justkids Fall 2010
Children’s Hospital & Medical Center
Tips to Tame Obesity’s Threats • Your Baby’s Ailing—Now What? • Banish the Cabin Fever Blues
Obesity’s Threats & Tips to Tame Them Act now to get rid of the extra pounds that can cause serious problems for kids You know obesity is bad for kids. But do you know just how bad? With nearly one in three children and teens overweight or obese, health problems that were once “adults only” now show up in children. Kids who weigh too much also have a heightened risk for weight-related problems as adults. Here are some key threats:
Heart Disease Researchers estimate three out of five overweight 5- to 17-year-olds have at least one risk factor for heart and circulatory diseases. Those risk factors include: ■ Abnormal cholesterol. Among 12to 19-year-olds, surveys show 22 percent
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of the overweight and 43 percent of the obese have high levels of “bad” cholesterol or triglycerides (blood fats) or low levels of “good” cholesterol. ■ High blood pressure. In a study of more than 5,000 Texas children ages 10 to 19, 5 percent had high blood pressure. The strongest risk factor was obesity. ■ Metabolic syndrome. This syndrome includes insulin resistance, high cholesterol and high blood pressure. Up to half of severely obese adolescents have metabolic syndrome, which worsens the odds for heart disease, diabetes and stroke.
| To find a physician, call 1-800-833-3100
Bone Damage Healthy bones and joints are the building blocks of a healthy body. Childhood obesity can have a devastating impact on a child’s musculoskeletal system. A child’s extra weight adds stress to growing bones. This can cause pain and interfere with normal growth and development. Physicians are seeing a marked increase in fractures in children, as well as obesity-related musculoskeletal disorders such as Blounts disease at a much younger age, as a direct result of the increase in childhood obesity. Blounts disease is a growth disorder of the shin bone in which the lower legs
height. The BMI can help to identify if turns inward, resembling a bowleg. your child is overweight or obese.” “Families seem to have a better If your child’s BMI does put him or understanding that obesity in children her in a high-risk category, these tips can contribute to heart problems or lead can help: to diabetes, but we fear they’re ■ Offer children overlooking the potential impact on their child’s Overweight children reasonable portions of well-balanced meals low joints, muscles and bones,” often have fewer in fat and sugar. says Paul Esposito, M.D., friends and face ■ Set specific snack orthopaedic surgeon at Children’s Hospital & teasing about their times to discourage constant munching. Medical Center. “Children weight. Social Stock healthy snacks are continually growing and discrimination and such as frozen yogurt, their skeletal systems are developing. The issues that isolation can lead to low-fat string cheese, can result cause significant stress and low self- nuts or fruit. ■ Limit the amount of pain and a risk of disability. esteem that sugar-filled juices and In severe cases, surgery may be needed.” linger into adulthood. sodas you give your child. Juice and soda offer only empty calories that Other Diseases children do not need. Water is a great Other problems linked to children’s way to keep kids hydrated throughout increased weight include: the day. ■ Diabetes: Type 2 diabetes, once rare ■ Add exercise, such as hiking or biking, among children, has risen dramatically. to weekends and vacations. Help your ■ Asthma: This common lung disease child find physical activities that he or causes breathing difficulty. she enjoys. Your child may enjoy a ■ Liver problems: Extra weight hip-hop dance class or getting involved causes fatty degeneration of the liver, or with a sports team at the YMCA. hepatic steatosis. ■ Limit TV watching to an hour or two ■ Sleep apnea: Breathing stops a day. Screen time includes television, repeatedly during sleep for at least 10 video games, computer or hand-held seconds. game systems. On average, children who watch at least four hours a day tend to Social Problems be heavier than children who watch less Overweight children often have fewer than two hours. friends and face teasing about their ■ Practice what you preach. Children weight. Social discrimination and imitate their parents. If you eat well and isolation can lead to stress and low stay physically active, your children are self-esteem that linger into adulthood. more likely to do the same. Their progress in school and on the job may suffer—and they may be prone to anxiety and depression.
How You Can Help Ask your pediatrician if your child’s weight is in a healthy range. “Have your pediatrician review your child’s BMI with you,” says Liz Walenz, M.D., a pediatrician with Children’s Physicians. “The BMI is a body mass index that is calculated using your child’s weight and
Is Your Child Overweight? Are you concerned that your child’s weight could be hurting his or her health? If so, talk with your primary care provider. Need a physician for your child? Call Children’s Find-ADoctor service at 1-800-833-3100.
