Summer Slide and DIY Sunscreen – PediaCast 433

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Show Notes

Description

• Students lose lots of math and reading skills over the summer. We examine the summer slide and offer fun tips for keeping kids on their academic toes during the break. Then we explore sun safety, including the dangerous practice of making sunscreen at home. We hope you can join us!

Topics

• Summer Slide
• Sun Safety
• DIY Sunscreen

Guests

• Dr Emily Decker
  Medical Director, CAP4Kids
  Nationwide Children’s Hospital

• Dr Cody Hostutler
  Pediatric Psychology
  Nationwide Children’s Hospital

• Dr Lara McKenzie
  Center for Injury Research and Policy
  Nationwide Children’s Hospital

Links

• Feedspot: Top 15 Pediatric Podcasts
• The Children’s Advocacy Project of America (CAP4Kids)
• Reading Rockets (Book Ideas and Tips for Struggling Readers)
• USDA National Summer Meal Finder
• Pinterest Homemade Sunscreens: A Recipe for Sunburn
• Center for Injury Research and Policy at Nationwide Children’s
• Is Sunscreen Safe? (American Academy of Dermatology)
• Sun Safety Guidelines (AAP)

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone. And welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio.

It is Episode 433 for May 29th, 2019. We're calling this one "Summer Slide and DIY Sunscreen."  I want to welcome everyone to the program.

0:00:57

I hope all of you have a terrific Memorial Day weekend. Our family certainly did, until the tornadoes in Western Ohio on the evening of Memorial Day. And our thoughts and prayers certainly go out to those folks who are affected in the Dayton, Ohio area. My fellow Ohioans, who many of you I understand are struggling and really having a difficult time when you lose homes. 

And so, we're praying for you and stand with you, and also with the first responders and those who are providing food and shelter. Just great when a community comes together, but certainly don't want it necessarily to be under those circumstances.

But anyway, hope you all did have a good Memorial Day weekend. Our family is back from vacation. We were in California last week. That's why we didn't have a podcast.

And let me tell you, it was a wonderful time of unplugging. Really stayed off social media. We were just unwinding, relaxing, and visiting Mickey Mouse and his friends at Disneyland.

0:02:08

I highly recommend your family do the same, not necessarily at Disneyland, but somewhere fun and meaningful for your family.  I mean, the key really, not so much important where you go or what you do, but do get away and you do something fun as a family. Just unplug, unwind, relax.

It doesn't have to be a big expensive trip. Just spend some quality time together this summer. Make some memories, something that your family will talk about for years to come. It's an important thing to do and always worth the time it takes and the expense that it takes to do that. You get a lot out of it when you spend some quality time and make some memories as a family.

Speaking of summer, we are heading fast into the summer season as you could probably tell by our show's title today. And with temperatures rising, schools closing, swimming pools opening, with those things in mind, we're going to talk about the summer slide and sun safety and sunscreen this week.

0:03:07

Now, the summer slide is not a new piece of playground equipment. It is a term to describe what can happen to our children's reading skills, math skills, and their overall learned knowledge over the summer months while school is out. Of course, it's great to take a break in the summer, hang  with the family, take that vacation. But it's also important to keep on reading and learning over the summer while you're having fun.

And the statistics which we're going to cover surrounding the summer slide, they're pretty impressive with the potential of losing so many reading and math skills and previously learned knowledge that it takes one to two months of the new school year simply to catch up to where you were before the summer begin. 
And the results are cumulative, with as much as two years of knowledge lost by the time you hit ninth grade. And these things, this idea of losing knowledge and skills over the summer has a much larger impact on some kids compared to others.

0:04:12

So we're going to learn more about this problem of the summer slide and how you can protect your kids against its effect. And I have two terrific studio guests joining me for that conversation. Dr. Emily Decker is a pediatrician and medical director of CAP4Kids here at Nationwide Children's Hospital. Also Dr. Cody Hostutler, who is a pediatric psychologist with Nationwide Children's. 

And then, we're going to turn our attention to sun safety and DIY sunscreen. And yes, DIY means do-it-yourself. It's all the rage on Pinterest with hundreds of pins featuring recipes for making your own sunscreen at home. But is this a safe practice? Are homemade sunscreen effective? We'll ask our resident safety expert, Dr. Lara McKenzie with the Center for Injury Research and Policy at Nationwide Children's.

0:05:04

We'll talk about the risk and benefits of sun exposure in the summer. We'll also consider the risks and benefits of commercial sunscreen products. We'll cover the types. We'll explore the mysteries of the SPF, including what it means and the number you should use, how much sunscreen should you apply, how often. Should it be a lotion, a stick, a roll-on, a spray? Does it even matter?

And the biggest question you probably have -- are commercial sunscreen products safe? And we'll talk straight with you because as it turns out, nothing in life is 100% safe, but we're going to run through the ingredients.

There could be some issues and the FDA is asking for more data. However, we also know that sun exposure is not 100% safe, not even close. So we have to consider all the known data points as we compare risks and benefits and make a sound judgment for our family. So we'll talk through that. We'll journey with you down the road of sun safety including do-it-yourself sunscreen. All coming your way very soon.

0:06:04

Before we get started, I just have a few housekeeping items for you. First, we won another award here at PediaCast. We're really proud and honored to be chosen as number 2 in the Top 15 Pediatric Audio Podcasts and Radio Shows. Yes, we will strive for number 1. But number 2, from Feedspot is feeling pretty good. We're in the Top 15.

And there's just been an explosion recently of other pediatric podcast. Many of these podcasts, I know the pediatricians who do them. We're friends. And so, it's a friendly competition. But the other pediatric podcast that are out there, many of them are really fantastic and also recommended.


Also, I want to remind you, PediaCast is on Facebook. We're on Twitter. We try to share not only the shows each week and some interesting ones from the past but also try to put new knowledge and articles into your hands, into your feed that we think would be interesting for you as a parent. Lots of stuff that does not make it into the podcast.

0:07:06

We're also on Instagram. It's a little more family oriented there, sharing glimpse into the studio and what our family is up to. I'd love to connect with you in that space and see what your family is up to as well. So look for PediaCast on Facebook, Twitter, and Instagram and please do consider connecting with us in those locations.

Also, remember we love to hear from the audience in terms of what questions you have or what topics you think that we should be addressing on the program. Easy to get in touch, just head over to pediacast.org and click on the Contact link. 

And then, finally, I want to remind you that the information presented in this podcast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plan for specific individuals. So if you have a concern about your child's health, be sure to call your doctor and arrange a face-to-face interview and hands-on physical examination. 

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement which you can find at pediacast.org.

0:08:07

So let's take a quick break. We'll get our guests settled into the studio and then we'll be back to talk more about the summer slide, sun safety, and DIY sunscreen. That's coming up right after this.

[Music]

Dr. Mike Patrick: Dr. Emily Decker is a pediatrician at Nationwide Children's Hospital and an associate professor of Pediatrics at the Ohio State University, College of Medicine. She serves as medical director for CAP4Kids in Columbus, which is an important resource for families, medical professionals, and educators. More on that to come.

