Hylton I Lightman, MD DCH (SA) FAAP

School is winding down and summer vacation is gearing up.  The long summer break is necessary for the physical, mental and emotional well-being of children.  Most psychologists concur that children need time away from the regimentation of school.

This does not mean time children are to be “hefker” or that summer time for growth is fallow.  Camps and summer programs offer environments for other kids of learning.  These include team work so kids learn that there is something greater than themselves.  Kids learn resilience.  You fall down or make a mistake: pick yourself up and move on.  Kids learn to move out of their comfort zone and to make new, healthy decisions.

We agree that summer is a great time but we cannot leave it to chance.  We parents are obligated to structure our children’s environments for success during the summer months.

Here is a look at several points that you, Mommy and Abba, can implement to assure a win-win this summer for your child.

The well visit

Readers know that I believe in the well visit, that annual pilgrimage to the pediatrician once a child is past 3 years of age.  No matter your child’s age (or anyone’s age, for that matter), the well visit is important.  Your car requires an oil change every several thousand miles to stay healthy.  The annual well visit is the minimum one should do for our children and ourselves.  Launch your children into summer fun knowing that they are healthy by making sure that each one has had a well visit within the last 11-12 months.

Each age demands that the pediatrician looks at the child with a set of eyes appropriate to that point in development.

Overall physical development including height and weight – Is your child following his own curve?  Has there been an unexpected weight gain or loss?  Are you concerned that your child may be too short for his age?  Too tall for his age?  Is precocious puberty a possibility?  Is puberty delayed?  There are many points to review to assure optimal development.

Speaking of physical development, this is the time that the pediatrician should examine the patient’s genitalia.  In my practice, we have diagnosed testicular cancer (which was caught early and the person is now married and has a baby, Baruch HaShem) as well as non-malignant masses.  You get the message!

This is also an ideal time for you to communicate to your child the importance of his respecting his body.

The bottom line:  You want your child to have maximize physical activity this summer.  Make sure they are physically up to it and can participate to their heart’s content.

Vaccines – Vaccines save lives.  Period.  Say YES to vaccines.

The Centers for Disease Control and Prevention (CDC) has a robust website with information for the layman about vaccines as well as the recommended schedule of vaccines from birth into young adulthood (https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html).

Mental health

The adolescent well visit has several surveys to be completed.  The two most common ones are the 9-question survey for screening depression and the CRAFFT Screening Interview, a short clinical assessment tool designed to screen for substance-related risks and problems in adolescents.

If either tool hints at or reveals any problems, then please, Ema and Abba, deal with them and get your child the appropriate help AND inform the camp accordingly.  The more information the camp has, the better the staff can help your child.  See below.

Camp forms

Each camp has its own set of health forms to be completed and submitted in a timely manner.

Be honest, Mom and Dad, when completing the camp forms.

For example, does your child have ADD or ADHD and functions more optimally with medication?  Perhaps your child has allergies and needs to be with an epipen at all times.  Inform the camp accordingly and arrange for the medications together with explicit instructions for dispensing.

This is not the time to be “embarrassed” or to think that this information will compromise shidduchim for your children.  Do not hold back on notifying the camp nurse about psychiatric or neurological medications.  There are confidential boxes that can be checked and the camp nurse will call you privately.

Children’s physical, mental and/or emotional selves are at stake here.  If the camp staff encounters an emergency, then having the facts on hand will only help them to resolve it successfully and happily, without permanent harm or loss of life.

The camp environment

Whether it’s overnight or day camp, a travelling camp or NCSY program, your child will be changing clothes in close proximity to others.  Your children’s camps should have guidelines for changing times and workflows.  This should be included in a child protection policy and code of conduct developed by the camp which the camp’s professional heads have communicated to all staff and trained accordingly.

Further, if, G-d forbid, anything like inappropriate touching happens, what is the camp’s policy for addressing it?  How is such a situation reported?  How will the camp deal with a predator of any age?

Rooms that are on camp grounds that are not required for camp activities should not be accessed.  The rooms required for activities must be clearly seen and easily accessed.  During camp activities, doors should be kept open.  Preferably, camp staff should be working in pairs.

This is an ideal time, when speaking with you child, to instill or re-instill in him/her a respect for his/her body as well as respecting his peers for their bodies.  It’s also an appropriate time to discuss that no person should ever touch or examine his private parts unless it is a physician or other health care professional and only with a parent in the room.

Sometimes, intuition can tell us when another person’s vibe is projecting something off kilter or danger might be lurking.  Encourage your child to listen to his “gut feeling” and keep away.  Your child may want to discuss these feelings with a trusted staff member.  They might want to speak with you and that should be honored.

No drugs, no alcohol, no anything

It seems so obvious but it needs to be said.

No drugs, no alcohol, no anything.

