Summer and Travel Tips with the Kids & Pediatric Vision Screening by Dr. Jon-Michael Castelli MD

Summer With the Kids

As summer approaches, we thought it could be helpful to send out a few tips and answers to some frequently asked questions. Even though City will be foggy and cold, the rest of California should see the sun, and many of our families will be traveling. Here are some tips to help stay safe and healthy during these fun-filled summer months!

Fun in the Sun

Lots of you will be enjoying the sun this summer. One of the most common questions we get as pediatricians is, “Which sunscreen do you recommend?” And, as a parent considering sunscreen for the kids, what you thought would be a quick online search can spiral into hours of head-spinning confusion! UVA, UVB, Vitamin A, Oxybenzone, sprays, mineral only… It’s enough to make you want to throw up your hands. Here’s a few basic tips and resources to help you navigate the confusing world of sunscreen, but also some things to think about other than just which sunscreen you choose………

  1. Sunscreen should be the last line of defense

Think about things like sleeves, hats, time of day, and bringing or finding shade in addition to which sunscreen you slather on. This is especially important for infants, as it’s recommended to not start using sunscreen until 6 months of age.

  1. Hydrate, hydrate, hydrate!

It’s so easy for kids having fun in the sun to forget to drink water. If they are asking for water because they’re thirsty, you’re already behind. Push the liquids, remind your kids to take sips of liquid often. And while we mostly shy away from juices because of the sugar-to-nutrition ratio, one liquid I’m loving right now as a hydration solution is coconut water. It tastes great, has electrolytes in it, and a little sugar, but really not too much.

  1. That’s all great, but what about the sunscreen?

Check out the link to the Environmental Working Group website for more information than you ever wanted to know about sun protection. The link below rates their 22 favorite sunscreens for kids. Many can be found at Whole Foods, and almost all of them can be ordered on Amazon.

  1. Use a lot, and reapply often.

The SPF is calculated by using about 1-1.5 ounces of sunscreen per total body application, which is 1 and a half shot glasses worth! Most of us aren’t applying that much, and if you’re not, you can’t really rely on the SPF to be a true indicator of how long you can be in the sun without starting to burn. So when using the sunscreen, apply liberally and often.

Don’t Bug Me!

Another common question, especially with the increasing distribution of the the mosquitos which cause Zika and the ticks which cause Lyme disease, is about safe and effective insect repellant for kids. Similar to sunscreen, there are multiple different types of repellant, and some advice on how to use them.

DEET– DEET is the ‘gold standard’ for insect repellants. It helps protect against both mosquito and tick bites, although at low concentrations it may not work as well, especially against ticks. The usual recommendation is to use a repellant which contains 10-30% DEET. DEET is not carcinogenic, and serious adverse effects are extremely rare. It appears to be safe for use in children (not under 2 months of age) and pregnancy

Picardin– An alternative to DEET which is less sticky, less smelly, but unfortunately, a little less effective. Preparations which are 20% work about as well as DEET, but not for as long, and not as well against ticks.

Oil of Lemon Eucalyptus– PMD is the active ingredient. Studies show it to be about half as effective as DEET, and it is not recommended for use in children under 3 years old, as there have not been studies to demonstrate effectiveness and safety

In the end, if you’re traveling somewhere that prevention of mosquito and/or tick bites are really a concern- go with DEET.

Some tips for application

  1. Spray on skin, or clothes, or both, but not on skin under clothes
  2. Wash hands after application to avoid getting it in your eyes or mouth
  3. Don’t apply to young kids’ hands. It will definitely end up in their eyes or mouths
  4. Don’t apply concurrently with sunscreen, and don’t use products which contain both in the same product. Insect repellant can reduce the effectiveness of sunscreen, and sunscreen needs reapplied much more frequently than the repellant.
  5. If you need both sunscreen and repellant, apply the sunscreen first, give a few minutes to absorb, then apply the repellant next.
  6. Reapply after swimming or bathing.

Miscellaneous Travel Tips

Here’s a few other ideas just to make sure everyone stays safe and healthy during our summer trips.

  1. Medical Facilities

Plan ahead to find out what facilities are available in the area in case of emergency. Whether traveling internationally, or within the states, making sure you have some idea about what emergency, urgent care, and pharmacy facilities are nearby is always a good idea

  1. Get Immunized

Check the CDC website for the recommended vaccines when traveling internationally. Here’s a great place to start:

If you think you might need vaccines other than the usual, make sure to contact the office well in advance, wither for advice, or to schedule, as some of the less common vaccines we don’t necessarily keep in stock and will have to order.

Another resource is the San Francisco Travel Clinic.

And CPMC has a travel clinic as well.

  1. Bring your meds

If your child is on regular or as needed medicines, such as inhalers, Epi-pen, etc.. Make sure to pack them, optimally in a carry on in case luggage gets lost! Always a good idea to bring some basics like Tylenol and ibuprofen for minor pain and fever, and Benadryl for those itchy rashes, help with sleep, and even motion sickness in a pinch. If you think there’s a high chance of motion sickness, we can always prescribe Ondansetron (Zofran) for you to bring with. And let us know if you’re worried about traveler’s diarrhea at your destination and we can have a chat about whether or not to take antibiotics with you.

Vision Screening with GoCheck Kids!

Many of our families have already seen one of our exciting new pieces of technology for vision screening. In the past, screening vision in young children has been unreliable at best, and for the youngest kids basically impossible for us to do. We recently started using GoCheck Kids, an app-based program which uses the flash camera on a smartphone, and the red-eye reflex in the picture, to evaluate the risk for issues with both eye alignment and actual vision in kids as young as 6 months! The computer algorithm is backed up by actual pediatric ophthalmologists for results which are complicated or inconclusive. Check out their website at to see more, and feel free to email Drs. Herbsman or Castelli with any questions.

Chanel Aflatoun

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