !) ***] Parents should individualize
interventions based on their child's skin color and susceptibility to
burns, family history (including diseases that predispose to melanoma), and
presence of moles. Sunscreen should not be used as an excuse to stay in
the sun longer.7
How about a tan? Should parents individualize sun exposure for their
children to allow or encourage tanning, without burning? This is more
controversial, but I would say yes. However, we need evidence-based
research that tells us whether parents can balance all of these factors to
achieve tanning without burning, and what approaches work best to reduce
sunburns, the development of childhood nevi, and malignant melanoma."
I am a great believer in fresh air and sunshine for all sorts of reasons,
exercise, weight control, mental health and my basic "Flo" understanding
that sunshine and fresh air chase away germs. (Flo is Florence
Nightengale). It is the old routine of throw the baby out with the bath
water. Keep all kids covered and just give them the Vit D drops. Simpler,
easier, requires no thought or effort on anyones' part (HCPs, parents,
etc.) Acck People need fresh air and sunshine. Just how, when and for how
long is variable depending on culture, skin color, geography etc.
Remember: NO one rule for ALL situations :-) That's what makes being a
human interesting. I must get off my soap box now and chase my 3
grandchildren outside and off the play station! Sincerely, Pat in SNJ
----------
> From: Diane Wiessinger <[log in to unmask]>
> To: [log in to unmask]
> Subject: vit D and sun exposure
> Date: April 07, 2001 03:10 PM
>
> >From James Akre's "Infant feeding: the physiological basis", 1989:
>
> "It takes only brief exposure to sunlight to produce sufficient vitamin
D;
> to satisfy a week's requirements for white infants in a midwestern US
city
> the exposure time is 10 minutes unclothed or 30 minutes with only the
head
> and hands exposed."
>
> Nikki raises a good point with that ubiquitous blanket-over-the-bucket
> technique. I'll start talking to mothers. I had a mother comment
yesterday
> that her daughter is usually too hot when she bundles her in culturally
> acceptable ways, but she figures people will think she's a bad mother if
she
> doesn't...
>
> Diane Wiessinger, MS, IBCLC Ithaca, NY
> www.wiessinger.baka.com
>
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