0:09:05

Dr. Cody Hostutler is a pediatric psychologist at Nationwide Children's and an assistant professor of Pediatrics at Ohio State.

Thanks so much to both of you for being here today.

Dr. Emily Decker: Thank you.

Dr. Cody Hostutler: Thanks for having me.

Dr. Mike Patrick: Really appreciate both of you taking time out of your busy schedules. So, we're talking about the summer slide today. And Dr. Emily, what is the summer slide and why is this a big deal?

Dr. Emily Decker: Yeah, that's a great question. When parents think about a summer slide, they typically envision their kids having fun, going down a slide out in an amusement park. But when teachers talk about a summer slide, they're really talking about something quite different. And that's the summer learning loss that occurs for a lot of kids over the summer months each year. 

Summer slide is not a new concept. In fact, it's been studied for decades and what we do know is that on average, kids lose about one to two months of reading and math skills over the summer.

0:10:00

It's important for parents to know about and understand it because we want them to be able to prevent summer slide as much as possible. And we want kids to start the next school year ready to learn and we don't want them to fall behind the other classmates.

Teachers often spend not days but weeks or even months reteaching forgotten material at the beginning of each school year. And that can be costly for school districts. It's estimated that cost about $1,500 per student per year to reteach this material.

Dr. Mike Patrick: A couple impressive things that you mentioned through that. One is that this is not a new concept and the research actually spans like 100 years...

Dr. Emily Decker: That's right. 

Dr. Mike Patrick: In terms of people understanding that this is a problem. And yet so many of us, even with all these research behind it and as long as we've known about it being a problem, there's not a lot of awareness concerning it.

And in terms of the most recent research and kind of showing some proof that this really does exist, when you look at standardized test scores, the same test at the end of the school year and then at the end of the summer break before you start again, they're substantially lower after the summer, right?

0:11:14

Dr. Emily Decker: That's absolutely right. That's why it's so important for parents to know about it.

Dr. Mike Patrick: Yeah. It's kind of a use it or lose it, that sort of thing. And so, now, the other interesting thing that I learned and discovered because I really hadn't heard of this before. In fact, when you had contacted me to say, "Hey, I want to talk about summer slide on the podcast," I really had no awareness of what exactly that meant. 

And so, I did quite a bit of research and one of the things I found really fascinating is that this is not one of those things where all kids have equal risks, right? There's some kids who are at much higher risk of significant summer slide than others. Cody, what are some of those risk factors and which kids are really impacted the most by this?

0:12:00

Dr. Cody Hostutler: You mentioned it perfectly earlier. It's kind of like a muscle, right? If you don't use it, you lose it. You got to work that muscle out. And so what we noticed is that for some kids, they're just not getting it as much practice over the summer and there's a lot of variables that go into who those kids are. 

What we do know is that most recent research had shown us that there isn't any differences based on race, or gender or even IQ, which I found interesting, or level of intelligence. But sometimes, those kids who just don't get enough opportunities to practice over the summer or those who are falling behind, that might be because they don't have access to some other programming that exist out there. They might live in a rural place where there isn't much available or there might be transportation barriers.

And so, oftentimes, it's those educational or economic factors that can get in the way of accessing some of those summer learning opportunities that other kids get. And so, that's one of the things that can definitely keep it low. 

But also, some kids who just start behind for whatever reason often seem to fall even further behind in the summer. So they start catching up to their peers during the school year, but then the gap rewidens again over the summer break.

0:13:06

Dr. Mike Patrick: And books, access to books are really one of the big determining factors here, right? And so, kids who don't have access to books over the summertime are really at huge risk of this.

Dr. Cody Hostutler: Absolutely. It's one of those things that's necessary but not sufficient. I don't even know if this is true or this is just lore that I learned in graduate school, but we always talked about this mayor in Indiana. I'm not even going to mention the town, about how he just dropped off books at everybody's doorsteps and then waited around to watch the test scores rise because he read the research about how important having the availability of books was for kids. 

So he figured, if he handed out books that the reading scores would just kind of go through the roof by the time they came back at the next school year, but it actually didn't happen that way. And this isn't published in a peer review journal but there is definitely some news articles about it.

And the reason why is that is not just having access to the books but it's understanding how to use the books. Are we asking questions about the books? Are people reading the books? Are they being used as a coaster? And are we talking about making like predictions about the book and interacting with it and telling stories? Those are the things that are really important. 

0:14:12

So, yes, having books are absolutely important, understanding how to use them, how to open them, reading from front to back but we need to be able to practice with them as well.

Dr. Mike Patrick: And to some degree, there is then a difference in terms of low income versus high income families, which probably really still goes back to the access to books and knowing how to use those books, and really engaging. And those opportunities just aren't there often with for lower income folks. 

And this was from a peer-reviewed study, that if you look at the changes in reading test scores from the end of a school year, then you take the summer, you do the same test of the beginning of the next school year, low income families without access to books actually had a drop of about 10 points in their reading levels. 

0:15:03

But when those same families, same low income families had access to books, they actually jump up by 24 points on their reading skills. And then, high income families with access to books jump up about 16 points. So whether you're low income or high income, if you have access to books, it seems like your reading improves over the summer. However, the low income families may be more at risk for not having that access. Is that a good generalization?

Dr. Cody Hostutler: Yeah, I think that's great. Like we talked about, it's a muscle. And so you had to have the opportunity to work out that muscle and having books is a great way of being able to do it, yeah.

Dr. Mike Patrick: And then, you'd mentioned this idea of sort of a cumulative effect with this. Because you'd said you do catch up as you head into the school year, but then the next summer, you fall behind again. It's not just an equal amount, right, like there is a cumulative effect of all of this summer loss, right?

0:15:59

Dr. Cody Hostutler: Absolutely, yes. Particularly if you start school a little bit behind and then you start to catch up and then you fall further back behind during the summer, these cumulative effects can increase over time. And it also increases with all kids as well. So what we know is that early in school, those rates are around 20% to 27% loss. And then when we get to older kids, those loses can jump off into the 30%, 40%, and 50% range of how much percent of what they gained during the school year do they lose over the summer.

And so it's cumulative, meaning that it adds up every single year. And then, it's also getting larger and larger every year as well. It becomes you lose more and that bigger loss adds to those smaller losses that you had when you were younger.

Dr. Mike Patrick: And one of the articles that I had read is that by the time ninth grade rolls around, especially low income families can be two years behind their classmates who did have access the books every summer or other learning opportunities. And that then can impact whether you earn a high school diploma or if you go to college. And so, it can really make a big difference in kids' lives.

0:17:10

If you look at the individual summer, they're about a month to two months, about six weeks behind at the beginning of the next school year. But then, when you look cumulatively, by ninth grade, they could be two years behind.

Dr. Cody Hostutler: Yeah. And some of those gaps that we see can account for up to two-thirds of the gap between the high-performing readers and the low -performing readers as well.

