Anyone who follows our blog knows that we love to speak with safety experts. At Life Saver Pool Fence, our driving goal is to keep kids safe. Today we’re speaking with Dr. Andrea Burns.

Who is Dr. Andrea Burns?

To put it simply, Dr. Andrea Burns is someone who cares deeply about children’s safety. She is a well-known board certified Pediatrician. Dr. Burns has been practicing in the Orlando and Seminole County areas since 2008. She is known for her community involvement, as a speaker and volunteer. Additionally, her medical expertise and genuine love for children is highly regarded in Florida.

Today, she spoke with Life Saver Pool Fence‘s president, Eric Lupton, about her practice and other important swimming safety related topics, including the myth of Dry Drowning.

You can watch their conversation right here:

Thanks to Dr. Andrea Burns for sharing her story with us. She’s truly doing her part in the community to help save lives.

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Below is a Direct Transcript of the Child Safety Resource Interview with Dr. Andrea Burns on July 3rd, 2018:

Eric Lupton:   And that’s it, we are on the internet just like that. Just like magic. Good morning, how is it going?

Andrea Burns:     Good, how are you?

Eric Lupton:    Awesome!

Andrea Burns:   Happy Monday!

Eric Lupton:    Right, happy Monday. We are two days shy of Fourth of July.

Andrea Burns:    Yes, we are!

Eric Lupton:    Which is in the middle of the week. Which I was not happy about , its kind of a weird spot.

Andrea Burns:   It is a weird spot, I agree!

Eric Lupton:    I’m excited because I have known Dr. Andrea Burns for a long time. How long have I known you?

Andrea Burns:   Oh my gosh, at least 10 years, right?

Eric Lupton:   At least 10 years for sure.  It may have been ten years ago since I’ve seen you.

Andrea Burns:   Probably

Eric Lupton:   And then, how long do we know each other on top of that? So, you prefer Dr. Andrea or Dr. Burns? Because I saw both.

Andrea Burns:   either one is fine.

Eric Lupton:   Dr. Andrea is a paediatrician she practices out of Orlando and a private practice.  She prides herself on her community involvement and her bedside manner and just being awesome in general and you just transitioned into private practice you said?

Andrea Burns:   I did yes, a few months ago. It’s been great.

Eric Lupton:   Nice so, what’s the difference?

Andrea Burns:   There are some big differences but basically, you have your Hospital Based Systems where the hospital owns the practices and then you have your private practices which are usually owned by physicians.

Eric Lupton:   Okay!

Andrea Burns:    The practice that I’m at is owned by a physician for over 45 years.

Eric Lupton:   What is the origin story of Dr. Burns? Why did you decide to become a doctor?

Andrea Burns:   Well my mom loves to tell this story.

Eric Lupton:   She’s not here!

Andrea Burns:   She’s not here so, I would say for me, I’m one of those people that knew that I wanted to be a doctor since I was a child. I decided around five years old to become a paediatrician or a kid doctor and that’s because one of my doctors, Dr. Talbert was such an amazing doctor. What I remember is, he always talked to me whenever I was in the room, even as a young child he asked me questions and looked to me to answer questions about how I was. That just made me feel special as a child and as a person.  I always took that with me and wanted to give that to children as I got older.  I just naturally loved children in general.

Eric Lupton:   Nice and where did you go to school?

Andrea Burns:   I went to Florida A&M; University for undergraduate in Telhase Florida and I went to the University of Florida, College of medicine for medical schools, 12 years.

Eric Lupton:   For anybody who doesn’t know, in Florida there is a steep rivalry between teams the FSU the Gators, it’s a trifecta of hate.

Andrea Burns:   If you’re from Florida, you usually love football.

Eric Lupton:   Most people, right?

Andrea Burns:   Yes!

Eric Lupton:   I’ll brace myself but something about guys playing with balls, I never really cared. So how long did you finish?

Andrea Burns:   I graduated and became a doctor ten years ago.

Eric Lupton:   okay! You know, you were still at school when we met so there’s the yardstick about that. Did you immediately go into hospital system?

Andrea Burns:   I did not, got a few years in private practice before I transitioned into the Hospital Based System and then again, this year came out back into private practice which is where I think I fit best.

Eric Lupton:   Since you’ve been doing it what surprised you about the reality of doing it versus kind of what you expected before it.

Andrea Burns:   Oh, there’s so many surprises I mean there’s always something, you’re always learning. I mean they call it the practice of medicine because you literally are practicing you know you’re learning something every day and I think one of the things that I value about it is just knowing that the parent, the mom the father knows so much about their child. Their advice to you or their information to you is very important. I mean, if you see a child that looks healthy, but the parent says something is wrong, probably something is wrong.  You know, heeding the advice of the parent is so important and working as a team.  I think for me, it’s just a humbling experience because as a doctor I’m privileged to go into people’s private lives to hear things that they wouldn’t tell anyone else. So just seeing how much people trust their position it’s an honour to me and I value that.

Eric Lupton:   Was there anything you expected about becoming a doctor that’s turned out to be completely wrong?

Andrea Burns:   No, I don’t think so. It’s a lot of work, I mean it certainly is a lot of work and it’s a lot of a time commitment, but I don’t think you can honestly expect it until you’re in it. So, I think for anyone that’s probably a little bit of a surprise but when I get to participate in the patient care and see the kids it’s everything I would love it to be. Kids say the funniest things so, it gives back every day.

