just kids | fall 2009

justkids

Getting Your Kids

Organized

Fall 2009

Children’s Hospital & Medical Center

• Keeping the Flu at Bay• Acetaminophen: What Parents Should Know

2 | To find a physician, call 1-800-833-3100

The flu has made a lot of headlines in recent months, especially with this year’s outbreak of H1N1 influenza A, also called swine flu. But, despite the headlines, experts still say that the best way to keep from getting the flu is to practice good hygiene and get a flu vaccine.

Flu FactsThe seasonal flu is a contagious

respiratory infection caused by different strains of the influenza virus. Symptoms include fever, headache, extreme tiredness, cough, sore throat, runny or stuffy nose and muscle aches. For most people, the flu is just an inconvenience. But for some—including older adults, young children and people with chronic health conditions such as asthma, diabetes and heart disease—it can cause serious complications such as pneumonia and even death.

H1N1 flu symptoms are similar to those of regular flu, including fever, cough, sore throat, headache and body aches, chills and fatigue. In some cases, vomiting and diarrhea may also occur. Rather than display the typical symptoms, young children may experience difficulty breathing and be less active than normal.

According to the Centers for Disease Control and Prevention, people with H1N1 can pass the virus to others up to seven or more days after they get sick. And children, especially younger ones,

might be contagious for even longer.“Pregnant women appear to be

especially susceptible to more severe symptoms from this type of influenza,” says David Kaufman, M.D., a pediatrician with Children’s Physicians. “It will be critically important for pregnant women to get the H1N1 vaccine when it becomes available.”

Healthy HabitsThe best way to handle either type of

flu is to avoid getting sick in the first place. Simple measures can help. Frequent, proper hand washing is one of the easiest ways to prevent illness.

Show children how to properly wash their hands with warm soap and water for at least 20 seconds. If your kids are young and tend to rush, teach them to sing a short song, such as “Row, Row, Row Your Boat” or the “Happy Birthday” song, while washing their hands. It’s a fun and effective way to make sure they wash long enough.

Teach children to cough or sneeze into a tissue, their elbow or their upper arm, and to keep their hands away from their eyes, nose and mouth. Also, discourage them from sharing cups, utensils and bottles with others.

Finally, get vaccinated. Since the seasonal influenza viruses change from year to year, you need an annual vaccine. Although recommended for just

about everyone, the flu vaccine is particularly important for those at risk for complications.

“If your child is at least 2 years old and generally in good health, the FluMist vaccine is a safe and effective alternative to the flu shot,” says Dr. Kaufman. “It is given in the nose, and children do not have to inhale to receive it.”

Know How to Treat IllnessIf your kids become ill and display

typical flu-like symptoms, keep them at home. Make sure they get lots of rest and drink plenty of fluid.

Keeping the Flu at Bay

A flu vaccine is one of the most

effective ways to keep your children

healthy over the flu season. Call your

child’s physician to schedule an

appointment for a flu shot. Need a

physician or specialist for your child?

Call the Children’s Hospital &

Medical Center’s Find-A-Doctor

service at 1-800-833-3100.

Meet Our ExpertDavid Kaufman, M.D.Children’s Physicians pediatrician

ChildrensOmaha.org | 3

To reduce a child’s pain or fever, more parents turn to acetaminophen than to any other drug. According to the Food and Drug Administration (FDA), acetaminophen is generally considered safe and effective when used according to the label directions. But using too much can cause liver damage.

In late June 2009, medical experts advising the FDA suggested that the agency reduce the maximum adult daily dose of acetaminophen, and require just one standard formula for the nonprescription liquid acetaminophen for young children. Right now, the infant drop formula is three times as strong as the children’s liquid formula. This means that giving a child a child-sized dose of the infant formula could result in an overdose.

Another thing to consider is that there are currently about 600 different products on the market containing acetaminophen, including cough and cold medicines. Thus it’s possible to give your child an overdose if you happen to give them two medications at once that both contain acetaminophen.