Dr. Mike Patrick: So, Dr. Emily, what then can families do? What are just some really practical tips for preventing this from happening?

Dr. Emily Decker: Sure. That's a great question, Dr. Mike, because that's the great news. I mean, this is so easy to prevent really. We're not talking about taking your kids home, recreating the classroom setting for eight hours a day, every day during the summer. That's not what it's about. The research shows that all it takes really is two to three hours a week of learning or reading and this translates into just 15 to 30 minutes a day. That's it. 

0:18:04

You don't want to nag your child. They probably are not going to engage in learning very effectively, but on the other hand, you don't want them sitting around being a couch potato all summer watching TV. It's  important to find that healthy balance.

And I want to emphasize that learning can be low cost or even free. It can be in the home. It's not about signing up your child for the most expensive summer camp or learning program. So when I talk to families in my office and most of them are low income families, I really encourage parents to turn daily activities into learning experiences.

For example, if they're cutting a pizza for dinner, that's a good time to talk to your kid about fractions. If they're going to a grocery store, that's a good time to talk to them about adding and subtracting. If you're going to a museum, engage them and ask them questions. The key is kind of putting away your cell phone and actively engaging them because they're much more likely to learn in this scenario.

0:19:07

And summer is a good time to learn a new skill as well. Planning a garden or exploring a new hobby, those are important learning experiences as well. And then I guess the biggest thing that I talk to parents about really is taking advantage of free library programs. It's been shown that reading just four to six books over the summer can prevent a summer slide. And like you talked about earlier, having access to books has a bigger impact on a child's education and household income. That's so powerful.

Dr. Mike Patrick: Especially the library I love. And so almost every community has library and with free books and it's a fun place for kids to go and explore.

Dr. Emily Decker: Right.

Dr. Mike Patrick: Because one of the things that's going to be important is for kids to be interested in what they're reading. And so once you kind of get an idea what your child's interests are, then you can go explore the library and find all sorts of books that you may not even have known were available.

0:20:08

Dr. Emily Decker: Right. That's important, too. And there's research on that, that kids are much more likely to learn when they choose a book that they like instead of books being chosen for them. So it's really important to find out what their interests are, ask them what they want to read. And then within reason, help them choose.

And a librarian is a great resource for that. They can help guide you what's the appropriate reading level for the child, what are some books that they might be interested in.

Dr. Mike Patrick: And I love what you say there. It's not just the matter of picking the right topic, it's also you want a book that's not too easy for them to read and too difficult for them to read. So you want to get that sweet spot and the librarian can really help you out with choosing and picking.

Dr. Emily Decker: Yes.

Dr. Mike Patrick: There's also a website called Reading Rockets that has some book ideas and tips, especially for struggling readers. And it may give parents some ideas on what books to look for, what age levels and had some great ideas if your child is struggling. And I'll put a link to that in the Show Notes for this episode, 433, over at pediacast.org.

0:21:11


But also, for those struggling readers, you may just start out that you are reading to your child and really being engaged in that. And then having them read out loud bits and pieces of the books, so you're kind of reading together. And that maybe an easy way to start when you have a struggling reader, right?

Dr. Emily Decker: Yeah. Ask them questions, get them engaged, get them interested. That's so important.

Dr. Mike Patrick: And go ahead, Cody, yeah.

Dr. Cody Hostutler: I think reading can be way more active than when we think about reading. I think making predictions what the books going to be about before we start reading it, having kids act it out. 

A lot of the parents that Dr. Emily and I see in clinic, they're like, "I just can't get them to sit down long enough to go through a book." But maybe we just read a couple of pages and we act out what we heard, which can help with reading comprehension. It can help kind of get the wiggles out a little bit while they're reading. And it can make reading a lot of fun, especially for kids who aren't as passive when they learn. They want to get up and act it out and think about it and make guesses and guess whether they're right or wrong.

0:22:06

Some of our parents tell me, "I'm not a great reader and I don't want to model for him how to read incorrectly." But I think just opening the book and looking at the pictures and telling your own story, regardless of what's going on, asking the kid if they recognize any words from school or just storytelling. I think over the summer, telling ghost stories at the campfire or telling stories around the house or family stories with a good beginning, middle, and end, I think can be really good ways to start kids to understand how stories work beyond just sitting with the book.

Dr. Mike Patrick: And this can be done in such a natural way just to having fun together, right? And engaging and asking questions and as you're reading, then maybe make a game or roleplaying out of what you just read. I mean, there's so many ways that you can get creative and have fun with this, right? It doesn't have to be like being in a classroom.

Dr. Cody Hostutler: Absolutely, yeah. The more you can do that, I think the better that it works.

Dr. Mike Patrick: And then I also love, Emily, you had mentioned do get your kids involved in just some what you would consider daily chores almost, things like shopping trips, and cooking, and following recipes or planning a trip and looking at a map app and plotting how you'd get from one place to another, how long it's going to take. There's all kind of opportunities to really get involved and have fun even with just regular stuff.

0:23:22

Dr. Emily Decker: That's right. We're not teaching kids to raise their test score. That's not what we're talking about in terms of learning. There's a lot of learning that goes in summer and can go on that helps kids' creativity and helps them learn.

Dr. Mike Patrick: We always like Scavenger Hunts in our family. You can make a list of things to go out and look for, maybe in the metro park. And then, you can incorporate questions about those things as you go or encourage your kids to ask questions. And if you don't know the answer, say, "I don't know the answer but let's look it up" and kind of model for your kids how you do a search and find good resources and get answers to their questions. So, lots of fun engaging kind of ways that you can do this.

0:24:04

The other thing that I found interesting is how nutrition sort of fits into the summer slide. Dr. Emily, tell us about that.

Dr. Emily Decker: That's really important. I mean, there are lots of studies that kids that don't have good nutrition or don't have access to good nutrition can fall behind. It's really important to connect kids with resources in the community. And there are several federal programs out there that help kids get nutritious meals during the summer because there's a lot of research that they do fairly well during the school year, but then it drops off during the summer.

Parents maybe busy or it may be hard to connect them with those resources, but kids that are hungry or kids that go hungry are much less likely to learn.

Dr. Mike Patrick: And your brain really needs energy to work. And so, if you're missing meals, it can impact memory and concentration, your energy level and then that all kind of ties in to how well your brain can package information and put it in a place that can be recalled. And you need that energy then to also recall. 

0:25:08

So learning really does depend on good nutrition and meals. And breakfast is as just important, probably more important than lunch and dinner. I mean, they're all important meals.

And you had mentioned, for folks who may have trouble financially providing meals for your kids, there are lots of federal programs. And the USDA has a National Summer Meal Finder link where you can put in your ZIP code and find out who offers free meals in your area and which meals they offer. And I'll put a link to that in the Show Notes for this episode, 433, over at pediacast.org, so folks can find that easily.

Speaking of resources available in communities, it would seem to me, Cody, that communities really ought to, especially when we think about the fact that there's a difference low income kids and high income kids, the communities really have ethical responsibility for providing some kind of help. What do you think about that?