Eric Lupton:   Do you have something funny that he could have said recently?

Andrea Burns:   Oh, my goodness! Ah, let’s see, we ask kids about pain scales sometimes. A scale of 1 to 10 and when asking about pain in the head or the throat I’d say, on a scale of 1 to 10, 10 being the worst pain one being no pain. Where you would put the pain and they’ll give you a little pause and they’d say, on my throat.

Eric Lupton:   That’s awesome, that is a correct answer.

Andrea Burns:   It is, they’re just so innocent.

Eric Lupton:   Do you go all the way to age 18?

Andrea Burns:   Basically 17, typically kids will transition out by the time they turn 18.

Eric Lupton:   I mean, that’s a broad transition from 17s to zero.  I almost feel like that should be two specialties, right? Because that’s a broad.

Andrea Burns:   You do have some physicians that specialize in adolescent medicine for the teenagers, but most paediatricians cover from new born to about 17,18 and for some of our more complexed children we follow some of them up until the age of 21.

Eric Lupton:   Oh, well I’ve known people who stuck with their paediatrician into their 20s. I don’t think they are complexed, I think they just decided they liked the doctor.

Andrea Burns:   Yes, it sounds very difficult separating. We love them, but we must set them free eventually, yes.

 Eric Lupton:    So, do you prefer treating younger children or the adolescent age?

Andrea Burns:   I love all ages, but I would have to say, I had this debate with one of my colleagues. Six-month-old is my favourite age. They’re just so happy and excited, they’re not afraid and they don’t have the stranger anxiety yet. They’re just so cute and adorable so, that would probably be my favourite age to see.

Eric Lupton:   They can’t talk much?

Andrea Burns:   They scream and babble. I had parents ask me why they are screaming like this again. Because they found out that they can, right?

Eric Lupton:   And why not?

Andrea Burns:   Exactly!

Eric Lupton:   They don’t have any other ways to express themselves, right?

Andrea Burns:   They don’t! Screaming or snatching something, like hair tool said they got to use when they got yeah

Eric Lupton:    I mean, limited tool set

Andrea Burns:   Exactly, exactly

Eric Lupton:   So, are you familiar with the term Secondary Drowning or Dry Drowning?

Andrea Burns:   I have heard that term, yes.

Eric Lupton:   You know anything about it?

Andrea Burns:   I do, yes.

Eric Lupton:   Would you tell me your thoughts on Dry Drowning or Secondary Drowning?

Andrea Burns:   My understanding I think, it’s a term that came up over time which is just a description of delayed symptoms of drowning. So, basically you know what a child is so the definition of drowning itself is when a child is having a respiratory impairment or compromised because they’ve been submerged or immersed in large amounts of water. They’re not even the large amounts with a good amount of water and they developed a difficulty breathing, shortness of breath, spasms things like that. That can compromise the oxygen getting to their body and sometimes they don’t developed symptoms when the side effects of the tissue damage and things like that until later. Usually in that first 24 hours after that’s happened to them and I think some people have started calling that dry drowning because they think it’s something that happened later but it’s a process that started when the actual drowning occurred.

Eric Lupton:   Yes, it’s kind of a misnomer, right? The media kind of latched on to it and you saw a lot about Dry Drowning in secondary drowning but really, it’s just drowning happening later which I think is important for you’ll to realize before you start freaking out about Dry Drowning, knowing what the thing is, it’s probably helpful.

Andrea Burns:   Exactly and it’s not going to be three days from now that your child is having an issue that would be exceedingly rare. Typically, if we’re worried about a child we will watch them for about 24 hours and if they’re doing fine then they’re probably going to be just fine.

Eric Lupton:   And there will be signs of an accident. Your kids are not going to be in the pool and then get out, be fine and drop dead of Dry Drowning 24 hours later.

Andrea Burns:   Exactly so, common signs can be they could be coughing, they might have short of breath, they may be gasping a little bit and that brings fast chest discomfort. They may feel tired, they may be more irritable than usual and trying to sleep. So, these can be seen with other things but if your child was previously doing well and then slowly your start seeing these things evolved they’ll certainly want to seek medical attention right away.

Eric Lupton:   Absolutely, so since it is summer and the 4th of July what kind of things do you tell parents coming up for summer, to keep something safe and happy and avoid any problems?

Andrea Burns:   Well the big thing, because fourth of July certainly means swimming, especially if you’re over at the beach where I’m from. It means lots of exposure to the sun, at picnics, while you’re swimming or just spending time at the playgrounds. So, it’s important to make sure that you cover Sun safety. I’ve been doing reviews for the last few months, with parents on how to pick out sunscreens, how to apply those sunscreens and making sure that you don’t get dehydrated while out there.

Eric Lupton:   So, what should someone look for in a sunscreen?

Andrea Burns:   Basically, especially for children there’s a few things you want to look at. You want to make sure that when you buy a sunblock or sunscreen that it’s SPF 30 or higher. The American Academy of Dermatology recommends 30 or higher but recently on TV, I’ve seen some reports that say when they’ve tested these sunscreens not all of them did what they said. So, what I’ve been recommending to my patients is to go with the SPF 50 or higher and then that way you at least know that you’re getting the 30.

