Cub Chat | Fall 2005

Winter 2005

Fitness for Kids........2

Children’s Heart Group.........4

Meningitis Vaccine........6

Volume 11, Number 4

We’re YOUR Children’s Hospital

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enn State Children’s Hospital feels a great responsibility to children and families in central Pennsylvania and beyond. The continuous hard work of our physicians and staff has resulted in better patient outcomes and satisfaction.

Penn State Children’s Hospital faculty are also proud to provide outreach clinic locations in communities outside the Hershey area, making it that much easier for children across the state to take advantage of Penn State resources.

In addition to providing the most

advanced equipment, tools and programs, Penn State Children’s Hospital caters to pediatric patients and their families. Each day, as we look forward to the physical expansion of Penn State Children’s Hospital as its own facility on the Medical Center campus, we build on the momentum of providing the best all-around family-centered care. We recognize the importance of a child’s family in his or her recovery.

Penn State Children’s Hospital continues to provide outstanding care for kids in as comfortable a setting as possible.

And as the opening of our expanded facility draws nearer, we look forward to new possibilities for pediatric patients, both within its walls, and in the various outreach clinics across Pennsylvania. ❖

To Learn More For more information on contributing to Penn State Children’s Hospital, contact the Office of University Development at (717) 531-6086, or log on to www.pennstatechildrens.com.

Thanks for Your Feedback!

At Penn State Children’s Hospital, we value the opinions of families. You want to ensure the good health of the children in your life. We know—we share that same passion.

Thanks to all who returned the spring 2005 Cub Chat survey. Your opinions let us know what we’re doing right, and in some cases, how we can improve. Most importantly, your input enables us to deliver the information that’s most important to you.

Congratulations to Jody Weltmer, our Hersheypark family four-pack winner!

We’re happy to hear that 65 percent of you rated Cub Chat as “excellent,” while the remaining 35 percent called it “good.”

That’s a 100 percent approval rating!

Additionally, after reading Cub Chat, 94 percent of you feel that you know

more about Penn State Children’s Hospital, and 40 percent began using a Children’s Hospital physician or service.

You also told us what health topics your family thinks about most. The top three concerns are asthma, prevention, and healthy eating. Other important issues you wrote about were heart health, cancer, and allergies. Be on the lookout for articles covering these topics in future issues.

Thanks again for letting us know what you think about Cub Chat. We appreciate your support and hope we can continue to be a vital resource to your child’s health. ❖

Still have more to say?

Drop us an e-mail to let us know what you think: abuehlerstranges@psu.edu.

Please include in the subject line, “Cub Chat Feedback.”

Leave No Children on Their Behinds Health clubs add classes and gear to help kids get fit and stay slim

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t’s ironic. As concern grows over harmful weight gain among children, physical education gets less and less emphasis in many schools.

In response, there’s more and more interest in fitness programs for kids outside of schools.

An International Health, Racquet and Sportsclub Association survey shows that 4.5 million kids in the United States under age 18 belong to health clubs— up 25 percent in five years. Call it “No Children Left on Their Behinds,” says exercise physiologist Jan Schroeder, Ph.D., director of event programming for the IDEA Health and Fitness Association, a fitness professionals’ group.

Local Ys have offered kids programs for years. Many health clubs are joining them.

“These are great opportunities to keep your children fit and help reduce the chance for obesity. If your child is overweight, increased activity is essential to

2 Penn State Children’s Hospital, www.pennstatechildrens.com

help prevent weight gain and to help in weight loss,” according to Ronald Williams, M.D., director, Penn State Children’s Hospital Pediatric Multidisciplinary Weight Loss Program.

What should you look for in a fitness program for your child?

■ Age-appropriate gear. Many kids can’t reach the pedals on a stationary bike, for instance. If your child wants strength training, the grips on normal resistance machines are too far apart and the weight increments are too big.

■ Age-appropriate programs. Look for a class geared to your child’s size and abilities. “Typically, you want a child in a class with peers, not with adults,” says Schroeder. “A child’s motor coordination may not be as well-defined, and sociological issues, including possible embarrassment or intimidation, may make your child feel uncomfortable.”