The Brown-Bag Lunch Packing a punch against obesity
Pizza, cookies, soda, chips—these may be on your child’s lunchtime list, but they’re also culprits in a growing health concern: childhood obesity. In the last 20 years, the number of overweight children has increased more than 50 percent. In fact, one out of five children in the U.S. today is overweight. Obesity puts your child at risk for serious health conditions, such as type 2 diabetes, high cholesterol and high blood pressure. Schools are working hard to provide healthier lunchtime options. But by packing a lunch for your child, you can make a difference in his or her health now—and into adulthood. When planning a healthy lunch for your children, keep these tips in mind: ■ Add eye-appeal. Children can be attracted to how foods are packaged. Choose bright, colorful foods like strawberries. Vary the shape and size of usual lunch fare. For instance, use a cookie-cutter on a sandwich or pack mini-bagels. ■ Go with grain. Select healthy wholegrain bread, tortillas, pitas or crackers. ■ Lower the fat. Try low-fat versions of lunchmeat. Tuna packed in water instead of oil is another good choice. Use mustard instead of mayonnaise or opt for low-fat or no-fat mayo. ■ Vary the veggies. Add thinly sliced vegetables to sandwiches. Pack a little bag of carrots or pepper strips. Build a veggie kebab by putting vegetable slices on a skewer or toothpick. ■ Favor fruit. Pack a banana or slice it onto a peanut butter sandwich. Send kids off with applesauce or a snack bag full of sliced kiwi, raisins, or dried apricots. ■ Don’t forget dessert. Choose a healthy treat such as vanilla wafers, graham crackers or a low-fat granola bar.
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The Best Emergency Care for Your Child As a parent, there’s nothing worse than seeing your child sick or in pain. When your child has a serious medical emergency, you want the best care available. That’s why bringing your child to Children’s Hospital & Medical Center, which has the state’s only emergency department (ED) designed especially for kids, is a good decision.
Specially Trained Staff Our doctors and nurses are specially trained in pediatric emergency medicine. They have additional expertise in easing the pain and anxiety that can come with emergencies. They are skilled at: ■ Explaining what is happening to your child during treatment ■ Understanding that children might react differently than adults ■ Providing instructions on how to care
for your child when you get home ■ Assessing the unique treatment needs of children and teenagers. Some treatments for adults aren’t appropriate for kids. Plus, medical research done with adults may not apply to teens.
Kid-Sized and Kid-Friendly Crowded adult EDs can lead to long waits and a frightening atmosphere for young patients. But the Children’s ED staff is used to the conditions and ailments typical of children and teenagers. Children’s ED is specially outfitted with kid-sized equipment, beds and supplies, including: ■ Lifesaving defibrillators customized for children ■ Child-sized blood pressure cuffs ■ Systems that quickly identify equipment and medicines appropriate for a child’s age and weight.
Urgent Care Centers When your child or teen is seriously ill or injured, Children’s ED is the best bet for prompt, thorough emergency care. But what if your child’s injury is less severe? Children’s two Urgent Care centers are staffed by the board-certified pediatricians and pediatric nurses from Children’s Hospital & Medical Center. Each Urgent Care center is open seven days a week – on weekdays from 6 to 10 p.m., and on weekends and major holidays from noon to 10 p.m. While no appointment is necessary, you can call ahead to receive wait times at either location. Benefits of using a Children’s Urgent Care center include: ■ Staff experienced in all varieties of pediatric sports and other injuries ■ Digital X-ray and lab services on site ■ Cuts and lacerations can be treated with stitches or sealed with Dermabond®.
Urgent Care vs. the Emergency Department When your child is sick or hurt, it can be difficult to determine whether an Urgent Care or Emergency Department (ED) is the best choice.
When Urgent Care Is Best Urgent Care centers treat illnesses and injuries that require medical attention, but are not life-threatening. They should be used when your primary care physician’s office is closed. Some common conditions that can be treated at Urgent Care centers include: ■ Ear infections ■ Sore throats ■ Minor burns ■ Minor asthma ■ Sprains or minor pains ■ Small lacerations
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■ Fractures or broken bones that are not crooked and do not cause severe pain.
When the ED Is Best If you are ever unsure about whether your child needs emergency care, treat it as an emergency. In general, take your child to an Emergency Department any time you think the problem needs immediate attention, including for the following: ■ Shortness of breath or trouble breathing ■ Blue or purple lips, skin or fingernails ■ Chest or stomach pain or pressure ■ Seizures ■ Animal, snake or human bites ■ Head, spinal cord or eye injuries ■ Infants under 2 months of age with a fever
| To find a physician, call 1-800-833-3100
■ Signs of allergic reaction such as hives; swelling of the face, lips, eyes or tongue; fainting or trouble breathing ■ Uncontrolled pain.
