1. Good nutrition makes a healthy child. Be sure your child eats regularly and has a variety of nourishing foods.

2. Everyone should buckle up in the car. If your child needs a car seat, make sure it is a proper size for his or her height and weight and that it is properly installed into the vehicle.

3. Help reduce tobacco use among children and adolescents. If you smoke, quit. If you cannot quit, smoke outdoors to protect your child against second-hand smoke.

4. Lower the risk of Sudden Infant Death Syndrome (SIDS). When infants are put down to sleep, place them on their backs (unless otherwise instructed by a physician).

5. Make sure your children visit the doctor regularly. Children should be immunized on time. It is the best defense against dangerous childhood diseases.

6. Give your home a safety check. Install smoke detectors, store poisonous substances out of your child’s reach and know how to reach emergency services.

7. Prevent violence by setting good examples for your child. Remember words can hurt, too.

8. Read to your child on a daily basis beginning at 6 months of age to enhance his or her early brain development.

9. Monitor what your child sees in the media. Children are affected by what they see and hear. Teach the difference between fantasy and reality.

10. Provide a nurturing environment in which your child feels safe and valued. Tell your child “I love you” every day.

Colleen Schultz is the education manager for Children’s Health Education Center. Learn more at www.BlueKids.org.

 

Happy holidays from all of us at Children's Hospital and Health System!

Cold winter days now have replaced the warmth and activity of summer. With winter come the holidays – stuffed with festivities, fun and food – lots of food. Childhood obesity is on the rise across the United States, which is why keeping your kids physically active year round is so important.

Staying active can be a challenge when your kids are stuck inside. The winter months are a good time to take advantage of resources in your community, including local community centers or the YMCA. Both offer programs for your whole family to stay active together.

Research shows physical activity decreases stress levels and promotes family time. At home, create obstacle courses. While watching TV, perform physical activities during commercial breaks, or get your kids moving to age-appropriate exercise videos.

Just because it’s winter outside, your kids don't have to stay inside. Make the most of winter and have fun participating in outdoor activities like:
•    Ice-skating.
•    Snow shoeing.
•    Playing hockey.
•    Cross-country skiing.
•    Building a snowman or snow fort.
•    Sledding.

Another way to make exercise fun is to create an activity chart. Set weekly or monthly goals and when your kids achieve those goals, reward them with things other than food.

Remember to limit “screen” time (TV, video games, computer games and even phone time) to less than two hours a day. Kids should get 60 minutes of exercise or physical activity every day. It’s important to note, however, that exercise for an adult is not the same as exercise for a child. Physical activity should be packaged into smaller increments for kids.

No matter what time of year, it’s important for parents to get involved and be active with their kids. Be a role model for your children and set a positive example. Kids will respond to that. The key is to make exercise fun, be creative and lead by example.

Stacy Stolzman, PT, is a physical therapist at Children’s Hospital of Wisconsin.

The holidays have arrived, and can be a joyous time for children and adults alike. But often decorations, entertaining and other festivities can distract parents from taking proper child-safety precautions, especially when it comes to dangerous holiday poisons.

Parents should be aware of these holiday dangers and ways to prevent them:

Food
Food poisoning is very common over the holidays due to large amounts of food around the house. Hot foods should be kept hot, and cold foods should be kept cold. Remove food from the serving table as soon as the family or guests have eaten. Leftovers should be put in small containers in the refrigerator in order to cool quickly. Food poisoning is difficult to diagnose without a laboratory test, but symptoms could include nausea, vomiting and diarrhea, which can lead to dehydration in small children. These symptoms usually develop six to eight hours after the spoiled food has been consumed. Making your child vomit or using over-the-counter anti-vomiting or anti-diarrhea medication is not recommended.

Alcohol
All types of alcohol are poisonous. After a holiday party is over, be sure to empty all glasses so your child does not sip any alcoholic beverages.

Medications
If holiday guests stay overnight, make sure their medications are out of reach from your children. Heart and diabetic medications are extremely dangerous because these may be swallowed without any obvious outward symptoms.

Tobacco
Tobacco is very toxic. Make sure children cannot get their hands on any guests’ tobacco or cigarettes. Be sure to empty ashtrays promptly, too.

Lead in toys
There is a possibility that lead could be found in children’s toys. Be aware of toy recalls due to the presence of lead.

Plants

• Holly’s bright red berries may intrigue children. Make sure your children do not swallow any of the berries.
• Mistletoe’s berries also can be extremely poisonous. Keep mistletoe out of your children’s reach.
• Poinsettias are not a highly poisonous plant, but if eaten, can cause choking, nausea or vomiting.

Decorations

• Angel hair, a type of garland, consists of spun glass similar to fiberglass and can cause injury to the eyes, skin and even the digestive system, therefore, children should not play with this decoration.
• Artificial trees are not poisonous, but they can be a choking hazard if a piece is swallowed.
• Bubble lights are filled with a liquid such as alcohol or a solvent. Beware of burns and broken glass if a child bites into the bulb.
• Candles can cause serious injuries when swallowed. Most of the scents, colorings and waxes in candles are nontoxic, however, melted wax can cause burns.
• Ornaments primarily are made from thin plaster, glass or Styrofoam® and do not necessarily pose a poison hazard if swallowed. However, if your child puts a piece of ornament in his or her mouth, remove any portion immediately to prevent choking.

To prepare for any holiday poison incidents that could occur, place Wisconsin Poison Center’s toll-free number, 1-800-222-1222, by all phones. Also, make sure babysitters know how to reach you. If you suspect your child has come in contact with a poisonous substance, call the poison center immediately. For more poison prevention information, visit www.wisconsinpoison.org.

