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Fall 2013
JustKids NOW PLAYING! A Fun and Safe 3-D Experience p4
LAINEY’S STORY
sibling’s shadow?
FACT OR FICTION?
Heart Transplant Gives New Hope 2
Help Your Child Avoid It and Shine 5
Busting Health Myths 10
Contents ➍ Focusing on a
Fun and Safe 3-D Experience
Children’s Starts
➎ New Electronic
Medical Record The nation has a new pediatric heart transplant program located right in the heart of the country. Earlier this year, Children’s Hospital & Medical Center in Omaha received approval from the United Network for Organ Sharing to perform heart transplants on infants and children, and just a few short weeks later, performed its first transplant. Lainey Wilkinson was born on March 22, 2013, delivered by scheduled cesarean section at The Fetal Care Center at Children’s Hospital & Medical Center in affiliation with Alegent Creighton Health. She was listed for transplant one week after her birth. “Lainey’s heart had a very unusual combination of one severe heart defect, hypoplastic left heart syndrome, on the left side, and another severe defect, Ebstein’s malformation, on the right side,” explained James Hammel, MD, transplant surgeon and clinical service chief of Cardiothoracic Surgery at Children’s. “We determined that these anomalies could not be surgically repaired.” Lainey’s mother, Jessica, said that talking to Children’s team about a heart transplant wasn’t as devastating as she and her husband thought it might be.
➏ Help Kids Avoid a Sibling’s Shadow
➐ Upcoming Parenting U Classes
➑ Immunizations:
What Every Parent Should Know
➓ Tall Tale or
Totally True?
Children’s Launches Sports Medicine Clinic
Your Online Source for Health Info For the latest information and news, support groups, events, patient stories, recipes and perspectives from our physicians, check out these online resources: Facebook.com/ ChildrensOmaha YouTube.com/ ChildrensOmaha Twitter.com/ChildrensOmaha Pinterest.com/ChildrensOmaha
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JustKids
“We knew a transplant was a possibility, but we had confidence in the team. And, my husband, Jeff, and I had already seen Lainey do better than anyone had expected,” she said. Dr. Hammel and a full team of pediatric specialists performed Lainey’s heart transplant when she was just 2 weeks old. Children’s offers the only infant and pediatric heart transplantation program in Nebraska. It is the 41st pediatric heart transplant program in the United States. Nationally, 370 pediatric heart transplants (ages 0 to 17) were performed in 2012. Lainey’s transplant went well, and she continues to make strides in her recovery. Just a month after receiving her new heart, Lainey and her family were able to go home. Now that Lainey is home, the Wilkinsons stay in contact with her team of doctors at Children’s. She is closely monitored through regular check-ups. “This transplant represents the culmination of a year-long collaboration throughout Children’s,” said Dr. Hammel. “All of the resources Children’s has assembled to provide world-class cardiac care for families of children with heart defects, we can now apply to provide the best heart transplant care. Our goal is to give every child the best chance at life, and transplantation is a powerful tool we can now use to do that in Omaha.”
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Gary A. Perkins President and CEO Martin W. Beerman Vice President, Marketing & Community Relations David G.J. Kaufman, MD Medical Advisor Dannee Schroeder Senior Editor
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. © 2013. All rights reserved. Printed in U.S.A.
What’sNew? Heart Transplant Program
Our goal is to give every child the best chance at life, and transplantation is a powerful tool we can now use to do that in Omaha. — James Hammel, MD, transplant surgeon and clinical service chief of Cardiothoracic Surgery at Children’s. He performed Lainey’s heart transplant.
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feature story
Focusing on a Fun and Safe
More and more movies, TV programs, video games and even classroom lessons are becoming available in 3-D. Despite the potential benefits of the new technology, some parents have raised safety concerns. But you can take steps to avoid or lessen the risks while still having fun with 3-D.
