HealthWatch Magazine Fall 2011 by Brainerd Dispatch and Echo Journal

Table of Contents

4 8 10 13 14

A HEALTHY START: Whole foods for whole family by Jodie Tweed CHILDHOOD OBESITY: A family prevention approach by Jodie Tweed LIFETIME OF HEALTHY HABITS: Lakewood’s 5-2-1-0 program by Jodie Tweed BREAST-FEEDING SUPPORT: New La Leche League chapter

by Jodie Tweed PREVENTING ILLNESSES:

County offers immunizations by Jodie Tweed

On the cover

15 16 18 21 23 24

BACK-TO-SCHOOL: Don’t forget the well child exam by Jodie Tweed HEART HEALTHY TOURS: A stroll in the grocery store by Jodie Tweed HANDWRITING MATTERS:

Child handwriting help by Jodie Tweed HELPING INFANTS SEE: Free eye exams for babies by Amy Gray Ellingson FALL IS IN THE AIR: Finding family fun activities by Sheila Helmberger ATHLETIC CONCUSSIONS: C-I’s newest technology by Jodie Tweed

Who we are Publisher — Tim Bogenschutz Advertising — Sam Swanson Cover design — Cindy Spilman Editor — Jodie Tweed HealthWatch is a quarterly publication of the Brainerd Dispatch. Brainerd Dispatch/Steve Kohls

Our cover girl is Anna Kenow, 6, of Brainerd, standing in her family’s backyard garden.

Read HealthWatch online at www.upnorthhealthwatch.com.

For advertising opportunities call Sam Swanson at (218) 8555841. E-mail your comments to jodie.tweed@brainerd dispatch.com or write to: Jodie Tweed Brainerd Dispatch P.O. Box 974 Brainerd, MN 56401

A HEALTHY START

Brainerd Dispatch/Steve Kohls

Amy Kenow enjoyed a healthy snack with her children, twins Oliver (left) and Josephine, 2, and their big sister, Anna, 6, at their south Brainerd home.

Brainerd mother of three makes effort to feed her children healthy, whole foods and 2-year-old twins, Oliver and Josephine. Oh, and that year when her twins were my Kenow is one busy mom. When sheâ&#x20AC;&#x2122;s not teaching yoga classes or work- babies? She was even much busier and more sleep deprived back then. ing one-on-one with a client as a perBut a busy work and family life isnâ&#x20AC;&#x2122;t a good sonal trainer and natural health nutritionist through her business, Sunlife Wellness, Kenow excuse to always feed your children fast food is chasing after her 6-year-old daughter, Anna, on-the-go. by JODIE TWEED HealthWatch editor

A 4

“If I said it wasn’t a lot of work, I’d be lying. It’s so much easier to feed your kid processed junk.” — AMY KENOW Years ago, before Anna was born, Kenow and her husband Shawn made a conscious decision that even if money was tight, they would sacrifice in other ways to provide good, healthy food for their future children. It started with her breastfeeding her daughter and then both her twins. Then Kenow began making her own baby food. “I’m a ‘go big or go home’ person,” Kenow said with a laugh. Now, despite the fact that she really doesn’t like to cook and doesn’t consider herself to be a particularly good one, she provides healthy, natural snacks and meals for her children. And no, none of these meals come with a small toy inside the box. “If I said it wasn’t a lot of work, I’d be lying,” said Kenow. “It’s so much easier to feed your kid processed junk.” Kenow earned her bachelor’s degree in health and physical education at St. Cloud State University, but it wasn’t until her children were born that she realized just how important nutrition is for optimal growth and immunity. By providing her children with healthy meals, her goal is to position them to become healthy, active adults who won’t suffer from chronic conditions like obesity or dia-

betes. “You can either pay now in good health or pay later in poor health,” Kenow said. “It’s better to pay the grocer and farmer than the doctor. “I want the best body and brain fuel for these important, little humans. Giving them anything less would feel very neglectful on our part.” Kenow said she is fortunate that her children are great little eaters. They’ll eat fresh fruits and vegetables and also enjoy her green smoothies, loaded with kale, spinach and other fruits and vegetables. But then, they don’t have a choice. “You can’t control what your kids eat, but you can control what is presented to them,” said Kenow. “We went from breastfeeding to nutritious food and they don’t know any different.” Staple ingredients for her smoothies — she doesn’t usually follow a recipe — include coconut, rice, almond or hemp milk; frozen fruit of all kinds; fresh fruit like bananas and berries; brewer’s yeast; flaxseeds; any vegetables, especially green ones, including leafy vegetables; blackstrap molasses, which is high in iron; herbs like alfalfa, rosehips and dandelion;

and local, raw honey or a bit of agave syrup or stevia to sweeten it up. She said the smoothies, which she serves at least every other day to her children, don’t keep for more than two days in the fridge but you can freeze portions for later. Kenow has learned some shortcuts. She’s had to. Don’t think you have time for oatmeal in the morning? Kenow will prepare a big bowl of oldfashioned oats soaked in almond milk overnight in the refrigerator. She’ll also add frozen fruit and flaxseeds. In the morning, the oatmeal just needs to be heated up for her children and it’s ready to eat. She also might add for breakfast a hardboiled egg or a piece of Ezekiel bread with almond butter, sliced bananas, a little drizzled raw, local honey and chia seeds on the top. Her children enjoy her fruit parfaits, which consist of cut-up fresh fruit, Greek yogurt and some chia seeds sprinkled on top. A snack may include a hummus dip with cut-up vegetables or homemade trail mix. Everyone in the family takes probiotics daily, especially in the winter, and vitamin D during the winter.

Amy Kenow often roasts a pan of sliced, assorted vegetables that are in season for her family meals. This photo shows green beans, beets, zucchini, squash and carrots. She prepares a side mixture of brown sugar, minced garlic, olive oil (or butter if you prefer), sea salt and herbs and drizzles it on the vegetables, then cooks it around 425 degrees for about 45 minutes.

Amy Kenow buys organic macaroni and cheese. Several minutes before the macaroni is done boiling, she’ll throw some cut up fresh or frozen vegetables like broccoli, peas, spinach or carrots into the boiling water to soften them up. She strains the macaroni/vegetable mix, adds the cheese mixture and in a snap she has a more nutritional lunch. She sometimes adds tuna.

Brainerd Dispatch/Steve Kohls

Healthy snacks don’t have to be boring. Amy Kenow tries to use fun small plates for her three children. Here she prepared some homemade granola and apple slices, which have cinnamon and a bit of sea salt sprinkled on them.

Amy Kenow’s three children enjoy her easy fruit parfaits (far right). She cuts up fruit and adds Greek yogurt, topped off with chia seeds. For breakfast she often toasts Ezekiel bread (right) and tops it with almond butter, sliced bananas, a drizzle of local honey and chia seeds.

Kenow said she often relies on “planned leftovers” for her crew for lunches. This could include roasted veggies served over brown rice or quinoa. She and her husband will make a few meals ahead of time on Sundays so something is always ready on the table during the week. When she and the kids are on the go, she’ll pack a cooler with healthy snacks so there’s no temptation to go through a fast food drive-through when someone is inevitably hungry. She plans ahead to go no more than three hours without a snack or meal. “Make everything easy and accessible,” said Kenow. “If you don’t have everything ready, it’s a recipe for making poor choices.” She also recommends not letting the bad food in your shopping cart to begin with. Kenow serves her children primarily water. Each child has his or her own water bottle with a built-in plastic straw that they use each day. “Kids will drink more if you give them a straw,” Kenow said. Kenow said the real test will come now that Anna is in kindergarten. She plans to send to

school with her a homemade meal, which could include a frozen smoothie that will melt enough to drink just in time for lunch. “If she wants to have a school lunch once a week, I’m OK with that,” said Kenow. “Just not every day.” Kenow said her family lives by a 80/20 rule. They try to eat “clean” 80 percent of the time, which allows for some wiggle room for the other 20 percent of the time. The Kenows eat meat about three times a week and purchase locally raised chicken and grassfed beef. She has an organic garden and the family also receives a CSA share of produce each week from a local organic farm. She purchases food from Crow Wing Co-Op, as well. They’re also very physically active and enjoy their large fenced in backyard as an extension of their home. If you begin to eat well, you’ll notice a positive change in your bowel movements. Kenow said if your child is constipated or irregular, try feeding them a natural diet; her children have no prob-

lems with their digestive systems. A whole foods diet also provides you with better skin and hair and nice, bright eyes, she said. In her business, Kenow’s emphasis is a holistic approach to preventative health and wellness. She is developing a blog to share her adventures in raising her children and feeding them healthy, whole foods. She’ll also include recipes on her blog. Visit her website, sunlifewellness.com, for more information. Kenow will be teaching a Brainerd Community Education class on natural living from 6-7:30 p.m. Oct. 11 at Forestview Middle School in Baxter. Cost is $10. Contact community education to preregister. “I’m not obsessed,” Kenow said with a smile. “Just really dedicated.” JODIE TWEED may be reached at jodie.tweed@brainerddispatch.com or 855-5858.

