Ask Dr. Jay: Sun Exposure, ADD and RSV

Pediatrician Jay Gordon answers questions about your baby's health.


Bone of contention

My sister is so worried about sun exposure that she doesn't let her children play outdoors during the day. I've heard that kids can develop weak bones if they don't get enough vitamin D from the sun. What do you recommend?

Because calcium absorption depends on adequate amounts of vitamin D (which comes from the sun, among other sources), bone strength can be adversely affected by underexposure to the sun.

Moderation works, though: 10 to 15 minutes of sun a few times each week (preferably when the sun's rays are not at their strongest) probably creates enough vitamin D to head off problems. Avoid sunscreen and sun-protective clothing during sun time, as they can nearly eliminate vitamin D production; after a few minutes, apply sun protection with SPF 15 or higher. I prefer sunblocks, which typically contain titanium dioxide or zinc, rather than sunscreens that contain chemicals such as octyl methoxycinnamate.

Also, if you live in New England, the upper Midwest, the Pacific Northwest or another cold-weather area, ask your doctor about giving your child vitamin D supplements during the winter months.

Could my baby have ADD?

My 18-month-old seems more easily distracted than his friends; he also hits more often. Could this be an early sign of ADD/ADHD?

Most 18- to 36-month-olds who act this way are simply showing their strong will and absence of reasoning. That said, children with attention-deficit issues often are tremendously active and aggressive. They also may have a strong aversion to being cuddled or read to; they may display delayed gross- or fine-motor skills (such as not crawling or having a good pincer grasp at about 9 to 10 months); and they may be clumsier and much more difficult to control than their peers.

If you are worried that your toddler is quite different from others his age, insist on a developmental evaluation. Nobody knows your child better than you do.

Avoiding RSV

My twins were born eight weeks early and needed oxygen for their first three weeks. They're 14 months old now and have been getting Synagis injections to help prevent respiratory syncytial virus (RSV). Should they continue to get these shots?

RSV is one of the nastiest respiratory viruses around, so I'm pretty comfortable recommending preventative shots for preemies and higher-risk babies, such as those with cardiac disease, immune system problems or asthma. While it rarely endangers healthy full-term babies or toddlers, they still can be at risk. So follow these prevention tips for all children:

-Make sure everyone washes his hands before touching your baby.

-Avoid people who are coughing and sneezing, and minimize your child's exposure to toddlers.

-Stay out of crowds.

-If someone even thinks about smoking near your child, kill him and feed his body parts to sharks.