Cathy Smith is coordinator of Wisconsin Poison Center at Children’s Hospital of Wisconsin, which is the poison control center for adults and children for the state of Wisconsin.





 

These days, it seems parents and their children are bombarded with many images pointing to the hottest new toy. Not advertised is the latest toy craze that is inexpensive, fun and good for your child: creativity.

Play for a child should be about the process, not the actual toy. Sometimes, the simpler the toy, the better. Activities that let children explore their creative sides help them learn. For kids, play is work – it’s how they learn who they are, what their roles are, what skills they have and how to get along with others.

Creative activities should be “open-ended.” In other words, let the child decide where the activity should go. A few thoughts to inspire creative play include:

• Tupperware containers or other household items that can teach sorting or grouping.
• Playdough or clay, which is an excellent activity for developing fine motor skills.
• Watercolors, which are easy to clean up.
• Reading, followed by making puppets or pictures to describe the story they just heard or read.
• Exercise is a benefit of participating in outdoor adventures and games.

Another way to spark creativity is to have an area set up in your house just for your child. Keep it stocked with crayons, markers and other materials so that your child feels welcome to explore and play there any time.

Save items around the house such as an old sheet, a cardboard box or even toilet paper rolls. They can come in handy for a variety of activities.

If you have trouble coming up with creative ways to use things around the house for unique activities, there are many resources on the Internet to help you. A few of these include:

• Familyfun.com
• Pbs.org
• Zerotothree.org

Parents shouldn’t feel they have to buy their children the latest and greatest toy on the market. There also is such a thing as too much television or video games. Children’s Health Education Center recommends a maximum of two hours total per day for children to be on the computer, watching television or playing video games. Televisions and computers also should be in areas where the family gathers and where the child can be monitored, not in the child’s room.

Overall, your family should strike a balance in activities to make sure there are enough creative options. Creativity benefits the emotional health of children, encourages them to think on their own and celebrates their uniqueness – plus, it can be fun for the whole family!

Colleen Schultz is the education manager for Children’s Health Education Center. Learn more at www.BlueKids.org.

Attention-deficit/hyperactivity disorder, commonly referred to as ADHD, is a condition of excessive distractibility and impulsivity. Kids easily are drawn away from their tasks and make quick and sometimes poor judgments. They have difficulty waiting for rewards. You don’t have to be hyperactive to have the condition. In fact, you don’t even have to be a kid. Many adults now are diagnosed with ADHD.
 
Children are more frequently diagnosed with ADHD when they start school because the demands of paying attention at school are greater than at home. The problem occurs in the brain, where areas that control impulse are underactive. We know this from modern imaging studies, like MRIs. The main area that this occurs is in the frontal lobe. In addition to controlling impulses, the frontal lobe also is involved with our decision-making skills.
 
ADHD is common, occurring in about one in 25 kids. Boys tend to be more affected than girls. Girls often will have a lot of symptoms without being hyperactive. There are a few factors, such as prematurity, that can make ADHD more likely. For the most part, it is a condition that is present from birth. It is not caused by inappropriate parenting, the wrong diet (such as too much sugar) or stress. While genetics now are being tested, we know there is a strong family correlation. Other family members often have similar traits.
 
There are two main therapies for ADHD. One is behavioral. The other is medication.
 
Changing the school or home environment may help. Allowing for the strengths and weaknesses of each child is important as well. Working with schools and therapists can be beneficial.
 
Dietary measures usually do not change symptoms.
 
Most kids with ADHD do well with medication. There may be reluctance to use these medications, but with the proper dosage and administration they are safe and effective. There are several types of medications that can help. A health care professional can work with you to find the right one and the right dose.
 
Parents may wish to avoid labeling their child or, if diagnosed, use medication. This often leads to unnecessary school or social problems. Many physicians and other health care professionals have good questionnaire screening tools to help. If you are concerned, talk with your doctor.     

Paul Norton, MD, is a behavioral specialist at Children’s Medical Group-Greensquare Developmental Specialists.

FAST FACT: Children’s Medical Group physicians provide primary and behavioral care for children in 18 clinics throughout southeastern Wisconsin. In addition, the medical group oversees the School Nurse Program located in central city Milwaukee Public Schools, where Children's Hospital and Health System and private schools provide care for students. Find a local pediatrician at www.childrensmedicalgroup.org.

Looking for some tools to skyrocket your family to better health? Check out Children's Hospital of Wisconsin's 3-2-1-0 Blast Off to a Healthier Family! program that helps families like yours achieve better health. We know obesity continues to be an epidemic problem in both adults and children. And, as the obesity numbers in children rise, so do the number of children diagnosed with type 2 diabetes.

Adult diabetes on the rise in kids

Historically, children were diagnosed with type 1 diabetes, a condition that usually is due to genetics, in which the body does not produce insulin. Type 2 diabetes, formally known as adult onset diabetes, is more directly the result of unhealthy lifestyle behaviors. Usually, this condition would take years to develop, but with today’s access to fast food, sweetened beverages and highly processed foods, in combination with sedentary activities such as video games, cable and cell phones, type 2 diabetes has started to affect people at a younger age. Children are being diagnosed with type 2 diabetes as young as 6 years old.

3-2-1-0 Blast Off!

Making better meal and snack choices, as well as being physically active, can help prevent obesity and potentially type 2 diabetes. 3-2-1-0 Blast Off to a Healthier Family! Can help launch healthier habits for your family. This program, developed by the NEW (Nutrition, Exercise and Weight Management) Kids Program at Children's Hospital helps families to make healthy choices every day.

