just kids Winter 2009
Children’s Hospital & Medical Center
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Does Your Sick Child
Really Need an Antibiotic? ■
Infant Formula Facts
Does Your Sick Child Really Need an Antibiotic?
Not for Ear Infections or Runny Noses If little ones have a runny nose or an ear infection, they probably don’t need an antibiotic prescription. Most kids get better without antibiotics. For every child who benefits from an antibiotic, there are six other children who do not. In addition, most guidelines don’t recommend antibiotics as the first step in treating a runny nose. These medicines can have adverse side effects on a child’s digestive system. They also promote
antibiotic-resistant bacteria. Should you ask for antibiotics for your child’s next ear infection? One study found that children who did not get antibiotics for an ear infection did almost as well as those who did. In reality, 80 percent of children with acute ear infections get better without antibiotics. Plus, each antibiotic given to a child can make future infections more difficult to treat. “While most ear infections clear up on their own, there are some that still need antibiotics,” says John Moore, MD, a pediatrician with Children’s Physicians. “If the ear infection is accompanied by a fever of more than 101.5 degrees that lasts longer than three days, take your child to the doctor.” John Moore, MD
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arents may be tempted to ask for antibiotics for a sick child, but experts say that often, antibiotics won’t do your child any good and can even be counter-productive. Antibiotics kill bacteria, but not viruses. According to the Centers for Disease Control and Prevention (CDC), most colds, coughs, flu, sore throats and runny noses are caused by viruses. Taking antibiotics will not cure viral infections, keep others from catching the illness or help your child feel better. While antibiotics are good for bacterial infections, they cause the most emergency visits of any drug. An estimated 40,000 children are brought to emergency departments each year because of adverse side effects from antibiotics, according to the CDC.
Dangers of Antibiotics Antibiotics are powerful and necessary defenders against illnesses such as pneumonia and strep throat. But taking an antibiotic for something other than a bacterial infection can be downright dangerous. Here’s why: ■ Antibiotics may cause side effects. Most are simply uncomfortable, but some, such as allergic reactions, can be serious. ■ Bacteria in the environment and in
your body adapt to fight off the antibiotic attack. Taking antibiotics when you don’t need them spurs the growth of these antibiotic-resistant bacteria. Once a bacterial bug develops a resistance to some antibiotics, it requires stronger, more expensive antibiotics to beat it. These antibiotics may have to be given to your child in the hospital. Even worse, they sometimes have toxic side effects. Should current antibiotics lose their effectiveness, certain bacterial infections may eventually become untreatable.
Tips for Parents Here are things to keep in mind about antibiotics when considering what’s best for your sick child: ■ Do not ask for antibiotics when a doctor says they’re not needed. ■ If your child is prescribed an antibiotic, make sure to take all the medicine as prescribed, even if your child feels better. Stopping antibiotic treatment too early can let some bacteria survive or fuel the growth of an antibiotic-resistant strain. ■ Once the course of treatment is completed, throw away any unused medication. ✷
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Chi ldren’s Hos pit al & Medic al Cen t er | W in t er 2 00 9
Tune In to the KAT Radiothon April 16-18 Young patients at Children’s Hospital & Medical Center will have the opportunity to take a behind-the-scenes look at the radio business when Omaha radio station KAT 103 sets up a temporary studio in the hospital lobby for the KAT 103 radiothon. The radiothon will be held April 16 to 18 with all proceeds to benefit Children’s. Throughout the radiothon, families of young patients will share their personal stories and explain how their lives have been touched by Children’s. This is the seventh year for KAT to host the radiothon.
Safety Matters ■ Thinking about buying a car? Consider choosing a light-colored one. White and yellow vehicles were slightly less likely to be in an accident than dark-colored ones. This was especially true on open roads, during the day and in poor weather. Epidemiology, Vol. 13, No. 6 ■ Most stroller accidents happen when babies fall out of their strollers. Strollers can also tip over with the baby in them. To keep your youngster safe, buckle the baby in each time. Also, avoid hanging heavy
objects from the stroller handle, which may cause a stroller to tip. Pediatrics, Vol. 110, No. 5 ■ In baseball and softball, head-first slides are linked to more serious injuries than feet-first slides. But some players and coaches prefer head-first slides because they believe these slides are faster. Not so, says one study. Feet-first slides were just as fast or faster than head-first slides. American Journal of Sports Medicine, Vol. 30, No. 6.