Benefits of 3-D Viewing For children who enjoy 3-D movies and games, the most obvious benefit is the fun of an enhanced entertainment experience. Did you know there are other benefits to 3-D technology? Not only are 3-D lessons presenting material to students in fun new ways, but some evidence points to improved levels of concentration and test scores. Since 3-D viewing is a more sensitive test of vision than the standard eye chart, it might help find previously undetected vision problems in your child. If your child
mentions any difficulty with viewing something in 3-D, visit an eye doctor. Some of these problems can be treated.
3-D Viewing Is Safe for Most People According to the American Optometric Association, a 2011 survey found that 53 percent of parents believed 3-D harms kids’ eyes. Most of those worries are unfounded. However, the parents in that same survey did report that their children had the following problems after 3-D viewing: • Headaches: 10 percent • Nausea: 7 percent • Dizziness: 6 percent Children who have a type of epilepsy triggered by flashing lights or who take medications that can lower their seizure threshold could face trouble with 3-D technology.
The bottom line: Following manufacturers’ instructions, using common sense and enjoying 3-D in moderation are likely to result in a fun experience for most users.
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Take Proper Precautions When it comes to 3-D viewing or any other type of screen time, don’t overdo it. Children shouldn’t spend more than two hours a day viewing a screen. That includes all electronic screens, such as TVs, video games, computers, tablets and others. If you want to help give your child’s eyes some rest during screen time, consider the 20-20-20 rule: Every 20 minutes, take a 20-second break and look at something at least 20 feet away.
Children’s New Electronic Record System Ensures Even Better Care Children’s Hospital & Medical Center has implemented a new electronic medical record system called Epic Enterprise. With the new system, Children’s patients now have one electronic health record that caregivers can access, no matter their location or specialty. By taking advantage of the latest technology and a single health record, Children’s is able to provide you and your child with even better care. Here are four ways that Epic improves your health care experience: • Improved Safety — The new electronic system includes safeguards against errors, automatically flagging potential data-entry mistakes or conflicting information. • Improved Quality — One health record gives caregivers a more complete picture of your child’s past and present health, and helps them have a better, more effective dialogue with you. • Improved Efficiency — Providers have quicker access to your child’s test results, medical history and more, resulting in more timely, efficient care. • Improved Convenience — Our online health portal, Children’s Connect, allows you to request appointments and view test results, immunizations, medications, growth charts and more from any Children’s specialist. This fall, Children’s also plans to debut patient check-in kiosks where patient families can sign in for appointments, pay co-pays and update information electronically. Children’s is excited about Epic and the benefits it provides patients, families and staff. Our team appreciates your support as we embrace this new system of care.
Ready to Connect? To learn more about our online health portal, visit www.ChildrensOmaha.org/Connect.
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sibling rivalry
Help Kids Avoid a
Sibling’s Shadow What can parents do to ease family tension when one child is more successful or popular than another?
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As challenging as sibling rivalry can be for families, it’s normal and bound to exist in any household with more than one child. The tenor of the rivalry between brothers and sisters—jealousy, competition, perceived favoritism and trouble getting along—often depends on the children’s temperaments, ages and developmental needs. Clashes can result from children’s natural competitive drive to be the best at everything and win parents’ favor. In turn, the child who thinks a sibling is more intelligent, athletic, attractive, popular or successful is likely to grow jealous and insecure. The tensions of sibling competition aren’t likely to vanish from your household, especially if one child is more talented than another. Still, you can use parenting strategies that help your children respond more positively to such conflict. The key is getting children to balance their emotions and express their feelings constructively.