“Acetaminophen can be a safe medicine that’s useful in treating your child’s fever or pain,” says Michelle

Mogenson, D.O., a pediatrician with Children’s Physicians. “However, be aware of all the medicines your child is taking and don’t hesitate to ask your doctor any questions you may have.”

Using Acetaminophen SafelyHere are some of the FDA’s

recommendations regarding how to safely give acetaminophen to infants, children and teenagers: ■ Check the active ingredients in all the medications your child is taking or may take. Your child should never be taking more than one medicine containing acetaminophen at a time. You might see acetaminophen abbreviated as “APAP” on prescription medicines.■ Read all the information given by your child’s doctor and follow directions. ■ Read the information on the “Drug Facts” label on over-the-counter (OTC) medications or on the prescription label and follow directions. ■ Choose the right formula and the right dose based on your child’s weight and age. On OTC medicines, the “Directions” section of the “Drug Facts” label gives you this information. If it’s not clear what is right for your child, ask your

pharmacist or doctor what to do.■ Use the measuring tool that comes with the medicine. It will give the exact dose. If you don’t have the right measuring tool, ask a pharmacist. Don’t use a spoon that’s meant for cooking or eating.■ Give your child the medicine only as directed. Don’t give more. If the medicine isn’t helping your child feel better, talk to your doctor or pharmacist.

Liver Damage Symptoms of liver damage—yellow

skin and eyes, dark urine, nausea, vomiting and appetite loss—may develop only after irreversible damage occurs. They can be similar to flu symptoms and may go unnoticed for several days. So, if you think your child may have had too much acetaminophen, call 911 or Poison Control at 1-800-222-1222 immediately.

Acetaminophen: What Parents Should Know

Have questions about your child’s

medications? Speak to your child’s

primary care provider. Need a

physician or specialist for your

child? Call the Children’s Hospital

& Medical Center’s Find-A-Doctor

service at 1-800-833-3100.

Meet Our ExpertMichelle Mogenson, D.O.Children’s Physicians pediatrician

One Step at a Time:Getting Your Kids Organized

Does your child struggle to get things done, such as homework or household chores? For most children, being organized is learned behavior. And believe it or not, it is possible to teach your disorganized child organizational skills.

Start by asking your kids how they could benefit from getting more organized. Have a few ideas in mind as suggestions in case your child struggles to identify tasks.

Next, help your child choose just one task that poses a particular problem, and work on getting organized in relation to that one task. Explain that any task can be organized into three steps: getting started, sticking to it and finishing up.

Getting StartedThis step is essentially the same whether

the task is setting the table or finishing a history report. It means deciding what needs to be done and gathering the things you need. To get started setting the table, you have to gather the place mats, dishes, glasses, napkins and silverware.

In the case of a history report, getting started may mean making a list. Your child’s checklist might include these items:■ Break down the assignment into parts, such as research, taking notes and writing.■ Gather necessary tools, such as books and computer printouts.■ Mark the due dates for completing each stage on a calendar.

Teach your child to use the list as a tool for figuring out what needs to be done and in what order.

“Bigger tasks often require many steps to complete,” says Mike Vance, Ph.D., lead psychologist with Children’s Hospital & Medical Center’s Behavioral Health. “Help your child use small bits of time wisely to help complete the project.”

Sticking to ItStaying focused means learning to resist the

temptation to drop what you’re doing and go do something else. Your son’s history report may require him to keep working for a set period each day. Teach him to stay focused by encouraging him to ask himself, “What should I be doing right now?”

Encourage kids to do the hardest work first, when they have the most energy, and to plan something fun after they’ve finished the task they set for the day. Also, let your child know that everyone gets distracted. The best skill to develop is being able to redirect your focus after a brief distraction.

Finishing UpFor the table setter, finishing up may mean

taking a last look to make sure everything is there. Finishing up the history report may require another checklist. For example, your son will want to make sure he included everything his teacher asked for, that his report is neat and accurate, and that it gets into his backpack on the due date.

