pediatrics
developmental milestones kids and concussions diet choices and mental health
July/August 2016 A Publication of the
July/August 2016 ~ living well
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here are many things to love about Montana. A D D O N E M O R E T O Y O U R L I S T. . .
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People in Missoula and western Montana want to feel good, look good and live well. Available at more than 150 newsstand locations throughout the area, Western Montana Living Well is well suited to more than 30,000 readers monthly who want health tips on fitness, nutrition, family, financial advice, wellness, therapy and beauty.
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advertising sales 406-523-5223 contributors Jesse Patterson Lindsey Flint Kay Jennings Shawn Lake
The opinions, beliefs and viewpoints expressed by the various authors and forum participants in this publication do not necessarily reflect the opinions, beliefs and viewpoints of the Missoulian or Lee Enterprises. The author of each article published in this publication owns his or her own words. No part of the publication may be reprinted without permission. ©2016 Lee Enterprises, all rights reserved. Printed in the USA.
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(L -R) Dirk Gottman, MD • Jennifer Hall, MD Kathleen Rogers, MD TIffany Ford, NP-C • Tara Laslovich PNP-BC
july/august 2016 VOL. 36
in this issue
developmental milestones pg. 6
kids & concussions pg. 8
pediatrics
diet & mental health pg. 12
couplet care pg. 14
also inside breastfeeding myths debunked pg. 22 Children’s Hospital partners with Missoula pg. 26 baby-proofing the home pg. 29 healthy teeth pg. 30 children & anxiety pg. 32 emergencies: who to call pg. 34
birthing plans pg. 16
when to call a doctor pg. 20
July/August 2016 ~ living well
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Developmental milestones for movement
H
ow many parents out there ever wonder if their child is developing “normally”? The first years of life involve many changes, both physically and mentally. The rate of development depends on many factors, including environment, genetics, and nervous system maturation. However (luckily for parents), there is a predictable sequence of movement milestones typical of an infant. Below is a brief summary of these guidelines for gross motor milestones (source: American Academy of Pediatrics).
They will also begin to accept weight onto their feet in the standing position.
By 3 months, an infant should be able to push themselves up on their arms while on their tummy, as well as lift and hold their head up. They begin to have more neck control and ability to hold their head in midline.
By 9 months, an infant should be able to move from tummy or back into a sitting position. They can sit and reach for toys while maintaining balance. Crawling is the primary mode of transportation, but they are able to begin pulling to stand and “cruising” around on
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By 6 months, an infant should be able to begin rolling from back to tummy. They have generally good head control in all directions and should be able to reach forward while on their tummy, as well as start to weight bear on their arms. They should be independent in pulling to sitting, with use of their hands to support themselves in sitting, and able to stand while holding someone’s fingers.
By Jessie Patterson, DPT
The first few years of life involve many changes, both physically and mentally.
furniture, as well as walking with arms supported. By 12 months, a child begins to stand independently and attempt small steps with a wide base of support. They are able to correct their body position against gravity. All of their main motor skills should be present and now is the time for practice! By 18 months, a child should be able to walk up steps with support, walk backwards, and begin to run. By 24 months, a child should be able to walk up and down steps, foot over foot, and throw a ball overhead without falling. They are able to stand on one foot for short durations, step over a small object, and kick a ball forward. What you can do: Tummy Time is one way to assist your child in meeting their gross motor milestones! Placing them on their tummy for short durations soon after
birth can help them develop muscles in their neck, trunk, and back. As time goes on, duration can be increased as able, just be sure to watch them closely to make sure they have adequate room to breathe. (For more information, including handouts with positions, go to www.Pathways.org) Parents, along with their child’s healthcare provider, should monitor their child for these gross motor milestones for early detection and treatment of potential problems. If problems or concerns arise, a physical therapist that specializes in pediatrics can help to get your child on the right track to normal development with individualized treatment plans, including tips for how to encourage these movements at home!
