Sun avoidance: Healthful practice or child abuse?

Sun avoidance: Healthful practice or child abuse?

Sun avoidance for children. By Marc Sorenson, EdD.

Sun avoidance or sun protection?Children must not practice sun avoidance.

Sun avoidance is deadly. And, no one would disagree that sun protection (covering up and seeking shade—not sunscreen use) is essential when one has reached sufficiency, further exposure could cause burning and thereby damage the skin. So, the operative phrase should always be, “protect against sun exposure when one has had enough.” Most noteworthy, however, is the fact that we abuse both our children and ourselves when we demand sun avoidance. This is not to say that the abuse is deliberate, since parents and health professionals alike may have their hearts in the right place. They are simply misinformed and lacking in knowledge.

Is sun avoidance as dangerous as water avoidance?

As a result of withholding water, a child (or adult) will quickly develop multiple organ failures and die. The results with sun avoidance might not be quite so dramatic, yet the same scenario occurs. Much as water deprivation leads to catastrophe, sun deprivation leads to multiple maladies, life-threatening or otherwise. And unfortunately, the term “sun protection,” as used by many dermatologists, means staying out of the sun at all costs. Hence, we could call it sun avoidance. To suggest or promote that idea is not really protective; rather, it might be considered abusive, no?

First of all, the vital need for safe sun exposure in children has been firmly established by research. Therefore, we should review the facts:

  • Do we love our little girls? Consider this: those who have the greatest sun exposure have a 35% reduced risk of breast cancer as adults. So sun avoidance, aka “sun protection” may lead to breast cancer.[2] Requiring sun avoidance of girls could be child abuse, no?
  • Also, sun exposure in expectant mothers reduces the risk of leukemia and other cancers in their children.[3] Therefore, could encouraging sun avoidance end up as child abuse?
  • In addition, children also benefit from sun exposure’s protection against Non-Hodgkin’s-lymphoma (NHL) risk. Sun exposure is associated with a 40% reduced risk.[4] Therefore, could advocating for sun avoidance be child abuse?

More outcomes of sun avoidance in children: prostate cancer, blood pressure, multiple sclerosis and asthma.

  • Another point is this: men exposed to high quantities of sunlight as children have one-fifth the risk of contracting prostate cancer.[5] So, is demanding childhood sun avoidance a form of  child abuse?
  • It is most noteworthy that in children, blood pressure is higher in winter than summer.[6] This is probably due to nitric oxide production by sun exposure to the skin. It is especially relevant to remember that vitamin D is only one of many vital photoproducts stimulated by sun exposure. Therefore, could it be that promoting sun avoidance is child abuse, due to the fact that it may lead to heart disease?
  • In addition, adults who experienced low childhood sun-exposure are three times more likely to develop multiple sclerosis (MS).[7] So, does it seem like promulgating sun avoidance could be child abuse?
  • Also, living in rooms without sunlight is associated with a 930% increase in the risk of childhood asthma.[8] Hence, could sun avoidance be like child abuse?

Are childhood pneumonia, lower respiratory infection, autism and rickets predicted by sun avoidance?

  • First of all, each one-hour increase in sun exposure per day lowers a child’s risk of contracting pneumonia by about 33%.[9] And, pneumonia kills many children. Does promoting sun avoidance seem like child abuse to you? So here is another question: should you also limit your child to only an hour per day outside?
  • Another fact is that children with very low blood vitamin D levels are ten times more likely to contract acute lower respiratory infection (ALRI).[10] That is, compared with children with the highest levels. Especially relevant is the fact that about 90% of vitamin D in serum is produced by sun exposure to the skin.[11] Therefore, this study really shows the benefits of sun exposure for children. And, does it also establish that suggesting sun avoidance could be a form of abuse?
  • Finally, urban children have significantly higher rates of both rickets and autism when compared to rural children. Lack of sunlight, of course, is the reason.[12] Is this another reason to define sun avoidance as child abuse?

Other disorders associated with sun avoidance in children: bipolar disorder, eczema, myopia, anaphylaxis and rickets.