The K-5 rules to live by Amy Kenow said when she and her husband Shawn had their eldest daughter Anna, now 6, was born, they made a promise that they would feed their children healthy meals, starting with her breastfeeding them as babies. Even though life became insanely busy after the birth of their twins Josephine and Oliver, now 2, they continue to feed their children well. Here is what has worked for her family, or the K-5, as she likes to call them, for those families that would like to make similar lifestyle changes: • Eat real, whole foods and stay away from packaged foods, refined flours and sugars as possible. • Plant a garden or buy a CSA share, or both. Buying your food directly from local farmers allows you to know where your food is coming from. The Kenows have a CSA share from a local farm, which provides them with organic produce once a week. They also have a garden. As a result, their food bills have decreased. They also utilize the Crow Wing Food Co-Op. • Buy organic as much as possible, especially meat, dairy and produce. The Kenows purchase meat from a local farmer. • Add vegetables to anything you can. It will boost the nutritional value of your meal. • Eat as much raw food as possible. • Move — a lot! Build in fun, play and exercise into your families’ schedule; it becomes a way of life. • Ditch the TV and video games, especially in the summer. • Eat lots of fruit — it’s nature’s candy. • Stick to the 80/20 rule. Eat clean, healthy foods for at least 80 percent of the time and then you have a little wiggle room for the not-so-healthy stuff. • If you can’t read the ingredients, that food item doesn’t belong in your body. • Smoothies! The Kenow kids enjoy smoothies at least every other day. She packs them with a nutritional punch, including flaxseeds, kale, spinach and any vegetable you can think of. She also adds frozen fruit and a little local, raw honey to sweeten them and they drink them up every time. Add a straw and the kids will think it’s a special treat. • Make lots of healthy leftovers, so you’ll always have healthy food in a pinch. Freeze portions to save for later. • Get your kids involved. Let them help prepare food, set the table, mix ingredients. Make it a fun family activity. It gives children a sense of involvement, self-sufficiency and pride. • Bulk cook. The Kenows often plan out their meals for the week and cook a few meals on Sunday. It saves time during the week when things get more chaotic. • Stay away from anywhere you can drive up to get food; it’s a nutritional disaster. Kenow packs a small cooler with healthy snacks in her car for when she and her kids are on the run and need a snack. • Add your omegas and essential fatty acids. The Kenows all take a tablespoon of organic lemon-flavored fish oil daily. • Cook with coconut or olive oil. They also use flax or chia seeds daily, which support regularity. The family also takes a high grade multivitamin. She uses herbs in her cooking, according to seasons. • Water is the only beverage your body requires. She’ll add some lemon for cleansing or a dash of honey or stevia to help with water boredom. Her entire family also drinks kefir and kombucha tea. Limit pop, juice and other sugar laden beverages. She said they also drink coconut, almond, rice or hemp milk. • Play hard ball. “If your kids won’t eat what you’re eating, they don’t eat. They’ll figure it out,” said Kenow. “If you start making separate ‘kid’s meals,’ it becomes complicated and they begin to expect this.” But Kenow said it’s important to be creative, to make food more appealing. • Make your meals and snacks count. Some children don’t eat much, so make each meal or snack nutrient dense. Make sure to have some portable, convenient foods, like some trail mix or healthy multigrain muffins ready when you have to dash out the door.

PREVENTING CHILDHOOD OBESITY: A FAMILY APPROACH By JODIE TWEED Staff Writer

CROSBY — Chronic diseases found in many adults — type 2 diabetes, high blood pressure and cholesterol, obesity and fatty liver disease — are now more frequently being diagnosed in children. Dr. Kara Maucieri, a family medicine physician at Central Lakes Medical Clinic in Crosby, said the real solution in combating childhood obesity issues is education, educating families and the community about the importance of making healthy lifestyle changes. “I would never tell them to go on a diet,” Maucieri said, of the overweight children she often sees in her practice. “It’s not about the child. It’s about education. I had a family that thought it was cool that their seven month-old could eat a whole Blizzard.” She said a child is considered overweight when he or she is over that 85th percentile in body mass index, or BMI, percentage which factors in the child’s age, height and weight. The BMI percentile can be calculated on children starting at age 2. Your physician can calculate this or you can also find a BMI calculator on the Centers for Disease Control and Prevention website under healthy weight. Many times, simple changes are effective. Maucieri, who has three boys of her own, said it is easier to make healthy changes when children are young. “It’s easier when you have control and can start to teach them early about healthy choices,” said Maucieri. “Kids are getting way too many liquid calories. Juice is still sugar. Looking at those liquid calories is something that can be easily modified.” Maucieri recommends keeping children physically active every day and having strict limits on screen time. She said as school districts provide fewer and fewer physical education classes due to budget cuts, it makes it even more difficult for children to be physically active. She said her seventh-grader only has one quarter of physical education during the entire school year. “If they’re not getting it at school, are they getting it at home?,” Maucieri asked. “At a time when one-third of children are overweight or obese, we’re taking away their physical activities.” Maucieri, in her 16th year of practicing medicine, said she will refer a family with an overweight child to a registered dietitian for additional assistance. “It’s important for parents to model healthy behavior,” explained Heather Erickson, director of clinical nutrition at Cuyuna Regional Medical Center in Crosby. “We try to make it family habits that we are changing.” Erickson said the Cuyuna Range has a great trail system, including mountain biking, activities for the entire family. Erickson said children as young as toddlers are being referred to her. She said she works with the

Brainerd Dispatch/Steve Kohls

Dominick Baillif (left) and Mollie McFarlin enjoyed themselves as they played an active game of dodgeball during the Brainerd Family YMCA summer day camp in late August. Children should have at least one hour of physical activity a day.

family to add more fruits and vegetables into meals, offer healthy snacks and make these types of food choices fun and engaging. It’s also important that everyone in the home is eating healthy, not just forcing the overweight child to go without chips or soda while everyone else continues to indulge. Many families raise concerns about the price of eating healthy. They say it can be more costly. Erickson tells her patients that there are ways to save money, by purchasing fresh fruit and veg-

etables that are in season and purchasing food at local farmers’ markets. She said the most important recommendation she has is to plan ahead. Take some time on Sunday night to clip coupons or find online coupons to take with you to the grocery store, along with your prepared shopping list. “Having that plan is so important,” Erickson explained. Erickson said frozen vegetables can be as nutritious as fresh vegetables and when you purchase

Heather Erickson

Dr. Kara Maucieri

canned vegetables, make sure to rinse them to eliminate the added sodium. She also recommended buying store or generic brands, which can be less expensive. Erickson said many teens drink too much soda, which are empty calories. “We’ll have teens drinking a six-pack a day,” Erickson said, of soda. “That’s 900 calories. Water is always the best option.” Shelly Hanson, diabetes clinical nurse specialist at Cuyuna Regional Medical Center, said the rise in type 2 diabetes in children is sobering. Historically, type 2 diabetes mellitus has been an adult disease. Hanson said one in six children ages 12-19 in Minnesota have diabetes or pre-diabetes, which is when blood glucose levels are already higher than what they should be. She said that 2,100 children in the state have diabetes but 92,000 children in the state have pre-diabetes, according to the state Department of Health. “If we can catch those kids we can delay or even prevent type 2 diabetes,” Hanson said. A large research study called the diabetes prevention program found that those who make lifestyle changes reduced their risk of developing diabetes by 58 percent. Those who were 60 years and older reduced their risk by 71 percent. Those who used medication called metformin reduced their risk by 31 percent. Hanson said while both treatment options were effective, the lifestyle changes

Shelly Hanson

were much more effective. Cuyuna Regional Medical Center will be offering a 16-week diabetes prevention program beginning in January for those who have pre-diabetes. “This program is for adults and unfortunately, it is not covered by insurance yet,” said Hanson.“But this could be an invaluable course to not only help adults live healthier, but their children and grandchildren.” Erickson said she has spoken to Cuyuna Range Elementary School kindergarten children before on the importance of eating fruits and vegetables, and hopes to do more outreach into the schools. “The kids are great, they love to go home and share the information with their parents,” said Erickson. “The parents need to hear the information.” “We have the power to delay pre-diabetes,” said Hanson. “It’s pretty simple. We all have to eat to sustain life and move to sustain the quality of life.”

