MIDIRS Essence > June 2009 > Midwifery News

How best to protect babies from the sun’s harmful UVA & UVB rays

Originally posted on Jun 2009

With summer approaching, the question of how best to look after babies in the sun is going to be arising more and more. It is an important question, and parents must be properly educated in baby sun protection in order to make informed choices about looking after their children’s skin health through the warmer months.

An example of the importance of proper sun protection can be found in Australia. As the country with the biggest skin cancer incidence, a shocking one in two (WHO 2001), the now-famous ‘slip slop slap’ message was introduced to inform the public of the steps that they can take to reduce their exposure to dangerous UV rays. This campaign has successfully managed to reduce the incidence of the two most common types of skin cancer, basal-cell carcinoma and squamous-cell carcinoma (WHO 2001). Whilst the UK does not usually experience the same kind of intense, extended periods of sun that parts of Australia can do, we can certainly learn from them when it comes to educating parents about the importance of sun protection.

The UV exposure a baby or child experiences can have a lasting impact on their chances of developing skin cancer and the younger that exposure occurs, the longer there is potential for disease to develop. Estimates from the World Health Organization suggest that people endure 80% of their lifetime exposure to UV before the age of 18, a figure which surely can be reduced by instilling better sun habits in parents and children alike. According to the Skin Cancer Foundation, one blistering childhood sunburn more than doubles the risk of melanoma later in life (The Skin Cancer Foundation 2009).

With these sobering statistics in mind, it is time to start examining the measures that parents can take to reduce their child’s exposure to UV rays and chance of sunburn. The first step is determining when it is appropriate to take action to guard against the sun. It is not only when taking a beach holiday or in the height of summer that babies and children need to be protected from the sun, it is every day during the warmer months – even cloudy ones. Even in the middle of winter, reflected UV rays from snow can pose a threat, especially at high altitudes.

Babies have much thinner and more sensitive skin than adults and whilst very young, under six months, should not be exposed at all to direct sunlight. Simple measures such as buying a parasol for their pram, staying in the shade or planning trips outside for early morning and evening can reduce UV exposure in young babies. It is not advisable to use sunscreen on babies under six months as the main focus should be instead on stopping exposure in the first place.

Babies over six months should be kept out of the sun as much as possible and, where sun exposure is likely to occur, covered up with UV-protective clothes, sunglasses and a hat. On areas where it is simply not practical to cover up, such as the hands, face, ears and where items of clothing join, a broad-spectrum sunscreen should be used. The term ‘broad-spectrum’ indicates that the sunscreen protects against both UVA and UVB rays. UVA rays penetrate deeply into the skin but do not cause any visible damage. However, these are thought to be responsible for indirect DNA damage, which can contribute to melanoma, the most serious form of skin cancer. UVB rays affect the top layers of skin, causing DNA damage and the easiest to recognise sun-related skin condition, sunburn.

What factor sunscreen?
When deciding what factor sunscreen to use, it must be kept in mind that no sunscreen will provide 100% protection against the sun’s rays but all can help to provide UV mitigation. The SPF system is often misunderstood by consumers and increasing understanding here could be very beneficial in getting babies the proper protection they need in order to prevent problems down the line.

The SPF, which indicates the protection against UVB rays, indicates how much longer with sunscreen a person can stay in that sun than with nothing. So an SPF25 allows people to stay in the sun 25 times longer without burning. There are many variables which must be taken into account so it is not something which can be calculated accurately on an individual basis, but it is a helpful general indicator.

As far as SPF recommendations go, it is rarely necessary to use anything above SPF25, unless there is a medical condition such as vitiligo. The SPF system is on a logarithmic scale, which means that intervals are not always the same. The difference between SPF15 to SPF25 is much bigger than SPF25 to SPF35. In reality, the level of additional protection offered by SPF ratings higher than 25 is insignificant because even at SPF25, only 4% of UVB rays get through to the skin.

An SPF figure does not have any relation to the amount of UVA protection a sunscreen offers. The UVA protection offered by sunscreens is often indicated in the UK by the use of a star rating system, which is owned by Boots. One star is least and five stars is most. It is not quite so straightforward though because the star rating only shows the UVA protection in relation to the UVB rating instead of on a stand-alone basis.

Applying sunscreen correctly

• Apply 15-30 minutes before exposure to the sun to allow the skin to absorb it properly.


• Reapply after getting in to the sun to ensure full coverage and then again every two hours to give optimum protection.


• It should be remembered that people tend to underestimate drastically the amount of sunscreen they need so it is advisable to recommend twice as much as you think you need.

It is not advisable to use a sunscreen that is past its use by date or which has been opened for an extended period (see instructions on the bottle for detail). Sunscreens lose their protective abilities with age and once expired, may not deliver the level of protection which is advertised on the bottle.

As well as applying sunscreen to the skin, it is also important to protect babies’ lips from UVA damage. The lips are a sensitive area of the body where the outer layer of skin is much thinner and there is very little melanin (the pigment which can protect from UV damage). They therefore do not have much natural protection, especially when wet, as saliva intensifies sun exposure. An ultra-gentle SPF lip balm should be used at all times in warm weather and reapplied regularly.

Sun protection for babies with sensitive skin
It may be worth suggesting scent-free sunscreens for babies with sensitive skin, as added fragrance chemicals can increase the chance of an allergic reaction. However, even on babies who do not have sensitive skin, it is worth patch-testing sunscreens before slathering all over a baby in case of irritation. The day before sun protection is needed, take a little sunscreen and apply to the inside of the wrist. If there are any signs of redness or reaction, choose a different sunscreen. Sometimes children can become sensitised over time to certain chemicals in sunscreen so if a rash ever appears, immediately stop using the product and re-test it.

Some children and babies benefit from using natural sunscreens which are generally gentler and contain fewer harsh chemicals than some mainstream brands. These are worth recommending for babies with sensitive skin and ‘prickly heat’. Prickly heat is common in babies and children as their sweat glands are not fully developed and can be easily blocked, leading to the itchy, red rash typical of the condition. Natural sunscreens are less likely to contain pore-clogging ingredients, like those used in waterproofing, which can contribute to the prickly heat. Alcohol-based sunscreens should certainly be avoided as these can dry out the skin.

References

• World Health Organization (2001). Protecting children from ultraviolet radiation.
  http://www.who.int/mediacentre/factsheets/fs261/en/index.html
  
  
• The Skin Cancer Foundation (2009). Worst case scenario: treating sunburn.
  http://www.skincancer.org/worst-case-scenario-treating-sunburn.html

Emily Sheldrake | IT Coordinator & Product Manager | Green People Skincare

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