  • Increased number of hours of daylight at the location of birth during the first three months of life are associated with a significantly older age of onset of bipolar disorder.[13] Babies need sunlight, so be sure to carefully provide them substantial, non-burning sun exposure. Why? Because regular sun avoidance for babies might be considered abusive.
  • Children with low sun exposure also have a significantly increased risk of eczema.[14] Could sun avoidance, therefore, be considered a form of child abuse?
  • Children who spend most of their lives indoors also have 9.5 times the risk of developing myopia compared to children who spend their lives outdoors! So, sun avoidance may lead to blindness in children. Does that constitute child abuse?
  • Anaphylaxis is much more prevalent in countries with low sunlight availability.[15] Anaphylaxis can kill. So could sun avoidance, especially in countries that already have low sun exposure, be considered abusive?
  • Rickets is returning to the U.S.[16] This can only be due to the lack of sufficient sunlight to produce vitamin D, either in the expectant mother or in the child itself. Therefore, could promoting sun avoidance for these children be considered a form of abuse?

Growth rates, brain cancer and melanoma in children: are they associated with sun avoidance?

  • Children’s growth is accelerated in seasons of greater sunlight exposure.[17] Does retarding a child’s growth, through promoting sun avoidance, seems like a good idea to you?
  • Children born in seasons of little sunlight have a greater risk of developing brain cancer.[18] Do you really want your children to avoid the sun? That seems like a form of abuse to me.
  • Children who engage in outdoor activities are less likely to develop melanoma than those who do not.[19] Since 1935, sun exposure has decreased by 90%. Melanoma has increased by 3,000%. So, promoting sun avoidance seems abusive to me. How about you?

Sun avoidance predicts poor outcomes for dental health in boys.

• Boys (and probably girls) growing up with high sunlight exposure have 40% fewer dental caries than boys who grow up with low exposure. So sun avoidance, aka “sun protection” obviously has a detrimental effect on dental health.[1] Hence, could requiring sun avoidance of boys be child abuse?

No sun avoidance in my youth

As a youngster, I spent most of my days on the farm working in the sunlight. No illnesses developed in the summer. And, I never had a skin cancer later in life. How can that be? I am a blue-eyed, light skinned Caucasian, and yet skin cancer never materialized. So did sun exposure protect me? Probably. I was never subjected to sun avoidance, the abuse that is so prevalent today.

Caution! Remember that at no time should you burn yourself. People who cannot tan need to stop sun exposure to the skin at the first sign of redness. Work into a few minutes of sunlight over days or weeks if necessary. And, one way for light-skinned non-tanners to obtain sun is to be under a beach umbrella in a bathing suit. Nevertheless, do not burn. Watch for reddening and cover up immediately if it occurs.

Words of caution regarding sunscreens

Caution! Don’t think that sunscreens will help you avoid damage. That is because they are not sun protection. First of all, the latest research, a meta-analysis, shows that sunscreen use does not make any difference in skin-cancer risk.[20] Secondly, other late research also shows that people who use sunscreens are much more likely to experience sunburns than non-users.[21] As a result, those who used sunscreens were about two-and-one-half-to-four-times more likely to sunburn compared to those who used other methods to prevent excessive exposure. Hence, covering up with clothing or seeking shade is a far better method of protection than sunscreens, which are no protection at all. Could the use of sunscreens with children constitute sun avoidance and be another form of abuse?

Embrace the Sun, but do it carefully, and please do not engage in the abusive practice known as sun avoidance.

Read more about sun avoidance and children’s diseases in my new Sun avoidance is abuse. book, Embrace the Sun, available at Amazon. https://www.amazon.com/Embrace-Sun-Marc-B-Sorenson/dp/069207600X

Also, read hundreds of blogs on sunlight at https://sunlightinstitute.org/

[1] McBeath, E. The role of vitamin D in control of dental caries in children. J Nutr 1938;15:547.

[2] Knight JA, Lesosky M, Barnett H, Raboud JM, Vieth R. Vitamin D and reduced risk of breast cancer: a population-based case-control study. Cancer Epidemiol Biomarkers Prev 2007;16(3):422-9.

[3] Christina Lombardi, Julia E. Heck, Myles Cockburn, and Beate Ritz. Solar UV Radiation and Cancer in Young Children. Cancer Epidemiol Biomarkers Prev 2013;22:1118-1128.