Childhood obesity: A growing epidemic About 17 percent, or 12.5 million children and adolescents, ages 2-19, in the United States are obese. Since 1980, childhood obesity has nearly tripled, according to the Centers for Disease Control and Prevention. Nationally, about 18 percent of school-age children and about 17 percent of teens are at risk for being overweight while 19 percent of school-age children and about 17 percent of teens are overweight. In Minnesota, nearly 63 percent of Minnesota adults are overweight or obese. In 2004, 13.8 percent of children ages 2-5 years of age enrolled in Women, Infants and Children (WIC) programs in the state were overweight, according to Minnesota Department of Health. — Information provided by the CDC and Minnesota Department of Health

A family that plays together, shares healthy habits

Dr. Jonathan and Amy Claussen built a gym in their rural Staples home for their children as a way to provide a healthy outlet for them to enjoy indoor activities. It’s one of the most popular rooms in the house.

Lakewood Health System promotes new 5-2-1-0 program for children, families By JODIE TWEED Staff Writer

TAPLES — Dr. Jonathan Claussen doesn’t just talk the talk.

The rural Staples family physician bikes, runs, plays basketball and other sports with his seven — soon to be eight — children. Claussen and his wife, Amy, believe that a family that plays together, well, has more fun and is healthy, too. After the couple moved from town into the country, they equipped their new home with a full gymnasium so the family would have a place to be active during the winter or on rainy days. A home gym was a lifelong dream of Claussen’s, who in fifth grade would sketch photographs of his future home containing his own gymnasium. The children are all homeschooled by their mother, and Claussen is in charge of gym class. He enjoys planning weeklong volleyball and bas-

ketball camps, and other sports, with the children for fun. “My husband is extremely physically active, so it’s part of our family culture,” explained Amy Claussen, who is due with their eighth child in February. Jonathan Claussen said it’s important for parents to model an active lifestyle and get out and play with their children. “I’ve never had a kid say, ‘No, I won’t play,’” Claussen said, when he has initiated a pick-up game of basketball or throwing around the football in the yard. That’s why Claussen fully supports Lakewood Health System’s new 5-2-1-0 program, which kicks off this fall. In an effort to combat childhood obesity, Lakewood received a Statewide Health Improvement Program grant through Todd, Wadena and Morrison counties to develop both a screening tool and educational outreach program to encourage families to engage in healthy habits. The health system formed a team to implement the protocol to consistently track body

mass index, or BMI, for children ages 2-11, explained Laurie Bach, a Lakewood registered nurse and a diabetes educator. Starting soon, when families bring their children in for well child visits, all children between 2-11 will have their BMI checked, or height and weight, and parents will be given a questionnaire about their child’s health habits. This questionnaire basically asks parents if their children are eating at least five fruits and vegetables per day, having two hours or less of screen time, getting in at least one hour of physical activity a day and drinking no sugar beverages. These are the basic goals. “The 5-2-1-0 is a simple algorithm that people can remember,” explained Bach. Young children will receive a kid friendly water bottle with the 5-2-1-0 logo on it to encourage them to drink more water. Middle elementary school-aged children during these well child visits will receive reusable lunch bags and learn about packing healthy lunches while fifth- and sixth-graders will get pedometers to encourage them to get out and be active. Todd-Wadena Healthy Connections is a collabo-

Brainerd Dispatch/Steve Kohls

Maggie Claussen, 6, rode a scooter along the gym floor at her rural Staples home.

Brainerd Dispatch/Steve Kohls

Dr. Jonathan Claussen helped his youngest son, Silas, 3, slam dunk a basketball at the family’s home gymnasium at their rural Staples home.

ration working on taking the 5-2-1-0 message to schools and the community. A website is in development at toddwadenahealthyconnections.org. Staples-Motley teachers were introduced to the program during an inservice on Sept. 1. In October, four medical students at Lakewood will be preparing a presentation on 5-2-1-0 for students at area schools, including Browerville, Eagle Bend, and Staples-Motley. Billboards also will advertise the importance of

5-2-1-0 program throughout the community. Bach said the Lakewood Foundation is also interested in sustaining the program beyond the initial grant funding. “It’s awesome to feel the energy around it,” Bach said. “Certainly the providers are very excited about it.” Dr. Christine Albrecht, a Lakewood family medical physician, said most families do want to do what is best for their children. She and other

Albrecht said it’s important when doctors are speaking to children and parents about a child’s weight issue, that the focus isn’t simply on losing weight. “We don’t want our kids to get focused on the scale,” Albrecht said. “We want to focus on healthy lifestyle changes.” Albrecht said many children are drinking too many calories, in fruit juices, soda and other sweetened beverages. She said it’s important for children to drink more water. “We need to teach kids that water tastes good,” said Albrecht. “It’s part of a societal trend, we don’t recognize we’re thirsty and we think we’re hungry and we eat.” Albrecht and her husBrainerd Dispatch/Steve Kohls band, Tim Leach, are themselves hoping to proDr. Jonathan and Amy Claussen of rural Staples believe so strongly in mote healthy activities family group activities that they had a gym built in their home for their seven — soon to be eight — children. The Claussen children include Emma and eating. Next summer they hope to open Oasis (top left), 12; Lydia, 8; Jacob, 14; Benjamin, 11; Elijah (bottom left), 5; Orchards, their apple Silas, 3; and Maggie, 6. orchard in rural Staples. physicians, like Claussen, have specially designed The orchard has 265 apple trees. They hope to prescription pads to write out for their young offer hay rides and other family friendly activipatients during well child visits as a reminder of ties. 5-2-1-0. Albrecht said she hopes with community-wide Albrecht said she appreciates the simplicity of support, that the 5-2-1-0 initiative will encourage the program. long-term healthy behaviors in families. “It gives parents something concrete to follow,” “I hope to see some differences made, to see she explained. “It’s not a bad guideline for every- these lifestyle changes before it becomes a chronone to be following.” ic condition,” Albrecht said.

Brainerd Dispatch/Steve Kohls

Tim Leach and his son, Alex, 1, worked in Oasis Orchards, the apple orchard he and his wife, Dr. Christine Albrecht, are starting in Staples. The young orchard should be ready for visitors next year. Albrecht (below), a Lakewood Health System family medicine physician, said she wants to encourage healthy habits beyond the scope of her medical practice.

What does 5-2-1-0 mean?

Screen time: By the numbers

The 5-2-1-0 program was developed by the American Medical Association, the Centers for Disease Control and Prevention and the Maternal and Child Health Bureau to address America’s crisis of overweight and obese children and families. It’s a simple formula that parents and children can remember. Here’s what it stands for: ➤ 5 — the number of servings of fruits and vegetables or more a child should eat each day. ➤ 2 — children should have two hours or less of screen time a day, including television, video games, computers and cellphones. ➤ 1 — Children should have at least one hour or more of physical activity per day. ➤ 0 — the number of sugary beverages — including soda and juice — that children should have each day. They should drink lowfat milk and more water.

— Information provided by the Office of Statewide Health Improvement Initiatives, Minnesota Department of Health.

