Summer in New York City and across Long Island is prime time for kids to be outside, where there’s no shortage of sweltering heat, stinging insects, and whatever infections the season doles out.
Whether you need advice on extracting a tick or soothing a painful sunburn, the pediatric experts at NYU Langone Health are here to help. Here’s your guide to managing common summertime menaces, plus doctor-approved tips to help keep Mother Nature from spoiling all the fun.
Hand, Foot, and Mouth Disease
Hand, foot, and mouth disease, also known as coxsackievirus, causes fever, mouth sores, and rash on the palms of the hands and soles of the feet. It’s common in infants and young children, especially in the summer and fall, and it’s contagious. The virus spreads through contact with bodily secretions and stool, which makes dirty pool water a potential source of infection. To reduce the risk of spreading germs, empty kiddie pools and water slides daily, rinse them with clean water, and let them air dry.
“The first time that kids get it is usually the worst,” says Sara Siddiqui, MD, a pediatrician at Hassenfeld Children’s Hospital at NYU Langone and NYU Langone Huntington Medical Group on Long Island. Keep your child home and use over-the-counter medicines to treat fever and pain. Your child should drink plenty of fluids to stay hydrated. It can take a week to 10 days for kids to feel better. Contact a pediatrician for a fever lasting more than three days or severe symptoms, including dehydration.
Kids need to replace fluids when they sweat, particularly when it’s a scorcher outside. Working, playing, or exercising in the heat boosts the risk of dehydration. Water is great for staying hydrated, but oranges, watermelon, and sports drinks count, too, says Ethan S. Wiener, MD, director of the Division of Pediatric Emergency Medicine.
Karen N. Goodman, MD, a pediatric emergency medicine doctor at NYU Langone, is a big fan of ice pops, “especially for a kid who doesn’t want to drink water.” Pro tip: You’ll know your child is parched if their mouth or tongue is dry, they’re not urinating, they’re not making tears, or they’re extremely tired or weak, she says.
Sweating is nature’s air conditioning. But when kids sweat excessively or become dehydrated, they may not be able to cool off, leading to heat illness. This can be a problem for teens who play sports in the heat and humidity, Dr. Wiener points out. Along with frequent water breaks, he recommends misting fans to keep cool.
Heat exhaustion, a type of heat illness, can cause muscle cramps, headache, and nausea, among other symptoms. When children are overheating, get them out of the sun, cool them down, and slowly start rehydrating them. Heat stroke, the most severe type of heat illness, occurs when body temperature spikes to dangerous levels—above 104 degrees Fahrenheit. Call 911 right away if a child has a high temperature or seizures.
If your child’s skin burns after being outside, consider doubling down on sun protection. Dress kids in sun-protective clothing, avoid midday sun exposure, if possible, and use enough sunscreen to cover any exposed skin. It’s best to apply your child’s sunscreen before they go outside. But sunscreen wears off, especially when children swim or sweat, so reapply it every 2 hours or immediately after they’ve been swimming or sweating.
Dr. Siddiqui reminds parents to keep babies in the shade. Sunscreen isn’t recommended for newborns or babies under 6 months old.
For minor sunburns, cool baths or compresses, over-the-counter pain relievers, and lotions or sprays made for post-sun exposure can ease symptoms.
Germy water that remains in your child’s ear after swimming can lead to a type of ear infection called otitis externa, or swimmer’s ear. Your child may experience significant ear pain or itchiness. The treatment? Antibiotic ear drops plus over-the-counter pain medication. It can take a week or more for the infection to resolve.
To help prevent these infections, towel-dry kids’ ears after they’ve been in the pool or hot tub. “A head tilt or ear pull can help the water trickle out. Or consider ear plugs or a bathing cap,” says Dr. Wiener.
Long Island and upstate New York are hotbeds for Lyme disease–carrying ticks, but that doesn’t mean New York City is in the clear. Blacklegged ticks, also called deer ticks, inhabit Staten Island and the north Bronx. Since ticks pose their greatest threat from the spring through the fall, protective measures are children’s best defense. As Dr. Siddiqui points out, “We all want the kids to be outside being active.”
If your child is venturing into wooded, shrubby, or tall grassy areas, insect repellent can help. DEET is safe and effective, “but don’t keep it on the skin longer than needed,” Dr. Siddiqui advises. Alternatives include products containing picaridin, IR3535, 2-undecanone, para-methane-diol (PMD), and oil of lemon eucalyptus (OLE), but do not use PMD or OLE on children under 3. Kids should wash off after being outdoors, and parents can do a tick check. Look for these tiny parasites under your child’s arms, behind the knees, between the legs, in and around the ears, in the belly button, around the waist, and in and around the hair. The sooner you remove a tick, the better. It generally takes 36 to 48 hours for a Lyme-carrying tick to transmit the disease.
For non-emergencies, our Virtual Urgent Care service providers can see a child 5 and older, accompanied by their parent or guardian, on a video visit.
To remove a tick, use fine-point tweezers to grab it at the point closest to the skin. Pull upward in a gentle, steady motion, and then wash the area with soap and water or rubbing alcohol. Flush the tick or wrap it tightly before tossing it in the trash. If your child develops a fever or rash, contact your pediatrician.
Wasp and Bee Stings
Bees often do not sting unless provoked, and they only sting once. But some wasps are aggressive, and they can sting multiple times, so teach your child to remain calm and move away slowly. Kids who have a known allergy to bee or wasp venom ought to carry an EpiPen and administer a dose if they have signs of anaphylaxis. Per Dr. Goodman, “If a child starts having difficulty breathing, swelling of the lips or tongue, vomiting, or abdominal pain or experiences a sense of doom or has fainting along with a possible rash, these are signs of anaphylaxis,” a rare but serious reaction. Call 911 or go to the nearest emergency department.
Most stings can be treated at home. If the stinger remains embedded in your child’s skin, use the blunt edge of a butter knife, the end of a credit card, or a fingernail to scrape it out. Try not to pinch or squeeze the venom sack. Clean the area with soap and water, and apply a cold pack to reduce swelling. Give ibuprofen or acetaminophen for pain relief.