Learning the important life skill of organization takes time and patience, for both you and your child. Prompt your children by asking questions such as, “What do you need to do next?” to help them come up with the answers themselves. Be positive, but avoid making their chores and homework your project or simply doing tasks for them. Instead, ask how they think they’re doing and encourage them to take pride in their own progress toward independence.


Meet Our ExpertMike Vance, Ph.D.

Lead psychologist atChildren’s Hospital & Medical Center’s Behavioral Health

Children’s Hospital & Medical Center has been named one of health care’s “Most Wired” according to the results of the 2009 Most Wired Survey and Benchmarking Study released in the July issue of Hospitals & Health Networks magazine.

The Most Wired designation recognizes the 100 organizations scoring highest on the survey. Children’s is the only hospital in Omaha and one of only three children’s hospitals in the nation to earn a spot on the Most Wired list.

“Children’s Hospital & Medical Center takes great pride in using electronic medical records in order to help our physicians, nurses, pharmacists and medical staff provide the best care possible,” says Allana Cummings, vice president and chief information officer at Children’s. “For example, implementing computerized provider order entry across our organization has helped to optimize patient safety. This technology is good for both our families and our clinicians.”

Hospitals & Health Networks conducted the 2009 survey in cooperation with McKesson Corp. and the College of Healthcare Information Management Executives (CHIME). The July H&HN cover story detailing results is available at www.hhnmag.com.

If you’re worried about your child’s

emotional development, speak to

your child’s primary care provider,

who can offer you advice or refer

you to a specialist. Need a physician

or behavioral specialist for your

child? Call the Children’s Hospital

& Medical Center Find-A-Doctor

service at 1-800-833-3100

anytime, day or night.

Want to learn more about the unique programs

and services offered through Children’s Hospital

& Medical Center? Visit us online at

ChildrensOmaha.org/Services.

Children’s Named Most Wired Hospital


Preventing and surviving a fire is not a question of luck. It’s a matter of planning ahead.

Preventing FiresChildren as young as age 2 have been

known to start fires with matches, usually out of curiosity. Kids usually play with fire in bedrooms, closets and under beds. Check these areas for burned matches to see if your children are being curious. If they are, explain the dangers of playing with matches and keep them out of little ones’ reach.

Some other fire prevention tips: ■ Never overload circuits or extension cords. Do not place cords and wires under rugs, over nails or in high-traffic areas. Immediately shut off and unplug appliances that sputter, spark or emit an unusual smell. ■ Unplug appliances when not in use. Use safety caps to cover all unused outlets, especially if you have small children at home.■ Portable heaters need their space. Keep anything combustible at least three feet away.

■ Keep fire in the fireplace. Use fire screens and have your chimney cleaned annually.

Smoke Alarms Save LivesA working smoke alarm can double

your chances of survival. Install one on every level of your home, including the basement. Alarms should be installed on the ceiling, or six to eight inches below the ceiling on the wall. Make sure to test them monthly, clean them and replace the batteries at least once a year. Smoke detectors themselves should be replaced after 10 years, or as recommended by the manufacturer.

Plan Your Escape as a FamilyAs a family, practice your escape plan

regularly from every room in the house. Have a primary and secondary escape from every room. The first way out should be a door. Stay low to the floor, even when practicing. In an actual fire, use the back of your hand to feel the top of a closed door, the doorknob and the crack between the door and the frame. If the door feels hot, use your secondary escape route.

Even if the door feels cool, open it carefully. If a fire occurs, do not waste time saving property—every second counts. Pick a safe and easy-to-remember place where everyone can meet outside the house. And once you’re out, stay out.

Don’t Get Burned on Fire Safety


FREE Injury Prevention CalendarKeeping kids healthy and safe is one

of a parent’s most important, and most

difficult, tasks. Help keep safety

top-of-mind every day with our FREE

2010 Kohl’s Keeps Kids Safe Calendar,

brought to you by Children’s Hospital

& Medical Center and Kohl’s

department stores. Each month

contains safety awareness issues

along with tips you can follow to help

prevent injury at home. Supplies are

limited, and the offer is only available

for residents of Nebraska and Iowa.