May/June 2016 ~ living well
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Kids & concussions By Lindsey Flint, DPT, OCS Element Physical Therapy
C
oncussions have been all over the news and in the movies recently, and for good reason. The Centers for Disease Control and Prevention (CDC) reports the number of reported concussions has doubled in the past ten years. Research is now demonstrating long term effects from concussions, especially repeated concussions. Given that many concussions often go unreported and untreated, education is key to better diagnose and treat them. This article will provide useful information regarding concussion specifics, signs and symptoms to look for if you think your child has sustained a concussion, resources for treatment, and recommendations for decreasing concussion risk. What is a concussion? The CDC defines concussion as a type of traumatic brain injury that causes the head and brain to move rapidly back and forth. The brain can bounce and twist in the skull causing damage to brain cells and creating chemical changes in the brain. Typically, damage from a concussion cannot be seen on CT scans or MRI, so health care professionals rely on signs and symptoms to diagnose a concussion. What are the signs and symptoms of a concussion? Signs and symptoms of a concussion may show up immediately after an impact or may not show up for hours or days. The CDC emphasizes that it is important to seek medical attention if you notice the following signs and symptoms after a injury, even if it is hours or days later.
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Observable Signs: difficulty remembering evens prior to or after a hit or fall, appears dazed or stunned, is confused about the situation, moves clumsily, answers questions slowly, shows changes in mood, behavior, or personality, loses consciousness. Reported Symptoms: headache or pressure in head, nausea or vomiting, balance problems or dizziness, double or blurry vision, light or noise sensitivity, feeling “off�, sluggish, or foggy, confusion, concentration or memory problems, change in sleep patterns, more emotional or irritable What do I do if I think my child has had a concussion? If you notice any of above signs or symptoms in your child, seek medical attention immediately to ensure a proper diagnosis is made and to get referrals to the appropriate providers. A child who has been diagnosed with a concussion should not return to sports or recreational activities until they have been cleared by a licensed health care professional. If your child has had symptoms for greater than a week and more serious injuries have been ruled out, he or she may be referred for physical therapy. A physical therapist trained in concussion diagnosis and treatment, such as the therapists at Element Physical Therapy in Missoula, will fully evaluate your child and prescribe a treatment plan to focus on his or her individual deficits. Treatment often includes; specialized vestibular exercises to reduced dizziness and imbalance, manual therapy and exercises to address pain and issues with the
July/August 2016 ~ living well
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neck, visual exercises to improve the ability to track an object with the eyes (gaze stability) and reduce sensitivity, and progressive training to return to physical exertion and return to sports. Often other health care providers, such as neurologists, speech therapists, and counselors may be included in the treatment plan to help return your child to his or her activities as soon as possible. How do I prevent my child from sustaining a concussion? Here are some suggestions by the CDC to limit your child’s risk of sustaining a head injury: 1. Use the appropriate size safety seat when buckling children into the car and buckle them up for every ride, no matter how short. Consult www.safercar.gov and your safety seat owner’s manual for specifications on age, height, and weight limits to ensure the safest fit for your child. This website also has helpful videos detailing how to correctly install many types of safety seats. Also be sure to register your car or booster seat so you are notified if there is a safety recall. 2. Prevent unnecessary falls down stairs or from open windows by using safety gates at the top and bottom of stairs and installing window guards on open windows. 3. Go to playgrounds with shock-absorbing surfaces, such as rubber, wood chips, or sand, under the play areas to reduce the risk of injury if a child falls. 4. Wear a helmet for all contact and high speed sports and activities. Although a helmet will not protect from a concussion (where the
brain moves quickly against the walls of the skull causing injury), helmets reduce the risk of more serious brain injury and skull fracture. Helmets should be the age and size appropriate and fit snugly so they are not displaced by an impact to the head. For more specifics regarding sizing and fit for individual sport helmets, please visit www.cdc. gov/headsup/. It is also important to remember that if a helmet has been involved in a crash or an impact, it needs to be replaced. Although you may not see any damage, the foam has been crushed and will be less able to cushion the head from another impact. The CDC has also created a free Heads Up App that provides helmet fit and care instructions in addition to the signs and symptoms of a concussion. 5. Encourage kids to avoid hitting his or her head, especially in sports. Avoid illegal or aggressive contact with other players, and limit the amount of contact kids are subjected to in practice. For kids under 13, avoid heading the ball in soccer and avoid head-first sliding in baseball and softball. Please visit www.cdc.gov/headsup/ for more concussion information and resources for kids, parents, and coaches. You can also contact Element Physical Therapy at 543-7860 for more information and treatment options if you or your child has sustained a concussion.