75 — the percentage of children in the United States who watched television for an average of about one hour and 20 minutes, according to the Minnesota Department of Health. 27 — the percentage of 5- and 6-year-olds who used a computer for an average of 50 minutes on a typical day. 61 — the percentage of children under two who use screen media and 43 percent watch TV everyday. 41 — the percentage of 2- and 3-year olds who use screen media for two hours or more on an average day. Forty-three percent of 4- to 6-year-olds use screen media for two hours or more each day. 32 — the percentage of children who are 6 years or younger who live in households where the TV is on all or most of the time. 30 — the percentage of children who are 6 years or younger who live in households where the TV is on during meals all or most of the time. 27 — the percentage of children ages 6 months to 6 years who use a computer. Thirteen percent play console video games and eight percent play handheld video games several times a week. In addition, many young children (one-fifth of 0-2-year-olds and more than one-third of 3- to 6year-olds) also have a TV in their bedroom. There is a link between television and obesity. Studies have found that having a TV in the bedroom is more strongly associated with increased risk of a child being overweight. Children, both boys and girls, who had TVs in their bedrooms reported they spent less time in vigorous activities, watched more television, reported eating fewer fruits and vegetables and shared fewer meals together with their families.

Breast-feeding support in lakes area Pequot Lakes mom forms Brainerd Area La Leche League chapter

Brainerd Dispatch/Jodie Tweed

Vanessa Bye, Pequot Lakes, said breast-feeding her daughter Gena, 2, not only provided health benefits to her and her daughter, but helped strengthen the bond between them. Bye is an accredited La Leche League leader and is forming a chapter, the Brainerd Area La Leche League, here. By JODIE TWEED Staff Writer

EQUOT LAKES — Frustrated over the lack of breast-feeding support for mothers in the Brainerd lakes area, Vanessa Bye decided to do something about it.

Bye, a Pequot Lakes mother of two, has gone through the training process to become an accredited La Leche League leader. She recently formed the Brainerd Area La Leche League chapter, which will start meeting in November. La Leche League was founded in 1956 by seven mothers from Illinois to help other mothers who had difficulties or questions about breast-feeding. At the time the organization was founded, the breast-feeding initiation rate had dropped to 20 percent. The organization’s name is Spanish, meaning “The Milk League.” When Bye had her son, Ayden, now 7, she breastfed him for two months and then switched to formula. “It was an uneducated decision on my part,” Bye said, of quitting breast-feeding. “My mom didn’t breastfeed, my grandma didn’t breastfeed. It doesn’t come as naturally

The La Leche League will meet monthly at the Brainerd Public Library in Brainerd, starting in November. The dates and times had yet to be determined before this story was published. The meetings are open to pregnant moms, nursing moms and even grandparents or other support people who want to learn more about breast-feeding. The meetings are an opportunity for moms to connect with other moms, perhaps to help work through any breastfeeding issues that may be occurring. “I hope people will get out of it encouragement, support and a normalcy of breast-feeding,” said Bye. “And I hope La Leche League can be a place where moms can get evi-

dence-based information.” As an accredited La Leche League leader, breast-feeding moms may call Bye 24 hours a day, seven days a week, at (218) 568-5214 or email her at vanessabye@live.com with any breast-feeding issues or concerns. La Leche League also has a 24hour breast-feeding toll free hotline, which Bye has volunteered for. The hotline is 877-4-LA LECHE, or (877) 452-5324. To attend an upcoming Brainerd Area La Leche League meeting or for more information, contact Bye or search for the group’s Facebook page, “Brainerd Area La Leche League.” (For breast-feeding statistics, see Page 26.)

anymore.” Bye said when she gave birth to her daughter Gena, now 2, she decided she would exclusively breastfeed, a decision she said not only provided health benefits for her and her daughter but it created a greater bond between them. Years ago there was a La Leche League chapter in the Brainerd lakes area but that disbanded. Bye’s passion and interest in breastfeeding motivated her to become trained to start a new chapter. She is also a certified childbirth educator and a midwifery student, so breast-feeding support seemed a natural fit for her.

Public health offers vaccinations for all ages By JODIE TWEED

Brainerd Dispatch/ Steve Kohls

Staff Writer

As lakes area children returned to school this month, many parents are rushing to get them up to date on their vaccinations. But adults, too, should be up to date on their vaccinations. Stephanie Kubas, public health nurse for Crow Wing County Public Health, said those who are underinsured or don’t have health insurance coverage can get vaccines for little to no cost at Crow Wing County Community Services Health Division. The Centers for Disease Control and Prevention recommend that adults get the following vaccines: • Tetanus, diphtheria, pertussis, or Tdap, a onetime dose of this adult whooping cough vaccine. This is especially important if they have contact with an infant, are a healthcare worker or wants to be protected from whooping cough. A Td booster dose is needed every 10 years. • Pneumococcal, one or two doses for adults who smoke or have certain chronic medical conditions. • Hepatitis B, which is given in three doses, usually over six months. • Hepatitis A, usually given as two doses, six to 18 months apart. • Human papillomavirus, or HPV, for women age 26 or younger. One brand, Gardasil, can be given to men ages 26 or younger to prevent genital wards. The vaccine is given in three doses over six months. • Measles, mumps, rubella, or MMR, is necessary for those born in 1957 or later. You may also need a second dose. • Varicella, or chickenpox vaccine, is necessary for those who never had chickenpox or were vaccinated but received only one dose. • Meningococcal, for those who are going to college and plan to live in a dormitory or have one of several medical conditions. Zoster, or the shingles vaccine, which is given to people ages 60 or older. Most adult vaccines cost $10 but those who are unable to pay are not turned away. Influenza, or flu vaccine, a dose every fall or winter for your protection and for the protection of others around you. County public health offers flu shots for $25. For children entering kindergarten, they need to have received five DTap, four polio, two MMR and two varicella vaccine doses by that time, said Kubas. Seventh graders need a Tdap booster vaccine and have to have had two doses of the chickenpox vaccine or a history of chickenpox verified by a physician, she said. The HPV vaccine is recommended for girls and boys between the ages of 11-26. School immunizations cost $5 each, but no one is denied access due to an inability to pay. Kubas said the county holds immunization clinics the second and fourth Tuesday of each month by appointment only throughout the year. For more information, contact Margie Young at Crow Wing County Public Health at 824-1098 or 8241079.

Emily Kautz braced herself for an immunization, given by Crow Wing County public health nurse Stephanie Kubas Aug. 30 at a school immunization clinic.

Minnesota public health officials set goal for an outbreak-free school year MINNEAPOLIS – Minnesota child wellness experts are encouraging parents to add vaccinations to this year’s back-to-school checklist. The percentage of Minnesota children receiving vaccinations is declining, which concerns many in the medical community. Minnesota vaccination rates rank poorly. Only 58.1 percent of Minnesota children ages 24-35 months are up to date on all recommended vaccines. The vaccination rate for tetanus, diphtheria, and whooping cough among 11- to 12-year-olds is 52 percent, which is below the national average and ranks 35th among states. Going unvaccinated puts people at an unnecessary risk of acquiring vaccine-preventable diseases. The biggest danger is to infants who are not old enough to be vaccinated and get exposed to a variety of diseases. “Immunization is one of the best decisions every parent can make to protect their child,” said Deborah Moses, senior director of Head Start and Early Head Start at Community Action Partnership of Ramsey and Washington Counties. “It’s like putting their child in a car seat.” Recent outbreaks show that vaccine-preventable diseases have not been completely controlled. In 2010, 1,000 cases of whooping cough were reported in Minnesota. Last spring, Hennepin County experienced one of the biggest measles outbreaks of the year in the U.S. More Minnesotans caught measles during this time than the past 13 years combined. The outbreak, which originated from an unvaccinated child, affected 20 people who had not been vaccinated or were too young to be vaccinated. “Measles is highly contagious, and its complications can be serious,” said Michael Garvis, MD, a pediatrician practicing at South Lake Pediatrics, a member of Children’s Physician Network. “The only way to prevent it is to make sure you and your children are immunized. I strongly encourage Minnesotans to check their vaccination status to prevent future outbreaks.” Immunization is commonly regarded as one of the greatest success stories in public health.