[ health bits ] Smoking Adds Asthma Risk If you smoke while pregnant, your children—and their children—face a higher risk for asthma, a study shows.

“The findings suggest that smoking could have a longterm impact on a family’s health that has never before been realized,” says study author Frank D. Gilliland, M.D., Ph.D., of the University of Southern California in Los Angeles. The study appeared in CHEST, the journal of the American College of Chest Physicians. Children whose moms smoked while pregnant were 1.5 times more likely to develop asthma. Children whose grandmothers smoked while pregnant were 2.1 times more likely to get asthma. If both mother and grandmother smoked while pregnant, the child was 2.6 times more likely to get asthma. Gilliland speculates that smoking while pregnant affects the unborn child’s DNA and harms the immune system, making the child more prone to asthma. The DNA damage is passed to the child’s own children.

“Lazy Eye” Treatments Help Older Kids

Qualified supervision. Seek trainers who are used to working with kids.

Look for better instructor-to-student ratios than adult classes. Schroeder suggests one supervisor for every 20 teens and one for every 12 younger children.

■ Fun. “Kids are so stressed with school that the emphasis should be on having a good time,” says Joan Missett-Gambill, coordinator of Junior Jazzercise. Some 500,000 3- to 16-year-olds have joined this Jazzercise program nationwide. Besides music movement routines for girls, Jazzercise now offers 6- to 12-year-old boys classes that include kickboxing and strength training.

“Make sure it’s noncompetitive,” she adds. ❖ ■

Treatments used mainly on younger children could help a lot of kids ages 7 to 17 with “lazy eye” (amblyopia), says a study funded by the National Eye Institute. All the children in the study wore glasses, but some also used an eye patch or eye drops that limited use of their strong eye. Those children then did work that made them rely on the lazy eye for close-up vision. Their vision improved more than the kids who just wore glasses. “This study shows that age alone should not be used as a factor to decide whether or not to treat a child for amblyopia,” says study cochairman Mitchell M. Scheiman, O.D., of the Pennsylvania College of Optometry. To learn about amblyopia, visit www.nei.nih.gov/ats3/background.asp.

Don’t Call Medicine “Candy” Have you ever gotten a child to take medicine by calling it candy? A survey by the American Society of Health-System Pharmacists (ASHP) found that about half of parents and caregivers have pretended to take their child’s medicine or called it candy to sway a child.

These dangerous tactics could lead to poisonings, says Daniel J. Cobaugh, Pharm.D., director of research for the ASHP Research and Education Foundation. “By telling a child medication is candy, they are led to believe it is harmless when, in fact, medications should be treated seriously,” he says. You should keep all medicines in a secure place. To learn more about medicine safety, visit ASHP’s web site, www.safemedication.com. In cases of poisoning, immediately call (800) 222-1222, the national number for poison control centers.

AAP Slams Use of Drugs in Sports The American Academy of Pediatrics condemns performance-enhancing drugs in sports “and vigorously endorses efforts to eliminate their use among children and adolescents.” It urges: ■

Schools to take a strong stand against the use of performance-enhancing substances.

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Coaches to encourage fair competition, with a tough stance against cheating.

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Athletes who admit using such substances to get the unbiased medical facts about risks and purported benefits.

Penn State Children’s Hospital, www.pennstatechildrens.com 3

Have you heard of our Children’s Heart Group?

We’re All Over Pennsylvania!

Who we are Did you know there is a team of worldrenowned pediatric cardiologists and pediatric cardiovascular surgeons practicing at a location close to your home?

Children’s Heart Group provides care to children throughout Pennsylvania with 18 outreach offices, including York, Lancaster, Reading, State College, WilkesBarre, and Scranton, to name a few.

Children’s Heart Group at Penn State Children’s Hospital is a team of experienced pediatric cardiovascular specialists providing advanced heart care for children, treating even the most rare heart defects and conditions. Made up of a team of pediatric cardiologists, cardiac surgeons, intensivists, anesthesiologists, and a faculty of highly trained pediatric specialists and sub-specialists, the group has more than 140 years of combined experience, and cares for more than 10,000 children a year.

