Changing patterns of sun protection between the first and second summers for very young children

Objectives: To determine if an intensive intervention directed to mothers of newborns would increase levels of sun protection practice and lower rates of sunburning for their children; and to examine changes in sun protection practices and burning rates experienced between the first and second summers of life. Design: Randomized study Setting and Participants: Mothers of infants residing in the coastal town of Falmouth, Mass. Intervention: Mothers were randomly selected to receive hospital education alone or hospital education plus tailored materials and telephone counseling. Main Outcome Measures: Child's sun protection practices and degree of skin damage at mean ages 6 and 18 months, as reported by the mother. Results: Baseline surveys were completed by 108 mothers; 92 (85%) of the mothers completed posttests. There were few differences between intervention and control groups in use of sun protection for infants from the first summer (mean age, 6 months) to the second summer (mean age, 18 months). The child's routine use of hats, shirts, and shade dropped substantially from the first to the second summer. Conversely, sunscreen use rose from 34% to 93% (P<.001) for both groups during the same period. During the first summer, 22% of children received a sunburn or tan compared with 54% during the second summer (P<.001). Conclusions: Comprehensive sun protection begins to decline at a much earlier age,than previously reported. Future studies should focus on parents' beliefs about the need for, and practice of, vigilant sun protection as their children grow from infancy to toddlerhood.