Eric Lupton:   Is there any downside to a 50 over a 30? I always wonder why people just didn’t pick the highest number.

Andrea Burns:   Not really, there’s no downside to a higher number but what people need to understand is once you go past that 50 there’s not really a much more added value that is shown.

Eric Lupton:   Okay!

Andrea Burns:   Basically, if you get that 50 area you’re good getting up to like 200 and so forth doesn’t necessarily mean they’re going to have better coverage. You also want to buy one that’s broad-spectrum. There’s different ultraviolet rays from the sun, there’s UVA and UVB think of UVA as aging so that’s where you get your sunspots and your wrinkles and the UVB think of that as your burn that’s the one that’s most likely to give you a sunburn. So, you want to buy a sunblock that covers both hence, broad spectrum. There is no such thing as waterproof, they’re water resistant so pick one that’s either water resistant which means it lasts usually about 40 minutes or very water resistant which can be up to 80 minutes and make sure that again it’s water resistant not waterproof. If you’re washing it off or you’re drying it off a lot, if you’ve been in the water or in the sun for more than two hours you need to make sure that you’re reapplying it.

Especially for children you need to use one that’s for children because they have more sensitive skin so buy a product that says for kids or for babies and stay away from the ones that have the chemical oxybenzone in them because it’s been shown to possibly have some hormonal properties.

Eric Lupton:   Got you! What’s in the kid ones that is better for kids, is it just to avoid rashes or irritation?

Andrea Burns:   That’s the big thing yes, because a lot of kids have sensitive skin some people have eczema and I can kind of cover younger babies too, but they do tend to have more sensitive skin. So, you want to make sure that these products don’t have extra perfumes, extra unnecessary chemicals, you don’t want any tanning products in there either. It’s just that there’s more and more added to the adult products, zinc oxide and titanium dioxide or other great ingredients that can help protect sensitive skin. For babies especially if they’re having a hard time with different sunblock stick you’re buying you can look for that and then a big thing that parents asked me with their young kids is; Can I put sunblock on my baby? That’s a good question because you do want to be cautious so, sunblock is recommended, or sunscreen is recommended for children six months and older and that’s because babies under six months old have very sensitive and thinner skin than older children and adults do. It may not provide enough protection for them and they’re so very little with big heads so you’re putting on something that has some chemicals in it. They’re going to be absorbing more over their body surface area and that may not be good for them.  So, in general you want to give them loose breathable clothing with a tight weave, floppy hats, cover their feet and if you’re going to use sunscreen only use it on their face like their ears, their neck and the top of their feet or areas that may not be covered by the clothing that you have them in.

Eric Lupton:   Yes, I think a lot of people don’t realize your clothing is one of your best forms of sunscreen.

Andrea Burns:   Absolutely, long sleeves pants and they do sell products that have sun proof factor that blocks the sun. Those are the clothing that you can buy for babies, but a big thing is when you buy those hats make sure, for babies or anyone, get the floppy hats don’t get the baseball caps because it’s not going to cover your ears and your neck. Athletes come in and tell me how they got burned because they weren’t thinking, and they thought it was enough.

Eric Lupton:   Perfect so, with the kid sunscreen if it has less stuff in it, is the sunscreen safe for adults does it go through the way around?

Andrea Burns:   Yes, absolutely!

Eric Lupton:   Because as someone who doesn’t like putting extra stuff on me the baby sunscreen sounds more appealing than the adult sunscreen with all the extra junk in it.

Andrea Burns:   Now, there is another caveat. I don’t know how you grew up, you’re from over on the beach side too but believe it or not most people buy the right sunscreen, but you have to put it on properly and most people put on half to less than half of what’s needed.

Eric Lupton:   Really?

Andrea Burns:   Yes, so you must put it on properly, when we were growing up, you would see kids standing at the beach like parking and spraying the sunscreen on or putting it on the beach you’re supposed to apply it fifteen to thirty minutes before the sun exposure for it to absorb and  working properly. So, you want to make sure that you’re doing that, you want to make sure that you use an abundant amount when it comes to the sprays. It’s hard with the sprays, people love them, I love them but it’s hard to tell if you put it on because you don’t really see it so once you spray it all you want to rub it in really well and you don’t want to spray in the face because you don’t want to breathe it in. Kids can get a reaction too, it can cause problems in your lungs but it’s free on your hand and then rub it in and rub it in all over.

Eric Lupton:   That’s it yes, I always think the spray reminds me of shampoo that doesn’t bubble like it doesn’t feel like it’s working, I want to see it lather up for it to work.

Andrea Burns:   Right, see it to believe it.

Eric Lupton:   I’m sure the shampoo’s doing a fine job but if it doesn’t lather up, I’m like no, I don’t trust it. So obviously when someone gets sunburned they turn red are the other signs and when someone does get sunburned how do you treat them?

Andrea Burns:   So, typically you can see red skin well, let me back up, so most of the time symptoms of sunburn usually show up hours later but you do want to keep your eye out, especially for those babies and then going back with a baby that’s less than six months old you don’t want them in direct sun at all. You basically want them under a canopy and a tent, under a beach umbrella because you want to limit their exposure as much as much as possible and keep them hydrated but if you start seeing that the skin is very warm it can be red. It can be painful with younger babies if they start crying more, if they seem more irritable those can all be sign that the sun burn is developing. So, what you want to do immediately is, what people forget, remove yourself from the sun don’t stay there, come out of the sun especially for the babies and then you want to hydrate.