Vaccines have eradicated smallpox and significantly reduced the number of cases of measles, polio, and other dangerous diseases. Despite these efforts, an increasing number of Minnesotans are refusing or delaying shots for their children. Many parents have never witnessed the damaging effects of vaccine-preventable disease, which has led many to feel unconcerned about the importance of getting vaccinated. People refusing vaccines come from all socioeconomic situations, from the impoverished to the highly educated. “There is no credible research supporting a link between autism and vaccines,” said Amy Gilbert, M.D., a family physician and chair of the Minnesota Medical Association Public Health Committee. “Many people continue to have this concern and refuse vaccines for this reason. We are still working hard to dispel this rumor and reinforce the importance of keeping children’s vaccines up to date. Our goal is for Minnesota to surpass a 90 percent overall vaccination rate.” Most Minnesota clinics are part of a program called Minnesota Vaccines for Children (MnVFC), which will cover the cost of the vaccines. Many clinics ask for a fee or donation to cover the cost of administering the shot. MnVFC distributes about $39 million worth of vaccines to public and private clinics in Minnesota each year. Getting shots at the right ages is important, but it is never too late to catch up. Please see the full schedule of vaccinations under state vaccination law at: http://www.health.state.mn.us/divs/idepc/immunize/laws/index.html. Minnesotans may also call the Minnesota Department of Health at 800-657-3970 or 651201-5503. Information provided by the Children’s Physician Network, which includes Children’s Hospitals and Clinics of Minnesota and Gillette Children’s Specialty Healthcare; Minnesota Medical Association; Minnesota Head Start Association; and Community Action Partnership of Ramsey and Washington Counties. The organizations worked together to raise awareness as part of August’s National Immunization Awareness Month.

Backpack, check! Pencils, check!

Don’t forget the check-up By JODIE TWEED HealthWatch editor

rowing up as the son of a small town family doctor, Dr. Nate Laposky would often ride along with his dad, Dr. David Laposky, when he had to meet patients with emergencies at the Pine River clinic. Now Laposky is a family practice physician himself, having followed in his father’s footsteps. He started his practice July 25 at Essentia Health St. Joseph’s - Brainerd Clinic. Laposky and his wife Melissa have three children, ages 2, 4, and 6, which has personally driven home to him the importance of well child check-ups and immunizations. Even if a child is healthy, well child exams are beneficial so a child’s growth and development can be evaluated over time, he said. “I recommend yearly checkups. We’re trying to get an overall snapshot of how the child is doing,” Laposky explained. Laposky said during a well child visit, he has a child’s height and weight checked. He asks about the child’s sleep habits. “In elementary and junior high, children need 10-12 hours of sleep a night to really feel good,” Laposky said. “It really does impact how they feel. I can tell from my own experience if kids aren’t getting enough sleep.” He said he’ll talk with the child and par-

ent about whether the child eats breakfast, an important first meal of the day. “Breakfast is the big one. Really, anything is better than nothing but getting a well balanced diet is important,” said Laposky. “Something to keep you going.” Laposky said he asks children about their grades in school. It’s possible, if a child’s not doing well in school, that a vision problem could be to blame. Children sometimes don’t recognize that they’re no longer seeing as well as they did before. “Kids do 80 percent of their learning with their eyes,” Laposky noted. While Laposky said he’ll do an eye exam, he’ll often refer the child to an optometrist. “About onequarter of children have a visual impairment.” Laposky also asks how the child’s relationship is with his or her parents, siblings and friends as a way to gauge how the child is feeling. “They’re not going to come out and say ‘I’m depressed’ or ‘I’m anxious,’” said Laposky. In addition to a physical, Laposky said he asks about a child’s bladder and bowel habits. He will speak to the child and to parents about the child’s diet. The start of the school year is a perfect time to get a check-up. It’s an opportunity to also bring your child in for an annual flu shot. “I really encourage getting flu shots,” said Laposky. “I hope we can keep the flu out of the

schools. It not only benefits the kids, but the elderly and those around who can’t get the shot.” Laposky said it’s also important that children are up to date on their vaccinations, and the vast majority of his patients do receive vaccines. While some parents do have concerns about vaccines, Laposky said he is very willing to talk to them about those concerns. A small minority of parents wish to spread out the vaccinations over a longer period, and Laposky said he is fine with that as long as the child is getting them. “There’s no evidence out there implicating vaccines are dangerous, especially the seasonal flu vaccine,” said Laposky. “It’s one of the most studied out there. If I felt anything was wrong with them I wouldn’t do them with my kids.” Laposky said if a child does get sick during the school year, the child has to remain out of school until he or she is without a fever for 24 hours without medication. Laposky said he also discusses safety issues, making sure children are wearing their bike helmets and children younger than eight years or shorter than 4 feet, 9 inches, use a car or booster seat in a vehicle. Laposky said the seat belt needs to be in the proper position on the shoulder of the child, not on the neck. “I compare my kids to my patients and my patients to my kids,” Laposky said with a smile. “I think it’s made

me a better doctor and a better parent. I’m very sympathetic with my patients. I try to tell them the right things to do but it doesn’t always translate into my own home.” Essentia Health has almost become a family business for Laposky. His wife, Melissa Laposky, is a new oncology nurse navigator and his brother, Ryan Laposky, is a new pharmacist, both working at Essentia Health St. Joseph’s Medical Center in Brainerd. Their father remains a family physician at Essentia Health St. Joseph’s Pine River Clinic.

Dr. Nate Laposky is a family practice physician at Essentia Health St. Joseph’s - Brainerd clinic.

Brainerd Dispatch/Kelly Humphrey

Shellie Cibuzar (left), registered dietitian at Essentia Health St. Joseph’s Medical Center in Brainerd, discussed the nutritional label on frozen garlic bread with Shirley Seelen, Jennifer Skorich, and Annette and Dave Olson during a grocery store tour Aug. 23. Additional monthly grocery store tours are planned through November.

Essentia Health offers Heart Healthy grocery store tours By JODIE TWEED HealthWatch editor

When Annette Olson was diagnosed with diabetes a couple years ago, she and her husband Dave decided they needed to change their lifestyles. “I felt at the time, if she has to watch what she eats, then I’d go along with her to eat the same foods,” Dave Olson explained. “It made it a lot easier for her.” The Brainerd couple took it seriously and began reading nutritional labels for the first time. Since then, Annette has lost more than 40 pounds and Dave has lost 30 pounds. The Olsons participated in a grocery store tour at Cub Foods in Brainerd Aug. 23. The one-hour guided tour of the store by Essentia Health St. Joseph’s Medical Center registered dietitian Shellie Cibuzar provided participants with information on how to make healthy choices. The grocery store tours are a partnership between the Brainerd Lakes Heart and Vascular Center at Essentia Health St. Joseph’s Medical Center and Cub Foods stores in Brainerd and Baxter and SuperValu in Pequot Lakes. The Heart Healthy program also involved the

placement of 400 blue tags identifying a sampling of items that meet criteria set by the American Heart Association throughout the grocery stores. This includes foods with fewer than 480 milligrams of sodium per serving, less than one gram of saturated fats and less than .5 grams of trans fat per serving. The grocery store tour included a presentation by Cibuzar on healthy eating and reading nutritional labels. Cibuzar said a 2004 study found that seven out of 10 Americans read food labels. “What I’ve seen with working with individuals is that they may read them but they don’t understand them,” Cibuzar explained. Cibuzar said portion control is important since eating too much leads to weight gain. She said a serving of baked beans is one-fourth of a cup; a serving of mashed potatoes is one-half cup. A serving of milk is 8 ounces. However, many people consume much more than that. “People don’t realize how big servings have gotten,” said Cibuzar. After her presentation, Cibuzar led participants on a tour of the grocery store, providing tips and information on making healthier food choices. “It’s a pleasure to hear from Shellie, who really

knows what she’s teaching,” Dave Olson said of the tour. Bryan Jelinski, Brainerd Cub Foods store manager, said the partnership between the grocery store and Essentia Health has been a positive one. The Heart Healthy blue tags throughout the store complement the Nutrition IQ tags that the store already has, which lets customers know about other healthy choices. Jelinski said his store has had the Nutrition IQ tags for the past year. “It’s good for us to partner with Essentia,” said Jelinski. “This is the first time we’ve had this type of partnership and so far I think it’s been very successful.” The next monthly grocery store tours are planned for 9:30-11 a.m. Sept. 21, Baxter Cub Foods; 7-8:30 a.m. Oct. 25, Pequot Lakes SuperValu; and 10-11:30 a.m. Nov. 16, Brainerd Cub Foods. Pre-registration is required as tour sizes are limited. To register, call 828-7650 or e-mail hearthealthygrocerytour@essentiahealth.org. JODIE TWEED may be reached at jodie.tweed@brainerd dispatch.com or 855-5858.