[4] Petridou ET, Dikalioti SK, Skalkidou A, Andrie E, Dessypris N, Trichopoulos D. Sun exposure, birth weight and childhood lymphomas: a case control study in Greece. Cancer Causes Control. 2007 Nov;18(9):1031-7.

[5] Moon SJ, Fryer AA, Strange RC. Ultraviolet radiation: effects on risks of prostate cancer and other internal cancers. Mutat Res 2005;571(1-2):207-19.

[6] Polat M, Akil I, Yuksel H, Coskun S, Yilmaz D, Erguder I, Onag A. The Effect of seasonal changes on blood pressure and urine specific gravity in children living in Mediterranean climate. Med Sci Monit 2006;12:CR186-90.

[7] van der Mei IA, Ponsonby AL, Dwyer T, Blizzard L, Simmons R, Taylor BV, Butzkueven H, Kilpatrick T. Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study. BMJ 2003;327:316-321.

[8] Kamran A, Hanif S, Murtaza G. Risk factors of childhood asthma in children attending Lyari General Hospital. J Pak Med Assoc 2015 Jun;65(6):647-50.

[9] Paynter S, Weinstein P, Ware RS, Lucero MG, Tallo V, Nohynek H, Barnett AG, Skelly C, Simões EA, Sly PD, Williams G; ARIVAC Consortium. Sunshine, rainfall, humidity and child pneumonia in the tropics: time-series analyses. Epidemiol Infect. 2013 Jun;141(6):1328-36.

[10] Wayse V, Yousafzai A, Mogale K, Filteau S. Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 y. Eur J Clin Nutr 2004;58:563-7.

[11] Reichrath J. The challenge resulting from positive and negative effects of sun: how much solar UV exposure is appropriate to balance between risks of D deficiency and skin cancer? Prog Biophys Mol Biol 2006;92(1):9-16.

[12] Williams JG, Higgins JP, Brayne CE. Systematic review of prevalence studies of autism spectrum disorders. Arch Dis Child 2006;91:8-15

[13] Bauer M, Glenn T, Alda M, Andreassen OA, Angelopoulos E, Ardau R, Baethge C, Bauer R et al. Influence of light exposure during early life on the age of onset of bipolar disorder. J Psychiatr Res. 2015 ;64:1-8.

[14] Rueter K, Jones AP, Siafarikas A, Lim EM, Bear N, Noakes PS, Prescott SL, Palmer DJ. Direct infant UV light exposure is associated with eczema and immune development. J Allergy Clin Immunol. 2018 Oct 15. [Epub ahead of print]

[15] Mullins RJ, Camargo CA. Latitude, sun, vitamin D, and childhood food allergy/anaphylaxis. Curr Allergy Asthma Rep. 2012 ;12(1):64-71.

[16] Weisberg P, Scanlon KS, Li R, Cogswell ME. Nutritional rickets among children in the United States: review of cases reported between 1986 and 2003. Am J Clin Nutr 2004;80(6 Suppl):1697S-705S

[17] Marshall WA. Evaluation of growth rate in height over periods of less than one year. Arch Dis Child. 1971;46:414–420.

[18] Heuch JM, Heuch I, Akslen LA, Kvåle G. Risk of primary childhood brain tumors related to birth characteristics: a Norwegian prospective study. Int J Cancer 1998;77:498-503.

[19] Kaskel P, Sander S, Kron M, Kind P, Peter RU, Krähn G. Outdoor activities in childhood: a protective factor for cutaneous melanoma? Results of a case-control study in 271 matched pairs.Br J Dermatol. 2001 Oct;145(4):602-9.

[20] Silva ESD, Tavares R, Paulitsch FDS, Zhang L. Use of sunscreen and risk of melanoma and non-melanoma skin cancer: a systematic review and meta-analysis. Eur J Dermatol. 2018 Apr 1;28(2):186-201.

[21] Kasey L. Morris, PhD; Frank M. Perna, EdD, PhD. Decision Tree Model vs Traditional Measures to Identify Patterns of Sun-Protective Behaviors and Sun Sensitivity Associated With Sunburn. JAMA Dermatol. Published online June 27, 2018

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