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Steps to Take How well the following approaches work to ease competition among your children will depend on their ages, genders, birth order and relative success at school, sports, work or social skills. With that in mind, consider these tactics: • Avoid comparing your children’s individual talents and achievements. True, your children may compete with one another on their own. But a perception that you view one with more favor or pride than the other can feed a feeling of inferiority and competition in the child who may not be excelling. Take special care not to say something like, “Adam, why can’t you be more like Ashley and get on the honor roll?” That’s likely to make the underachieving child feel even worse about
Help for You:
Upcoming Parenting U Classes This Fall
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his performance. He may feel that without achieving equal success, he’ll fail to win your love and approval. Treat each of your children as an individual with personal strengths and weaknesses. Avoid labeling one child “the smart one” or “the star athlete.” This can make the less successful child feel even more insecure, worsening the rivalry. Encourage and praise each of your children for his or her various accomplishments. Avoid contributing to the rivalry. Try to treat and respect each child fairly. Organize your day to allow you to spend some time alone with each of your children. Doing so will help them feel special and successful. Encourage cooperation rather than competition. For example, instead of having your children race each other to complete a task, time them together against the clock. Ensure that each of your children has time and space to play with his or her toys and friends without a sibling tagging along. Foster appreciation among siblings by asking them what they like about their sisters and brothers. When resolving conflicts between your children, avoid taking sides or backing one child over the other. Instead, help them strive for win-win solutions, where each child is respected and gains something he or she wants.
Take comfort in knowing that sibling relationships are fluid and bound to change over time. Helping your children respect each other and easing competition based on success or lack thereof can teach brothers and sisters to treasure each other as friends instead of rivals.
With the arrival of a child, there are some things parents learn automatically, like how little sleep an adult actually needs to function and that polar bears may be hiding in your closets. For other lessons, 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. Each session will be held in the Glow Auditorium at Children’s Hospital & Medical Center from 6 to 7 p.m. Space is limited, so call 800-833-3100 or log onto ChildrensOmaha.org/ParentingU today to register for one or more of our upcoming educational sessions.
Oct. 15 Effective Time Out Techniques Ashley Harlow, PhD, NCSP Children’s Behavioral Health
Oct. 22 Preparing for Your Newborn Joe Straley, MD, FAAP Children’s Physicians
Oct. 29 Baby’s First Years Tina Scott-Mordhorst, MD, FAAP Children’s Physicians
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ask the experts
Immunizations: What Every Parent Should Know
Q
Diseases such as polio and pertussis are rare, so why are vaccines necessary?
Many of these diseases still thrive in other parts of the world, and have the potential to make a comeback in the United States due to inadequate immunization. Travelers can—and do—bring these viruses back to the United States. Without the protection of vaccines, these diseases could easily spread here again.
Vaccines protect children from serious infectious diseases— and save lives. Millions of parents immunize their children each year without concern. Yet some parents have heard rumors that vaccines can cause serious health problems. It can be confusing for parents. Deciding who is credible and who is not can be difficult. If you have questions, talk with your child’s doctor who knows your child’s health and medical needs better than anybody. Another resource for in-depth information on vaccine safety is the Centers for Disease Control and Prevention (CDC). You can check its website at www.cdc.gov/vaccines. Here are some frequently asked questions about immunizations:
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Q
Don’t vaccines cause harmful side effects and illnesses?
Some children have minor side effects from being vaccinated, such as a slight fever or swelling at the injection site. The risk of death or serious side effects is so small that it is difficult to document. Claims that vaccines cause sudden infant death syndrome (SIDS), autism or other diseases have been carefully researched and never proven.
Q
Won’t giving babies multiple vaccines at once overload their immune system?
Many studies have been done to assess the safety of multiple vaccinations. None has shown that multiple vaccinations cause a problem. Scientists agree that the tiny amount of virus or bacteria in vacines is not enough to harm a child.
Q
Is Your Child Up-To-Date?
Do you know if your child’s shots are up-to-date? Check out the chart at right with recommended ages for routine childhood immunizations to make sure. Keep in mind that in order to be fully protected against common childhood diseases, your child may need several shots spread out over months or years.
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Have a Health Question? If you have questions about vaccines or other children’s health topics, you’ll find a variety of health information on our website. Visit ChildrensOmaha.org/ HealthAndSafety.