NEED A DOCTOR FOR YOUR CHILD? Call the Children’s Hospital & Medical Center FindA-Doctor Service at 1-800-833-3100, 24 hours a day, seven days a week.
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When you signed on for parenting, you relinquished afternoon naps and disposable income. You found it requires skills and knowledge never mentioned in Algebra 1 or American Lit. Fortunately, there’s Parenting U from Children’s Hospital & Medical Center—FREE classes given by professionals known for their knowledge of children, to help you through some of a parent’s most challenging times. Along with a new topic each week, we’ll provide food, child care and prizes. Each session will be held in the Glow Auditorium at Children’s Hospital & Medical Center from 6 to 7 p.m. Or, you can watch the live webinar broadcast. Whether attending in person or online, be sure to call 1-800-833-3100 or log on to ChildrensOmaha.org today to register for one or more of our upcoming educational sessions. Also, check back on our Web site after the series to view a complete history of all our Parenting U webinars.
ADHD Clinic Connects Parents with Experts
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Dealing with ADHD............................Tuesday, april 7. Kim Levering, PhD, Children’s Behavioral Health Sibling Rivalry.......................................tuesday, april 14. Katie Anglim, MD, Children’s Physicians ”Things That Go Bump in the Night:” Easing Childhood Fears..................................Tuesday, april 21. Margaret Floress, PhD, Children’s Behavioral Health Preparing for Your Newborn.....tuesday, april 28 John Andresen, MD, Children’s Physicians
ttention Deficit Hyperactivity Disorder (ADHD) is one of the most common mental disorders that develop in children. Children with ADHD have impaired functioning in multiple settings, including at home, at school and in relationships with peers. If untreated, the disorder can have long-term adverse effects into adolescence and adulthood.
Symptoms of ADHD Inattention symptoms include, but are not limited to: ■ Poor attention to detail, listening skills or follow through ■ Difficulty with organization ■ Avoiding tasks of sustained mental effort ■ Easy distraction and forgetfulness in daily activities. Characteristics of hyperactivity include, but are not limited to: ■ Fidgeting ■ Excessive running and climbing ■ Difficulty playing or engaging in quiet leisure activities ■ Excessive talking.
No Rush to Diagnosis Even if your toddler has several of these behavioral characteristics, it’s no guarantee he has ADHD. This is a naturally curious and high-energy phase of life. Most doctors agree it’s difficult to diagnose ADHD until toddlers are a few years older. Children’s Behavioral Health offers an ADHD Clinic for children ages 5 to 12 who are having difficulty with behavior at home or at school. These behavioral struggles may include inattention, distractibility, hyperactivity and impulsivity. The ADHD Clinic provides specialized diagnostic services using top methods of assessing ADHD symptoms. Experts in pediatric behavioral issues create a treatment plan based on the child’s symptoms. Patients receive individual therapy that focuses on behavior management. ✷
Learn more about ADHD by getting a copy of our FREE brochure, When a Child Has ADHD. Call 1-800-8333100 to receive your copy.
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Chi ldren’s Hos pit al & Medic al Cen t er | W in t er 2 00 9
Safe Cycling for You and Your Kids
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iding bicycles with your children or grandchildren is a fun way to get fit and spend time together. These precautions can help everyone cycle a little more safely: ■ Wear a helmet on every single trip, no matter how experienced the rider or how short the trip. ■M ake sure the helmet fits right now, not a too-big one to wear for a few years. A helmet should fit snugly and not slide from side to side, from front to back or around the head. ■ Adjust the helmet to sit straight atop the head, not slant backward. The chin strap should keep the helmet from wobbling. If any part of the buckle breaks, replace the chin strap.