3 - Eat three meals a day. Many families today are busy and look for quick and convenient ways to provide meals. This often means stopping at fast food restaurants or buying prepared, processed foods. These meals tend to provide inadequate fiber and are higher in fat, sodium and calories.

2 - Allow less than two hours of sedentary activity per day. Limit the amount of time children are involved in screen time activities. This includes watching television, playing video games, using the computer and talking or texting on the phone.

1 - Aim for at least one hour of physical activity each day. Encourage your children to participate in activities they enjoy. This can include riding a bike, playing tag, jumping rope, running, family walks and basketball. Make this a family event!

0 - Eliminate sweetened beverages. Choose beverages that have less than three grams of sugar per serving. Sweetened beverages can provide empty calories that add up very quickly.

Family Meals. Try to have as many meals as possible together as a family. This provides a great opportunity to learn about the events of the day and make you more conscious of how quickly and how much you are eating.



A new section of Children's Health Education Center's Bluekids.org Web site offers interactive games for kids, meal and activity tracking sheets, parenting information and more at www.bluekids.org. Introduce your kids to characters like "Skipper" (skips meals), "Hypnotica" (encourages kids to watch TV and play video games) and "Buzz" (cons kids into drinking sweetened juices and sodas). Fun, interactive activities teach kids how to battle these "aliens" to good health.

Fast Fact: About 151,000 people below the age of 20 have diabetes in North America.

Brian Fidlin, PsyD is the program director of the NEW (Nutrition, Exercise and Weight Management) Kids Program at Children’s Hospital of Wisconsin. Heather Fortin, RD, CD, CSCS, CLC is a registered dietitian with the NEW Kids Program at Children’s Hospital of Wisconsin.

Soon your neighborhood will be filled with ghosts, goblins, witches and more as they take to the streets in search of tricks and treats. Although children look forward to the festivities and traditions surrounding Halloween, the excitement can cause them to forget to heed safety precautions, which can lead to unintentional injuries.

Check out these Halloween safety tips for a fun and safe Halloween.

Streets
• Pedestrian injury remains the second leading cause of unintentional injury-related death among children ages 5 to 14. Children are twice as likely to be hit by a car on Halloween.
• Make sure drivers can see your kids’ costumes in the dark. Be original with a glow-in-the-dark costume or a reflective trick-or-treat bag. Children should use a flashlight or glow stick when walking at night.
• Trick-or-treat in a group, not alone. Kids younger than 13 should go with an adult. Older kids always should go with buddies and follow a preplanned route.
• Remind your kids to cross streets at crosswalks and intersections, stop at street corners, look left, right and left again before crossing. They should not cross between parked cars or step into the street without looking to see if a vehicle is coming.

Motorists
Drivers also need to do their part to keep trick-or-treaters safe from harm.
• Be especially alert. Remember that popular trick-or-treating hours are during the typical rush-hour period, between 5:30 p.m. to 9:30 p.m.
• Drive more slowly. Slow down ¬– expect a lot of pedestrian traffic.
• Lights on. Drive with your full headlights on so you can spot children from greater distances.

Treats
• You should check your kids’ treats before they eat them. Tell your kids to pick only wrapped candy when they trick-or-treat.
Costumes
• Make certain your kids’ costumes fit properly. Costumes should be large enough to allow the child to wear warm clothes underneath, but short enough to prevent tripping. Do not allow children to wear adult shoes or boots.
• Use facial paints and cosmetics in place of masks. If a mask is used, make certain the eye and nose openings do not restrict vision or breathing. Children should remove masks in between trick-or-treating stops.

Other
• Children should trick-or-treat only during your community’s predetermined hours.
• Kids should only visit homes of people they know and to only accept treats at the door.

FAST FACT: More than 93 percent of children, age 12 and younger, will go trick-or-treating.

Lisa Klindt Simpson is coordinator of Safe Kids Southeast Wisconsin Coalition, a member of Safe Kids Worldwide. Safe Kids Southeast Wisconsin works to prevent accidental injuries, the leading cause of death among children 14 years of age and younger. Children’s Health Education Center is its lead agency.
 

Children in homes without working smoke detectors are at a greater risk for fire-related injury and death. Take these simple steps to prevent fires, prepare your home for a fire and teach your child fire safety. They could save your child’s life.

Preventing fires
To help keep a fire from starting, closely inspect your home to eliminate potential hazards.
• Keep matches, lighters, candles and other heat sources locked and out of children’s reach.
• Keep children away from cooking and heating appliances.
• Never smoke in bed.
• Extinguish all candles and cigarettes before leaving home or going to bed.
• Avoid plugging several appliance cords into the same electrical socket.
• Replace old or frayed electrical wires and appliance cords, and keep all cords on top of rugs.
• Store all flammable liquids, such as gasoline, outside of the home and locked out of children’s reach.

Preparing your home
• Install smoke alarms in every sleeping area and on every level of your home.
• Test and clean smoke alarms monthly. 
• Maintain alarms by replacing batteries at least twice a year – when you change your clocks, change your batteries (unless it is a newer smoke alarm that uses 10-year lithium batteries).
• Replace smoke alarms every 10 years.
• Plan and practice two escape routes out of the house and each room.
• Designate one outside meeting place to make sure all family members are accounted for quickly.
• Sleep with bedroom doors closed. This prevents smoke, gas and heat from entering.
• Keep furniture and other heavy objects out of the way of doors and windows so they won’t block an escape.
• Place space heaters at least three feet from curtains, papers, furniture and other flammable materials. Make sure heaters are stable, and use protective coverings.