Birth to age 4 months
Ages 6 to 18 months
Hepatitis B
2 doses
1 dose
Diphtheria, Tetanus, Pertussis (DTaP)
2 doses
2 doses
Haemophilus influenzae type b (Hib)
2 doses
1-2 doses*
Polio (IPV)
2 doses
1 dose 1 dose
Measles, Mumps, Rubella (MMR)
(when child is at least 12 months)
1 dose
Varicella (chickenpox) Pneumococcal Conjugate (PCV)
(when child is at least 12 months)
2 doses
Hepatitis A
1 dose
1 booster dose
1 dose 1 dose
2 doses*
2 doses
1 dose (if needed)
Human Papillomarvirus (HPV) Meningococcal, meningitis (MCV4)
Ages 11 to 18 years
1 dose annually** 1 dose annually** 1 dose annually**
Influenza Rotavirus
Ages 4 to 6 years
3 doses‡ 2 doses
(for children only with certain risk factors)
2 doses
2 doses
(when child is at least 12 months)
* Depending on vaccine used, a third dose at 6 months may or may not be required. ** Two doses given at least 4 weeks apart are recommended for children age 6 months through 8 years who are getting a flu vaccine for the first time. ‡ Can be given as early as age 9.
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Find the Right Doctor Selecting a physician who’s a good fit for your family is important. You—and your child—should feel comfortable with the physician. To find the right one for your family, call Children’s Find-A-Doctor service at 800-833-3100.
Tall Tale or Totally True? Urban legends and old wives’ tales about children’s health pass back and forth among families, friends and coworkers — along with solid advice. David Kaufman, MD, FAAP, a pediatrician with Children’s Physicians at the Eagle Run office, talks about five common beliefs and offers the real information on whether they’re fact or fiction.
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Spinach is a good source of iron.
Fact. While it’s not the best source, it’s in the top dozen. Half a cup of fresh cooked spinach has about as much iron as 3 ounces of cooked beef. Fortified cereals and white beans are rich in iron, too. Iron-fortified infant cereal is an excellent source of iron for infants age 6 months to 1 year of age. A quarter cup provides 45 percent of the recommended daily value of iron, so I routinely recommend a quarter-cup serving at least twice a day for my patients ages 6 months through 1 year. Having said that, our bodies absorb iron from animal sources better than iron from vegetables and grains. Your child’s body may get more iron from non-animal sources (including spinach) if you serve them with foods rich in vitamin C, such as orange juice or kiwi fruit. Children need iron because it helps carry oxygen throughout the body’s cells.
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Sitting too close to the TV is bad for your eyes.
Fiction. There’s no evidence that plunking down right in front of the TV set damages the eyes. Children can focus up close without eyestrain better than adults, so they often get into the habit of sitting right in front of the TV or holding reading material close to their eyes. However, if your child is consistently sitting close to the TV and always holds reading material close to his or her eyes, this could indicate significant nearsightedness. I recommend visiting your child’s pediatrician for an evaluation if this is happening.
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You should wait at least 30 minutes after eating to swim.
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Eating carrots improves eyesight.
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Wounds need fresh air to heal.
Fiction. According to the American Red Cross, you probably don’t need to wait that long. Still, use common sense: If you’ve just had a huge meal and you’re about to begin strenuous exercise, give your body some time to digest your food.
Fact. This one is true on a technicality. Carrots contain vitamin A, which promotes vision health. However, if a child eats a healthy diet that includes daily servings of many fruits and vegetables, you don’t have to focus solely on carrots. Spinach, cantaloupe and vegetable soup are also good sources of vitamin A.
Fiction? It depends. It makes sense to think that wounds must breathe in order to heal. And, in truth, the air aids healing by keeping them dry. But large scrapes are best kept covered, moist and clean to avoid excessive scarring and to promote healing. It’s also wise to cover wounds in spots that tend to get dirty or that may be irritated when clothing rubs against them. Oxygen does promote wound healing; however, it is equally important to keep an open wound clean. A compromise is to keep a wound covered during the day, but then leave the wound uncovered at night while your child is sleeping.