Eric Lupton:   Do people really forget that?

Andrea Burns:   Yes, well that will go in like into the shade, but you must remember that the shade is still exposing you to the sun and then also remember that the sand, the water, concrete, all those things reflect the sun’s rays, it’s still bouncing towards you especially if you’re at poolside and you don’t always realize it. There’s a little guest jumping on the screen with us, it’s Prodi.

Eric Lupton:   What kind of dog is Prodi?

Andrea Burns:    Prodi is a toy Poodle.

Eric Lupton:   How old is Prodi?

Andrea Burns:   Prodi is 10. So, he’s been alive for a little less than I know you

Eric Lupton:   Prodi is cute, my girlfriend has a toy Pitbull and oh he’s like nine weeks old but he’s like a little puppy, that’s amazing.

Andrea Burns:   Thank you! For treatment of sunburn, remove yourself from the sun and then you want to apply cool compresses or cool running water fresh water over the area to decrease the burning and then and you want to try to hydrate because when you have the burn your body starts losing its ability to retain the water so, cool water cool compresses and then moisturize with a gentle moisturizer to kind of help soothe the dryness and the pain that you’re feeling. You can also take

pain medications for children six months and older and adults you can do like an Advil or something like that or Ibuprofen this is generic name which is perfectly fine and then for children under six months old you would only want to use Acetaminophen which is Tylenol as one brand for that. It’s also recommended to stay away from products that have things like Cane like an Analgesic in it pain reliever just because there can be some concerns with that, especially for children.

Eric Lupton:   Why do you avoid ibuprofen until six months risk is Acetaminophen?

Andrea Burns:   It has to do with the development of baby’s kidneys. Their ability to regulate the water and sodium level in their body so, they don’t develop that ability well and it’s not complete until after six months, solely it to be cautious which we can talk about some risks with swimming with that sure babies, but the ibuprofen affects the arteries and the kidney so that’s why you stay away from it.

Eric Lupton:   Okay, because I always think of Tylenol instead of Acetaminophen which, Ibuprofen for me is always been the safer one because I’ve been on blood thinners. So it’s weird to hear it the other way around or am I backwards?

Andrea Burns:   It’s the opposite.

Eric Lupton:    So, what about the kidneys and salt in swimming?

Andrea Burns:   So, a lot of people talk about swimming lessons recommended and although in the last few years it’s been recommended well, it is okay to do swimming lesson for children’s ages one to four. Before the American Paediatrics was against that, now they say that it’s based on the parents’ choice and then if a child  develop mentally appropriate, which you would ask the pediatrician about.

Eric Lupton:   We used to argue with them extensively because their age was under five and most kids who drown between one and four years old. So, if you wait till five most kids have already died, and we’ve seen videos and I’m sure you know of kids successfully teaching themselves how to swim a year or even six months. So, yet to deny a kid swimming lessons until at least five years old. Five was late but you’ve taken a lot of risk for that kid who you know might not make it to five with the time they are worried about ear infections, I think it was one of the main risk, the ear infection.

Andrea Burns:   I’m seeing that pretty much twice a day now. The most common infection through swimming but I think kind of cover based on age. So basically, as you said it’s pretty much always been recommended or recently recommended for kids four and up its fine that swimming lessons is recommend. It can reduce the risk of drowning, it’s not going to drown proof your child, but it will certainly, help and then they did find in some small studies, ages one to four that it does show some reduction of the risk. So, again consult with your Paediatrician or your kid doctor to make sure that your child is appropriate to take these lessons and that would be recommended as well but as far as formal swimming lessons that’s not recommended until the age of four just because a lot of kids under the age of four aren’t developed mentally to be able to hold their breath long enough for that formal swimming lesson.  Is there any safety and things like that? It’s fine. Now when it comes to those babies that are infants that are under one-year-old there are a few concerns. One of the concerns are the water intoxication which is the sodium we were talking about or I think people call it, water poisoning okay?

Babies they open their mouth a lot they can swallow a lot of water so when these babies are being submerged which is not recommended under the age of 1 they start swallowing water often or they can get water into their face and they’re taking in large amounts of water than usual and this can drop that sodium level in the body which can put a child at risk for seizures and even more severely if they get a lot of it you know brain swelling. So, that’s one of the reasons it’s not recommended and then also babies under the age of 1 aren’t as good at regulating their body temperature so if they’re in waters that are less than about, I think it’s like 85 degrees and they can’t start dropping their body temperature and become Hypothermic, that’s a concern as well. if you ever see a child that is shivering, or their lips would look a little bit blue you immediately want to take them out of the water dry them off and then take a dry towel and wrap them up to try to warm them back up and monitor them closely. Those things can be infection.

Eric Lupton:   So, if some people do start as early as 6 months old what other signs you will be looking out for if they are eight-month-old we’ll say in the middle of lessons – you know there’s something wrong?