Camps have zero tolerance for drugs and alcohol and inappropriate touching (as discussed).

What is the camp’s protocol for addressing drug and/or alcohol use and inappropriate touching?

I urge you to discuss this with your child in advance of camp so that he is prepared in case he encounters the “Heaven Forbid.”

Some suggested language:  “I love you very much and want only the best for you which means that you are safe at all times.  It is possible that you may see people indulging in drugs and alcohol.  I won’t be physically present but I hope and pray that you will exercise your free will to walk away and never touch the stuff.  You are helping others by reporting it to the camp.  Please know that I love you and you can talk to me about anything.”

Discuss the insidiousness of vaping, Juuling and now “Zyn-ing” as well as they are detrimental to their long-term being.

Fun in the sun means practicing sun safety

Summer time equals sun time and it’s crucial that our children (and all people) need sunscreen in order to be protected from the sun’s harmful rays, no matter how wonderful sunning may feel in the moment.  Sunscreen use can help prevent skin cancer which any person can get, regardless of age, gender or race.

Of course, the first and best line of defense is to cover up and to remain in the shade as much as possible between 10 am and 3 pm.  Sunscreens should offer broad-spectrum protection, Sun Protection Factor (SPF) 30 and higher, and water resistance.  Teach your children to apply, apply and apply, especially after swimming.  Instruct counselors how they can help as well with younger children and applying.  Sunscreens are also for cloudy days.  Brimmed hats are also a good avenue for sun protection (black-hat Borsalinos not necessary) as are some of the contemporary swim cover-ups.

Try to limit sun exposure midday when the sun is at its zenith.

By the way, sun safety is not limited to the time period between Memorial Day and Labor Day.  We should be vigilant about protecting ourselves against the sun and its harmful rays throughout the year.

The Colette Coyne Melanoma Awareness Campaign foundation (http://ccmac.org) has practical, useful information, including how to do body checks.  Colette’s tragic death at the age of 30 from melanoma spurred her mother to action to educate others so they would not suffer the same fate.  Educate ourselves to help your children.  Her story is on the website and is a moving tribute by a mother in pain who wishes to help others to save themselves and their children from the same fate.

Water

Summer time equals water.  Water is fun.  It also means following the rules.  Swim only where it is clearly marked and a lifeguard is on duty.  This includes pools, lakes and oceans.  Hopefully, your child’s camp has a strong swim program.  Investing in swimming lessons is a fabulous way to empower children.

A lifeguard should always be present in a public pool or beach.  No one should ever use a pool unsupervised.  If a child is older and knows how to swim, it’s still best practice that another person is present, in case of accident or anything.

Speaking of water, a win-win summer entails encouraging your children to hydrate at every opportunity with water.  Children are at greater risk for dehydrating because their bodies do not cool down as efficiently as adults.

• Make sure your child has access to cool drinking water at all times.
• Speak with them about scheduling hydration breaks. Before prolonged physical activity, a child should be well-hydrated. During the activity, periodic drinking should be enforced:  For example, each 20 minutes, 5 oz of cold tap water or a flavored sports drink for a child weighing 90 lbs, and 9 oz for an adolescent weighing 130 lbs.  This holds true even if the child does not feel thirsty.
• Sugary drinks are not recommended as they can aggravate dehydration. Sorry kids, my own grandchildren included.

Swimming pools, both public and private. Must be fenced off without easy access.  There should be some kind of pool covering in private pools.

Ticks

It is important to check for ticks.  Prior to bathing, palpate your child’s scalp and head.  Often, the tick can be felt as a bump and is not always seen when looking perfunctorily at the scalp.

For prevention purposes, spray all clothes with insect repellent.

FYI – If you are concerned that a tick bite has happened, after making sure the tick is not on your child’s body.  Note the date and then about 7-8 weeks later, reach out to your pediatrician to discuss blood tests to ascertain the presence of Lyme disease.

Helmets and head protection

Playing sports and riding bicycles smartly is the trick.  This includes protecting your head.

A sports-related injury to the head is called a “concussion,” which can temporarily interfere with the way the brain works.  Head injuries take time to heal and require rest.  Concussion symptoms can include headaches, dizziness, fatigue, irritability and difficulty with thinking skills, such as memory and attention. Post-concussion syndrome is a complex disorder of concussion symptoms that last longer than a normal recovery period.

Prevent injuries with appropriately fitting headgear and other equipment is a must.  It is also important to find out the camp’s protocol for an injury.

Be careful of dangling Tzizis getting caught in the bicycle chain or spokes of the wheel

Don’t leave your child in the car unattended

It is so easy to forget that you have a beautiful child sleeping in the back seat.  Sleeping are quiet and peaceful and in the craziness of our overprogrammed, hectic lives, it has happened that we forget they are there.

As always, daven.