Along with pleasures like picnics, beach outings, and woodland hikes, balmy spring and summer days bring a few outdoor health hazards. How do you keep your kids safe from Mother Nature’s nastier side? We asked the experts: Ontario camp nurses Cheryl Bernknopf and Tilda Shalof; Surrey, BC, paediatrician and Canadian Paediatric Society spokesperson Glen Ward; Heather Hudson, an advanced nursing practice educator with the Ontario Poison Control Centre at Toronto’s Hospital for Sick Children; and Bruce Minnes, a paediatric emergency physician at Sick Kids and chief medical editor of aboutkidshealth.ca.
Don’t want your kid to be a bug buffet? Keep munching to a minimum by covering skin with clothing: Dress kids in long sleeves and pants at dawn and dusk when mosquitoes are most active and when walking in wooded or grassy areas, where you’re most likely to encounter ticks. Wearing hoodies and tucking pantlegs into socks can help prevent tick bites, too. Dark colours are a magnet for mosquitoes, so encourage kids to wear light shades, which are also less likely to attract bees than brighter hues. If your child is older than six months, you can apply insect repellent to any exposed skin. If you choose one containing DEET, opt for the lowest available concentration: 10 percent or less.
Tip: To prevent your child from inhaling repellent, spray it into your hand and rub onto the skin.
Give a stinger the brush-off by gently scraping the skin with a credit card. If a tick has attached itself to the skin firmly, try to remove it whole, using tweezers to grasp the insect as close to the skin as possible, and gently pulling without twisting. Stow the tick in a container (save it to show the doctor, if necessary) and clean the bite with soap and water or rubbing alcohol. To ease the ouch or itch of bites and stings, apply a cloth-wrapped cold pack; or dab on a dot of toothpaste, baking soda and water mixture, or an over-the-counter remedy like AfterBite.
When to seek help
Call 911 immediately if a child develops wheezing, breathing difficulties, hives and swelling of the face or mouth — all signal a potentially dangerous allergic reaction. (By contrast, a large amount of swelling around the bite itself isn’t cause for alarm.) And see a medical professional promptly for stings in or near the eye; if the child develops an unusual rash; or the bite begins to show signs of infec- tion, such as cloudy discharge, or renewed swelling or redness. Ditto if you’re unable to remove a tick using the methods mentioned, or if the head of the tick breaks off beneath the skin. While ticks carrying the bacteria that causes Lyme disease are relatively rare in Canada, you may want to report any tick bite to your child’s doctor when you have a chance, just to be on the safe side.
What about dehydration and sunstroke? Read on for home treatments. >>
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Dehydration and sunstroke
On hot, sticky days, limit outdoor activities, or schedule them during the cooler morning and evening hours. When kids do head outside, help them keep cool by dressing in light, loose-fitting clothing and wide-brimmed hats, and by staying in the shade as much as possible. A steady supply of fluids to replenish the body’s water stores is also essential. Give your child a water bottle to carry and encourage frequent sipping.
Move your child to a cool, shaded area at the first sign of a tummyache, headache, dizziness or cramps, if your child seems listless or otherwise unwell, or even if she just hasn’t peed in the last four hours. (For kids who aren’t old enough to talk, crabbiness or misbehaviour may be the only clue.) Pat the skin with a cool, damp cloth, and offer sips of lukewarm or cool water (cold fluids can cause stomach cramps). Better yet, keep a supply of rehydration drink on hand to replace minerals lost through sweating. A sports drink such as Gatorade will work for older children, as will Pedialyte or Gastrolyte for smaller kids.
Tip: You can make your own rehydration drink at home with one litre of water, plus one teaspoon of salt and eight teaspoons of sugar.
When to seek help
Get immediate medical attention if symptoms worsen, or the child develops hot, dry or cool clammy skin, vomiting, diarrhea, weakness, confusion, or rapid breathing.
Read on for information on how to treat sunburn. >>
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On days when the UV index is high, try to keep kids indoors between 10 a.m. and 2 p.m. Insist children wear wide-brimmed hats and sunglasses, and cover up as much as possible. (That means wearing a T-shirt, or special sun-protective swimsuits, even in the pool or lake.) Keep babies in the shade. For kids over six months, slather sunblock on exposed skin before going outdoors. Be vigilant about reapplying every few hours, and after swimming or sweating.
Tip: Make sure you use enough sunblock: It takes a shot-glass-full to cover the face, neck, hands and arms.
Turn down the heat with cold compresses or a cool bath. You can also soothe the burn by gently dabbing on a non-perfumed moisturizer, or aloe vera gel. Advil or Tylenol may also help. (Skip numbing sprays, which can irritate the skin and trigger allergic reactions.) Keep your kid out of the sun until the burn has healed.
When to seek help
Consult a medical professional immediately if the child develops signs of heat illness (see “Dehydration/sunstroke” on the previous page). You should also seek help if blistering covers large areas of the body, the sunburn is accompanied by a fever, home remedies don’t sufficiently relieve the pain, or the burn doesn’t improve within a few days.
Read on for information about toxic plants. >>
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Find out which poisonous plants grow in your area, and teach older kids what to look for and avoid. Poison ivy (“leaves of three, let it be”), wild parsnip and giant hogweed are some plants that can cause severe skin irritation; toxic berries include winterberry (a.k.a. Canada holly) and black nightshade. Dispose of any mushrooms sprouting in your yard, and learn he names of garden plants, too.
Identify the plant if possible; if not, snip a sample, or snap a photo with your phone. In the meantime, offer small sips of water. Do not try to get the child to vomit, which can pose additional dangers.
First, remove any clothing that touched the plant, and set aside until you can launder it. Next, wash the affected area well with mild soap and water, and apply a cold, wet washcloth for pain relief. Since some poisonous plants also cause sun sensitivity, keep skin away from the rays until it has healed.
When to seek help
If your child has swallowed part of a poisonous or unidentified plant, immediately call your provincial or territorial Poison Control Centre. (Find the number at capcc.ca.) This can often save a trip to hospital.
See your doctor or nurse practitioner if a large area of skin is affected, if the rash begins to worsen after a few days, or if the skin shows signs of infection (such as cloudy discharge). You should also see your doctor if home remedies don’t sufficiently relieve symptoms such as pain or itching.
What about tetanus? Read on. >>
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Tetanus bacteria, which can live in soil, produce toxins that cause an illness known as lockjaw. If your child gets a cut or puncture outdoors — and it’s been more than five years since her last tetanus shot — wash the wound with soap and water and contact a medical professional. Children usually receive tetanus protection as part of the 5-in-1 vaccines during the first 18 months, a booster between ages four and six, and a third dose at age 14 to 16.
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Questions about other illnesses that can affect your kids? Join the Kids’ Health discussion on our community board.
A version of this article appeared in our May 2012 issue, with the headline Outdoor Survival Guide (p. 42).
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