■ When you ride in the street, stay on the right side in a single file. ■ Avoid riding at night with young children. ■ Wear neon, fluorescent or brightly colored clothing so drivers will notice you. ■ Take special care at intersections—look both ways twice—and always signal before turning or changing lanes. Healthy cycling also means making sure your child’s bike fits properly. If necessary, experts suggest asking your bike dealer for help. Follow these tips for a good fit: ■L evel the saddle. A forwardtipping saddle rests too
much weight on the hands and lower back. A back-tilting saddle also may strain your lower back and hurt your bottom. A too-narrow saddle also can cause buttock pain. ■P osition handlebars correctly. Too-high handlebars put excess weight on the saddle. Too-low bars can cause lower arm or hand pain. The handlebars should place your hands about an inch wider than your shoulders. ■C onsider where your child’s feet hit the pedals. When the pedal is down, the knee should be at a 35- to 45-degree angle to it. This angle minimizes stress on the knees.✷
■P ut off riding with a little one in a bike seat until after the baby’s first birthday. Younger babies’ neck muscles cannot support the weight of a helmet.
Gear Up for Bike Safety with Kohl’s and Children’s Gear up for cycling safety and enjoy the scenic Keystone support of child injury prevention programs. Trail at the Kruizin’ with Kohl’s Bike Safety event Wearing a properly fitted helmet can reduce the on Saturday, April 25 from 10 a.m. to 2 p.m. risk of head and brain injury by 85 percent. Free FREE The family friendly fun starts at the Kohl’s Store bike helmets will be provided and properly fitted Helmet located at 909 South 72nd Street (on the corner of for registered children ages 4 to 14, while supplies 72nd and Pacific streets). The bike safety clinic will last. (Restrictions may apply.) Safety information, food, be held near the Keystone Bike Trail. games, face painting and more will make it a fun-filled and The event is part of the Kohl’s Keeps Kids Safe program, a informative day. The event kicks off National Bike Month in May and partnership between Kohl’s and Children’s Hospital & Medical Center. it coincides with National Safe Kids Week, April 26 to May 2. Since 2000, Kohl’s has donated more than $700,000 to Children’s in For registration information, visit ChildrensOmaha.org.
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Infant Formula Facts – What Every Parent Should Know provided on the container. No matter which form you choose, check the expiration date on the container and don’t use formula from leaky, dented or damaged containers. When preparing formula, always follow the directions on the container. Be sure to measure carefully. Never add extra water or extra formula. Too little water can upset your baby’s stomach or hurt the kidneys. Follow the directions on the container to properly prepare powdered formula. Elizabeth Walenz, MD
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nfant formula is made to meet all your baby’s nutritional needs. Whether you plan to use it once in a while to supplement breast-feeding or all the time, here is what you should know to help keep your baby healthy. “All infant formula is regulated by the Food and Drug Administration and provides a good balance of fat, protein and carbohydrates,” says Elizabeth Walenz, MD, a Children’s Physicians pediatrician. “Infant formula or breast milk is all that your baby needs for the first four months of life. In the beginning, your baby will take a half ounce to two ounces per feeding. By 4 months of age, many have increased to four to five ounces per feeding.”
Lack of Nutrients Prepare Formula Safely Infant formula comes in three forms. Readyto-use formula is ready for your baby to consume. Concentrated liquid needs only to be mixed with an equal amount of water. For powder formula, follow the directions
Signs that your baby is not getting enough to eat include: ■ Your baby’s wet diaper has orange crystals in it ■ Your baby’s skin stays wrinkled well into the first month of life
■ Your baby’s face doesn’t “fill out” ■ Your baby seems hungry after a complete feeding. Call your child’s doctor if your baby has any of these signs or if you have any concerns about feeding.
Store It Safely After mixing formula, be sure to use it within two hours, or keep it in the refrigerator for up to 24 hours. This will prevent bacteria from growing. Once open, ready-to-use and liquid concentrate formula can be kept in the refrigerator for up to 48 hours. After feeding your baby, throw away any formula left in the bottle. If you have any questions or concerns about formula safety, contact your child’s physician. If you need a physician or specialist for your child, call our physician referral line at 1-800-833-3100. ✷
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Chi ldren’s H ospit al & M edical Cen t er | W i n t er 20 09
Check-Ups Keep Your Child Well
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egular check-ups—also called well-child visits—ensure your children are growing up healthy and strong. But at least 20 percent of kids miss some recommended visits. Take your child to the doctor at the following ages: ❑ Newborn
❑ 2 to 4 days
❑ 2 weeks
❑ 1 month
❑ 2 months
❑ 4 months
❑ 6 months
❑ 9 months
❑ 12 months
❑ 15 months
❑ 18 months
❑ 24 months
❑ 30 months
❑A nnually every year from ages 3 to 21 years
In addition to a physical examination, where the doctor examines your child’s body, every visit should involve: ■M easurements. The doctor will weigh your child and check her height. Until age 2, infants’ head sizes are measured with a tape. Growth charts show if your child is meeting development milestones. Blood pressure is also taken. ■ I mmunizations. The doctor will give your child shots to protect against serious illnesses such as measles, pneumonia and the flu. Eleven different childhood vaccines are available. For the latest recommended schedule, ask the doctor.