Teaching safety
Children need to be taught what to expect in a fire so they can act quickly. Teach children:
• Leave the house immediately if they hear the smoke alarm, smell smoke or see flames. Stay low and crawl – the best air is by the floor.
• Always feel doors before opening them. If hot, do not open and find another way out.
• Never go back into a burning building. Children should be reminded not to stop or return for toys, pets or to call 9-1-1 from inside the burning building.
• Call the fire department from a neighbor’s house or cell phone outside the home.
• Do not hide in closets, under beds, in bath tubs or in other areas of the home.
• When firefighters arrive, immediately tell them if someone is inside or missing.

FAST FACT: Playing with matches and lighters is a leading cause of fire deaths for children ages 5 and younger.

Lisa Klindt Simpson is coordinator of Safe Kids Southeast Wisconsin Coalition, a member of Safe Kids Worldwide. Safe Kids Southeast Wisconsin works to prevent accidental injuries, the leading cause of death among children 14 years of age and younger. Children’s Health Education Center is its lead agency.
 

It’s a scary statistic, but true: by eighth grade, one in five young people has used an inhalant to get high, risking brain damage and death. Young people can get high on more than 1,000 legal, useful, everyday products.

Inhalants are chemicals that cause a person to feel "high” after inhaling or breathing them in. People might abuse inhalants because they feel pressure from peers. They’re also cheap and easy to find.

Common ways to abuse inhalants include:
• Huffing—Breathing in fumes from a cloth soaked in a chemical.
• Sniffing—Breathing in fumes from an open container or filling a closet or car with vapors.
• Bagging—Placing the substance in a plastic bag and holding it over the mouth and nose.
• Spraying—Spraying a substance directly into the mouth.

Signs of inhalant abuse may include:
• Red or runny eyes or nose.
• Spots or sores around the mouth.
• Unusual chemical breath odor.
• Drunk, dazed or dizzy appearance.
• Nausea, loss of appetite.
• Anxiety, excitability, irritability.
• Disappearance of household products.
• Discovery of chemical-soaked rags, socks or bags.

Abuse of inhalants may cause many harmful effects such as:
• Permanent damage to the nervous system, lungs, kidneys and other organs.
• Coma.
• Sudden cardiac arrest.
• Danger to unborn children when used by pregnant women.
• Poor judgment, vision and coordination, and loss of many other skills needed for safe driving and making safe decisions.
• Increased risk of major depression and suicide.

In addition, mixing inhalants with other drugs, especially depressants like alcohol or tranquilizers is hazardous.

Abused substances include everyday products found in the home. Below is a room-by-room list of examples.

Kitchen
• Butane.
• Cooking spray.
• Correction fluid.
• Lighter fluid.
• Whipped cream propellants.

Bedroom
• Hair sprays.
• Nail glues and polish remover.

Garage
• Gasoline.
• Kerosene.
• Refrigerants.
• Turpentine.
• Carburetor cleaner.

Workshop
• Aerosol sprays.
• Felt tip markers.
• Glues and adhesives.
• Enamel paint and paint thinners.
• Solvents.
• Spray paints.

Prevention is key
Talk with your children. Teach them the dangers of this abuse. Education must start at a young age. Inhalant abuse often begins in elementary school and can lead to further drug abuse, lifelong problems or even death. If you suspect inhalant abuse, consult a school counselor, doctor or drug counseling center.

FAST FACT: Substances commonly found in the home are the most likely agents to be involved in a poison exposure. Toxic products located in the home account for more than 90 percent of poison exposures.

Mark Kostic, MD, is the associate medical director of Wisconsin Poison Center, specializing in medical toxicology and emergency medicine. The Poison Center, located at Children’s Hospital of Wisconsin, provides 24-hour, toll-free poison information for all individuals in Wisconsin. Anyone who has had direct contact with a known or potential poison can receive immediate advice on what steps to take to prevent injury from that exposure by calling 1-800-222-1222. Translators are available.
 

Ear pain, sore throats, the cold and flu, minor burns and cuts. For some children, childhood is marked by more than just a few visits to the local emergency room or urgent care clinic. Invariably, like Murphy's Law,  it seems that your child is sick or injured when your pediatrician's office is close. Parents are left asking whether to head to the emergency room or an urgent care clinic.

Urgent care clinics are for illnesses and injuries that your child normally would receive care for at his or her doctor’s offices. Most often, urgent care locations are open when regular doctor’s offices are closed. In many cases, urgent care clinics will offer lower co-pays and shorter wait times than emergency rooms.

Your child may need urgent care for:

•    Ear infections with pain and/or fever.
•    Sore or strep throat.
•    Cold or the flu.
•    Mild asthma attacks
•    Vomiting and diarrhea, especially in babies and small children.
•    Non-severe bleeding.
•    Minor burns or cuts.
•    Minor head injury with no loss of consciousness.
•    Hives, rash or diaper rash.
•    Bruises or sprains.
•    Lice, scabies or ringworm.
•    Drug reactions such as hives or rashes.

The emergency room is for more serious illnesses and injuries. Emergency rooms are equipped to care for all patients, from those with minor illnesses to those with life-threatening injuries. Because of this, patients with a less severe problem usually will have to wait – sometimes hours – until the more critically ill patients are treated. For appropriate cases, urgent care clinics have shorter wait times.

Your child may need emergency care for:

•    Serious broken bones, such as the leg or arm.
•    Gun or knife wounds.
•    Severe or unusual bleeding that will not stop.
•    Heart attack or severe chest pain.
•    Suspected stroke.
•    Sudden inability to see, move or speak.
•    Choking or trouble breathing.
•    Possible poisoning.
•    Unconsciousness.
•    Fainting or syncope.
•    Convulsions or prolonged, repeated seizures.
•    Drug overdose.
•    Major injuries.
•    Severe pain.

