This position statement is endorsed by the Australasian College of Dermatologists
Too much ultraviolet (UV) radiation can cause sunburn, skin and eye damage, and skin cancer. Overexposure to UV during childhood and adolescence is a major factor in determining future skin cancer risk.
A baby’s skin is sensitive and can burn easily. The mechanisms are unclear, but the skin is particularly susceptible to the harmful effects of solar UV during childhood. The possibility that sun exposure during childhood stimulates the initial mutational step in the development of melanoma is supported by epidemiological research. The cumulative nature of sun damage indicates that infants should be protected from exposure to UV from the day they are born. It is recommended that infants under 12 months are always well-protected from direct sun when UV levels reach three and above.
When UV levels are below 3, sun protection is generally not required and a few minutes of direct UV exposure is considered safe and healthy for babies. However, if spending longer periods of time outdoors during low UV periods, it is recommended that your baby is wrapped or dressed in clothing that covers as much skin as possible, wears a hat and is kept in the shade.
Parents and care providers are encouraged to access UV levels and the daily sun protection times for their location which are available in the weather section of the newspaper, at Cancer Council's website www.myuv.com.au, on the free SunSmart app, and at the Bureau of Meteorology website.
To protect babies from solar UV, Cancer Council Australia recommends using a combination of sun protection measures whenever UV Index levels reach three and above as shown by the daily sun protection times.
Plan daily activities to ensure the baby is well protected from the sun. Aim to minimise time (or take particular care) outside during the middle hours of the day during the summer period when UV levels are at their strongest. These vary depending on your location in Australia, so checking the UV index is recommended.
Children often copy those around them and learn by imitation. Research shows that if adults adopt sun protection behaviours, the children in their care are more likely to do the same.
Sunscreen use and babies
Physical protection such as shade, clothing and broad brimmed hats are the best sun protection measures. If babies are kept out of the sun or well protected from UV radiation by clothing, hats and shade, then sunscreen need only be used occasionally on very small areas of a baby’s skin.
Sunscreens work in two ways:
- Blocking or reflecting the UV radiation away from the skin. These are known as reflectant or physical sunscreens, such as zinc oxide and titanium dioxide. Reflectant sunscreens may take on a milky-white appearance when applied to the skin.
- Absorbing UV radiation, preventing it from getting into skin cells. These are called absorbent or chemical sunscreens and usually containing a mixture of synthetic chemicals, such as cinnamates, dibenzoylmethanes (salicylates) and benzophenones. Absorbent sunscreens are usually invisible when applied to the skin.
The Australasian College of Dermatologists does not recommend the widespread regular use of chemical sunscreens in very young babies (less than six months of age), as they absorb more of any chemical applied to the skin than adults. However, physical sunscreen can be used on the areas of skin not covered by clothing and a hat.
Some babies may develop minor skin irritation in response to sunscreen use. True allergic contact dermatitis to the active chemicals in sunscreen is very rare, but may result from reactions to preservatives or perfumes in the product.
Sunscreen milks or creams formulated for sensitive skin usually contain titanium dioxide or zinc oxide and are less likely to contain alcohol or fragrances that might irritate the skin. It is recommended to first test the sunscreen on a small area of the baby’s skin to check for any skin reactions, which can take up to 48 hours to develop. As with all products, use of any sunscreen should cease immediately and medical attention should be sought if any unusual reaction is observed.
A lack of UV exposure can lead to low vitamin D levels. Vitamin D is produced when the skin is exposed to UV radiation and is necessary for the development and maintenance of healthy bones and muscles.
There is no evidence to indicate Australian children are low in vitamin D and most babies and children will get enough vitamin D from their daily exposure. Babies with darker skin types may produce less vitamin D. Vitamin D deficiency can also be a problem in chronically ill, or institutionalised children and in babies of vitamin D deficient mothers. However, because Vitamin D is only produced for the first few minutes of sun exposure each day, extended and deliberate sun exposure without any form of sun protection is not recommended, even for those diagnosed with vitamin D deficiency.
If you are concerned about a baby’s vitamin D levels, it is best to speak with a doctor.
Nappy rash includes a number of inflammatory skin conditions of the groin and buttock area that are direct or indirect result of wearing nappies. Nappy rash is extremely common and generally results from a combination of factors that begin with prolonged exposure to moisture from urine and faeces. Appropriate recommendations include frequent nappy changing, applying barrier creams to the affected areas and exposing the inflamed area to the open air as much as possible. The practice of exposing a naked baby to direct or indirect sun puts them at high risk of sunburn and skin damage and therefore is not recommended.
Neonatal jaundice generally only causes concerns in about 10% of babies. Treatment for jaundice should be under medical supervision in a controlled environment. Exposing babies to direct sun is inappropriate to treat neonatal jaundice.
Position statement details
This position statement was developed by Cancer Council Australia's National Skin Cancer Committee. The position statement was externally reviewed by Dr. Vanessa Morgan, Dermatologist. It was endorsed by Cancer Council Australia's principal Public Health Committee and published in April 2017.
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