0:26:09

Dr. Cody Hostutler: I completely agree. Just like you talked about, reading is essential for kids' health and development in life moving forward. Academic success is one of the strongest predictors of a kid's physical health as they grow up and whether they chose healthy behaviors or unhealthy behaviors.

It's the same thing for community. The stronger the education is and as more kids are able to learn and develop within the schools, the stronger the community is going to be. They're going to have people to fill the jobs and to work well and to develop all of the programming that they want.

So communities can work hard to do this in a lot of different ways and I think people have been really creative over the years. This is something that's gathering more and more attention.

We were just talking at clinic this morning about the book mobile. I'm not sure how many people out there have a book mobile driving around their community, but it was fantastic. It was like the ice cream truck except for those of us who love reading. And so, it would drive around in the community over the summer. We knew where it would be and when it would be there. 

And so, those of us who couldn't get to the library in a regular basis could just walk down the street, go to the book, talk to the librarian, pick out what the books that were interesting to us. And the librarian would help us find them. And then, they come back a couple weeks later and we drop them off and get a new book.

0:27:14

So reaching out like that can be really helpful. 

Sending text messages, there's some intervention where the Department of Education would send text messages to parents about activities that we're going on over the summer, reminders to do some of that summer reading and that summer math and give them different ideas over the summer. And that had pretty moderate effects sizes. It made a pretty big difference in how much they were able to prevent summer loss by just reminding families what to do through PSAs like texting, and billboards, and commercials on TV.

Dr. Mike Patrick: Not every town is fortune enough to have a mayor who drops books off...

[Laughter]

Dr. Mike Patrick: At your doorstep, right?

Dr. Cody Hostutler: Yep.

Dr. Mike Patrick: It can be helpful just for your average mom and dad to get involved. And maybe you are the catalyst for your particular community, getting some sort of program started, right?

0:28:01

Dr. Cody Hostutler: Absolutely, yeah. And then you can even advocate with your school or talk to your school board or your teachers about what can we do about this for our community. Because there's a lot of different schools who are trying different things, whether it be extending the school year or going to school for more days of the school year. 

There's pluses and minuses to that because like Dr. Emily was talking about earlier, there's lots of non-academic growth that can happen that these studies don't measure. So learning how to play with other kids in the neighborhood and going on trips and vacations, in museums, all of that is really good summer
growth that's not being measured by the studies. 

These studies are only measuring academic skills. And so, oftentimes, when we talk about just going to school all year long, people get upset because they miss out on some of the good family learning opportunities. But it can help reduce some of those gaps that we see because we know that lower SES families fall behind in those summers. 

And if we go to school all year long, we can do that. But we don't want to do that differentially or in unfair way either saying, "These kids have to go to school all year and these kids don't have to go."

0:29:03

One of the more creative ways that they've been able to do it is just modifying the school schedule. So they don't go to school for more days but we don't get a solid three months off in the summer. They just kind of break that big break up into small breaks throughout the school year so that there isn't as much time being missed and that gap doesn't fall behind as much. So they take a couple weeks off after each quarter, for example, instead of taking off three solid months. 

And if you're interested in this, you could talk to your school about whether that's something they're interested in or thinking about and your voice can be heard. And you can advocate for the solution that you think works best for your community.

Dr. Mike Patrick: I can imagine that there are some passionate opinions on both side of that debate. But it is done successfully both ways in different communities. And I love the idea of the book mobile bringing books right to where the kid is because they may live far away from the library. Even though there is a library in their community, it may still be difficult for them to get there.

One way I think communities can look at this is what barriers are preventing book access or educational opportunities or fun workshops or metro park programs or whatever and providing transportation, or if there's a cost to having like grants or something that families can apply for funding to pay for these things. 

0:30:19

So in addition to just offering programs, getting people to the programs and helping overcome barriers or finances can also be a way that communities and other parents... Maybe you're in a more fortunate situation where you can pay for your kids do this and you can provide transportation for your children. Is there somehow that you can be a catalyst for improving those things for other kids?

Dr. Cody Hostutler: Absolutely. And investing in the parks like you were talking about, I love your idea of scavenger hunt. I think that's wonderful. And can we set some of those programming up? Because sometimes we go and then we're not sure how to fully take advantage of that.

My uncle is a science teacher and I'm always amazed at the ways that he can squeeze science into just cooking recipe with his kids or deciding who gets to get the first slice of pizza by who can get the fraction right first between these kids. There's just so many fun ways that I see him interacting that I'm like, "Man, I wish I would know that myself." 

0:31:11

And I think there are ways to disseminating that, like when you go to the park giving the kids scavenger hunt, kind of scaffolding and modeling that for some parents who maybe didn't have the opportunity to learn how to teach their kids at home either.

Dr. Mike Patrick: Dr. Emily, you're a pediatrician. And some would say this is more of an educational issue and kind of in the teacher's realm. But as a pediatrician, we do have a lot of pediatricians who listen to this podcast, how can pediatricians and teachers raise awareness about this problem with their families and then their community?

Dr. Emily Decker: I think the first thing is to acknowledge it and know about it. That's really the first step. And I try to reach out to families before summertime and prepare them and talk them through resources that they can find or use. Teachers often send information home about it in the child's backpack as well. And I encourage parents to reach out to the teachers and ask them what books and online learning programs they recommend.

0:32:11

There's a lot of good mobile apps out there and ebooks and many of them are free. So it's important to access those resources. You mentioned Reading Rockets. That's a great national program that has tips and resources for parents, especially for struggling leaders.

Dr. Mike Patrick: We're thinking about summer slide right now because we're heading into summer. But some pediatricians, you may see your families for well check-ups, let's say in February. And so, it's not really on your mind to talk about summer slide. And even if you did, we're so busy and have so many things going on, you don't remember it.

But this is an opportunity I think where pediatricians or any medical professional who takes care kids can really utilize their social media presence to remind folks this time of year about this problem and maybe provide some helpful hints or share some resources to help families with this.

0:33:05

Turns out a lot of doctors have Facebook pages or they're on Twitter. And so, social media is another good way to spread this message.

Dr. Emily Decker: Yeah, that's right. And there's so much information out there. Sometimes it's hard to figure out what's good information and what's bad information. There's a lot of mobile apps out there and some of them are good and some aren't so good. I think it's really important to use your pediatrician or your teacher as a resource or the librarians. That can really help.

Dr. Cody Hostutler: I agree. I love Reading Rockets. I think it's a wonderful program. And a lot of the research is showing us that math is oftentimes the thing that slides the most over the summer. And so I'll throw a shout out to Khan Academy as well, which is a free program that kids can sign up on, select their grade or their grade level and then it has all kinds of activities and learning opportunities and YouTube videos just to keep kids fresh for the math side of things as well.

0:33:59

Dr. Mike Patrick: And those little tidbits where you find certain resource. If you're medical professional out there listening, share all those resources on social medias. So, more likely that people will come across these resources if you have that voice out there to get that information at this time of the year, especially.