Unfortunately, some childhood injuries and illnesses may require more immediate care. In emergencies, always call 9-1-1 for the most immediate care.

While arming yourself with information is one of the best things you can do as a parent, remember to trust your instincts. You know your child best.

For more information about Children’s Urgent Care locations call (414) 266-4800. For more information about the Children’s Hospital of Wisconsin Emergency Department, call (414) 266-2000.

FAST FACT: Children's Hospital of Wisconsin had more than 61,000 visits to its Emergency Department and six Children's Urgent Care sites last year.

Jane Chevako, MD, is the medical director of Children’s Urgent Care.
 

Staying dry at night is a major milestone in a child’s physical and social development. Bedwetting is children is very common, but it can be embarrassing for your child and frustrating for you.

Bedwetting should not be considered abnormal until a child has reached 5 or 6 years of age. It is important to understand bedwetting is not done on purpose or because the child is lazy. Bedwetting many times is an inherited problem. If both parents wet the bed when they were children, there is an almost 80 percent chance that the child also will wet the bed.

Sometimes children who wet the bed have smaller bladder capacities than others, or their bodies do not produce enough of the hormone that decreases the amount of urine made at night. Controlling the bladder while asleep is complex and the timeline for physical development of this process varies from one child to the next.

If a child begins to wet the bed after having been completely dry for at least six months or more, a medical problem such as a bladder infection, diabetes or kidney disease should be ruled out. Sometimes an emotional issue is responsible, such as a school stress, or a problem with peers or family.

Parents can take their children to a pediatrician to rule out any medical problems that may be causing bedwetting. If there are no medical problems, there are many things that parents can do to help their child achieve dry nights:
•    Stay positive, and help your child keep a positive attitude. Tell your child to visualize getting up to go to the bathroom and having dry nights.
•    Limit foods and beverages that contain caffeine, especially after dinner.  Caffeine causes the body to make more urine.
•    Have your child use the toilet just before he or she goes to sleep.
•    Put a nightlight in the bathroom.
•    If your child wets the bed, have him or her take off wet sheets and put them in the laundry. Explain that this is not a punishment. It helps him or her take charge of the situation.

Where to go for help
If the bedwetting continues or you are concerned, talk to your child’s doctor or seek help from professionals with the Voiding Improvement Program at Children’s Hospital. This program provides comprehensive evaluation, diagnosis and treatment for children and teens with daytime and nighttime wetting or other voiding problems. Health care professionals can help improve self-esteem by educating families, children and teens about their condition and helping them choose and implement a plan that fits their needs.

FAST FACT:  Bedwetting affects 15 to 20 percent of 6-year-olds, 5 percent of 10-year-olds and 1 to 2 percent of teenagers and adults. There are many ways that you can help your child overcome this problem. The most important way is to offer love and support, so your child can have dry nights and sweet dreams. Remember, punishment does not help bedwetting.

Patti Ring, RN, is a certified pediatric nurse practitioner with the Voiding Improvement Program at Children’s Hospital of Wisconsin.



 

As summer vacation draws to an end, it’s important to help children re-establish a healthy back-to-school sleep schedule.

Children need more sleep than adults. Children ages 5 to 12 require 10 to 11 hours of sleep each night, while teens should have at least nine hours.

Chronic sleep deprivation has many serious consequences, including poor school performance. Lack of sleep also can be linked to behavioral, developmental and mood problems in children. Drowsy teens who get behind the wheel of a car can suffer even more dire consequences.

Despite these facts, the National Sleep Foundation has found that only 20 percent of adolescents get enough sleep.

Parents can help children adjust their sleep patterns for the upcoming school year by following these guidelines:

• At least two to three weeks before school starts, set a bedtime and wake-up time. Children with bedtimes before 10 p.m. are much more likely to get enough sleep than children with later bedtimes. If necessary, the schedule can be adjusted at a gradual pace (about 15 minutes every two days) to ease the transition.
•  In the last days of summer, wake your children early. Emphasize activity and bright light in the morning. For example, send them outside to play, rather than allowing them to watch TV. 
• Be consistent with your children’s sleep schedules, even if they don’t have school the next day.
• Establish a relaxing evening routine. Avoid exercise or stimulating activities in the last few hours before bedtime.
• Create a sleep environment that is cool, dark, quiet and comfortable.
• Limit caffeine, especially after lunchtime.
• Avoid having a TV or computer in the bedroom. 
• Make sleep a priority and set a good example.

 Back to school means early to bed

FAST FACT: The National Highway Traffic Safety Administration estimates that drowsy driving causes at least 100,000 police-reported crashes and kills more than 1,550 Americans each year.

Nan Norins, MD, is a pediatric sleep specialist at Children’s Hospital of Wisconsin and an assistant professor of Pediatrics (Pulmonary/Critical Care Medicine) at the Medical College of Wisconsin. The Sleep Center at Children’s Hospital offers a full range of diagnostic and treatment services, including the state’s only pediatric sleep laboratory accredited by the American Academy of Sleep Medicine.

