(CNN) -- For parents, sending kids off to summer camp is an emotional balancing act: There's the prospect of fresh air and friendships, competition and camaraderie, but there's also the worry of insect bites, injuries and allergies.
Today's campers face new challenges, such as whether to continue ADHD medications.
The health and well-being of their kids is a concern of multitudes of parents, as more than six million American children head off to summer camp this year, their care thrust into the hands of teenaged counselors and skilled administrators. While there are no national safety standards for camps, and no data on how many campers are actually hurt or get sick, some reliable data suggests kids are in pretty safe hands, with just one adverse health event for every 1,000 camper days.
But parents remembering their own camp days should be aware the camp experience may be changing.
One interesting health trend is the increasing number of potential bunkmates with Attention Deficit Hyperactivity Disorder. "Five years ago, many camps wouldn't even accept kids with special behavioral needs or medications, but now do if the behaviors aren't too extreme," said Jeffrey Solomon, executive director of the National Camp Association. As a result, many camps hire and train staff to cater to the needs of kids who might need a little extra attention and supervision taking medications.
ADHD often presents a summertime dilemma for some parents who wonder if they should pack for camp the medication used primarily to help a child stay focused in school.
"You'd like the kids to have a break from ADHD medication," said Dr. Benjamin Siegel, professor of psychiatry at Boston University School of Medicine and a member of the American Academy of Pediatrics. Siegel, himself a camp doctor for 20 years, said exceptions would include kids who have more significant behavioral problems, or have anxiety or depression as well as ADHD.
He stressed any psychiatric problems should always be brought to the attention of camp staff.
Adults may recall routine camp checks for impetigo, a skin infection caused by strep or bacteria, and most camps still do that. But the emergence of a dangerous, drug-resistant staph germ has summer camps paying attention to another threat: superbugs.
While there's no evidence of increases in outbreaks of drug resistant infections at camps, emergency room doctors warn we are seeing an increase in MRSA -- a superbug known as Methicillin-resistant Staphylococcus aureus -- all over the country.
Dr. Denise Dowd, a member of the American Academy of Pediatrics Injury, Poison and Violence Prevention Committee, said she treats at least three cases a day in the emergency room.
A serious "superbug" infection can start as an innocent-looking insect or mosquito bite, but counselors need to be vigilant about anything that worsens or spreads, as it could be a sign of a serious staph infection. Simple handwashing -- something kids may forget to do at camp -- can greatly reduce the spread of dangerous germs.
Another trend is more campers with food allergies, particularly peanut allergies. "The peanut butter-and-jelly camp sandwich we grew up with is gone," explained Solomon, as camps strive to monitor not only what's served in camp cafeterias, but what's received in care packages.
Parents concerned about overweight kids can take comfort in another trend: better camp food. "While 20 years ago, 20 percent of our camps had salad bars, now well over 80 percent have them. And as a result campers are eating less carbs, and healthier meals," Solomon said.
What if your child hates more than bug juice, and wants to come home?
Experts say by age 9, kids should have mastered separation, and 80 percent of first-time campers join right in. But camp personnel are becoming more sensitive to another trend: the number of campers from divorced families.
"Some children from divorced families are perfectly comfortable, but if there's any trauma around the divorce, those kids bring with them to camp their family struggles," Siegel said. He said camp staff are increasingly trained to identify and pay attention to kids from painful family situations, to help them adjust.
As a final safety consideration, while many parents may feel like they're on holiday as well when the kids go to camp, one of the most important things to remember is, your child or camp needs to be able to reach you at all times. "It's extremely important for kids to have continuous emergency contacts at all times," said Dowd, in case things do go wrong.
The one thing that hasn't changed at America's summer camps, some of which are more than 100 years old, is the opportunity for your child to have fun.
"Kids really look forward to camp and friendships there," said Siegel. "It's a wonderful opportunity for them to grow." E-mail to a friend
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