Dr. Emily, we mentioned that you were the medical director for CAP4Kids. Tell us about CAP4Kids. What is that?

Dr. Emily Decker: CAP4Kids is a website that started in Philadelphia that help bridge the gap between resources in the community and families and kids that need those resources the most. There's 24 categories on the website. Everything from food, housing, healthcare to summer programs, education programs, counseling resources. 14 cities across the US now have a CAP4Kids website and the web address is www.cap4kids.org. I encourage parents to go online and see if their city has a CAP4Kids website.

0:35:06

Dr. Mike Patrick: And we'll put a link, of course, to that in the show notes, Episode 433, over at pediacast.org. CAP stands for the Child Advocacy Project. And so, really we're just trying to connect  families, healthcare provides, social workers, child advocates, educators, law enforcement, clergy, just all sorts of people with the resources that can help kids and families. And those can be, as you mentioned, social services, healthcare, after-school programs, camps, libraries. Just really resources that folks can help them in their own local community. 

And, as you mentioned, 14 cities all across the United States, so you can look and see if your city is one of them by heading over to their website. Again, we'll put a link in the show notes for that. But fantastic opportunity to really get connected, right?

Dr. Emily Decker: Yeah, that's right. We know the resources are so important for kids to grow and develop like Cody was saying. It's really important to connect to those resources because they can affect kids' health just as much as diseases like asthma or respiratory infections or other things can. The environment that they live in is so important.

0:36:18

Dr. Mike Patrick: Absolutely. Well, I want to thank both of you once again for stopping by the studio today. Dr. Emily Decker, pediatrician here at Nationwide Children's, and Dr. Cody Hostutler, pediatric psychologist at Nationwide Children's, thanks to both of you so much for being here today.

Dr. Emily Decker: Thank you so much.

Dr. Cody Hostutler: Thanks for having me.

[Music]

0:37:04

Dr. Mike Patrick: Dr. Lara McKenzie is a principal investigator with the Center for Injury Research and Policy at Nationwide Children's Hospital and an associate professor of Pediatrics at The Ohio State University, College of Medicine. She serves as our resident safety experts on PediaCast. Joining us for past conversations on fire safety, poison safety, water safety and the dangers associated with tip-overs and falls.

She joins us today to talk about sun safety and sunscreen, including the popular topic of making your own sunscreen at home. Is this a safe and effective thing to do? We're about to find out. Let's give a warm PediaCast welcome to Dr. Lara McKenzie. Thank you so much for joining us today.

Dr. Lara McKenzie: Thanks for having me.

Dr. Mike Patrick: Really appreciate you stopping by. So, I hadn't really heard about this, of the DIY sunscreen. What is this all about? What's going on?

Dr. Lara McKenzie: Well, I think it's borne out of that DIY movement or the idea that people want to make their own whatever, soap, face masks, shampoo, and that they want to use natural ingredients, organic ingredients, or ethically made products now.

0:38:13

Dr. Mike Patrick: And when you hear things in the news and we'll talk more about it as we progress. But you hear things about are all the ingredients in commercial sunscreen really safe? And so that kind of piques your radar to, "Should we be trying something else?" And there's a community feel of sharing recipes. And that's totally understandable.

Dr. Lara McKenzie: And Pinterest is a platform that a lot of parents use, a lot of moms use, and we started noticing a trend in homemade sunscreen recipes, and like with the popular ingredient of coconut oil. It's sort of like coconut oil is the apple cider vinegar of 2019. Apple cider vinegar, according to Pinterest, will soak the skin off your feet and cure whatever ails you. But the claims for some of that are unsubstantiated and the homemade sunscreen movement is similar.

0:39:05

There are a lot of claims that we found that the recipes that were included on Pinterest would protect you with the sun protection factor of anywhere from 2 all the way up to 500. With the ingredients listed, that just isn't possible.

Dr. Mike Patrick: And so tell us, kind of walk us through, what is sun protection factor? What does that mean? We hear that, SPF. What exactly does that mean?

Dr. Lara McKenzie: It's just a level of protection, how many hours of coverage you have when you stay in the sun with the level of sunscreen that you put on.

Dr. Mike Patrick: So if normally I burn in 10 minutes, if I wear something with an SPF of 50, it's 50 times as long, so that would be 500 minutes. But that ensures proper application over good coverage and the right amount and also not getting wet and wearing off or changing clothes.

Dr. Lara McKenzie: Yeah. And how the strong the sun is as well, I think, and how much you sweat. Are you swimming? Are you in shade? Are you wearing protective clothing along with that? So all that can affect how well it protects.

0:40:13

Dr. Mike Patrick: And this is something that you can really test. We have some knowledge of the individual ingredients and what their SPF is likely to be if they were to stay on the skin perfectly. And so what you're finding in terms of these recipes are that they're making claims of SPF being higher than what maybe it really is.

Dr. Lara McKenzie: So some of the ingredients that were listed in these recipes have a natural protective factor in them. You sort of think about our ancestors and what natural products were around to cure sickness or make you feel better or protect you from the sun. 

Some of these things at the very root of them are naturally protective but not to the extent that was made claim in Pinterest, and not necessarily in the combinations that were listed. Those were not tested for effectiveness or efficacy. We can't rely on that to protect our skin or that of a child.

0:41:16

Dr. Mike Patrick: And so, you generated an article based on your findings through Pinterest and the various sunscreen recipes that were there, which was recently published in the Journal Health Communication. The article is called Pinterest Homemade Sunscreens: A Recipe for Sunburn. And we'll put a link to the article in the show notes for this episode, 433, over at pediacast.org so folks can look at that for themselves if they'd like.

But what you've found was like 189 recipes for sunscreen, and 95% of them said that they were effective and 33% of them made claims ranging from an SPF of 2 up to 50. However, when you look through the recipes, what you found was that 68% of them were not really...

0:42:03

Dr. Lara McKenzie: They would provide...

Dr. Mike Patrick: Wouldn't give you the protection that you...

Dr. Lara McKenzie: Exactly. They would only provide minimal scientifically proven protection. And just to clarify one point, we found more than 189 pins. If you go on Pinterest and type in homemade sunscreen or coconut oil sunscreen, you will find thousands. We reviewed and sampled every fifth pin that we pooled. So we looked at and analyzed 189 pins, but there are way more.

Dr. Mike Patrick: And when you think about the pins being shared in terms of the reach of these recipes -- some of them were reached by 10,000, 20,000 other people -- which are putting a lot of kids at risk if you're relying on those to prevent sunburn and skin cancer.

Dr. Lara McKenzie: And the saves, people can pin things to their own board or save or share. Those numbers indicate how many times it was saved, but it could have been seen by way more people. Because you can scroll through things and see things, not necessarily pin or share them, but you're still influenced by the information on what you see.

0:43:09

Dr. Mike Patrick: Absolutely. And we're going to talk in just a few minutes a little bit more about the dangers of sun exposure, and also the concerns that people have with commercial sunscreen that's available out there. But while we're talking about these ingredients, as I was looking through this, the one that kind of jumped out at me was the grapefruit juice. That the SPF of grapefruit juice is 35. Thirty-five the SPF. And so that's a little bit higher than some of the others. But the question I have is what kind of coverage can you really get with the grapefruit juice?

