By Theresa Rapstine, MS, RN
Coordinator, Healthy Child Care Colorado

It is that time of the year for fun in the sun! Encouraging children in licensed programs to be outside and active is part of summertime fun, and we must ensure they are sun-safe while playing.

Colorado Child Care Regulations
For licensed child care programs, our state has established sun protection and sunscreen regulations:

A shaded area in the fenced play area of at least one hundred fifty (150) square feet must be provided by means of trees or other cover to guard children against the hazards of excessive sun and heat (7.702.73B6).

A policy is required for “Use of and how often sunscreen is applied, including authorization for use of sunscreen, and how infants are protected from sun exposure without the use of sunscreen” (7.707.41B23).

Applying Sunscreen
Topical preparations such as petroleum jelly, diaper rash ointments, sunscreen, bug sprays, and other ointments may be administered to children with written parental authorization. These preparations may not be applied to open wounds or broken skin unless there is a written order by the prescribing practitioner (7.702.52C14).

Sunscreen and Sun Protection
• Prior to outside play, the center must obtain a parent or guardian’s written authorization and instructions for applying sunscreen or use of another form of parent or guardian approved sun protection to their children’s exposed skin. A doctor’s permission is not needed to use sunscreen at the center.
• The center must apply sunscreen, have the parent or guardian apply sunscreen, or use another form of parent or guardian approved sun protection for children prior to children going outside. Sunscreen must be reapplied as directed by the product label.
• When supplied for an individual child, the sunscreen must be labeled with the child’s first and last name.
• If sunscreen is provided by the center, parents must be notified in advance in writing of the type of sunscreen the center will use.
• Children over four (4) years of age may apply sunscreen to themselves under the direct supervision of a staff member (7.702.52D).

National Best Practices for Sunscreen
Here are some additional best practices for child care programs to ensure sun safety. Caregivers and teachers should implement the following procedures to ensure sun safety for themselves and the children under their supervision:
• Keep infants younger than six months out of direct sunlight. Find shade under a tree, umbrella, or a stroller canopy.
• Wear a hat or cap with a brim that faces forward to shield the face.
• Limit sun exposure between 10:00 a.m. and 4:00 p.m. when UV rays are strongest.
• Wear child safe shatter resistant sunglasses with at least 99% UV protection.
• Apply sunscreen.

Over-the-counter ointments and creams, such as sunscreen, that are used for preventive purposes do not require a written authorization from a primary care provider with prescriptive authority. However, parent/guardian written permission is required, and all label instructions must be followed. If the skin is broken or an allergic reaction is observed, caregivers and teachers should discontinue use and notify the parent or guardian.

If parents or guardians give permission, sunscreen should be applied on all exposed areas, especially the face (avoiding the eye area), nose, ears, feet, and hands, and rubbed in well especially from May through September. Sunscreen is needed on cloudy days and in the winter at high altitudes. Sun reflects off water, snow, sand, and concrete. “Broad spectrum” sunscreen will screen out both UVB and UVA rays. Use sunscreen with an SPF of at least 15 or higher; the higher the SPF, the more UVB protection offered. UVA protection is designated by a star rating system, with four stars being the highest allowed in an over-the-counter product.

Sunscreen should be applied thirty minutes before going outdoors as it needs time to absorb into the skin. If the children will be out for more than one hour, sunscreen will need to be reapplied every two hours as it can wear off. If children are playing in water, reapplication will be needed more frequently. Children should also be protected from the sun by using shade and sun protective clothing. Sunscreen should be applied to a child at least once by the parents or guardians and the child should be observed for a reaction to the sunscreen prior to its use in child care settings.

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