Andrea Burns:   You look for the hypothermia and then you look for those symptoms of drowning certainly you know they’re swallowing a lot of water, you want to make sure that the child is not irritable, that the child is not more tired I see typically with babies they can be just irritable they can’t communicate – as well as they talked about the six month olds but if they’re more irritable they’re fussy maybe they don’t want to eat that can often be a sign that  something is wrong when the child is skipping more than one feed or if they’re just sleepier lethargic than usual they probably want to take that child in to see the doctor just to make sure that everything’s okay. The other big reason I believe that it’s not recommended under the age of 1 yet is because like that 1 to 4-year-old population there haven’t been any studies to show that it does reduce the risk of drowning. I think we’ve seen videos where the baby swimming under the water and that’s great, but the big question is; Is it making a difference overall?  I think that they’re going to investigate that certainly if it is then wonderful, but I think we must always be cautious and do the studies.

Eric Lupton:   I love Prodi back there just chilling, by the way. He is fantastic, he’s super grown and I kind of touched on this but it’s worth mentioning. The water safety community, for a long time was rallying against the term near drowning because drowning itself is a process as you said and near drowning implies that you missed out on drowning but if you had any kind of water incident where you breathe underwater and drowned I would say that is drowning. It’s like heart attack either you survived, or you didn’t, but you still had a heart attack? You don’t call it a near heart attack. When you are there you can feel or not feel drowning but it’s still drowning, your kids survive that everything turned out fine. He’s still technically drowned.

Andrea Burns:   That’s right, I agree with you.

Eric Lupton:   Thank you! I’m glad someone does. So, let’s talk about water safety in general what do you tell your parents?

Andrea Burns:   Well, especially for my more elementary school kids, when they’ve learned to swim a big thing about them as they learn to swim they get excited and they become overly confident and they think now that they learn how to swim they’ve reached this milestone and that’s it they’re done, they’re ready and they don’t need any supervision. I always tell parents and the kids, because as I mentioned earlier I love to talk to my kids, I’m like you always some adult so they always must be supervised by an adult swimming helps to reduce the risk of drowning, but it does not waterproof your child so, always having an adult present. I also talked with them about having buddies because the much older children like the teenagers they think that they’re okay they’ll go out to the beach with friends they may go onto the water, but they always have someone there with them.  Then also realizing that once you get into these other bodies of water like lakes and ponds and the ocean there are other risk factors that come into play there that the child is not going to be aware of or think about like rep tides and things like that or waves that are going to knock them down and disorient them.  They must be a lot more careful in these different environments and it’s important for parents to sit down and talk to their kids about this.

Eric Lupton:   What do parents freaked out about or get scared about not just with the pool but in general that they probably shouldn’t be worrying about? Is there anything the parents come in about that are maybe a trend that’s going on right now where people are nervous about, something that is that really a big deal.

Andrea Burns:   No, I think most parents are anxious about their toddlers I think I think probably what it is that they’re soaked there so most of the parent that I see are very focused on swimming and swim safety which I’m happy about, but I think sometimes they forget about the other risk factors. I want to say for the younger infants closer to the age of one you think about swimming pool the above-ground pools to in-ground pools, but you forget about the little play pools that you put water in that maybe your dog or Prodi or somebody’s playing in yeah it’s just as much a risk for a child to drown a young child they can dry them like an inch or two of water and I think parents forget sometimes when the baby’s in the bathtub you know that us do touch supervision which is where they’re always within arm’s length that you still must translate that to the swimming pool too little wading pools and all those different things because babies in that younger age group die from drowning in buckets and bathtubs and standing water like that you may not think about that when you’re so focused on the pool that’s the big body of water. Just reminding them that water is not only there there’s water in the ditches especially here in Florida there’s water and different like tyre swings or if you have tyres outside the bird baths just different areas and it also brings the risk of mosquitos to which we’re all familiar with.

Eric Lupton:   In Florida unfortunately, it is the official state bird of Florida, the mosquito.

Andrea Burns:   Pretty much. I used to camp out on an island they called a mosquito island.

Eric Lupton:   That sounds like a terrible idea why would you go there?

Andrea Burns:   I love camping.

Eric Lupton:   I hate camping, I am a lazy person. My idea of camping is a Four-Season Hotel room.

Andrea Burns:   One thing about insects and sunscreen is; they do sell combination sunscreen and insect repellent. What you know, and thought is a great idea however sunscreen as we talked about you reapply it every two hours you don’t realize insect repellent every two hours so it’s usually recommended to get one and the other one and platitudes apply them separately.

Eric Lupton:   Right, you don’t to overdose on insect repellent, right?

Andrea Burns:   Exactly and another common thing people ask, is insect repellent okay for children? It is okay to use Deet containing products down to like two months and up you know you want to use appropriate levels. Standard levels not like those huntsman levels where you’re hunting things like that but usually at 10 to 30 percent is okay.

Eric Lupton:   So besides drowning and sunburn what other things should parents be looking out for outside by the pool?

