Sun Protection for Infants: Parent Behaviors and Beliefs in Miami, Florida
Children who are not adequately protected from the sun have an increased risk for developing skin cancers later in life. The primary objective of this study was to determine the sun protection behaviors that black and Hispanic parents in Miami, Florida, employ in infants younger than 6 months. Secondary objectives included determining if this patient population is at risk for infant sunburns and tanning, beliefs among parents regarding sunscreen's efficacy in the prevention of skin cancers, and limitations of sunscreen use. An institutional review board-approved survey was administered to parents presenting to the University of Miami general pediatrics clinic. The main outcome measure was the self-reported consistency with which parents employed each of 6 sun protection strategies in infants. The results of this study highlight some potential shortcomings in current practices in sun protection for black and Hispanic infants.
Practice Points
- Infants of all racial and ethnic backgrounds need protection from the sun's rays. Remember to counsel parents on the importance of sun protection.
- Instruct parents to keep infants in the shade when outdoors and to dress infants in a long-sleeved shirt, pants, and a hat. Intentional sun exposure for infants is not recommended.
- The American Academy of Dermatology currently recommends that parents begin sunscreen application when their child reaches 6 months of age. Broad-spectrum barrier sunscreens containing zinc oxide or titanium dioxide are preferred and should provide a sun protection factor of 30 or greater.
Comment
The survey results indicated suboptimal sun-protection practices among parents of black and Hispanic infants in Miami. Although the majority of respondents (83% [58/70]) reported keeping their infants in the shade, less than half of parents consistently covered their infants adequately with clothing and hats (40% [28/70] and 43% [30/70], respectively). More alarmingly, one-third of parents reported intentionally increasing their infant's level of sun exposure to develop his/her tolerance to the sun. A minority of parents reported sunburns (3%) and tanning (12%) within the first 6 months of life. Twenty-nine percent of parents (20/70) reported consistently applying sunscreen to their infants who were younger than 6 months despite limited safety data available for this age group.
Although our study included a limited sample size and represents a narrow geographic distribution, these results suggest that shortcomings in current practices in sun protection for black and Hispanic infants younger than 6 months may be a widespread problem. Black and Hispanic patients have a lower incidence of skin cancer, but the diagnosis often is delayed and the mortality is higher when skin cancer does occur.4 The common perception among laypeople as well as many health care providers that black and Hispanic individuals are not at risk for skin cancer may limit sun-safety counseling as well as the overall knowledge base of this patient demographic. As demonstrated by the results of this study, there is a need for counseling on sun-safe behaviors from a young age among this population.
Conclusion
This study highlights potential shortcomings in current sun-protection practices for black and Hispanic infants younger than 6 months. Sun-safe behaviors instituted from a young age may help reduce the risk for future skin cancers.3 Additional studies are needed to further define sun-safety behaviors in black and Hispanic children across the United States. Further, additional studies should focus on developing interventions that positively influence sun-safety behaviors in this patient population.
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