Grab a plate: Government revamps old food pyramid she meets with her WIC families, particularly when a child is overweight or obese. “It’s hard to hear your child isn’t eating correctly or is obese,” said Nelson. “No parent wants to hear that. But the best time, for the child’s sake, to start working for a healthy life is when they’re young. Kids will do what their parents do, and parents need to own up to their own diets as well.” Nelson recommends to her WIC families that they start with small steps to make lasting changes. “It’s never too late to start with small changes,” she said. For more information on MyPlate, visit www.choosemyplate.gov.

By JODIE TWEED Staff Writer

In early June, the United States Department of Agriculture, along with First Lady Michelle Obama and Agriculture Secretary Tom Vilsack, unveiled the government’s new food icon, called “MyPlate.” MyPlate is meant to serve as a dietary guideline to help consumers make healthier choices. It is based on the 2010 Dietary Guidelines for Americans and replaces the MyPyramid image as the government’s food group symbol. Shari Nelson, nutritionist for the Women, Infants and Children program through Crow Wing County Public Health, said MyPlate is based on a nine-inch plate. The plate is a visual reminder of portion control. “We’ve exaggerated our portion sizes so greatly we don’t know what portion sizes are anymore,” said Nelson. MyPlate shows that less than one-quarter of the plate should be a fruit serving, and a little more than one-quarter should be a vegetable serving, which together take up half the plate. The other half of the plate includes a larger than one-quarter side of grains and less than one-quarter of the plate should be a protein serving.

Choose My Plate: The basics

Nelson said most Americans eat a serving at least half of the size of MyPlate of protein alone. Children need only four ounces of protein a day, which is about the size of a deck of cards. MyPlate also includes a small dairy serving. Nelson said the MyPlate icon is easy for people to visualize and remember. She uses MyPlate when

Balancing calories • Enjoy your food, but eat less. • Avoid oversized portions. Foods to increase • Make half your plate fruits and vegetables. • Make at least half your grains whole grains. • Switch to fat-free or low-fat (1 percent) milk. Foods to reduce • Compare sodium in foods like soup, bread and frozen meals — and choose the foods with lower numbers. • Drink water instead of sugary drinks.

Handwriting does matter Baxter therapists work with students to improve their handwriting skills

Brainerd Dispatch/Steve Kohls

Occupational therapist Margaret Knebel prefers crayons and chalk over markers, since those writing materials don’t glide so easily and provide feedback to the writer. By JODIE TWEED HealthWatch Editor

BAXTER — In this digital age of e-mail and texting, is handwriting really that necessary anymore? Yes, it is, says Margaret Knebel, an occupational therapist at Big Stone Therapies Inc. in Baxter. Knebel said the act of handwriting is a critical developmental tool for children. By putting pen or pencil to paper, children not only develop stronger fine motor skills but it stimulates brain growth and learning. Some children may feel embarrassed if their handwriting isn’t up to par. Not only does this affect a student’s learning process but if a child can’t effortlessly jot down ideas or answers on paper, it affects the more complex cognitive requirements required in the upper grades, said Knebel. Author and handwriting remediation specialist Jeanette Farmer has stressed that by age 11, a child’s handwriting should be unconscious and automatic, or flowing without anxiety. By investing in handwriting practice for 10-15 minutes a day, a student’s brain is better prepared and engaged to do well on tests. A child, particularly boys, may be viewed as lazy if his handwriting is illegible. Not necessarily true, said Knebel. Many times the child may have developed some bad habits, such an improper pencil grip or placement of the paper. These can be corrected and with practice, handwriting can improve. Knebel and Leah Hall, also an occupational therapist at Big Stone Therapies Inc. in Baxter,

specialize in pediatric occupational therapy. They will be offering an after school handwriting camp beginning Oct. 24 for students who need help on their handwriting skills. For more information on the camp, call Big Stone Therapies Inc. at 4547012. These eight one-hour sessions are designed to be fun, to feel more like play than work. “The occupation of children is to play,” Knebel explained. “For them to learn, it needs to be in a play environment.” Students at the handwriting camp will play games, work on arts and crafts and many other activities, including writing, to strengthen their handwriting skills. The camp is designed for children who do not qualify for special education services, those children who “fall through the cracks” in an educational system but could use help with handwriting. The most effective age group for this writing camp are children ages 5-9. Critical to developing better handwriting is strengthening a child’s core muscles, as well as their fine motor skills. Children aren’t as physically active as they once were and don’t have strong core muscles, which surprisingly are necessary for improving handwriting. These larger muscles are developed first. A child’s fine motor skills come next. The development of large motor skills begins at infancy but children today are being raised differently, which has affected these muscles. Babies are sleeping on their backs to prevent sudden infant death syndrome, or SIDS. As a result, most babies don’t get enough “tummy time” to build upper body

strength and coordination. And then there are the infant car seats that babies are toted around in by parents. “We have a generation of children growing up in containers,” Knebel explained, of the portable seats. She said a baby’s limited view from an infant seat and limited use of his or her core muscles translates to handwriting skills. It can negatively affect a developing child’s visual, perceptual and spatial awareness— where am I in relation to my environment? Later, it can affect how a child moves his or her hand to make letters, to properly space letters to form sentences. Knebel said there are many things parents can do to help improve their children’s handwriting skills. But this doesn’t mean putting a pencil in their hand and forcing them to repeatedly write their letters. Pushing handwriting too early can lead to bad writing habits. Fun, simple activities can build those fine motor skills that are necessary for handwriting later on. Big Stone Therapies has an occupational therapy room specifically designed for children, a fun place to work on their large motor skills. This then leads into the development of fine motor control for drawing, writing and cutting skills. The room includes a swing, scooters and a rock climbing wall. Knebel advises parents not to let their children struggle with these skills. This can cause frustration and low self-esteem. She visits area Early Childhood Family Education classes to talk to parents of young children about helping them find entertaining ways to encourage their children to develop their fine motor skills.

How handwriting benefits student learning

Brainerd Dispatch/Steve Kohls

Learning: Chronic stress causes a chemical change that shuts down learning and undermines the brain’s ability to lock information into memory. A multi-sensory handwriting program can relax the emotional brain to reduce stress levels in students and improve learning. Language development: Rhythm helps a child feel the cadence of language and this facilitates the acquisition of language skills. The regular, repetitive movement used in handwriting helps develop and maintain an internal rhythm that leads to a well-balanced person overall. Focus and concentration: Therapeutic music with a rhythm of 60 beats per minute can stabilize how the brain is firing, calming the emotional brain so it can focus. Handwriting activates neural impulses that are sent to the brain’s higher levels to improve attention. So handwriting and music are a powerful combination that can create a tranquil, effective classroom learning environment. Organization skills and work

habits: The repetitive manipulation of the thumb and fingers in the handwriting process helps active the left brain. The left brain manages executive functions such as planning, monitoring, organizing, revising and attending - skills critical to educational management and self-management. Impulse control: Handwriting is a repetitive movement that can help counteract the right brain’s impulsive behavior. Reading: The young brain needs the simulation of handwriting to prepare the brain for learning so reading can be developed more easily. It lays a foundation of neural pathways and connections that assist sequential processing and integration of thought with action, both necessary for the acquisition of literacy skills. Information provided by Margaret Knebel, occupational therapist, Big Stone Therapies Inc., Baxter, compiled from a variety of sources.

