Sunscreen and vitamin D: Getting the balance right

Sunburn was almost a rite of passage when I was a kid. Thankfully, as parents, we now know the dangers of sunburn and the long term risk of skin cancer.

Avoiding sunburn in our children is always best, but that doesn’t mean our kids should avoid the sun altogether.  Some sun exposure is important. The challenge for us as parents is making sure our kids get just the right amount.

Sun protection

To protect our kids from the sun we should encourage them to be in the shade and wear protective clothing when it’s very hot and sunny, especially in the middle of the day. But the main form of protection is sunscreen. Most kids hate putting on sunscreen, but the hardest part is to know when to reapply. In general, aim to reapply every two hours, especially when the kids have been swimming or sweating a lot, and hassle them to keep their hats on when not in the water. I think we underestimate how much washes off in the water or may be sweated out.

Vitamin D deficiency

If we avoid sun exposure altogether, however, we risk our children developing vitamin D deficiency. Vitamin D is essential for strong and healthy bones and muscles. Calcium is also needed to build strong bones, with at least two to three serves of dairy needed per day. The main source of vitamin D for kids is ultraviolet radiation in sunlight. When skin is exposed to sunlight, it produces vitamin D, and that’s why some sunlight exposure is very important.

Typically, kids at higher risk of vitamin D deficiency include dark skinned children, and children who get less sun exposure because they are veiled or covered for cultural or religious reasons or because they spend too much time indoors. With the advent of computer games and electronic devices, some children may be spending too much time indoors. Children with some specific medical conditions, such as obesity, or kidney, gut or liver problems, and infants who are exclusively breast fed or whose mothers are vitamin D deficient, are also at higher risk of vitamin D deficiency. But we are now also detecting a lack of vitamin D in kids without these risk factors, and this may be due to increased awareness of sun-protection measures and campaigns such as ‘Slip Slop Slap’.

I frequently get asked how much sun exposure kids should get by parents and teachers.  In summer, especially when the UV index is high, children should have full sun protection and wear sunglasses but they should be encouraged to play outside when possible. In general, sunscreen use does decease the amount of vitamin D that is made in the skin but normal use should not result in vitamin D deficiency.

In winter, when the UV index is lower, children don’t need sun protection unless they are outside for extended periods or they are near surfaces that reflect light easily such as water or snow. Darker skinned children can usually tolerate short periods of sun exposure without protection in summer, such as 20 minutes of sun exposure without sunscreen or cover at the start and at the end of the day (around 9am and 5pm). In winter, however, this is not necessary, and they may in fact need some vitamin D supplementation. Also ensure your kids are getting enough calcium. They should be eating at least two serves of dairy products per day. Great sources of calcium include milk, cheese and yogurt.

There are times I recommend parents in my clinic get their children tested for vitamin D deficiency. They may have symptoms, such as non-specific bone or muscle pain, slow motor skill development, bowed legs or delayed teeth (no teeth by nine months of age). You may want to consider getting your child tested if they have any of these symptoms and/or if:

  • Your child has any of the risk factors mentioned above
  • Your baby is exclusively breast fed
  • You have vitamin D deficiency yourself.

There are now strict criteria that need to be met to receive money back from Medicare for testing, so please check with your doctor first.

Next blog

I received plenty of topic suggestions from readers of my first blog, which was great to see. The topic of sleep was mentioned a few times, so my next blog will cover sleep for preschool and school aged children.

Keep the suggestions coming!

Please note: Dr Margie is no longer monitoring this post. If you are concerned about your child, please contact your child nurse or GP for advice. 

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