David Kaufman, MD, FAAP
www.ChildrensOmaha.org/Kaufman
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Make Family Playtime a Priority You don’t have to look any further than the mirror to identify your child’s main role model. Children naturally mimic their parents—that includes their attitude toward exercise. If you want your child to be more active, you can’t just talk the talk. You need to walk the walk. And run the run. And bike the bike. Studies show that children are more likely to exercise if their family and friends are interested in physical activity.
• Bike or walk to a neighborhood park. • Take an exercise class designed for the entire family
Your Whole Family Benefits
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Exercise as a family to make fitness fun for your family and ensure that everyone is getting the recommended level of activity they need. Children ages 6 to 17 should get at least an hour of physical activity every day, according to the Centers for Disease Control; adults require about half of that. Besides the obvious physical benefits from exercise, such as increased endurance and strength and maintaining a healthy weight, active children are generally more confident and are more likely to be successful both in their daily school work and on standardized tests.
Many Ways to Exercise as a Family Here are some activities for the whole family to try: • Walk the dog together.
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such as yoga or aerobics. Split up into teams for a game of basketball, soccer or kickball. Teach your kids the jump rope games from your youth. Play catch with a football, baseball, softball or Frisbee. Compete at an exercise-based video game such as Wii Fit or Dance Dance Revolution. Go on an outdoor scavenger hunt for natural objects, such as leaves of different colors, acorns or stones of various shapes. When the temperature dips, make a snowman, have a family snowball fight or try a more structured winter activity such as cross-country skiing or snow shoeing. Challenge each other to see who can win a Presidential Active Lifestyle Award. Anyone 6 or older is eligible for the award. Go to www.presidentschallenge.org to learn more.
Healthy Kohl’s Kids The Healthy Kohl’s Kids program can help you find fitness activities for your children at www.ChildrensOmaha. org/HKK. The website also features how-to videos of young chefs making healthy meals and snacks, and it enables people to share recipe and exercise tips via Facebook, Twitter and Pinterest.
Make physical activity as much a part of your family’s daily habit as eating dinner together. That way exercise will be just another part—maybe even the most enjoyable part—of your family routine.
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Children’s Launches Sports Medicine Clinic Like any exercise, playing a sport can help children control weight, improve self-esteem and do better in school. There are dangers for child athletes, however. More than 3.5 million Americans age 14 and younger are treated for sports injuries every year. To meet this need, Children’s Hospital & Medical Center launched a new Sports Medicine Clinic. Intended for young athletes who participate in competitive and recreational programs, the clinic provides specialized care for sports-related injuries ranging from concussion to sprains, strains and overuse. “Sports injuries in adolescents and teenagers are different,” said Kody Moffatt, MD, pediatrician and Children’s sports medicine specialist. “The body, bones and joints aren’t fully developed. We want to make sure these injuries are diagnosed and treated before they create a chronic, long-term problem that could impact the child’s ability to compete successfully down the road.” Before becoming a pediatrician, Dr. Moffatt was a certified athletic trainer in professional hockey. He has multiple degrees and credentials in pediatrics, sports medicine and orthopaedics. He is eager to share his expertise with young athletes. “At Children’s, we’ve worked to develop an integrated program that brings together my experience with sports-related injuries and the experience of Layne Jensen, MD, a pediatric orthopaedic surgeon who specializes in surgical repairs for young athletes who are still growing.”
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Most injuries do not need surgery. However, Dr. Moffatt points out that Dr. Jensen is available for on-site consultation. In addition, Children’s pediatric cardiologist Chris Erickson, MD, contributes to the multidisciplinary focus with comprehensive heart evaluations when needed. The Children’s Sports Medicine Clinic provides diagnosis and treatment for a range of sports-related injuries. Concussion follow-up care is a significant focus, particularly on helping injured athletes transition back into the classroom, a process often referred to as “return to learn.”
Families can contact the Children’s Sports Medicine Clinic directly to make an appointment. The number to call is 402-955-PLAY (7529). A physician referral is not required. You can find more information about the Sports Medicine Clinic at ChildrensOmaha.org/Sports.
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