We Can Help Children’s Hospital & Medical Center has the only dedicated pediatric Emergency Department in the region. It provides services around the clock. The Urgent Care centers are located just north of 144th and West Center Road at 14421 Dupont Court (402-955-7200), and southwest of West Village Pointe shopping center off 175th and Burke at 110 N. 175th St. (402-955-7300). Hours are Monday through Friday from 6 to 10 p.m., and weekends and holidays from noon to 10 p.m.
School-Aged Children Still Need Booster Seats Parents are well-aware of the importance of using car seats for infants and toddlers, but some are not as strict when it comes to using booster seats for school-aged children. Experts agree that children should use a booster seat until the seat belt fits the child correctly. This usually happens when the child reaches 4 feet 9 inches in height, which is usually around age 8 or 10. Why do older children need booster seats? Booster seats get their name because they boost the child up so the vehicle’s seat belt fits correctly. A properly-fitted lap belt should lie across a child’s hip area and not the softer stomach area. The shoulder belt should hit the middle of the child’s collarbone and not cut into the neck. Children will often place an improperly fitting shoulder belt behind their back. Plus, in event of an accident, an improperly fitting seat belt can cause internal damage to a child’s abdomen or neck.
Types of Booster Seats There are two types of booster seats: high back and backless. You are required to use a high back booster if the back seat of your vehicle doesn’t have built-in head support or has bench seating that is flat across the top. Backless boosters can only be used in cars that have built-in head support.
Other Important Reminders ■ Always place booster seats in the back seat of a vehicle. ■ After purchase, mail in the booster seat registration card or fill out the form online to be notified of any recalls or manufacturer’s defects. ■ Always read the manuals, both for the seat and for your vehicle, to ensure proper installation. ■ Look at the expiration date on your booster seat. Don’t use the seat after this expiration date because the plastic used to make the seat can become brittle and break easily.
Always Committed Children’s Hospital & Medical Center is committed to the health and wellbeing of all children. The Kohl’s Keeps Kids Safe program, a partnership between Children’s Hospital & Medical Center and Kohl’s department stores, is dedicated to reducing the number of accidental injuries in children. Since 2000, Kohl’s has donated more than $1 million in support of child injury prevention programs. For more information on safety programs sponsored by Children’s Hospital & Medical Center, visit ChildrensOmaha.org. Simply click on Health and Safety, then on SafeKids.
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A Legacy of Caring Children’s NICU Trusted for Compassion and Expertise The expertise and compassion of the physicians, specialists, nurses and other medical professionals of the Newborn Intensive Care Unit (NICU) at Children’s is remembered by parents and families long after they leave the hospital. Sometimes, for generations. When Cathy Dickerson gave birth to her daughter Jayne in 1976, her joy was
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quickly replaced by fear. The baby’s inability to swallow led to the discovery that Jayne’s trachea and esophagus were connected, a condition known as a tracheoesophageal fistula, or TEF. She needed special care—and surgery—to correct it. With Cathy hospitalized, Jayne was transferred to the Newborn Intensive
| To find a physician, call 1-800-833-3100
Care Unit at Children’s. Worried that she may not survive, Cathy and her husband asked that Jayne be baptized in the hospital. The nurse caring for Jayne, Lucy O’Hanlon, RN, served as a witness. Jayne made it through surgery and grew up to fall in love and be married. During her first pregnancy, she
Banish the Cabin Fever Blues Living Our Mission With nearly 39 years of experience as a nurse, Lucy O’Hanlon, RN, takes pride in her work in the Newborn Intensive Care Unit (NICU) at Children’s. “What brings me to work every day is the fact that we live the Children’s mission here in the NICU, ‘so that all children may have a better chance to live.’ I love that,” she says. “I love that any child who needs care comes here and gets the best available.”
developed severe preeclampsia. Daughter, Cate, was delivered by cesarean section in October 2008 – three months before her due date. Weighing just 1 pound, 11 ounces, Cate was immediately placed in Children’s NICU. As when she was born, Jayne asked that her daughter be baptized. Cate’s nurse stood at her side, serving as a witness. Again, it was Lucy O’Hanlon. “When my husband Duke went to introduce Lucy to my mom, he didn’t have to,” Jayne says, tears welling in her eyes as she recalls the moment. “They recognized each other.” A nurse for nearly 39 years, O’Hanlon has spent her entire career at Children’s, all but two years serving the babies of the 46-bed NICU. “What brings me to work every day is the fact that we live the Children’s mission here in the NICU, ‘so that all children may have a better chance to live.’ I love that. I love that any child who needs care comes here and gets the best available.” O’Hanlon says her fellow caregivers share her strong feelings for the NICU and for Children’s. “This is a sacred place,” she says. “You feel it when you walk into a church or a library, and that’s how we feel about Children’s. Big things happen here.