Dr. Lara McKenzie: Don't go drink grapefruit juice and think you're going to be protected from the sun. Don't dump it on your skin. None of ingredients that are listed and what's listed in the paper, don't use those as a basis for making your own. That is absolutely not what we're suggesting.

0:44:01

Dr. Mike Patrick: Because the SPF of 35 for grapefruit juice is like pure grapefruit juice thickly on the skin, not necessarily mixed in with shea butter and beeswax and the other things...

Dr. Lara McKenzie: And essential oils and everything. I mean, grapefruit juice might smell great but don't use it for sunscreen. 

Dr. Mike Patrick: Especially when we consider that skin cancer is the number one cancer in the United States. It affects more Americans than any other cancer. In fact, the lifetime risk of developing skin cancer like 20%, so one in five people over the course of a lifetime is going to experience skin cancer and there are many deaths.

Now, if it's caught early and removed completely and it hasn't spread, it can be very curable. But there are plenty people who do have significant health outcomes and die from skin cancer. So that makes it really an important point in consideration that we're talking about. 

Dr. Lara McKenzie: Right. And when we're talking about kids and how strong the sun is, how much they're outside, that's all good to be outside and playing and little bit of sun, but they have a lifetime of being in the sun. So we have to start them using sunscreen really young and all the time. Or they're going to end up being one of those 20%.

0:45:13

Dr. Mike Patrick: Absolutely. You bring up a great point, that we don't want to be afraid of the sun because it is good to get outside and play and have a day at the beach and all of these things. But we have to understand that there is risk associated with sun exposure. 

And every year, we talk about this on PediaCast about this time of year. And I think it's just a good review of exactly how does the sunlight result in skin cancer. How is this a dangerous thing?

Dr. Lara McKenzie: Well, I'm not a dermatologist, so I don't know if I can explain exactly how it causes but repeated sunburn over time is really going to put you at risk for potential skin cancer in the future.

Dr. Mike Patrick: Yeah, absolutely. And the UV radiation changes the DNA. And if it changes the DNA at just the right points, it can turn what's a regularly dividing cell that's supposed to make more skin into a cancer cell which is kind of goes crazy with reproducing itself. And that just takes the right change in DNA at the right point.

0:46:16

Now, the good news is that we do have cellular mechanisms that correct those changes but it has a limited capacity of how well it can work. And so sometimes, cancer cells can break through and then lead to terrible outcomes.

The other thing that happens is when your DNA changes, the cell dies. And that's how we get sunburn and then the immune system comes in and that's why you get the redness, increased blood flow. And the immune system kind of cleans up the mass of dead cells there, and that's why you get the peeling and the blistering and all that business. 

It really is something that we worry about when it gets to the point of sunburn, and then obviously, the development of skin cancer.

0:47:02

We have a natural pigment in the skin, some would say, right, to help us but you can't rely on that completely.

Dr. Lara McKenzie: No, not even people with darker skin shouldn't rely on that natural skin pigment to protect them.

Dr. Mike Patrick: And in fact, the darker your skin, so you do have more protection than fair skin folks do but it also makes it more difficult to tell that there is skin cancer there. And so, those are often found at later stages which make them more dangerous because they're not noticeable that the skin is changing or there's a changing mole or something like that. It's important for all of us to be using sunscreen. 

What other things can folks do to protect themselves from the sun aside from sunscreen?

Dr. Lara McKenzie: Not going in the sun when the sun is the strongest, the 10:00 to 4:00, 10:00 to 2:00 usually depending on where you live and wearing long sleeves, hat, sunglasses, protective clothing, staying in the shade. You can be outside but still be in the shade. And wearing that kind of protected clothing, in addition to sunscreen, is couple ways that will help.

0:48:21

Dr. Mike Patrick: And the sun's energy is the strongest when the sun's directly overhead. So that midday sun is really going to be the most dangerous in terms of sunburn producing in the possibility of skin cancer. So being out in the morning and the evening is going to be a little bit better. And then like you said, watch the shade and think about the clothing. And not all clothing completely blocks UV light, right? So you can still get a sunburn even under clothes.

Dr. Lara McKenzie: Yeah, you can still get a sunburn in your car, all through the windows, too.

Dr. Mike Patrick: Now, so we're advocating for using commercial sunscreen that's made for the purpose of preventing sunburn and skin cancer. But there's so many options available out there. Let's talk through the ingredients of sunscreen and how they protect us.

0:49:15

Dr. Lara McKenzie: Well, in FDA-approved sunscreen, there about 17 ingredients. And the combinations of them do different things. They're all required because some protect from UVA, some protect from UVV, some make it water-resistant, some make it very water-resistant. There's a lot of ingredients listed but what I would tell parents to be concerned about us is not the specific ingredients that make it up, but whether it's a broad spectrum, an SPF factor of 30 or higher. So we're looking for that broad spectrum coverage and higher than 30 SPF. That's what you have to look for.

And water resistant or very water resistant, those are the things that you want. I don't spend time worrying whatever they're called on the back. Some of them are hard to pronounce. That's not the point. The point is buy one off the shelf commercially available that has the coverage of 30 or higher and it's broad spectrum.

0:50:23

Dr. Mike Patrick: That is a great point. On the other hand, there's going to parents that say, "What about this? What about that? We hear that the ingredients have been associated with cancer." And it's true that they have. But the ingredients that are used in the United States that the FDA has approved, there is not substantial data to show that those ingredients are definitely associated with cancers. 

There are ones that have been and those are banned in the United States. They're not allowed to be used as sunscreen ingredients here. But it's still possible that the other one could be associated with cancers. The FDA in fact is saying that we want more data before we can say for sure.

0:51:09

But what we have to do is think about, "Okay, so this is the risk of commercial sunscreen." Maybe there is a small risk of cancer but there's a huge risk of skin cancer with unprotected sun exposure. And so, when we think about risk versus benefit, risk versus benefit of being in the sun, the risk and the benefits of the sunscreen, using the sunscreen, the benefit highly outweighs any risk that could potentially be there at this point in terms of what we know.

Dr. Lara McKenzie: And so, to me and how I interpret that information as a parent but also as a researcher is don't jump off the path of using the effective and the commercially available sunscreen right now. This is not a "jump off the path and go to your kitchen and decide to make your own." We need more data as you said to know definitely if any particular ingredient will cause cancer that's included in the sunscreen. But, for now, stay on this path of using the effective and tested versions of sunscreen.

0:52:16

Dr. Mike Patrick: Yeah, and especially when it's our kids' lives that we're talking about since skin cancer. And I've seen skin cancer in plenty of teenagers, it definitely happens. And so, it's something that we have to really think about and protect our kids from.

And also, as we're talking about UV radiations, sunglasses. You can't put sunscreen in your eyes. And so, you want sunglasses that are going to also protect their eyes.