Before the school buses return to their routes, it is time to start thinking about your child’s back-to-school physical. The American Academy of Pediatrics recommends a yearly physical for all school-aged children. Many summer camps, schools and sports require that a physical card be updated every two years. Here are some things you can expect at the exam:

• Medical history. An important part of every check up is the medical history. Nutrition, diet and exercise should be discussed. The doctor should be made aware of activities your child is involved in to consider risks, physical maturity and readiness. This also is a good time to review ongoing medical problems, like asthma or allergies, refill medications and complete medication sheets for school. The doctor will likely need to spend some time alone with teens in order to review confidential information related to drinking, smoking, drugs, sexual activity and depression. Write down questions for the doctor beforehand. Common questions during the medical history include:
• Were there missed school days last year?
• Any serious or recurring sports injuries?  
• Any visits to the emergency room, urgent care or another medical specialist?
• Has your child started any new medications, vitamins or supplements?
• Has your child been successful in school and maintained friendships?
• Medical exam. The medical exam begins with height, weight, blood pressure and comparison to past measurements. A child’s growth is one of the best indicators of overall health. A head-to-toe exam should be performed. After the exam, the physician will determine if any laboratory, X-ray or other tests are necessary. Vaccination history should be checked and shots should be updated. Vision and hearing may be screened. Forms for school, camp or sports can then be completed.
  

A healthy childhood means balancing home life, school, social activities, sports and extracurricular activities. An annual visit to the pediatrician can help ensure your child is fit to participate and can head off illness or injury with guidance and treatment of ongoing medical issues.

FAST FACT: Children’s Medical Group physicians provide primary and behavioral care for children in 18 clinics throughout southeastern Wisconsin. In addition, Children’s Medical Group oversees school-based health centers located in central city Milwaukee Public Schools.

Mary Lehrmann, MD, FAAP, is a pediatrician at Children’s Medical Group-Westbrook Pediatrics.



 

Proper hearing is essential to a child’s ability to develop speech and language skills, as well as his or her cognitive, social and emotional development. The first few years of a child’s life are particularly important. During this time, children learn to make sense of sounds via their ears, working in conjunction with their brains. The importance of these early years is what prompted many states to initiate hearing tests for all newborns. Early detection and appropriate intervention are key factors in eliminating or minimizing the negative impact of hearing loss.

Despite the importance of early intervention, on rare occasions parents still are told their child is too young for a hearing test. Very young children can be tested. Here are some of the more common tests:
 
Visual reinforcement audiology
This is a behavioral testing technique typically used with children between 6 months and 3 years old. In a special booth, the child is seated on a parent's lap with speakers situated on either side. An audiologist transmits speech and different pitches of sounds through the speakers. When the child hears the voice or sounds and looks in the direction of the sound, an animated, lighted toy appears. Using this type of visual reinforcement, the child eventually learns to look toward the source of the sound when he or she hears it, allowing the audiologist to evaluate the child’s hearing.

Conditioned play audiometry
This test typically is used for children between 3 and 5 years old. While wearing headphones, the child is encouraged to play a listening game. Different sound pitches are introduced through the headphones, and the child is taught to perform a task, such as putting a block in a bucket every time a sound is heard. If the child is willing and able, his or her ability to hear and understand speech also can be assessed by using a picture-pointing task or repeating words. By having the child wear headphones, the audiologist is able to determine the level of hearing in each ear.

Conventional audiometric testing
Most people are familiar with this test. It typically can be used with children age 5 and older. With headphones on, the child is asked to raise his or her hand every time different sounds or pitches are heard. In addition, the child’s ability to detect and understand speech is evaluated by having him or her repeat words.

Newborns, very young infants and some children with special needs, such as visual difficulties, cognitive or physical impairments, and/or behavioral issues, may not be able or willing to perform some of these tests. In these situations, audiologists rely on electrophysiological tests that do not require any responses from the child. These tests include auditory brain stem response evaluations and auditory steady state response testing. During these noninvasive and painless tests the child typically is sedated. Headphones generate a series of clicking sounds, and electrodes attached to the child’s head record neural responses. Using these tests, audiologists are able to obtain very good, objective estimates of a child’s hearing status.

If you have concerns about your child’s hearing, discuss them with your pediatrician. Masters Family Speech and Hearing Center at Children’s Hospital of Wisconsin offers comprehensive hearing tests by audiologists who specialize in working with kids.

FAST FACT: If you have concerns with your child’s hearing, don’t dismiss them just because he or she passed a newborn hearing screening. It is not uncommon for children to develop temporary hearing problems, such as fluid behind their eardrums, which require medical attention. On rare occasions, a progressive, possibly permanent hearing loss may develop that was not present at birth.

Catherine Holland, MS, CCC-A, is a pediatric audiologist with Masters Family Speech and Hearing Center at Children’s Hospital of Wisconsin.

 

Fourth of July activities can provide a fun-filled time for families. But, fireworks needlessly injure children every year.

Children ages 10 to 14 suffer from fireworks-related injuries more than any other age group. Sparklers, often considered the safest of fireworks, are most frequently linked to injuries among children age 5 and under.

To prevent accidents, keep these firework safety tips in mind during the Fourth of July:

• The best way for families to enjoy the holiday's festivities is to leave the fireworks to the professionals. Attend public firework displays where your whole family can watch the show from a distance.
• If your family has purchased fireworks, make sure your children do not use them, including sparklers.
• Discuss the dangers of fireworks with your children. Tell them never to purchase fireworks or accept them from friends, and to stay away from those who are using fireworks.
• Always have water handy–a hose or bucket of water–when using fireworks or sparklers.
• Never make your own fireworks.
• Don’t allow your child to pick up pieces of fireworks after an event. Some still may be ignited and can explode unexpectedly.

FAST FACT: Children, age 5 and younger, account for one third of all firework injuries. Keep your children away from fireworks, especially sparklers, because they can reach temperatures up to 1,800 degrees Fahrenheit.

Elizabeth Cleek, RN, MS, APNP, is an advanced practice nurse with the Trauma Program at Children’s Hospital of Wisconsin.