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2 2 5 C o ve rd e ll R d . , B ig f o rk , Mo n t a na 5 9 9 1 1 ( 4 0 6 ) 8 3 7 - 2 6 9 8 • w w w. ris in g m o u n t a in s . c o m TTY 711 (406) 257-8162 July/August 2016 ~ living well
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Did you know? I
By Kay Jennings BSN, MHSA, MSN, PHMNP-BC, DPSc
t is every parent’s dream that their child will have a healthy and happy childhood and grow up to be a productive citizen. However, that is not the case in a growing number of children who end up suffering from a variety of mental health issues. Parents find themselves caught up in a confusing and burdensome journey in their efforts to identify what is happening to their child. And often, the recommended treatments are incorrect. As a Functional Psychiatric Practitioner I am more interested discovering the root cause and then approaching the problem with lifestyle interventions in conjunction with other treatment methods as needed. Before I go into some of the root causes of mental health issues, I would like to address prenatal health. A significant contributor to the growing trend of very young children presenting with learning and behavioral problems is prenatal nutrition. The health of the mother has definitely been found to impact the mental health of the child. Mothers’ Vitamin D levels have been found to impact the rate of schizophrenia in the children.
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Children are being born with essential fatty acid deficiencies at an alarming rate. EPA and DHA fats are not provided in infant formula yet these fats are essential to the development of the infant’s nervous system. Then there is the matter of our Standard American Diet (SAD) diet with excessive amounts of carbohydrates, GMO’s, processed foods and too many Omega-6’s. This type of diet only serves to severely exacerbate the situation and compound the various learning and behavioral problems so often seen in this society. Vitamin deficiencies or imbalances, such as copper and zinc, have been associated with violent behaviors and intermittent explosive disorder. Another area that
The impact of diet choices on your child’s mental health is not addressed by traditional allopathic medicine (which has a drug for every symptom) are food sensitivities. Not allergies, but sensitivities. In one study, cognitive functional decline and underachievement in post-secondary educations is 400% more likely with Gluten Sensitivity. All ADHD patients or their parents report significant improvement in behavior and functioning after 6 months on a gluten-free diet (Niederhofer and Pittschieler 2006). Consumption of dietary sugar or high-glycemic foods can cause a rapid rise and fall in blood sugar, which can trigger behavioral, learning and mood problems. Our bodies, in an effort to pull blood sugar levels back to normal, releases Adrenalin. Adrenalin then triggers the fight or flight response and will cause a child to have extreme difficulty sitting, listening or being on their best behavior. Avoiding excess carbohydrates is key, along with regular consumption of protein and good sources of fat throughout the day. I dare not mention school lunch programs, which are very heavy on carbohydrates, play a role in the behaviors mentioned. OCD (Obsessive-Compulsive Disorder), tic disorders, anxiety, aggression, behavioral regression and severe restricted food intake can often be misdiagnosed and can actually be symptoms of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders) related to Strep Infections. Treatment must target the underlying infection and support the immune system. Testing is available for this condition. Another noninvasive treatment for some mental health disorders, such as anxiety and ADHD (Attention Deficit Hyperactivity Disorder), uses the concept of heart-brain interactions. HeartMath Institute has done research since 1991 in this area and has compiled impressive results of this modality to treat various conditions in adults and children. Appropriate diagnosis and interventions are critical to help a child avoid a lifetime of mental illness. Start with cleaning up the diet, getting children outdoors to get some sun and exercise each day, and make sure they get adequate sleep. There is hope for our children but it needs to start with parents modeling basic healthy life style choices which will not only change their health but the health of generations to come. Kay Jennings, BSN, MHSA, MSN, PHMNP-BC, DPSc is a functionally trained nurse practitioner who treats ages 5-90. She can be found most days at Aleph p.c. or Winds of Change Mental Health Center, 2685 Palmer Street Suite C, Missoula MT (406 721 2537).