Andrea Burns:   Well there’s mosquitoes like we talked about. make sure that you have something appropriate in place because there is mosquito borne infections. You want to think about stinging insects such as bees especially around ponds and lakes. Bees love bright colours, if you have on a beautiful floral print it’s very cute but the bees don’t understand they think it’s there for them and if you’re using fragrance products they may be more attractive to you so be careful with that and then if you do get stung you know take care of it and then you want to remove this stinger with a credit card or something or your finger nail to bring it out of this skin. Some less common things well swimmers your let’s back up to swimmers’ ear, so we mentioned that earlier that’s probably the most common thing that I see, and parents ask all the time what I can do to prevent swimmers ear well really the biggest thing that you can do is right there after the swim is get the water out of the ear. So, you basically take a towel or a clean rag or even maybe like a little cotton and tip the head to the side and just try to shake the ear and get as much water out as possible. Get the ears as dry as possible and that will greatly reduce the risk of infection there’s drops and things like that but that’s the biggest thing that you can do. Less common thing you can see is going to be around bodies of fresh water which is something that you see maybe in lakes or at the ocean it’s something called Cutaneous Larva Migrans which is an infection of a parasite that can come in through your foot, I think we treated a kiddo with this not that long ago. Basically, when you’re walking around at the beach in different areas if you don’t have long swim shoes or some socks these little hook worms can attached and it’s not the most common thing, but we do see it here and there. What happens is you’ll know.

Eric Lupton:   This is why I don’t walk, I could but I’m like no, this weird hook worm thing is terrifying and it’s going to be there all the time and that is way safer than putting my feet on the ground.

Andrea Burns:   Well you’re going to love this, you can tell there’s an infection, usually when you start seeing like a snake-like pattern where it’s you know in the skin it’s like reddish pink and that’s typically the tell-tale sign that you probably have an infection with this. The good news is treatable and it is self-limited because humans are not natural hosts for this parasite so eventually it will die but we can’t treat it. Another thing I wanted touch on which scares people to death but is very important thing because you more than that you hear about it and then the youth regularly you may know I was talking about is I never pronounce it properly the Naegleria Fowleri I believe it’s actually an amoeba that usually around this time of year you hear about it in the news which is people are afraid that it’s going to go into your nose and infect your brain and cause death. It is possible to die from this infection but the infection itself is exceedingly rare I mean there’s probably like a case or two or less a year so it’s very uncommon but it basically isn’t it may be that lives in fresh warm water so like your hot springs here in Florida you know you’re at your lake shirt your rivers that are freshwater and basically if you have a forceful amount of water going into the nose like if you’re diving in or jumping in or something like that the water can get up into your sinuses and then actually it migrates from there the amoeba into the brain and it can make you very sick.

Usually it’s fatal but again people get worried about it they worry about swimming it’s very unlikely that your child’s going to have this issue because again it’s like a one or so cases a year.

Eric Lupton:   when I think of things that were in the brain I’m worried about cats the Toxoplasma is that scares me more than the amoeba about things sitting in my brain is the evil cat brain control parasite you, must I worry about that too?

Andrea Burns:   Yes, you do have to be concerned about it but not overly concerned. A lot of you always cry always caution parents have fun you know live your life don’t be afraid of what may happen just be vigilant and if something seems wrong you know go see your doctor, call the doctor we’re on call we encourage parents of cause if they never want them to not call because they felt like they were bothering us. Live your life, follow the safety recommendations that we’re giving them and then if you have a concern call us you can’t prevent everything from happening, but you can do your best by following the recommendations.

Eric Lupton:   For anyone who doesn’t know. Can you explain what is Toxoplasma?

Andrea Burns:   I don’t want to go too much off subject it is something that we worry about. What we worry about most with cats is cat scratch disease which was an infection where you get a fever and a swollen lymph node because I try to do child safety in general that’s as cat scratches much far more common but basically, it’s a disease that you can get from being scratched by a cat. it’s not typically, older cats it’s actually cats that are kittens and they may get a scratch here and there and then a few days later the child may start complaining of fever and a swollen lymph node and it’s often mistaken for possibly a strep infection or mono or something else, but it really doesn’t get better.

Eric Lupton:   There’s a cat scratch fever?

Andrea Burns:   It’s called “cat scratch,” yes, usually kitten. So there’s something that you guys on keep in the back of your mind you know discuss with your kids doctor when you go and see them especially if the infection is not improving like it’s only put you on an antibiotic for Strep Infection and they’re not getting better typically cat scratch doesn’t get cured with the typical Antibiotics that we use most commonly for stress so you would want to follow back up with your doctor and let them know one had a kiddo with that I think last year

Eric Lupton:   So, it happens I taught all along, this was just a song. I didn’t realize it was a disease.

Andrea Burns:   It’s a song?

Eric Lupton:   Yes, it’s a song, Cat Scratch Fever. I forget who does it, hopefully someone in the comments can tell me who does it because I’m terrible but yes, there’s a there’s a song Cat Scratch Fever. I think it’s an 80s song you go look it up now that I said it would be an 85 yes, the picture like a hairband I forget those things, hopefully someone tells me how to look it up. So, what about in-home child safety use stuff childproofing baby proofing what do you remind parents as far as that?

Andrea Burns:   Well sticking with the idea of water safety a big thing for babies especially when they start walking is, they’re very curious and toilets is a major risk in homes. So, I always talk with parents about closing the toilet seat and closing the bathroom door because kids just love water they want to splash in it. They know things that go down they want to see what they can put in there and they lose their balance and babies and general have bigger heads so once they fall and they have a really hard time getting out because they are so top-heavy, and babies can drown in toilets.