Occupational therapist Leah Hall of Big Stone Therapies Inc. in Baxter demonstrates how children’s tongs and small objects to be sorted can be used by children to develop their handwriting skills. Hall is showing how the wrist should be properly extended, a skill that will lead to better handwriting when the child is older.

Brainerd Dispatch/Steve Kohls

Occupational therapist Margaret Knebel uses a corn cob holder and a drawing to poke holes around as an activity to develop a child’s handwriting skills. Knebel said there are many inexpensive but fun ways to help a child with his or her fine motor skills.

What parents can do

Brainerd Dispatch/Steve Kohls

Occupational therapists Margaret Knebel (left) and Leah Hall of Big Stone Therapies Inc. in Baxter demonstrate a great strengthening exercise for children to develop their core muscles.

Brainerd Dispatch/Steve Kohls

Leah Hall, an occupational therapist at Big Stone Therapies Inc. in Baxter, demonstrated how a swing, particularly a rope or tire swing, can strengthen a child’s upper body strength. Stronger core muscles can lead to better fine motor skills, which includes handwriting skills.

Occupational therapist Margaret Knebel demonstrated how this scooter is a great way for a child to have fun, yet also work on upper body strength. Big Stone Therapies Inc. in Baxter last year remodeled its pediatrics room to become a kid friendly place for children to be.

Parents can do many things to help their young children improve their fine motor skills, thus encouraging proper handwriting development. Margaret Knebel, an occupational therapist at Big Stone Therapies Inc. in Baxter, said children as young as 18 months should be allowed to use child scissors with supervision to cut paper. Those subscription cards inserted in magazines are easy for young children to hold and cut. She said parents may also buy a large pack of straws and let their preschoolers have fun cutting them into small pieces, then sorting those pieces into cups or bowls. The bits of straw bounce and fly in every direction when cut, making it an engaging activity for young children, she said. Eyelash curlers can also be a source of entertainment. Have your preschool child pick up jacks or other smaller objects with the eyelash curler and sort them into bowls. Tongs also can be used. These games help a child develop proper wrist extension and hand muscles required in handwriting. Other activities can include playing with building blocks or using containers to sort shapes or colorful objects. One of the best activities for a young child is to color while lying on the floor. Knebel said this simple activity builds a child’s core muscles, balance and coordination and fine motor skills. Writing on paper placed on a wall, easel or even using erasable markers on a window also builds hand muscles. For young children, a colorful pipe cleaner can be used to string large wooden beads together. The pipe cleaners can be easier for little hands to manipulate than string, said Knebel. Knebel said chalk or crayons are preferable to work with since they drag on the paper and they give a child feedback while using them. Markers can be too easy to use, she said. Playing with shaving cream and Play-Doh and other interesting textures can also be beneficial. Knebel said children — and their parents — shouldn’t feel squeamish about getting messy. Messy is educational, too. Core muscle development activities can include lying on the floor and batting a ball to one another. A rope or a tire swing is a fun activity that requires a child to hold on, building upper body strength. Knebel said parents of infants should try to become less reliant on infant carriers outside the car. Infants who are being held by a parent are using their vision and developing balance, as well as building their core strength.

Brainerd Dispatch/Steve Kohls

A simple large bead and pipe cleaner is a fun way for young children to develop fine motor skills, which can lead to better handwriting.

Program helps catch vision loss in young children By AMY GRAY ELLINGSON Special Correspondent

hen my daughter failed her eye exam at her five-year well-child pediatric exam, I didn’t think much of it. Her pediatrician said it could indicate an ocular problem or the problem could simply be her being an uncooperative 5-year-old (I found the latter of the two more likely). He recommended getting her eyes examined but, being a busy, working mother of two, I put it off. After all, she was reading her school books just fine, and she didn’t seem to have any vision problems. Well, several months went by and I started noticing her increased agitation when it came to reading to her dad and me at night. I finally asked her if she was having a hard time seeing the words, and she very meekly said, “yes.” According to InfantSee.org, one in every 10 children is at risk from undiagnosed eye and vision problems, yet only 13 percent of parents with children younger than 2 years of age said they had taken their babies to see an eye and vision care professional for a regular check-up or well-child visit. InfantSee, a national program offered free of charge by several local eye clinics, is an exam done between the ages of 6-12 months to check for conditions such as lazy eye, muscle imbalances and some diseases which may have no symptoms and may not be recognized by a parent or in a wellchild examination. Even though babies’ eyes can

be examined immediately after birth, a baby’s vision changes so much in the first three months, it makes it more challenging to adequately diagnose problems. “Babies under 6 months of age are not as responsive, and 1- to 2-year-olds get more scared, so 6-12 months is optimal for testing,” said Dr. Stephanie Parrish of Brainerd Eyecare Center. The testing is painless, and, according to Parrish, most kids think it’s fun. “We use toys to check peripheral vision and patterns to determine preferential looking which demonstrates a recognition of contrast. It’s like playing games, and they love it,” Parrish explained. I had been told when both my kids were infants about InfantSee, but getting my newborn’s eyes checked ranked somewhere on the list after feeding, bathing, rocking, diaper changing, stopping the crying, bathing myself, working and, oh, yes, sleeping. That said, I never had either of my kids’ eyes checked until we took my daughter in at 5-1/2 (both kids have now had eye exams). My daughter’s eye exam with Parrish went better than I anticipated, and it turned out my daughter is severely farsighted. Having never had glasses myself, I wasn’t sure how this whole new world of corrective lenses would look, but my daughter was far more excited about the prospect of glasses than I was and in the two months since getting them, she has done a great job wearing her glasses and is quite proud of her teal frames with the ladybugs on the sides.

the sides. Since we waited so long to have our daughter’s eyes checked, we have begun to question how much she missed out on, visually, since birth since, statistically, under normal circumstances, 80 percent of what we learn is through our visual sense. Parrish says many vision problems aren’t detected until kids begin school and start reading, and it made me wonder how many kids struggle academically because they simply can’t see properly. My daughter was initially wearing her glasses for reading and when she felt like it, but at her last checkup, Parrish explained how our eyes, like our brains, need to learn how to see. When our vision is not where it should be, our eyes don’t learn how objects should look, which could make letter and number recognition more difficult. My daughter is now wearing her glasses all the time, with the exception of sleeping, swimming and bathing, in an effort to train her eyes to see properly. Since my daughter began wearing prescription eyewear, I have spoken with many other parents whose kids wear glasses (one whose daughter has had glasses since she was 6 months old), and many people who started wearing glasses as young children. Everyone I spoke with who started wearing glasses early in life shared the same story of seeing a whole new world previously unknown to them, like Dorothy seeing things in Technicolor in Oz following a life of black and white in Kansas. Having never had significant vision problems myself, I have always taken my ability to see clearly for granted. Now, experiencing this positive change with my daughter, I am a believer in early detection through programs like InfantSee. French painter Henri Matisse said, “I would like to recapture the freshness of vision which is characteristic of extreme youth when all the world is new to it.” Having your child’s eyes examined early allows them the opportunity to more clearly see and experience the world while it is new and fresh. I’m glad we had my daughter’s eyes checked when we did but, knowing what I know now, I wish we had done it sooner. InfantSee is free, it’s easy, it’s available locally, and it can open up a whole new world to kids with undetected vision problems. AMY GRAY ELLINGSON is a mother of two and a writer/publicist with Locally Grown Communications. She also has a passion for health and wellness.

Participating Area Eye Clinics

➤ Brainerd Eyecare Center ➤ Associates In Eyecare, Baxter ➤ Lakes Area Eyecare, Baxter ➤ Mille Lacs Health System, Onamia

HealthWatch correspondent Amy Gray Ellingson and her daughter, who is proudly sporting her new pair of glasses.

French painter Henri Matisse said, “I would like to recapture the freshness of vision which is characteristic of extreme youth when all the world is new to it.” Having your child’s eyes examined early allows them the opportunity to more clearly see and experience the world while it is new and fresh. I’m glad we had my daughter’s eyes checked when we did but, knowing what I know now, I wish we had done it sooner.

Brainerd Dispatch/ Kelly Humphrey

Matt Simpson, 3, played on the rocks at Whipple Beach in Baxter in August.