They’re not all miracles, but they are very special.” The quality of care extends to each and every newborn in the unit. “You have to treat every baby as if it were your own,” says O’Hanlon, the mother of two daughters, one a nurse. “That way, you keep your standards high. What you need to do becomes very simple. Not easy, but simple.” That level of personal involvement means everything to the babies’ families. “Lucy was more than a nurse to us,” Jayne says. “She was our counselor and our coach. She had her goals for the day and she never sat down.” “Children’s is wonderful,” Jayne says. “The doctors, nurses and everyone we met, they all truly love what they are doing. They listen, they understand and you can tell they care.”
When it’s cold or rainy and your kids are stuck inside, what do you do? It’s easy to run out of ways to keep them occupied. You can help squelch cabin fever (and the whining that comes with it) with these ideas.
Surf’s Up Point your children to educational and fun resources on the Internet. Visit www.kids.gov, a children’s portal managed by the U.S. government, and click on “Fun Stuff.” It contains dozens of links to reputable websites designed just for children. For example, follow the clues and help solve a make-believe mystery with the Smithsonian National Portrait Gallery. Or build your own rocket with the National Aeronautics and Space Administration (NASA). Just make sure you limit your child’s screen time to an hour a day.
Get Moving Just because your children are stuck inside doesn’t mean they have to be couch potatoes. Suggest these ideas to get them moving: ■ Choreograph a dance to your favorite song. ■ If there’s enough room, get out the jump rope and count how many times you can jump without missing. ■ Bat a balloon back and forth and try not to let it hit the ground.
Break Out If the weather isn’t too nasty, why not go outside with your kids for a while? Bundle up and embark on a nature hike to look for animal prints. If it’s snowing, warm up by starting a game of tag, building an igloo, making snow angels or going sledding.
Saving the Tiniest Patients To learn more about the NICU at Children’s Hospital & Medical Center, visit ChildrensOmaha.org and click on NICU under Featured Services. Or, call us toll-free at 1-800-833-3100.
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justkids 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. © 2010. All rights reserved. Printed in U.S.A.
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Your Baby’s Ailing—Now What? Having a baby is exciting—and overwhelming, especially for a new mom. But here’s something you may find even more stressful: trying to figure out if your baby’s symptoms are cause for concern. “Don’t hesitate to contact your pediatrician during the first 2 months of life if your child shows any signs of illness,” says Kari Krenzer, M.D., a Children’s Physicians pediatrician. These tips may help when your baby isn’t feeling well:
fluids than usual. Nasal saline drops, a suction bulb and a cold-mist humidifier can help with nasal secretions.
Cold-Like Symptoms
Vomiting and Diarrhea
Many children have 8 to 10 colds by the time they turn 2. In fact, kids often have more colds than any other illness. Those in day care will likely have more colds than those at home. New moms whose babies are 3 months old or younger should call the pediatrician when the first signs of respiratory problems appear. Cold symptoms can progress to croup, pneumonia or other serious conditions. There’s no cure for the common cold. Antibiotics won’t work against the viruses that cause colds. Make sure your baby gets more sleep and drinks more
Viruses, bacteria, and other culprits can cause vomiting and diarrhea in children. It’s important to keep your baby hydrated if he or she suffers from vomiting or diarrhea. Your baby may need to see a doctor if he or she: ■ Is younger than 6 months of age ■ Has a dry mouth, decreased urination, or other signs of dehydration ■ Has blood in his or her vomit or stools ■ Is lethargic or excessively sleepy Handling your baby’s first illnesses isn’t always easy. The good news is you’ll get more experience—and more confidence—as your baby gets older.
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Fever Fevers can be serious in young babies. Even if your baby doesn’t seem sick, call the doctor if the baby is 3 months of age or younger and has a rectal temperature higher than 100.4 degrees. If your baby is 3 to 6 months of age, call the doctor if your baby has a fever of more than 101.
Your Baby’s Health If you’re worried about your baby’s health, speak with your primary care provider. Need a physician for your child? Call Children’s Find-ADoctor service at 1-800-833-3100.
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