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Couplet Care keeps moms and newborns close By Jessie Patterson, DPT
B
ack in the day, the first look a father got of his newborn was often through a picture window, looking at rows of pink and blue bundles. He may even have had trouble picking his baby out from the crowd. Hospital births have come a long way since then. Many hospitals now make birthing a family affair, with moms following their own birthing plans in birthing suites that feel more like home. At Community Medical Center, the Maternal and Newborn Center goes a step further with a policy that’s both new and traditional: couplet care. With couplet care, newborn babies don’t leave their mothers unless they are sick and need special treatment. At Community, couplet care starts with the delivery, which happens right in the room. Babies are immediately placed 16
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on their mom’s chest, skin-to-skin, which gives them important health advantages such as a head start with breastfeeding. Healthy babies delivered by Cesarean section are also placed skin-to-skin with their mom, both in the surgical suite and the recovery room. When a baby needs a procedure best done in another room—a hearing test, for example—mom comes along. Certified lactation consultants come to the room to answer questions and help moms get started with breastfeeding. They also help mothers who can’t or choose not to breastfeed with advice about the right way to feed babies with a bottle. And family members and significant others are a welcome part of the team. All this can seem like a step back in time, to a more homey approach to childbirth – and it is. But it’s backed up by solid
science. For example, breast milk is proven to provide not only the exact nutrients a newborn needs, but also to protect babies against infections and other illnesses. And studies show that cuddling babies skin-to-skin helps them regulate their temperature, breathing and heart rate. Couplet care also promotes the transfer of beneficial bacteria from mom to baby – a process that helps babies’ digestion and immune system. Research also points to some outcomes you’re likely to notice right away. Babies who get couplet care cry less and sleep more than those who don’t—and their mothers also get more sleep. If you tour a hospital that practices couplet care, you’re likely to see families together in comfortable rooms, friendly nurses and maybe a mom-to-be walking around as her labor progresses. Less obvious—but immediately accessible—are
the sophisticated technology and skilled professionals who treat babies that need emergency care. At Community Medical Center’s Level III Neonatal Intensive Care Unit (NICU), the staff and physicians care for premature and very ill babies while still focusing on a family-centered environment. What you won’t see with couplet care is a dad searching for his baby behind the nursery window. Fathers and the rest of the family know right where to find the new baby – in mom’s arms. You can find out more about how the Community Medical Center keeps new moms and newborns together by attending a tour of the Women and Newborn Center – tours are Tuesdays at 6:00 p.m. and Thursdays at 10:00 a.m.
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Birthing plans By Shawn Lake
B
ack in the day, having a baby meant turning yourself over to a doctor who called all the shots. That was then. In today’s birthing world, most doctors work with families as partners to ensure their labor and delivery come as close as possible to their ideal. You’ll have a head start toward having the birth experience you want if you make a birthing plan. 18
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Birthing plans are simple statements about your preferences for what happens during your labor, delivery and the first hours with your new baby. Every birth is different, and things don’t always go as expected. But creating your birthing plan helps you figure out what choices are most important to you. Your plan also shows caregivers, such as midwives, nurses and doctors, what your preferences are. Consider these questions for your birthing plan: • Who do you want to be present during your labor and delivery? • What activities will you do during labor? For example, you could walk, sit in a tub or just stay in bed. • Will you use a midwife, and/or doula? Doulas are non-medical women who provide advice and physical and emotional support before, during and just after childbirth. Midwives are trained to deliver babies and to advise and assist women throughout their pregnancies. • Do you want medication for pain relief? If so, you and your doctor will decide what type is best for you. • What position do you prefer for the delivery? Some women prefer to sit or squat to give birth. • Do you want to bank the cord blood? The blood in your baby’s umbilical cord has stem cells that can be used later to treat certain diseases. It can be collected right after birth and sent to a facility that preserves it for you. • If you need a cesarean section, do you want your partner present in the operation room?
• If you have your baby at home or at a birthing center, how will you get to a hospital if there is an emergency? • Do you plan to breastfeed your baby? Breastfeeding provides the exact nutrients babies need and also helps protect them against many infections and diseases. At Community Medical Center, certified lactation consultants can help you get started with breastfeeding or bottle feeding. It’s a good idea to talk over your birthing plan with your doctor ahead of time. If you use a midwife or doula, share it with them too. These experts may point out pros and cons to some of your choices—especially if you have any health issues that can make your pregnancy high-risk. When you’ve finished your plan, make copies for your partner, doctor and others who will be involved in the birth. But don’t feel locked in to your choices—in most cases you can change your mind about any part of your plan, even at the last minute. At Community’s Women and Newborn Center, caregivers work in collaboration with moms and families to give them the choices they want. You can find out more about creating a birthing plan by visiting the American Pregnancy Association at www.americanpregnancy. org. You can also tour the Women and Newborn Center at Community. That can give you a better idea of your options and answer some of your questions. To arrange a tour, call the Center at 327-4220.
call 406 721 2038 www.WindsOfChangeMontana.com
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When to Call the Doctor
W
hether you’re a new or experienced parent, it can be challenging to determine when to call your newborn’s pediatrician.
