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Sun Protection of Toddlers: Do as I Say and as I Do

Infants may have it "made in the shade," but mobile toddlers need more protection.

Babies should be protected from too much sun, but when they become able to run and play, sun protection becomes more difficult. Investigators in a coastal Massachusetts town assessed whether postdischarge education of new mothers produced better sun protection and less sunburn for their infants; they also looked at changes in sun protection between the babies' first and second summers.

The researchers randomly assigned the mothers to an intervention or a control group. All mothers received sun safety education in the newborn nursery during the first 48 hours postpartum. After discharge, the control group received no further instruction, but the intervention group received additional telephone counseling and two 4-page educational newsletters. Ninety-two mothers completed two questionnaires (when children were, on average, 6 and 18 months old), reporting sun protection practices, occurrences of sunburn and tanning, and mothers' self-protection.

There were few differences between intervention and control groups in the use of sun protection. The protective strategies of dressing babies in hats and shirts and keeping them in the shade were used substantially less often during the children's second summer than during their first. Although sunscreen use rose significantly in the second year, 54% of children became sunburned or tanned in the second summer versus 22% in the first. A high level of parental sunburn was associated with sunburn in the child. The authors conclude that effective sun protection declines, and skin damage begins, at a much earlier age than previously reported.

Comment: Keeping babies out of the sun is relatively easy. Consistent and effective sun protection of toddlers is much harder to achieve. Furthermore, a "Do as I say, not as I do" policy is likely to fail with children of all ages. Dermatologists who motivate adults to practice effective sun protection strategies are ultimately protecting children's skin as well.

— Mary Wu Chang, MD

Published in Journal Watch Dermatology October 12, 2004

Citation(s):

Benjes LS et al. Changing patterns of sun protection between the first and second summers for very young children. Arch Dermatol 2004 Aug; 140:925-30.

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