Fall family fun for everyone By SHEILA HELMBERGER HealthWatch correspondent

The summer may be winding down and you’re returning to the old routines of school days and fall yard work but that doesn’t mean all of the fun has to come to an end. There’s still plenty of good weather to come and some of the most beautiful days of the year are still ahead of us. The fall months mean temperatures are a little more agreeable and there are still great opportunities to engage in some healthy outdoor exercise. Autumn also means the bounty is abundant from those spring gardens and the payoffs are delicious and healthy for us. Our senses are busy this time of year taking in the smell of evening bonfires, the taste of hot apple cider and looking for that perfect pumpkin. Don’t be surprised if you discover there’s more healthy fun for your family in the fall than there was in the summer. Start the season with an outdoor scavenger hunt. Make a list of items to locate like a specific color leaf, an acorn, and a handful of berries, pine cones or other things. It can even be educational if you print pictures with the items and include

their proper names. Take a hike, Mike The area’s abundant hiking trails are still accessible and in great shape this time of the year. A family outing together for a leisure ride or day trip through the countryside will offer some of the most eye catching scenery of the area. If you didn’t get a chance to hit the trails this summer procrastinating might even pay off. Partake in a little pedal power For the same reason that hiking is a good idea in September and October – it’s also a good reason to keep that bicycle out of storage a little bit longer. Wax on, wax off It turns out that the movie “Karate Kid” got it right. Sometimes everyday chores do offer the most effective workouts. The leaves will have to be raked anyway and winter preparations need to be completed but it can still be fun when everyone pitches in. Use some of the leaves as a decorative filling to create a scarecrow for the yard. Harvesting the produce from the garden means fresh vegetables for dinner and any that are preserved will contribute to your meals all year long. Corn is an maze-ing thing Hunt up a local corn maze. There’s one at

This Old Farm on St. Mathias Road. Gather a group and head out for an afternoon of fun. Form one big group or break into smaller ones and create a friendly competition. Tromp through the openings and winding paths to further your way to the end. The assignment? Find your way out. Pumpkins are pretty good, too Scout out a pumpkin farm and spend the day searching one that is just that perfect shape for this year’s Jack o’Lantern. Pick up a couple extra and turn them into pumpkin bars and pans of roasted pumpkin seeds. The a ‘peel’ of apples Visiting an apple orchard in the fall is a treat for everyone. Sample the many varieties and vote on a family favorite. Purchase some to take home and some to pass on to friends. The Red Barn Orchard is located west of Jenkins and Gilby’s Nursery and Apple Orchard can be found off Highway 210 in Aitkin. Not only are there tasty apples to be had but you may be able to sample some homemade cider and scoop up a couple of recipe ideas for treats to make with your haul. It’s hard to say no to homemade apple pie, strudel and apple sauce. If you are inter-

ested in making a road trip out of it the Hidden Cove Orchard in Cold Spring hosts an apple festival the first weekend of October and other apple vendors offer their own special events. Sheila Helmberger contributes regularly to several Brainerd Dispatch and other regional publications. She lives in Baxter and has three children.

Brainerd Dispatch/Kelly Humphrey

Brianna Inkster gave Kaya Inkster, 10, and Maren Inkster, 1, a little boost as they swung at Whipple Beach in Baxter in August.

Combatting concussions Crosby-Ironton student athletes undergo baseline testing before sports season begins in case they suffer Brainerd Dispatch/Steve Kohls

a concussion By JODIE TWEED HealthWatch editor

ROSBY — In the past when student athletes would “get their bell rung” on the football field, they may have brushed themselves off and gotten back into the game. Not so anymore. School districts are taking a more serious approach to treating concussions in student athletes. Repeated concussions, even those that are considered to be mild, can lead to a lifetime of neurological and cognitive deficits. Concussions repeated within a short period of time — hours, days or weeks — can be catastrophic or even fatal, according to the Centers for Disease Control and Prevention. Crosby-Ironton High School athletic trainers and the coaching staff are now using state-of-theart technology to detect even the slightest concussion or lingering symptoms in order to keep play-

Al Bukowski, director of rehabilitation services at Cuyuna Regional Medical Center in Crosby, performed a baseline balance test on Crosby-Ironton football player Zack Olander in August at the medical center. If Olander suffers a concussion during the football season, he will be retested to make sure even subtle symptoms of the concussion have disappeared before he’s able to play again.

ers safe. Last year the district began using ImPACT, or Immediate Post Concussion Assessment and Cognitive Testing, a computer software program used to assess students after they suffered a concussion. An athletic trainer will assess a student on the field of a game. If he or she is suspected to have suffered a concussion, then the student has to remain off the field for seven days. On the eighth day they’re allowed to put a helmet on and practice, to see if the physical symptoms of the concussion are gone, such as a headache. After 10 days, the student is allowed to return to full contact sports as long as he or she is cleared by a doctor to play. Now students undergo ImPACT testing on day seven and if he or she doesn’t pass this testing, then the student won’t be able to play. Mike Gindorff, Crosby-Ironton head football coach, said last year he had two student athletes who suffered concussions. One student passed the ImPACT testing after a seven-day recovery period and the second student never got back to that baseline level and was unable to play the remain-

der of the season. “In the past, you wouldn’t have known,” Gindorff said, of the impact of a concussion on a student athlete. “The kid would have said they were fine and you wouldn’t have ever known. With all the research on the long-term effects of concussions, it’s better to err on the side of the kid than winning a couple of football games.” Now C-I schools, in a partnership with Cuyuna Regional Medical Center in Crosby, which provides athletic training services to the district, are taking another step toward detecting even the slightest of concussions in student athletes. Al Bukowski, director of rehabilitation services at Cuyuna Regional Medical Center, said in August about 40 C-I football players — those who are considered high risk for suffering a concussion because of their position — underwent baseline balance/postural sway testing using the Balance Manager. This machine tests and can find subtle balance issues a person may be having. For the past four years it has been used at Cuyuna with elderly patients who are having difficulty with balance.

“With much less trauma, you can cause significant injury if you play too early. That’s where we’re seeing the real damage occur.” — AL BUKOWSKI

How to recognize a concussion

Brainerd Dispatch/Steve Kohls

Al Bukowski, director of rehabilitation services, showed Crosby-Ironton football player Zach Olander the results of his balance test in August.

Bukowski said a concussion is a closed head wound and needs to be taken seriously. The Balance Manager, developed by NASA for its astronauts, will be used after the student athlete’s physical symptoms subside from a suspected concussion. It will detect subtle changes in the student’s results from the baseline test to the test following the concussion to determine if the student needs more recovery time. “These high school kids, they want to play, no matter the cost,” said Bukowski. Bukowski said the real danger to student athletes comes after suffering a concussion. If they suffer even a mild second concussion, the injury can be even worse. “With much less trauma, you can cause signifi-

cant injury if you play too early,” said Bukowski. “That’s where we’re seeing the real damage occur.” Bukowski said the balance/postural sway testing is a pilot project. They will likely be conducting similar testing for students in other contact sports this year as well. Gindorff said the district recently purchased 60 new football helmets for all varsity players — “the best helmet made” — which may help prevent concussions. JODIE TWEED may be reached at jodie.tweed@brainerddispatch.com or 855-5858.

Watch for two things: A forceful bump, blow or jolt to the head or body that results in rapid movement of the head and any change in the athlete’s behavior, thinking or physical functioning. Signs of a concussion by an athlete observed by coaching staff include: • Appears dazed or stunned. • Is confused about assignment or position. • Is unsure of game, score or opponent. • Moves clumsily. • Answers questions slowly. • Loses consciousness, even briefly. • Shows mood, behavior or personality changes. • Can’t recall events prior to hit or fall. • Can’t recall events after hit or fall. Symptoms reported by athlete suffering a concussion: • Headache or pressure in head. • Nausea or vomiting. • Balance problems or dizziness. • Double or blurry vision. • Sensitivity to light. • Sensitivity to noise. • Feeling sluggish, hazy, foggy or groggy. • Concentration or memory problems. • Confusion. • Does not feel right or is feeling down. Information provided by the Centers for Disease Control and Prevention.

HEALTHWATCH