 

Many parents consider leaving their children home alone while they are at work. Knowing when your child is ready for this added responsibility requires careful consideration.
   
First, contact your county social service agency and ask for local guidelines on the age children legally can be left alone. However, keep in mind that age alone will not determine if your child is ready. You also need to ask yourself the following questions:

Physical maturity
• Can my child lock and unlock the door?
• Can my child use the telephone?
• Can my child prepare a snack?

Learning ability
• Can my child read and write?
• Can my child follow directions?
• Does my child use good judgment?

Emotional maturity
• Is my child confident?
• Is my child fearful?
• Is my child stressed?
• Does my child display acceptable behavior consistently?
• Is he or she comfortable being home alone?

Safety considerations
• Can my child reach me in an emergency?
• Do I have a backup person my child can contact if I cannot be reached?
• Does my employer allow me to make personal phone calls to check on my child?
• Do we live in a neighborhood where my child will be safe and feel comfortable?
• Is there someone my child can go to in the neighborhood in an emergency?
• Will there be responsibilities for siblings?

Clear rules and expectations should be outlined. Parents also should prepare and rehearse an emergency plan with their child.

Interaction with adults is crucial to child development. Time spent home alone should be limited. Make building your family’s support system a goal, so other adults can be available to share in caring for children. 

Gloria Tarrer is the director of the Family Resource Center of Sherman Park. The family resource center is a service of Children's Service Society of Wisconsin. For more information about letting your child stay home alone or to receive a complete schedule of free parenting classes, programs and resources, call (414) 444-5760.
 

Every year, young children are involved in automobile accidents and sports-related injuries. If the adult in the vehicle is seriously injured, unable to talk or not present, those responding to the emergency have no easy way of identifying the child. But, two new programs offer added protection through identification.

W.H.A.L.E. (We Have A Little Emergency)
Wisconsin law requires all youngsters under 4 years of age or up to 40 pounds be seated and harnessed in an approved child safety seat when riding in a car. The safety seat can provide vital information about its young occupant in the unfortunate event that the driver of the car is incapacitated in a car accident. W.H.A.L.E. stickers are placed on both rear side windows of the car and on both sides of the child safety seat so emergency personnel will know immediately there is vital information about the child on the back of the car seat. The W.H.A.L.E sticker includes the child's name, medical history, names and telephone numbers of two guardians and up to three emergency names and telephone numbers.

That’s Using Your Head
That’s Using Your Head is a sports helmet identification program designed to provide identification to emergency personnel in the event of
an injury or emergency. Helmets are a critical piece of equipment for safety during all sports such as bicycling, inline skating, baseball, rock climbing or skateboarding. That’s Using Your Head includes a large emergency information sticker to be placed on the inside of a helmet and a smaller sticker for the outside of the helmet. Stickers will help with emergency identification and medical safety information in a crisis situation.

Children’s Medical Group-Bayshore Pediatrics provides both W.H.A.L.E. and That’s Using Your Head packets to local North Shore police and fire departments for distribution during car seat installations and to parents and children through clinic visits, day care centers and preschools.

Sharyl Paley, MD, FAAP, is a pediatrician at Children’s Medical Group-Bayshore Pediatrics.

FAST FACT: Children’s Medical Group physicians provide primary and behavioral care for children in 18 clinics throughout southeastern Wisconsin. In addition, CMG oversees school-based health centers located in central city Milwaukee Public Schools. Find a local pediatrician at www.childrensmedicalgroup.org.

 

Each year, more than 100 children age 14 and younger die, and 2.5 million are treated in emergency rooms for injuries from falls. Among children who die, more than half are younger than 4 years old.

There are many different ways children are injured from falls. They can fall from windows, down stairs, off furniture and from bikes or outdoor play equipment.

Fall-related injuries and deaths often are seasonal. Window falls peak during the spring and summer when people leave their windows open. Children also are outside playing on swing sets, jungle gyms and other playground equipment. Most playground injuries occur when children jump or fall from equipment to hard surfaces below. More than 70 percent of playground-related injuries involve falls to the surface.

Parents and caregivers can prevent falls in the home with supervision and safety products. To prevent falls at home:
•    Never use baby walkers.
•    Never leave young children alone on changing tables, beds, sofas or other furniture.
•    Always strap children into highchairs, swings and strollers.
•    Move chairs, cribs, beds and other furniture away from windows and draperies.
•    Install window guards that can be opened by adults on the first six floors of residential buildings. Install permanent window guards on floors seven and above.
•    Remember that children can fall from windows opened as little as five inches. Never rely on window screens to prevent falls.
•    Never let children play alone on fire escapes, high porches or balconies.
•    Use safety gates at the top and bottom of stairs.
•    Keep hallways and stairs well lit and     clear of clutter.
•    Never let kids play on stairs.

To prevent falls at play:
•    Check the surface under playground equipment. Avoid asphalt, concrete, grass and soil surfaces. Safer surfaces include mulch, pea gravel and shredded rubber at least nine to 12 inches deep and extending at least six feet in all directions around equipment. Work with local officials to clean up broken glass and trash to maintain safe playgrounds.
•    Insist children wear their helmets correctly every time they ride their bikes or skates. Only buy helmets that carry a sticker indicating they meet safety standards.
•    Make sure children wear protective gear including helmets, kneepads, elbow pads and wrist guards while inline skating or skateboarding. Skaters should take lessons, avoid skating at night and skate on smooth, paved surfaces free of motor vehicles.