You don’t want to overreact to every single indication of baby discomfort, but you don’t want to underreact if there is the chance of a serious health issue. When trying to assess your newborn’s health, it is important to remain calm. Remember, your emotions are probably still out of whack from childbirth or lack of sleep, so consult an outside opinion if you feel underprepared to handle the situation. And always trust your instincts.
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Greenshoot Media
What to Look For
The American Academy of Pediatrics urges you to call the doctor if your baby has any of the following symptoms: • No urine during the first 24 hours at home or no bowel movements in the first 48 • Rapid breathing of more than 60 breaths per minute or blue lips/fingernails • Rectal temperature above 100.4 degrees or below 97.8 degrees • Persistent coughs or nosebleeds • Yellow or green mucus in the eyes • Red skin at the base of the umbilical cord • Yellow color in the whites of the eye or skin (jaundice) that worsens three days after birth • Heavy bleeding at the circumcision site • Vomiting or diarrhea • Fewer than six wet diapers over 24 hours • A sunken soft spot on the baby’s head • Fussy eating or refusal to eat • Extreme, twitchy movements • Crying more often and intense than usual May/June 2016 ~ living well
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Breastfeeding myths debunked Greenshoot Media
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ver the years, a quirky array of misconceptions has discouraged many women from breastfeeding their babies. For example, at one time or another people believed that redheads shouldn’t nurse babies because their hot temperaments could harm their breastmilk, that breastfeeding was unsanitary, and that babies would do fine drinking cow’s milk mixed with malt flour, potassium bicarbonate and sugar. Thankfully, science prevailed. Most people today understand that breast milk is the perfect food for babies, and breastfeeding is on the rise in the U.S. Studies show that breastfed babies have fewer allergies, ear infections, intestinal upsets, skin problems, respiratory infections and other childhood illnesses. They are less likely to die from sudden infant death syndrome (SIDS), and they have lower risks for some serious conditions as they grow up, such as diabetes, obesity and some cancers.
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And yet, myths about breastfeeding persist. Here are five incorrect notions that make breastfeeding seem difficult and demanding, along with the facts that prove the contrary: Myth 1: Many women can’t nurse their babies because they don’t have enough milk. Fact: Most women – regardless of breast size – produce more than enough milk. So while infants do get hungry soon after a feeding, it’s rarely because they didn’t get enough to eat. Instead, it’s because they have tiny stomachs that must be filled frequently. As babies grow and need more milk, the mother’s milk supply will increase with the demand. Older babies also stay happy longer between feedings. Myth 2: Breastfeeding hurts. Fact: Breastfeeding sometimes causes mild discomfort at the beginning of a feeding, but that should quickly fade. If it lasts longer, it’s probably because the baby is latching on poorly. Latching on refers to how the baby’s mouth attaches to the breast, and it’s something mothers and babies learn. A lactation consultant can help you get started right. And contrary to some advice, you do NOT need to toughen up your nipples by rubbing them with a washcloth. Myth 3: Nursing a baby takes a lot of effort and preparation. Fact: Breastfeeding is simple and convenient. Breastmilk is there when you need it, with no bottles to sterilize or formula to warm. You don’t have to worry about switching formulas because of allergic reactions or problems with digestion. And all that advice about washing your nipples before each feeding and pumping
your milk to make sure your baby is getting enough? Not true. Myth 4: It’s hard to find a place to breastfeed away from home. Fact: Societal views on breastfeeding in public have changed, and most people treat it as a normal part of everyday life. You also have the law on your side – most states, including Montana, have statues that give mothers the right to nurse anywhere in public or private. Montana law also requires employers to accommodate and even encourage employees who breastfeed. Myth 5: Breastfeeding will ruin your figure. Fact: Women who breastfeed their babies find it easier to lose weight than those who don’t. And any changes to the size or shape of your breasts are from hormones released during pregnancy, not nursing. The American Academy of Pediatrics recommends that women breastfeed their babies exclusively for about six months, and then combine breastfeeding with foods for another six months or until mother and baby choose to stop. However, any time you breastfeed benefits both you and your baby. Montana has one of the best rates in the nation, with more than 90 percent of women breastfeeding at least some length of time. A good way to get started right with breastfeeding – or to get some help if you’re having trouble – is to talk to a lactation consultant. These experts are dedicated to helping mothers and babies have the best breastfeeding experience possible. You can get in touch with a lactation consultant at Community Medical Center’s Women and Newborn Center by calling 327.4219.