Then there is stairs Safety’s so, if you have any stairs in your home you want to make sure that you’re using the baby gates or baby gates for any dangerous area in your home and that you want to make sure that you’re always keeping them closed you know that even goes back to pool safety. Now we’re talking about indoors but with those pool safety fences that are definitely recommended separate from the home encircling the pool you want to make sure that it’s self-closing if possible and that the latch is high and that it’s not kind of all I mean we’ve all seen these YouTube videos Facebook videos of babies climbing out of cribs and everything else it’s possible that where there’s a will there’s a way right?

Eric Lupton:   Absolutely in the fast!

Andrea Burns:  It’s their job to figure it out so make sure that they don’t have anything that they can grasp onto and crawl over and that the slats are close enough so that they can’t get through them. Those are the two main things and then also as children get older are like 18 month olds children are about that age they will start trying to climb out of those cribs and there’s cute videos about it but usually you know there’s a fall involved and you want to avoid like head trauma and things like that so if your child is getting to the age where they’re showing you that they can climb or they’re trying to climb out of the bed put them into a toddler bed where they’re safer.

Eric Lupton:   What accidents do you see the most from inside the house not drowning what related necessarily unless it is.

Andrea Burns:   I would say probably Falls, kids climbing on two chairs. Kids are climbers, they’ll try to climb up the pantry, oh my goodness that’s my niece when she wants something, they’ll climb pantries will climb the cabinets you just the younger children they don’t have their balance down very well, yet they’ll fall or kids falling off their bicycles things like that. A thing that unfortunately, can happen is when babies are in car seats and someone actually bumps the car seat and the babies not strapped in the baby can fall out over the car flips over and a baby not secured inside then the car seat flips hits the ground and the baby comes out and then hits the ground as well. So, I always work them into my parents always make sure that you buckle the seat belt no matter how short of a time they’re going to be in the carrier or in the stroller because they can fall out if anything happens with a bump something we go over a curb.

Eric Lupton:   Speaking of car scenes, I saw a story two days ago of another child who passed away in the back of a car from paediatric you think you lucky stroke which is terrible obviously terrible and I’m not sure beyond some kind of change to vehicles and I guess we have the bag in the back idea right where people say leave their purse kind of in the back seat as a reminder.

Andrea Burns:   Yes, leaving like a stuffed animal and then moving into the front seat when the baby’s in there. There’s lots of different approaches people are looking at but it’s always so sad

Eric Lupton:   it is, I think I told you I’ve been advocating the three RS which is remind the parent technology a standard inside the car that rolls down the windows if the child is left in there and is to reverse the temperature if I’m rolling down the windows then sit in the car alarm off to rescue the child okay yeah I like the three RS I’m trying to try to get that out there.

Andrea Burns:   Well now you know you brought up cars and car seats, so I must talk about car seats, thank you. Two things that I often see parents are confused about or hear old guidelines on is when to turn the child around in the car so there was a previous guideline that said that children can face forward when they’re 1 years old and about 20 pounds that’s no longer the recommendation. Recommended for the child to remain backwards facing until the age of 2 and a lot of parents are like they’re so tall like my niece’s they’re so tall their father is tall, and they worry about the legs they’re like criss-crossing.  I tell parents your knees are meant to bend so, criss crossing of the legs is fine but whiplash is not natural. You do want to have them rear-facing longer so that they can be safer in their develop mental level in the car and then turn them around because if you turn them around before 2 years old it’s hard and going to be a task to get them to turn back around so that’s just to keep them backwards-facing.

Eric Lupton:  Why did they make that change?

Andrea Burns:   Because they found developmentally you know when it came to car accidents babies were not able to tolerate the whiplash it occurred in vehicles during a news event so it’s better to have them rear-facing. For older kids a big thing that we see is kids wanting to come out of a car seat into a booster seat and then even out of the booster. Typically on a rough guideline is about four years old and forty pounds is one a time is a time when you can start looking at booster seats but you have to check the booster seat that you bought and make sure it’s on appropriate for your child’s age and weight and everything else on it and then the kids that want to come out of the booster seats I see a lot of kids that are 6 years old maybe even five years old sometimes you’re 7 years old that come out and the best thing to do is to keep them in there and ask the doctor before taking them out because once you’ve taken them out they get upset they are social concerns my friends are in a booster I don’t want to be in a booster I’m embarrassed but the recommendation is to be eight years old 80 pounds and four feet nine before you come out of that booster seat so where you can be safe riding in a car with just a seat belt on and there’s some other things that you can look at in the car to make sure that it’s fitting appropriately so typically if you don’t meet all three of those you’re probably not as safe as in an accident.

Eric Lupton:   I was about 17 I think before I get out of mine.

Andrea Burns:   Well we can ride in the front seat. The front seat is 13 and up and then we’re on the back, I break a lot of hearts in the office.

Eric Lupton:   What’s something that parents don’t do that you wish they did or the other way around today they do that you wish they did it.

Andrea Burns:   Oh, give me an area.

Eric Lupton:   I would say like in-home child safety.