Dr. Lara McKenzie: Right. If you've gotten sunscreen in your eyes...

Dr. Mike Patrick: It's very uncomfortable.

Dr. Lara McKenzie: You know how that feels. Yeah, sometimes, we use for my kids the stick. It looks like a two Boob Glue, but it's the stick, so it stays on the skin very nicely and doesn't drip into their eyes. But sunglasses are the way to really protect your eyes. And hat too helps and sunglasses.

0:53:02

Dr. Mike Patrick: And we know that UV radiation over the course of your lifetime can lead to earlier on side cataracts and then you may have surgeries for those. So always important to wear the sunglasses that offer UV protection.

You mentioned the sticks. There are so many different options for applying sunscreen. There's lotions and sticks and roll-ons and spray. Obviously, you like the stick but do you have specific preferences or should any of them work fine?

Dr. Lara McKenzie: All of them will work fine but it's really about finding the ones that is best for you or for your family. People have preferences, right, about everything and including sunscreens. Some people might like the way a lotion feels and they might be very comfortable applying it. Some people like to spray or dry spray now they have, so you don't even feel sticky and it's very light but it still covers you.

Like I said, for my kids, we like using the stick because we feel like it stays on their skin, on their face, in their ears, and doesn't drip into their eyes. But it's really about finding one that you like how it feels, how it smells, it stays on, it's easy to apply.

0:54:14

Dr. Mike Patrick: And you don't get a sunburn.

Dr. Lara McKenzie: And you don't get a sunburn.

Dr. Mike Patrick: And if you do, you're either not putting it on correctly.

Dr. Lara McKenzie: Not putting it on enough.

Dr. Mike Patrick: Enough of the volume that you're using or not reapplying it often enough. And so then, you just want to make adjustments so that then, hopefully, you don't get a sunburn the next time.

Dr. Lara McKenzie: For example, if you're going on beach vacation for a week, a child should go through about an eighth-ounce container of sunscreen in that week. You should really blow through a whole bunch of them. 

And this kind of brings up the point of getting rid of old or expired sunscreen. If you're using it properly and you're out every day for a week, you're going to go through it quickly. And that's appropriate.

So, you shouldn't have that much leftover to sort of store year after year, season after season. But you do want to get rid of old or expired sunscreen because they can separate and the ingredients can lose their effectiveness. And they could smell funny or look different color than when you bought them. So it's good to just get rid of those. Maybe I think three years is the recommendation now. Do not keep something more than that. 

0:55:20

Dr. Mike Patrick: And most of them have an expiration date on it, so you definitely want to keep that in mind. There's a lot of folks in our audience. We have a lot of medical professionals, a lot of people who like science. 

It's interesting when you do think about the categories of the ingredients. There's barrier type category of ingredients like the zinc oxide, which that's less likely to expire. But then, those chemicals that absorb UV radiation, those are the ones that there are some controversy about. Those do have a limited, they break down and then they aren't able to absorb UV radiation as well. And so, you really do have to think about them expiring.

Dr. Lara McKenzie: Well, I think also how it stored sometimes too is a factor and how quickly it can breakdown. If you have something that you're maybe storing in the glove box of your car, it's going to be hot. It's going to be maybe wear down faster than something you might keep in your house in cool shade  cabinets or...

0:56:14

Dr. Mike Patrick: Yeah, because these are chemicals that absorb UV radiation. They change their chemical structure so that then they can't do that anymore. And that's another reason that there's a limitation to their use and you have to reapply because they have a limited capacity of UV radiation that they can absorb.

And so, if they're changing from other things, then they're not going to work for you. But when they work, they work well, which is why that they're in there.

The other controversy with the sunscreens that we don't want to completely discount is that a lot of people use them and then snorkel around reefs and then they are concerns about the products bleaching the reefs. That's a concern. But at the same time, I don't want skin cancer either and want to enjoy. So I don't know. It's hard to say like what's...

[Laughter]

0:57:06

Dr. Lara McKenzie: Right. I would say for the vast majority of people who are not snorkeling near reefs, commercial sunscreen is fine to use. And you really should use it. 
Most people are out in their backyard or at the pool or even at the beach are not going to be near the reefs that they're worried about. I guess it's a concern for some. But again, this is not...

Dr. Mike Patrick: We're talking...

Dr. Lara McKenzie: Something that should pull you off the path of using a commercially available sunscreen at this point to going into your kitchen and making your own.

Dr. Mike Patrick: And when you're talking about your kids and protecting them from things like sunburn and skin cancer, in your backyard, on vacation, in your world, they certainly are going to be beneficial with minimal risk compared to the risk of the sun.

Dr. Lara McKenzie: There's great way to save the environment that don't involve not using sunscreen. Just do some recycling instead.

0:58:07

Dr. Mike Patrick: Yeah, absolutely. And for those who do snorkel frequently around reefs, there are wet suits that can help prevent when you're underwater and how much UV radiation you're really getting. I guess if you're a researcher... So a few people who are doing that is then, is that really a problem for the reefs? And we could have a very long discussion just to...

[Laughter]

Dr. Lara McKenzie: Just to get somebody who does ocean science in here then.

[Laughter] 

Dr. Mike Patrick: We are often, for sure. So we've talked about types of sunscreen, how you apply, other things you can do. What about babies? You hear, don't use sunscreen in kids less than six months of age. Why is that and how can we protect babies?

Dr. Lara McKenzie: Kids under six months and even six months old and under year, their skin is very delicate. It's very thin. It's very sensitive. The recommendation is to not use it if they're under six months unless they're going to be in the sun and in which case you want to  use it sparingly, minimally, but also use all those other ways of protecting babies.

0:59:22

Keeping them in long sleeves and pant, long onesie or something and wearing a hat, and having them wear sunglasses, keeping them in the shade of an umbrella, keeping the hood of stroller over them. Keeping them out of the direct sun. There's all these other ways. But if they are going to be in the sun, it's okay to use a little bit.

Dr. Mike Patrick: And I think the really important point here to make because someone say if it's bad for babies, then is it going to be bad for older folks. It's not so much that we don't want you to use sunscreen in infants especially less than six months old because we're worried about what the sunscreen will do to your baby. 

1:00:03 

We're more worried that the sunscreen, you're not going to use enough of it. Or you're not going to do it appropriately or reapply it as often and then they get a sunburn because you have put confidence in this product that you may not be using correctly on a baby. And sunburn in little babies can be particularly dangerous and they can lose water and get dehydrated and going to heat stroke and exhaustion, and all that pretty easily.

Dr. Lara McKenzie: We think about giving baby a bath even or how we test a bottle temperature for baby, they're just sensitive on every level to everything, right? We have to make sure the water is not too hot, so they don't burn. Their skin is much thinner than adult skin or even older children. They will burn quicker in hot water, for example. It's the same with sunscreen. You just want to make sure they're not exposed to too much sun at too young of an age.

Dr. Mike Patrick: But again if you can't avoid exposure...

Dr. Lara McKenzie: Avoid it.