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Children’s hospital level of care comes to Missoula Communty Medical Center
W
hen a child is sick, the phrase “They took her to Seattle” is like a signpost that tells you the situation is very serious. But these words are also hopeful. Seattle Children’s Hospital is one of the best in the world, and you know children who go there will get the highest level of care. A partnership between Seattle Children’s Hospital and Community Medical Center now brings that same level of care to Missoula. According Daniel Beals, MD, a pediatric surgeon at Community, it’s an important arrangement for a community hospital. “It would be easy to say, ‘We’re doing the best we can with what we have,” Beals says. ”But that’s not good enough. All our cases are managed the same way as at Seattle Children’s.”
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That doesn’t mean every sick child can stay at Community – kids with certain conditions still go to Seattle for treatment. For example, hospitals must do 150 to 200 pediatric heart surgeries each year to be really good at these procedures. That kind of volume is unlikely in a rural state like Montana. On the other hand, many sick kids who would have made the trip to Seattle in the past now stay here for treatment. That includes infants born with serious conditions such as esophageal atresia, where the esophagus ends before it reaches the stomach, and gastroschisis, in which the baby’s intestines protrude through a hole in the abdomen. And children who do need to be treated in Seattle can usually have their follow-up care back at Community. A big part of the reason for this expanded care is Beals himself, who brought his 25 years of experience as a pediatric surgeon in large hospitals to Missoula last summer. Many surgeries that are rare in Montana are routine for him. The other part is Community’s partnership with Seattle Children’s, which began nearly 15 years ago and has been recently reinvigorated. It involves these practices: • Surgery outcomes at Community are reviewed using the same criteria as at Seattle Children’s, and refined until they meet those standards. • Seattle Children’s extends specialized non-surgical care to Community to diagnose and treat children with urologic and bowel problems.
• Beals holds weekly Web conferences between Community and Seattle Children’s to assess quality of care and how to improve it. • Patient evaluations are done the same way as at Seattle Children’s. That way if a child does need to be transported there for care, the evaluation won’t have to be repeated. • Dr. Beals will soon be getting privileges at Seattle Children’s Hospital where he could travel to Seattle with his patients, who need to go there, to participate in their surgeries. • Providers from Seattle Children’s will come to Community to assist with complex surgeries if the need exists. The advantages of this partnership go both ways. As a teaching hospital, Seattle Children’s benefits from treating cases from Montana that may be unusual or complex. Plans are in the works for Beals to teach medical students in Seattle, and medical residents from University of Washington may come to Community. “Practicing in a rural setting, where you may have to make decisions quickly on your own, is an experience young doctors should have,” Beals says. Seattle Children’s Hospital also partners with hospitals in Great Falls and Billings, as well others in Washington and Alaska. Most of these relationships aren’t as extensive as the one with Community. But according to Beals, they’re all valuable. “It’s all about getting quality care close to home,” he says.
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Baby-proofing the house Greenshoot Media
W
ith a new baby comes new responsibilities — ones that are impossible to comprehend without firsthand exerience. You may feel overwhelmed by the amount of time and care that goes into raising an infant. Remember that plenty of parents just like you have raised babies. The proper safety precautions are just as important as the confidence to know that you, too, can successfully survive the sometimes stressful experience. BABYPROOFING THE HOUSE Babyproofing refers to steps you take to safeguard your home when your child begins to crawl and walk. Babyproofing actually should start much earlier in your child’s life, even before he or she is born. It is your job to ensure that you create a safe
home for your baby. It also is important that you take the necessary steps to make sure that you are on top of any issues that could pose a threat to your baby’s well-being. Take regular walkthroughs of your house during your child’s early years to make sure enough safeguards are in place. Immediately address hazards that could lead to your baby choking or being pinned down by falling objects such as a TV. SAFETY TIPS Never shake a baby. Sounds pretty easy, right? Babies have very weak neck muscles and are not able to support their heads and brains. Shaking a baby can lead to serious injury or even death. If you’re frustrated by your baby’s crying or sleeping habits, ask your spouse, family members or friends to help. Knowing your own temperament and patience level is key to making sure your baby is in a safe, healthy place. Another important safety tip to remember involves your baby’s eating habits. Once your baby is old enough to start trying foods, be sure to cut everything into small pieces and keep an eye out for foods that may be causing allergic reactions such as red or itchy skin. SAFE SLEEPING Make sure you always put your baby to sleep on her back to prevent sudden infant death syndrome (commonly known as SIDS). Babies generally are not strong enough to turn themselves over from the belly position and can eventually suffocate. Also never allow your baby to play with anything that might cover his or her face. Avoid loading your infant’s crib with toys or blankets, and never give your baby a pillow.