Children’s Heart Group stands as a regional center of excellence in the care

of children with heart disease. In November 2004, Children’s Heart Group was named one of Aetna’s Institutes of ExcellenceTM Pediatric Congenital Heart Surgery facilities. The Institutes of Excellence is Aetna’s participating network of facilities for complex procedures.

The network identifies facilities that mark their delicate pediatric congenital heart surgeries with great positive outcomes and patient safety.

“We are very pleased to have been selected into the network,” states John L. Myers, M.D., director of pediatric congenital heart surgery. “Our combined team of pediatric cardiology and pediatric cardiac surgery has worked together for eight years to achieve this kind of excellence. We want our patients to know that they have a world-class program in central Pennsylvania at Penn State Children’s Hospital.”

The compassion of the physicians at Children’s Heart Group doesn’t end at their office doors or even in the

surrounding community. Instead, it reaches internationally. Since the 1980s, teams from Children’s Heart Group have traveled to such countries as Colombia and Ecuador to provide surgical care to children who would otherwise have no hope.

Our services: ■

Pediatric cardiology

Providing the most advanced heart care through diagnosis of and care for congenital and acquired heart disease in infants, children, and adolescents, the cardiology team also cares for congenital heart disease patients who have reached adulthood.

■ Pediatric cardiovascular surgery The cardiovascular surgical team specializes in the surgical treatment of all congenital cardiac and thoracic disorders, including reconstructive surgery of hearts with complex disorders, such as those with single chambers and those with multiple defects.

For a full listing of services, visit www.childrensheartgroup.com. ❖

Community Outreach:

Golfers at the Children’s Heart Golf Classic Jim Hiltz, Henry Rankow, Brett Dormer and Jeff Keiser 4 Penn State Children’s Hospital, www.pennstatechildrens.com

The physicians at Children’s Heart Group are committed to reaching out to the community. On Aug. 15, Children’s Heart Group hosted its first Children’s Heart Golf Classic. Partnering with area sponsors, Children’s Heart Group celebrated a successful fundraising event with all proceeds benefiting the care and treatment of children with congenital heart defects.

For information on sponsorship, call (717) 531-8674.

John L. Myers, M.D., cares for the tiniest of patients.

Children’s Heart Group Locations

www.childrensheartgroup.com

For more information, or to schedule an appointment, call (717) 531-8674.

Home Office Address University Physician Group 121 Nyes Road, Suite D Harrisburg, PA 17112 Altoona Bon Secours-Holy Family Hospital

Huntingdon J.C. Blair Memorial Hospital

Pottsville The Pottsville Hospital and Warne Clinic

State College Centre Medical and Surgical Associates

Kingston University Physician Group-Kingston

Reading Cardiology Associates of West Reading

Sterling Pediatrics of Northeastern PA

Gettysburg Herr’s Ridge Medical Center

Lancaster Lancaster General Women & Babies Hospital

Hazleton St. Joseph’s Medical Center

Lewisburg Evangelical Community Hospital

Reading Pediatrics

Williamsport/Muncy Muncy Valley Hospital

St. Joseph Community Health Center

Wyomissing Reading Pediatrics

Scranton Community Medical Center

York Apple Hill Medical Center

Penn State Children’s Hospital, www.pennstatechildrens.com 5

Give Eating Right a Green Light How to heed Uncle Sam’s diet advice

New Meningitis Shot Shields Adolescents Vaccine could save hundreds of lives each year

A

new vaccine can help head off meningitis for 11- and 12-year-olds, teens entering high school, and college freshmen in dormitories.

Though somewhat rare, meningitis can be deadly. Caused by bacteria that infect the bloodstream, brain lining, and spinal cord, it kills one in 10 victims—up to 300 Americans a year. One in five survivors may face permanent disabilities.

