Should My Baby Be Wearing Sunscreen?

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Baby Sunscreen

 

Now that warmer weather is here, we need to remember to protect ourselves against skin damage from the sun. And new parents often wonder if their babies need to use sunscreen, too. The answer to that question is, “Yes, but.. . .”

  • Yes, but remember that babies shouldn’t be out in the sun for very long, even with sunscreen on.

It is very easy for infants and toddlers to become overheated in the sun due to their size and decreased ability to sweat to cool off, so even if they don’t get sunburn, exposure to the sun can cause problems. So avoid having infants and toddlers out in the sun for extended periods of time, especially during the peak intensity hours from 10 am to 4 pm. If they are outside, try to keep them out of direct sunlight by moving them under a tree, umbrella or stroller canopy. And be sure to offer plenty to liquids to prevent dehydration in this age group.1,2

  • Yes, but remember to cover them up with clothes, too.

For all children, but especially those who are younger than 6 months for whom sunscreen is not recommended, protect them from the sun by covering them up. Wear clothes of tightly woven fabrics that cover the arms and legs, in addition to the trunk. If your child will tolerate it, use a wide-brimmed hat to shade the entire face, ears, and back of the neck. Cotton clothes are cool and protective. Another good idea is to use specific sun-protective clothing, such as a swim shirt.1,2

  • Yes, but only if she’s older than 6 months1-3

Sunscreen is recommended only in those older than 6 months. One reason is that due to the high body surface area to weight ratio of infants, they are more likely to absorb the ingredients in the sunscreen than older children and adults. Also, as mentioned above, infants younger than 6 months are at risk for overheating and dehydration, so they shouldn’t be out in the sun for long periods anyway. But if there is no way to avoid the sun in the these young children, then apply a sunscreen to small areas, such as the baby’s face and back of the hands.

  • Yes, but use a sunscreen that is safe.

Sunscreens are rated by the amount of Sun Protection Factor (SPF) they provide. The SPF represents the fraction of burn-producing ultraviolet light (UVL) that penetrates the sunscreen to reach the skin compared to untreated skin. For example, sunscreen with SPF 15 (when applied properly) allows only 1/15th(7%) of the burn-inducing UVL to reach the skin. Likewise, an SPF 50 sunscreen allows 1/50th (2%) of the UVL to pass to the skin, and an SPF 100 sunscreen allows 1/100th (1%)of the UVL to pass. So you can see there is very little difference between SPF 50 and 100: 98% of UVL blocked vs. 99%.3

For your children, use a sunscreen that is at least SPF 15. Be sure to use a sunscreen that is water-resistant, and reapply every 2 hours after swimming or sweating.  And apply 30 minutes before going into the sun, as it needs time to work on the skin.1 One technique is to put it on before breakfast if you plan on going out in the morning, so that by the time your child gets outside it will have had time to work.

Both Ultraviolet A and B (UVA and UVB) subclasses of UVL can cause skin damage and lead to cancer, so be sure to buy a sunscreen that is labeled “broad-spectrum” that protects against both UVA and UVB.1-3

In addition, some sunscreens contain the active ingredient oxybenzone. This ingredient has been shown to be absorbed by the human skin and has estrogenic effects in animal cells, so avoid using any sunscreen with oxybenzone on your children.1

You can also use inorganic sunscreens, such as zinc oxide, to cover areas that are more likely to burn, such as the nose, cheeks, tops of the ears, and shoulders.1,2

  • Yes, but you’re probably using it inadequately

Sunscreens are designed to work properly only by applying 2 mg per square centimeter of body surface area, which is a very thick layer. Research has shown that most people apply 0.5-1.0 mg per square cm. At this rate of application, all sunscreens, regardless of stated SPF, provide an actual SPF of <10.3 So be sure to apply a thick layer of sunscreen to your children.

  • Yes, but remember that even with the sunscreen, they can still get sunburn.

Use sunscreen to protect your children, not as a reason to stay in the sun longer. And remember that even on cloudy days, human skin can get sunburned. Sunlight reflects off sand, water, snow and concrete, so if you are outside in these areas, be especially careful.1

  • Yes, but don’t use a combination sunscreen/insect repellent.

Use of a combination sunscreen/insect repellent is not recommended for several reasons. First of all, products with DEET (N,N-diethyl-m-toluamide) decrease the SPF of the sunscreen by about one-third. In addition, because of the need for repeated applications of the sunscreen, the child may absorb more of the insect repellent. And inorganic sunscreens like zinc oxide can lead to increased absorption of the insect repellent. So apply a sunscreen separately from an insect repellent for your children.2


References:

  1. Sun safety and protection tips. 2018. (Accessed April 15, 2018, at https://www.healthychildren.org/English/news/Pages/Spring-Break-Safety-Tips.aspx.)
  2. Julian E, Palestro AM, Thomas JA. Pediatric Sunscreen and Sun Safety Guidelines. Clin Pediatr (Phila). 2015 Oct;54 (12):1133-40.
  3. Sunscreen revisited. Med Lett Drugs Ther. 2011 Mar 7;53 (1359):17-8.
Ruben Rucoba
Dr. Rucoba has over 25 years of experience as a primary care pediatrician after completing medical school at the University of California, San Francisco. His clinical areas of expertise include caring for children with special health care needs and assisting families with international adoption. He has been a freelance medical writer since 2010, writing for health websites, continuing medical education providers, and various print outlets. He currently works at Wheaton Pediatrics in the suburbs of Chicago, where he lives with his wife and four daughters, including a set of twins.

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