■B ehavior assessments. Young brains, like young bodies, are changing rapidly. The doctor will make sure your child’s mental health is on track using tools such as behavior checklists. ■M onitoring developmental milestones. Doctors know about when your child should be sitting up, walking and talking. Report these events and any concerns you have. Some appointments will also involve: ■H earing tests. The doctor will play noises and test how your child’s brain and ears respond. ■E ye exams. The doctor will watch your infant track a bright light and look inside her eyes to check for cataracts and other problems. As your child gets older, she’ll read letters from an eye chart to detect vision problems. ■O ther screenings if there’s a problem. Depending on your child’s risk factors, the doctor may recommend checking for lead poisoning or other issues. To make the most of well-child visits, write down your concerns beforehand. Ask questions and talk openly with your child’s doctor. If you need a physician or specialist for your child, call our physician referral line at 1-800-833-3100.✷
Children’s Opens at West Village Pointe As a parent, you want only the best for your child, and that’s exactly what you can expect from us. In our efforts to exceed those expectations, we are expanding our reach into the western metro area with the opening of West Village Pointe. Children’s at West Village Pointe, located at 110 N. 175th Street (175th and Burke) will house a Children’s Urgent Care Center and a Children’s Physicians office. Children’s Physicians pediatricians Kari Krenzer, Janie Mikuls, John Moore and Laura Nielsen, along with pediatric nurse practitioner Colleen Murphy, will relocate from the Indian Hills office to West Village Pointe. Dr. Fran Harrison will move from Indian Hills to the Val Verde office, located at 9801 Giles Road. The Indian Hills office will close on March 27, 2009. The Children’s Physicians office at West Village Pointe will open on March 30, 2009. The after-hours Urgent Care Center opens April 22 and is staffed by Children’s emergency room doctors. You can drop in, without an appointment, even if your child isn’t signed up as a patient. Urgent Care hours are weekday evenings from 6 to 10 p.m., and weekends and holidays from noon to 10 p.m.
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New Name and Logo Reflect Our Vision
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o support our vision of establishing Children’s as a national model of excellence, quality and value, our name has changed to Children’s Hospital & Medical Center. Although our name served us well for the past 60 years, Children’s is growing and evolving. We have become the leader for pediatric care in the region, and several of our programs offer consultation, treatment and support to families from across the nation, and even a few foreign countries. We will continue to deliver extraordinary care to children, but with the realization that we are more than a
just kids
Children’s Hospital & Medical Center has received accreditation or recognition from the following organizations for its delivery of extraordinary health care to children.
just kids is published by Children’s Hospital & Medical Center to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician. © 2009. All rights reserved Printed in U.S.A. Gary A. Perkins, President and CEO Martin W. Beerman, Vice President, Marketing and
Community Relations
David G.J. Kaufman, MD, Medical Advisor Dannee Hartley, Marketing Coordinator
Printed on Recyclable Paper
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hospital. We are the premier pediatric health care center in the state, and we are a significant resource to medical professionals and families from across the region. Of course, this new name doesn’t quite fit with our existing corporate identity. That’s why we developed a vibrant, contemporary logo that better reflects Children’s new name. We did not want to be trendy or take away the Children’s that people know. That’s why we are keeping “Hospital” in our name, while also adding the resources and expertise that come to mind when
thinking of a “Medical Center.” You’ll also notice that Children’s Physicians will mirror this new brand. As part of the Children’s family, and a valued health care partner, we thought it important to emphasize our collaboration in all aspects of pediatric care, from wellchild visits to specialized treatments and everything in between. This is an exciting time for Children’s Hospital & Medical Center as the beginning of a new journey and to continue our mission—so that all children may have a better chance to live—for many years to come.