Most meningitis patients are less than a year old. That’s why infants get shots to fight bacteria that can cause this contagious disease.

But meningitis peaks again in adolescents and young adults. “More deaths actually occur in teenagers,” says Paul A. Offit, M.D., chief of the Division of Infectious Diseases at Children’s Hospital of Philadelphia.

The federal Advisory Committee on Immunization Practices (ACIP) has long backed meningitis shots for college freshmen—especially those who live in packed dormitories. A vaccine sold since 1981 protected them for three to five years.

But early this year the ACIP approved a new vaccine to help block meningitis: the meningococcal conjugate vaccine (Menactra). Suggested for adolescents, it lasts longer than the old vaccine. “The advantage of Menactra is that one shot protects you, arguably, for the rest of your life,” says Offit, who served on the ACIP panel that recommended it. “And it also makes you less able to transmit the bacteria to someone else.”

The new vaccine protects against four of the five bacteria groups that cause meningococcal infection. “That means it protects you against about 70 percent of the meningococcal cases,” says Offit. ❖

Meningitis Symptoms According to the National Meningitis Association (NMA), meningitis initially presents like the flu or a migraine, but it worsens quickly. Symptoms include: ■

A headache, which may seem like the worst you’ve ever had

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A fever (perhaps very high) that doesn’t respond to a tepid bath, acetaminophen or ibuprofen

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Vomiting

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Numbness, cold, or loss of feeling in extremities

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Stiff neck

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Sensitivity to light

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Disorientation or confusion

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Seizures

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A rash or purple spots

The NMA suggests you call your doctor or go to an emergency room if you see more than one of these symptoms.

Antibiotics treat bacterial meningitis.

People who have been in close contact with the patient may be prescribed an antibiotic.

6 Penn State Children’s Hospital, www.pennstatechildrens.com

The government’s new Dietary Guidelines for Americans say everyone ages 2 and up should eat a variety from five basic food groups each day. You should focus on nutrientrich foods and avoid empty calories.

But the new advice raises an old question: How do you get kids to eat right?

“What the parents are doing, the kids are doing,” says pediatric psychologist Lamia Barakat, Ph.D., of Drexel University in Philadelphia.

She says it’s “essential” that your home environment support healthful eating.

Barakat favors keeping “go” and “no-go” foods in different places. You can further split foods into green light, yellow light, and red light

Don’t Sell a Short Kid Short Growth disorders are rare and small children do fine Your child seems short next to others of the same age. Should you worry?

The answer is usually no. The majority of short kids are healthy and have no underlying sinister disease— a condition referred to as idiopathic short stature. For the majority of children, studies have shown that being short seems to have little to do with social standing, peer relations, or academic success.

Some children simply grow more slowly than others. Given that genetics is the primary determinant of

What Kids Should Eat

groups. Put green light foods, perfect for snacks, within kids’ easy reach.

Green light foods: High-nutrition, low-fat, low- or moderate-calorie foods kids can eat often—celery, carrots, broccoli, apples, low-fat yogurt, multigrain pretzels Yellow light foods: Nutritious but higher-fat or calorie foods that must be eaten in moderation—meats, enriched breads and pasta, full-fat cheese Red light foods: Foods with no nutritional value, like cookies and candy, that you should save for special treats

growth and stature, if both you and your spouse are short, it is likely that your healthy child will join you.

While being short is common, serious growth disorders are not. But don’t ignore your concerns—talk with your child’s

Barakat also suggests: Don’t use sweets to reward or punish kids.

■ Set a good example for kids by eating well.

■ Encourage kids to eat at normal meal times.

■ Discourage snacking.

■ Develop a “try it” rule for new foods.

■ Trust that when kids are hungry enough, they’ll eat the healthful options you serve. ❖

■

Offer a balanced diet from these five groups: grains, vegetables, fruit, milk, and meat and beans. Kids need the same variety as adults.

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Start with small portions and let kids heed their hunger signals. Around age 4, kids can eat adult portions, like half a cup of fruit or vegetables, or 2 to 3 ounces of meat or fish.