1:01:01

Dr. Mike Patrick: It's going to happen. Yeah, you can't avoid it, then definitely still use the sunscreen.

And then there some combination products out there that have sunscreen and insect repellent together. It seems like that will be a convenient combination but also not recommended.

Dr. Lara McKenzie: I think like the bug protection stuff that has DEET in it is something you want to apply once, wash off after you're done for the day. But sunscreen is something you want to keep reapplying. The combination product I think you want to stay away from maybe just get a separate bug repellent and separate sunscreen.

Dr. Mike Patrick: Just off topic here, we're talking about going outside, having fun as a family. What are some of the fun things that you guys do as a family and getting out in the sun. You guys do a lot out there?

Dr. Lara McKenzie: We are at the pool. We're definitely a pool family and a beach family when we get out to New Jersey in the summer. 

1:02:01 

But, yeah, my kids are no stranger to putting on sunscreen every day. They just do it. They don't even flinch about it. They argue over who's going to get it first, so they can get in the pool first. 

[Laughter]

Dr. Lara McKenzie: I'll be first for sunscreen, they say. They line up.

Dr. Mike Patrick: Good. And they apply it themselves or do you still sort of supervise that?

Dr. Lara McKenzie: I usually spray them or put it on them and watch them with the stick or help them with the stick. And we'll even do that before they go to camp. In the summer, they go to a day camp and they're outside and they're at the pool for that camp. And we put it on in the morning before they leave but they are reapplying it all day long at camp.

Every kid is required to have sunscreen and we label all their different pieces and parts and they go through it really fast. I'm always surprise when I have to keep buying it, but they go through it because they are outside all day. They wear sunscreen and then reapply it. They swim two times a day at camps. So in and out of the pool and...

1:03:05

Dr. Mike Patrick: And the earlier of an age that you sort of start that habit and that process, the easier it is, especially the little ones. And toddlers may put up a fuss, but you do it regularly every time, then they're asking for it once it becomes...

Dr. Lara McKenzie: I feel like my kids just assume a position. They put their arms out and their legs are spread and they're just ready. It's just something we've always done. And so, they're used to it. It's like getting in their booster seats. They don't even question that they should or shouldn't. They're starting to ask and my kids are, they're about to be eight-year-olds triplets. And they started to ask about when they won't have to ride in the booster or when they'll be old  enough in the front seat. And we can talk about that now, but they don't question whether they should still sit on.

Dr. Mike Patrick: When your mom is a researcher on a safety issues, you best not argue.

[Laughter]

Dr. Lara McKenzie: That's an argument they won't win, for sure.

Dr. Mike Patrick: Yes, absolutely. Speaking of that, you're a principal investigator with the Center for Injury, Research and Policy here at Nationwide Children's. Tell us about that group.

1:04:08

Dr. Lara McKenzie: We do research on all different types of injuries to children and adolescents and adults, too. We look at sports related injuries. We look at consumer product related injuries. We look at home related injuries, farm, sports and activity related injury. We kind of cover everything.

Dr. Mike Patrick: Yeah, really, just trying to keep our kids safe. Sometimes you feel like the only way you can do that is to wrap them in bubble wrap and never let them go outside and have fun. But as we talk, there's a risk and benefit with everything that we do. And we want to minimize the risk, but we can't ever eliminate it completely, right? 

Dr. Lara McKenzie: I think there's one of my mentors in the field is not who says, "We don't want to make kids as safe as possible. We want to make everything as safe as necessary so that people can still participate and have fun and do activities. Safe as possible would be wrapping in bubble wrap. And so we don't need to be that extreme.

1:05:06

Dr. Mike Patrick: Except you can suffocate then, so you're still not really safe.

[Laughter]

Dr. Lara McKenzie: We want to make it as safe as necessary, so that means wearing a helmet when you ride a bike. That means having smoke alarms and carbon monoxide detectors in your house. It means having a fire escape plan. It doesn't mean not using gas or having a fire. It means ways to minimize the risk.

Dr. Mike Patrick: And for folks who are interested in your work, I will have a link to the Center for Injury Research and Policy at Nationwide Children's in the show notes for this episode, 433, over at pediacast.org.

We'll also have a link to your article again, Pinterest Homemade Sunscreens: A Recipe for Sunburn, and then Is Sunscreen Safe? which is a fantastic article from the American Academy of Dermatology, and Sun Safety Guidelines from healthychildren.org in the American Academy Pediatrics. More information for you at the website, again, Episode 433 over at pediacast.org.

1:06:03

Dr. Lara McKenzie, once again from the Center for Injury Research and Policy at Nationwide Children's, thanks so much for stopping by today.

Dr. Lara McKenzie: You're welcome.

[Music]

Dr. Mike Patrick: We are back with just enough time to say thanks to all of you once again for taking time out of your day and making PediaCast a part of it. Really do appreciate that.

Also, thanks to our guest this week, Dr. Emily Decker, and Dr. Cody Hostutler with Nationwide Children's Hospital, and Dr. Lara McKenzie with the Center for Injury Research and Policy at Nationwide Children's.

1:07:02

Don't forget, you can find us on all sorts of places. We are in the Apple podcast app, iTunes, Google Play, iHeart Radio, Spotify, most mobile podcast apps, and SoundCloud. If there is a location where you enjoy listening to your podcasts and you cannot find PediaCast there, please let me know to the Contact page over at pediacast.org, and we'll try to get the show added to their lineup as well.

We also have a landing site where you will find our entire archive of past programs, all 433 of them to be exact. Also, all the show notes with the links and the resources we talked about in each episode, written transcripts of the program, our Terms of Use Agreement and that Contact page so you can ask questions that you're interested in hearing answers for and suggesting show topics. We'd love to hear from you through the Contact page over at pediacast.org.

Also reviews are helpful. Wherever you listen, please, if you're getting some out of this podcast. There's no payment. It's absolutely free. We believe in free open access medical education for both parents and healthcare providers.

1:08:04

But if you want to give back, reviews are very helpful as other listeners come along and they're trying to decide where to spend their time in terms of listening to evidence-based information about their kids and parenting. And would really appreciate reviews if you have time to do so.

Once again, we're on social media, Facebook, Twitter, Instagram. Love connecting with you there. And also appreciate it when you tell others about the program face to face, your family friends, neighbors, co-workers, babysitters, anyone who takes care of kids. Please let them know that we do have a pediatric podcast on child health topics and parenting that may interest them. 

And that includes, by the way, your child's pediatric healthcare provider. Please let them know about the programs so they can share this with their other families.

And while you have their ear, let them know we have a podcast for them as well called PediaCast CME. That stands for Continuing Medical Education. Similar to this program, we do turn the science up a couple notches and offer free Category I CME credit for those who listen. Shows and details are available at the landing site for that program, pediacastcme.org. 

1:09:15

Thanks again to all of you for stopping by. And until next time, this is Dr. Mike, saying stay safe, stay healthy, and stay involved with your kids. So long, everybody.

[Music]

Announcer 2: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.