American Academy of Pediatrics: Get kids outdoors but protect them from insects, sunburn

  • Insect repellents should be applied only on exposed skin -- not under clothing -- and to the outside of your child's clothing.

    Insect repellents should be applied only on exposed skin -- not under clothing -- and to the outside of your child's clothing. stock photo

By Sophia Balk, MD, FAAP
American Academy of Pediatrics
Updated 6/12/2021 8:33 AM

It's great for kids and families to head outside to play and take hikes, especially after the pandemic kept everyone indoors for so long. What hasn't changed during those long months is the need to protect your children from insect bites and too much sun. Emergency rooms have seen reports of tick bites trending up over the past few years due to warmer weather. Sunburns still make us all miserable and raise your risk of skin cancer later in life.

We want families to take advantage of being outdoors but we all need to do so safely. Diseases transmitted by certain insects can cause serious health effects in children and adults. Lyme disease, West Nile Disease, Zika and other diseases are transmitted by mosquitoes and ticks. Fortunately, we have good ways to protect against insects and protect children from sunburn.


Below are some tips for parents to help keep outdoor summer activities safe.

Insect repellents

• DEET-containing repellents are one of the most effective insect repellents, as long you follow directions on the label to use the product safely. The repellent repels biting insects such as mosquitoes and ticks but doesn't repel stinging insects including bees, hornets, and wasps.

• Be sure to check the product label to find the concentration of DEET in a product, which indicates how long the product will work. For example, 10% DEET provides protection for about two hours, and 30% DEET protects for about five hours. The AAP recommends that repellents should contain no more than 30% DEET when used on children. Insect repellents also are not recommended for children younger than 2 months.

• Choose the lowest concentration that will be effective based on the amount of time kids will be outside. If you know you will be out for an hour, for example, choose a product with 10% DEET.

• Insect repellents should be applied only on exposed skin -- not under clothing -- and to the outside of your child's clothing. Read product instructions and use just enough repellent to cover your child's clothing and exposed skin. Using more doesn't make the repellent more effective.

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• Apply the repellent on young children and help older children apply -- to make sure the product is used properly. If you use a spray, do so in an open area to avoid breathing in the repellent. If using on your child's face, spray the product on your hands, then apply, being careful to avoid the eyes and mouth. Avoid using repellents on scrapes, wounds or other broken skin. Don't use sprays around food.

• Clothing is important. If you are in the woods where there may be ticks, for example, wear long sleeves and pants -- a long-sleeved shirt with a snug collar and cuffs is best. Tuck the shirt in at the waist and tuck socks over your pants, hiking shoes or boots.

• Once you're back inside, wash the product off your child's skin with soap and water to remove any repellent, and wash their clothing before they wear it again. Do tick checks at the end of the day by examining your child's hair and skin.

• For younger infants, use mosquito netting over strollers and baby carriers when the family is outside. You can dress infants in cool, comfortable clothing -- such as lightweight cotton -- to protect their skin.


• Other "natural" insect repellents repel insects only for a short time and don't require registration with the Environmental Protection Agency. They might include citronella oil, cedar oil, geranium oil, peppermint, peppermint oil and soybean oil.

If you suspect an allergic reaction, such as a rash, to an insect repellent, stop using the product and wash your child's skin with soap and water. You can call Poison Help at (800) 222-1222 or your child's doctor for help. If you go to the doctor's office or other facility, take the repellent container with you.

AAP does not recommend products that combine sunscreen with DEET. Sunscreen should be applied every two hours, but DEET is used once a day. You can use these products separately. Store DEET and other repellent products away from children's reach.

Preventing sunburn

Many families rely on sunscreen as their go-to method to prevent excessive sun exposure and sunburn -- but there are other important ways to keep you and your kids safe when in the sun.

Clothes and hats can protect skin -- whenever possible, dress yourself and your children in cool, comfortable clothing that covers the body, such as lightweight cotton pants, long-sleeved shirts, and hats. Select clothes made with a tight weave; they protect better than clothes with a looser weave. If you're not sure how tight a fabric's weave is, hold it up to see how much light shines through. The less light, the better. Or you can look for protective clothing labeled with an Ultraviolet Protection Factor (UPF).

Wear a hat with an all-around 3-inch brim to shield the face, ears, and back of the neck. Try to limit your sun exposure between 10 a.m. and 4 p.m. when UV rays are strongest.

Wear sunglasses with at least 99% UV protection. Look for youth-sized sunglasses with UV protection for your child. Seek shade for your activities whenever you can.

Other tips:

• Use sunscreen. Choose a sunscreen that says "broad-spectrum" on the label; that means it will screen out both UVB and UVA rays.

• If possible, choose a sunscreen with the mineral ingredients zinc oxide or titanium dioxide. If you can't find a product with these ingredients, remember that using any sunscreen is better than using no sunscreen. We don't want anyone to sunburn since sunburning raises the risk of developing skin cancer later in life.

• Use a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15 (up to SPF 50). An SPF of 15 or 30 should be fine for most people. Research studies are underway to test if sunscreen with more than an SPF of 50 offers any extra protection.

• Apply sunscreen to parts of your child's skin that may be exposed to the sun, even on cloudy days because the sun's rays can penetrate through clouds. Make sure to use enough sunscreen. Reapply every two hours when outside, and after swimming and sweating.

• Keep babies younger than 6 months out of direct sunlight. Find shade under a tree, an umbrella, or the stroller canopy. If it's not possible to find shade, sunscreen may be applied to babies younger than six months to small areas of skin that are not covered by clothing and hats -- this is because we don't want babies to sunburn.

• Make sure everyone in your family knows how to protect their skin and eyes. Remember to set a good example by practicing sun safety yourself.

• Children's health is a continuing series. This week's article is courtesy of the American Academy of Pediatrics. To check out more information, visit AAP's website for parents,

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