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Introduce high-nutrition dark green, orange, and starchy vegetables, as well as legumes.

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Serve whole grains, like whole wheat and oats, for at least half of kids’ daily grain intake.

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Give young kids at least 2 cups of milk a day.

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Limit fat to no more than a third of a child’s diet. Most fats should come from fish, nuts and vegetable oils.

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Urge at least 30 minutes of exercise a day.

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doctor. The doctor can check your child’s height against growth charts for children that age. The doctor can track your child’s growth year by year, a measurement that is perhaps even more critical than the height measurement itself.

A small child who stops growing worries doctors more than a small child who’s growing at a normal rate. Chronic illness, poor nutrition, and hormone problems can hamper growth.

Can growth hormones help? “I would make this recommendation only when a child is actually diagnosed by a doctor as growth-hormone insufficient,” says Concordia University psychology professor William Bukowski, Ph.D., coauthor of a study on height differences’ effects on kids. On the other hand, there is a significant variability in the types of children who might benefit from growth hormone treatment and most pediatric endocrinologists treat children with diagnoses other than classic growth hormone deficiency, adds

For details, visit www.health.gov/ dietaryguidelines.

Christopher Houk, M.D., Penn State Children’s Hospital.

If your child worries about height, explain that kids grow at different rates—and late bloomers tend to catch up. Focus on your child’s brains, personality and skills—and support activities that don’t rely on size. ❖

Stand Tall for Short Kids The Human Growth Foundation offers guidelines for parents of short children: ■ Encourage

children to talk about their

feelings.

■ Help

them define problems and solutions.

■ Explore

positive possibilities.

■ Help

identify personal qualities not related to height.

■ Foster

independence by serving as an advocate only when you need to.

Penn State Children’s Hospital, www.pennstatechildrens.com 7

Injury Prevention for All Children

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t’s every parent’s worst nightmare: A child is trapped in a burning house, found floating facedown in a swimming pool, or thrown from a car. Unintentional injuries are the leading cause of death for American children under age 14.

That’s why children’s hospitals are taking the lead to ensure all children lead active but injury-free lives.

Nearly all children’s hospitals (94 percent) engage in injury prevention advocacy, according to a NACHRI survey of member hospitals. Through educational activities, such as safety fairs, school visits, and community

To Learn More To learn more about the injuryprevention efforts of children’s hospitals, visit www.childrenshospitals.net, or call (717) 531-SAFE.

classes, children’s hospitals provide families with information on injury prevention topics, including motor vehicle safety, drowning, burn and poisoning prevention, and avoiding sports and play injuries. They also teach parents and caregivers how to keep children with disabilities safe.

Children’s hospitals work with local and state legislators to improve child safety laws and to increase funding for programs that help protect children from childhood injuries. Many hospitals provide free or discounted protective equipment, such as bike helmets and booster seats, to families who need them and also supply educational materials in different languages.

To help support children’s hospitals’ injury prevention efforts, NACHRI and Dorel Juvenile Group USA launched “Get on Board with Child Safety,” a nationwide injury prevention campaign. The campaign web

site—www.getonboardwithsafety.com— provides injury prevention information for families and free copies of the Essential Home & Travel Childproofing Guide in both English and Spanish. ❖

NACHRI National Association of Children’s Hospitals and Related Institutions www.childrenshospitals.net

Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date information. But no publication can replace the care and advice of medical professionals, and readers are cautioned to seek such help for personal problems. ©2005 Health Ink Communications, 780 Township Line Road, Yardley, PA 19067, 267-685-2800. Some images in this publication may be provided by ©2005 PhotoDisc, Inc. All models used for illustrative purposes only. Some illustrations in this publication may be provided by ©2005 The Staywell Company; all rights reserved. (405)

Cub Chat is a complimentary quarterly newsletter produced by the Office of Strategic Services at Penn State Children’s Hospital.

For questions or additional copies, please call (717) 531-8606. www.pennstatechildrens.com

A. Craig Hillemeier, M.D. Medical Director and Chairman

CHI-2099-05