Bridget Clementi is executive director of Children’s Health Education Center, CHEC is the lead agency of Safe Kids Wisconsin and Safe Kids Southeast Wisconsin coalitions. Each offer resources and programs for children, parents, teachers and caregivers to help keep children healthy and safe. Safe Kids Wisconsin and Southeast Wisconsin specifically work to prevent childhood accidental injuries, the leading cause of death among children ages 14 and younger.


FAST FACT: In 2007, more than 2,600 children ages 1 to 12 were treated in the emergency department at Children’s Hospital of Wisconsin for injuries they received from a fall.

Artistic expression often is used as a therapy to help people who have lived through traumatic experiences work through the grieving and healing processes. People of all ages experiencing behavioral, emotional and medical problems can benefit from art therapy by increasing self-awareness, resolving life-changing events, improving coping skills and expressing difficult feelings.

Children’s Hospital of Wisconsin art specialists use art in the hospital setting to help patients cope, and find it’s a wonderful way to help them express what they are thinking or feeling. But you don’t have to be ill or suffer a traumatic event to benefit from art or creating art.

Children of all ages benefit from self-expression through the artistic process. This can be as simple as finger painting for a 2-year-old or creating a multimedia collage with markers, paper, fabric and found objects for a 6-year-old. The experience of creating art offers a way for children to develop reasoning and to express their emerging thoughts and feelings. And, it’s fun!

This is YOUR Children’s Hospital
In spring of 2009, Children’s Hospital will open its new west tower. The 12-story, 425,000-square-foot expansion will increase the 236-bed hospital to 294 beds with space for 72 more beds in the future. The state-of-the-art facility also will include a larger Pediatric Intensive Care Unit and an expanded Herma Heart Center. Many people including physicians, nurses and our patients and families have been instrumental in the planning and design. In addition to the most cutting-edge technology and nationally recognized pediatric care, this expansion will offer a brighter and well-thought out environment with many amenities that will help children and families heal.

What does YOUR Children’s look like?
Last year Children’s Hospital cared for more than 250,000 children—many of whom live in your neighborhood or go to school with your own kids. Perhaps your family has been cared for by Children’s Hospital as an inpatient or in one of our outpatient clinics, by a Children’s Medical Group pediatrician or at a Children’s Urgent Care. We invite all children and adolescents ages 3-18 to share the story of their experiences with us through their art. We hope to use some of the submitted artwork in the following ways:
•    On the walls of Children’s Hospital.
•    Showcased in a Children’s Hospital coffee table book.
•    As part of a traveling art exhibit.
•    At a grand opening event for the new Children’s Hospital west tower.

Between now and June 13, 2008, submit artwork created on the entry form. Children can use crayons, colored pencils, markers, paint or pastels for their hospital artwork, be creative! All entries will be considered, and families will be notified if their child’s artwork has been selected. Four grand prize winners will receive a stay in Wisconsin Dells for four. We look forward to receiving your entries.

Download your entry form

Amy Phillips, MA, Fine and Decorative Arts, is an art therapist at Children’s Hospital of Wisconsin.

FAST FACT: More than 800 pieces of children’s artwork are hanging on the walls of Children’s Hospital and Health System facilities.
 

 

There is an outbreak of measles in our community right now. Following is information regarding measles and what you should do if you are concerned about a possible exposure in your family.

It is important to know that children and adults who have been fully immunized are not considered to be at risk.

What should I do if I’m concerned my child might have measles? Consult your pediatrician or family practice physician immediately. If you are being referred to Children’s Hospital for a blood test, your pediatrician should contact the Emergency Department prior to your arrival. Then, please go directly to the Children’s Hospital Emergency Department. A testing station has been set up in the Emergency Department to help screen for measles.

Please do not enter the hospital or clinics building and risk exposure of other patients and people.
_________________________________________________________________________________________________________________________________________________________

What is measles? Measles is an extremely serious and highly contagious viral disease that can be prevented by routine childhood vaccination.

How is measles prevented? The measles vaccine is usually given in combination with rubella and mumps vaccine (MMR). The current vaccination schedule suggests a first vaccine between 12 and 18 months of age. A second vaccine should be given between 4 and 6 years of age. If you are not sure if your child has received the MMR vaccine consult your pediatrician or family practice physician.

Who can get measles? Measles virus can infect any person of any age who has not previously had the disease or measles vaccine.

How is measles spread? Airborne droplets, from coughing or sneezing, spread the virus. It spreads easily and rapidly.

What are the signs and symptoms of measles? The disease begins with cold like signs and symptoms including a cough, runny nose high temperature and red, watery eyes. By the second day after onset, a red blotchy rash appears at the hairline and spreads down the body to the arms and legs. The rash disappears in the same order of appearance (head to foot) in about 5-6 days.

How soon do symptoms appear after exposure? It takes from 8-12 days for the cold-like symptoms to appear and 14 days for the rash.

How can parents be sure that their child’s illness is measles? The only sure way to determine if an illness is indeed measles is through a blood test.

When and for how long is a person able to spread measles? Measles can spread from one day before the onset of cold-like symptoms through the fourth day of the rash.

What are the complications associated with measles? Among children with measles, about 10 percent develop ear infections, about 5 percent develop pneumonia, about 0.1 percent  (1 per 1,000 cases) develop encephalitis (inflammation of the brain that can result in deafness or mental retardation) and in approximately 1 in 1,000 cases people die from it.

Is there a treatment for measles? There is no specific treatment for measles.

Can measles be prevented? Yes. Measles vaccine is recommended for all children at 12-15 months of age and again at 4-6 years of age. The two doses of vaccine normally provide life-long immunity.

For more information consult your pediatrician or contact your local public health department.

FAST FACT: A measles hotline has been established by the Milwaukee Health Department. Call (414) 286-3616.