Andrea Burns:   One thing is being cautious about what you call it Walker’s. A lot of people enjoy walkers for their children but walkers can be dangerous especially if you have an area in your home where you go from a soft service to like a hard surface because that if the child is moving very quickly which a lot of kids Tyler’s I get very excited they can be on the hardwood floor on beats going at a pretty good speed and when they hit that area where it meets the carpet it may slip the Walker over. So, making sure that they’re cautious about that and maybe just not using the Walker at all just using something like an extra saucer where it’s just a stationary plate area where the child can turn and stand and sit down when they want to that’s probably a big one just to prevent injuries at home. Then one thing I would want all parents to do is keep the number for poison control in their home and in their phone or on the fridge I recommend for when babysitters are there. A lot of things in the home are you know poisonous you know it could be a pill that you dropped it’s under the counter that you didn’t see but trust me a one-year-old will find it or it could just even be houseplants because of many houseplants are poisonous and if you’ve ever seen a young child everything goes straight in the mouth and they can ingest that you don’t know trying to go to the doctor do I need to go to the ER if you call poison control of the child stay well they usually can answer that question for you.

Eric Lupton:   Got you, what kind of houseplants people look out for?

Andrea Burns:   I wish I knew that, and I do not have a green thumb all my plants are outside, and they barely make it but I’m sure you look online you can probably buy that information.

Eric Lupton:   Google has a comprehensive list, is there anything else that you want parents to know that’s important, that you feel like isn’t getting out there enough or generally on anything a pet peeve?

Andrea Burns:   I wouldn’t say any pet peeves what I would just say is in general. When you ask your doctor a question your kid doctor you’re not bothering us I mean sometimes you may feel bad or you may feel guilty or someone else maybe make you feel guilty or you feel like maybe you’re calling or come to the office too much we would much rather that you ask us than to do something you’re not comfortable with and we would also much rather that you ask us instead of limiting what you and your family can do.  I would just want parents to know that if you’re concerned if you’re worried if you have any questions at all we are here for you we want to hear from you and we want to make sure that you and your children of your family are living a healthy, happy, low-stress life as much as possible. So, we’re here for you and we want to help so don’t forget that and worry don’t worry in general don’t worry policies guidelines ask the doctor not doctor Google hey that’s a pet peeve most people that come in and tell me they googled something regret it and now they think that they’re dying right so don’t google it call the office talk with us something one of the nurses they’re usually pretty great and experience and we’re healthy we’re happy to guide you and answer those questions.

Eric Lupton:   I saw a cartoon of my doctor’s office that said patients who looked up their diagnosis online pay double.

Andrea Burns: usually it’s something that’s easily treatable and everyone thinks that they all have a bad outcome.

Eric Lupton:   yep we all have some rare strain of Ebola and you know it’s coming for sure.

Andrea Burns:   Then for me personally you know I’m going to be giving a lot more health tips online so for people that are interested in finding out more about who I am.  Getting more information on more specific health topics at home Safety and other things I am on Social Media, so they can follow me at forward slash Dr Andrea MD that’s Dr  AAMD and I’m happy to answer questions that maybe people have about the podcast today that we didn’t cover awesome you have any questions for me I’m Joan I’m just glad that you’re doing this I’m so thankful that you have me on today to get to talk and educate families and just catch up with an old friend after its 10 or more years.

Eric Lupton:   One thing I haven’t done before, but I might start doing, you’re going be the guinea pig. Is there any question that you would like to ask the audience that you’d like to see them answer in the comments?  Any kind of general polling thing you could ask the 10 to 20,000 or so people that end up watching this each time that they can answer for you in the comments?

Andrea Burns:   I would just say what are some topics that you guys want to hear more about or what are some things that you feel like you wish you had known before you know you went to the Paediatrician maybe when you were having a baby that no one covered for you know if I know this thing would have been easier so anything like that we’re just questions in general because if one person has a question there’s probably about 500 other people that have the same question.

Eric Lupton:   I like that, what’s something that you wish you knew before you went to the doctor you didn’t know that’s a good one.

Andrea Burns:   I think a big thing maybe not so much that I wish I knew but a lot of people get embarrassed about certain health conditions you know maybe if it’s you know in a more private area and they worry oh the doctors going to judge me they’re going to you know think different things about me. That is not at all true we are not at all concerned about people’s private lives and what’s going on we just want to make sure that you’re healthy so never ever be embarrassed about going to the doctor and asking about personal things whether it’s your mental health, whether it’s something in a more private area of your life, more private area of your body and then as a patient. When you’re a doctor that becomes a patient, it helps you to be more sensitive to these needs of your own patients so just knowing that we are not going to judge you and we really do want to know about all your concerns.

Eric Lupton:    Perfect, awesome! Well thank you so much it’s a lot of fun. I might try and rope you into doing like a Q&A; for people one day.

Andrea Lupton:   That may be a good idea.   Well thank you I hope you have a safe and happy fourth use lots of sunscreen.

Eric Lupton:   I hope you don’t see anyone loses their fingers or toes from fireworks.

Andrea Burns:   I hope not, just don’t do it just go watch a show.

Eric Lupton:   Do you see a lot of fireworks injuries?

Andrea Burns:   I don’t, they probably end up in the ER to be honest that makes sense burns they’re dangerous burns blindness all kinds of things can happen so yes,

Eric Lupton:    I always been never been a fan of up-close fireworks you know even sparklers can be dangerous gave me the most yeah you know I mean fireworks on the ground are fine too holding it in my hand I don’t know hmm we got a famous sparkler yeah if we scared in general. Thank you, have a good one. We’ll talk again.

Andrea Burns:   Thank you so much okay bye-bye everyone.