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Healthy teeth start early Greenshoot Media
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living well ~ July/August 2016
D
o you know the most common chronic disease that faces young children today?
It’s not asthma or hay fever. It’s actually cavities in children’s teeth, according to the American Academy of Pediatrics. Fortunately, this common health problem can be corrected if it’s caught early enough and good habits are taught from a young age.
CRITICAL TO HEALTH For children, cavities are about more than mouth pain. They can distract students from learning or keep them home from school, which can have a big impact on their educational goals. It’s tough for a child to “be himself” when he is distracted by tooth pain, after all. To keep your child’s teeth in tip-top shape, experts recommend they see a dentist for a checkup by their first birthday, or shortly after their first teeth appear. That’s an early visit — and one too many parents skip — but it can help catch oral health problems quickly and also set the stage for a lifetime of healthy teeth. GOOD HABITS One of the most important aspects of good oral health is maintaining good habits, and that’s especially true for children. It’s another reason why regular dental visits are so important for young people. When children go to the dentist, they’re not only getting work done on their teeth. They’re also learning lessons about oral hygiene that can last a lifetime. Ideally, you’ll want to find a dentist who is good at teaching children how to take care of their teeth properly. If the dentist can make it fun for the child — and show them how important it is to take care of their oral health — they’ll be much better off later in life. After all, the habits they pick up now will likely stick with them for a long time. BABY TEETH Some parents may wonder why they need to pay so much attention to their children’s baby teeth when they won’t last through adulthood anyway. But the truth is that the health of their gums and teeth as children can impact their smile as an adult. Experts at the American Academy of Pediatric Dentistry say that baby teeth play three big roles: — Maintaining good nutrition by permitting your child to chew properly. — Play a part in speech development. — Help the permanent teeth by saving space for them. In the end, having healthy teeth is also an important part of having a healthy body. They will help your child eat right, learn to speak and smile with confidence.
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Children and anxiety
A
nxiety is part of being human, but for children, regular fears can be hard to rationalize and process.
Many adults suffer from anxiety, and oftentimes, those struggles begin at a young age. Children in pre-school, all the way up to high school, can have issues with anxiety and stress. According to the National Institute of Mental Health,
Greenshoot Media
approximately 25 percent of 13- to 18-year-olds have a “prevalence” for anxiety, while approximately 5.9 percent may suffer from severe anxiety. It’s a major issue for children, and most kids battle short-term bouts of anxiety over everything from a school project to a teacher they don’t like. YOUNGER CHILDREN For younger children, such as pre-schoolers and grade-schoolers), one approach that can help with processing anxiety is to have a discussion to explain exactly what anxiety is to them, on their terms. For children that young, it can be hard to differentiate between what is real and what’s imaginary. Try to explain to them that just because they think of something scary (such as a dinosaur chasing them), that doesn’t mean it’s actually going to happen. This can extend to the mundane, such as worries about success at school. Explain that just because they’re worried they won’t do well, it doesn’t mean they won’t. Take some additional time to work with your child and encourage her about whatever has her worried. It’s a relatively simple approach, but it can help. ANXIETY IN TEENS Anxiety gets more complex as a child grows older, and by the time they reach the teenage years, many could be grappling with the issues. One prevalent anxiety issue for teens revolves around social anxiety disorders, which are only exacerbated by the fickleness of teenagers and the challenges of navigating high school. A good first step is to have an open conversation with your teen and be accepting of their problems. Be encouraging, and remind them of past experiences in which they overcame adversity. Also help them talk through what they’re worried about, and what could be the cause. If problems persist for a few months with no improvement, consider professional counseling.
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living well ~ May/June 2016
Acupuncture
Independent Living
Acupuncture Clinic of Missoula
Independent Living
Safe, gentle and effective healthcare. Rebecca Sobin, D.A.O.M. L.Ac. Tonia Janzen, M.Ac.O.M., L.Ac. Dallas Seaber, M.Ac.O.M., L.Ac.
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Your well-being is our priority. Enjoy life to the fullest, doing the things you want to do rather than what you have to do. Pop by and see how Life is Just a Little Easier Here.
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We recognize each person is unique So you’ll find just the right level of care and support to enjoy your individual freedom. Pop by and see how Life is Just a Little Easier Here. 3710 American Way, Missoula
Missoula Manor Homes
Family Practice
Memory Care
(406) 273-0101
Blue Mountain Clinic provides patientcentered, family practice services to the local community from a choice-based perspective. We believe that choices in any health care decision should be met with dignity in a supportive environment. Our services include: pediatrics, mental health, general wellness, travel medicine, transgender health and reproductive care for women and men. 610 N California St, Missoula, Mt 59802 (406) 721-1646
909 W. Central Missoula, MT 59801 728-3210 or visit www.missoulamanor.com TTY Relay 711
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• Case Management • Adult Group Homes • Community Based Rehab & Support Staff • Recovery Mall • Health and Wellness Programs • Group Home Living • Payee Services y • Children's Mental Health Services (406) 721-2038 2685 Palmer St., Suite C Wocmt.com Same Day or Next Day Appointments
Footsteps Memory Care ®
We walk through the journey of memory loss with you providing genuine care and increasing support as the journey changes. Every day we embrace moments of success 3710 American Way, Missoula
(406) 273-0101 July/August 2016 ~ living well
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Emergencies: Who to Call
Green Shoot Media
S
ome parents make the mistake of thinking they will be always be around in emergency situations, but that is not always the case.
Children need to be equipped with the knowledge of who to call should they ever find themselves in a dangerous environment at school or at a friend’s house. Talking about 911 with children is a great place to start when discussing safety measures with children. What is 911 Before your child can fully understand the importance of 911, they must first realize what constitutes a real emergency. Talk with them about the various situations that would warrant a 911 call, including fire, an intruder or a family member seriously hurting him or herself. Role playing is a great way to introduce your child to the feel of a potentially dangerous situation without them having to really experience one. Place a toy phone nearby and act out an emergency situation that requires them to run to the phone and pretend to dial 911. Add a little fun to the situation by timing your child’s reaction time and challenging them to better it during the next scenario. When to Call 911 The National Emergency Number Association estimates that 75 percent of calls to 911 are actually non-emergency situations. A large portion of this statistic is made up of children calling 911 in predicaments that may seem serious to them, but do not constitute an emergency phone call. Teach your children that an unnecessary phone call to 911 can delay help
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living well ~ July/August 2016
getting to people who really need it at that time. It is also important for them to understand the severity of punishment related to placing prank calls to 911. Emergency Card Every home should have a detailed listing of phone numbers for not only the local police and fire departments, but also the numbers of family members to contact in emergency situations. Also write down any critical medicines or allergies for you and your family members. A list with all of this vital information can help first responders and doctors determine the best course of action to take.
MALLWALKERS FITNESS PROGRAM
GET FIT step by step Be a part of Missoula’s longest running free health program. Join us in Southgate Mall’s Community Room at 9 a.m. Mondays, Wednesdays and Fridays.
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in store
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YOUR DAY ONE.
OUR EXPERTISE.
It’s having confidence in knowing how we care for you and your family. With a new addition to your family, you need to know that you’re receiving the highest level of care and attention from our dedicated team of skilled obstetricians, nurses and specialists. For nearly a century, we’ve helped deliver exceptional birthing experiences for families across Western Montana. From the day you learn you’re expecting through your return home, this is a journey we share with you. Today may be your day one, but you can rest assured it isn’t ours. Discover why the Women’s and Newborn Center at Community Medical Center is the right choice for you. Visit communitymed.org.
Women’s and Newborn Care communitymed.org 38
living well ~ July/August 2016