Visit ChildrensOmaha.org/ChildrensCalendar today.

Learn more about potty training and other parenting challenges through Parenting U, FREE classes given by professionals known for their knowledge of children. Along with a new topic each week, we’ll provide food, child care and prizes.

Most sessions will be held in the Glow Auditorium at Children’s Hospital & Medical Center from 6 to 7 p.m. Space is limited, so call 800-833-3100 or log on to ChildrensOmaha.org today to register for one or more of our upcoming educational sessions.

Tuesday, Oct. 13Speech Development and DelaysSue Flynn, M.A., Children’s Rehabilitative Services

Tuesday, Oct. 20Baby’s First YearsMonique Macklem, M.D., Children’s Physicians

Tuesday, Oct. 27Why Is My Teen So Tired?Amy Lacroix, M.D., UNMC Physicians, and Brett Kuhn, Ph.D., Children’s Respiratory Medicine

Tuesday, Nov. 3Potty TrainingBernard Douglas, Methodist Physicians Clinic

Monday, Nov. 9Children and BullyingMike Vance, Ph.D., Children’s Behavioral Health

Tuesday, Nov. 17Preparing for Your NewbornRachel McCann, Children’s Physicians


One of the milestones for toddlers is toilet training. There is no right age to begin—only when your child shows signs that he or she is ready. If you try to toilet train before your child is ready, it can be a battle for both you and your child.

When Is Your Child Ready?Signs that your child may be ready

for toilet training include asking to have the diaper changed, following you into the bathroom to see how the toilet is used and having dry diapers for at least two hours during the day or being dry after naps or overnight.

Getting StartedThe following tips may help parents

get started with toilet training:

■ Children should be allowed to play with the potty: sit on it with clothes on

and later with diapers off to help get used to it.

■ Your child should not sit on the potty for more than five minutes.

■ Avoid using words like “dirty,” “naughty,” or “stinky” to describe bowel movements and urine.

If your child gets off the potty before urinating or passing a bowel movement, be calm; do not scold. Try again later.

Remember that every child is different and learns toilet training at his or her own pace. If things are going poorly with toilet training, it is better to put diapers back on for a few weeks and try again later. Even when children are toilet trained, they may have some normal accidents (when excited or playing a lot), or setbacks due to illness or emotional situations. If accidents or setbacks happen, be patient.

Getting Started on Toilet Training Your Toddler

We Understand Children

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PAIDChildren’s Hospital & Medical Center

justkids is published by Children’s Hospital & Medical Center to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician. © 2009. All rights reserved Printed in U.S.A.

Gary A. Perkins, President and CEOMartin W. Beerman, Vice President, Marketing and Community RelationsDavid G.J. Kaufman, MD, Medical AdvisorDannee Hartley, Marketing Coordinator

Printed on Recyclable Paper 881M

Children’s Hospital & Medical Center has received accreditation or recognition from the following organizations for its delivery of extraordinary health care to children.

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8200 Dodge StreetOmaha, NE 68114402-955-5400

Every baby develops at his or her own pace. As a parent, you know your child best, but you must monitor and be aware of variations in development.

In general, babies begin by developing skills on their tummy. It is important to begin working on tummy skills early, as they are essential to building future developmental skills, including sitting, walking, playing with toys, eating and talking.

You can begin tummy time early by holding your baby at your shoulder or chest, then progress to lying on the floor. When doing tummy time, choose a time when your baby is calm and alert. It is best to work on tummy skills on a firm surface, such as a blanket on the floor, versus on a bed or pillow that can be more difficult.

By around 3 months of age, babies on their tummies should be able to easily lift their head. On their backs, they should be able to reach up and bring their hands to the middle of their bodies. They also should easily move their

arms, kick their legs and open their hands to grasp small objects.

By 6 months of age, babies should be able to hold their head up on their own and begin to sit on their own momentarily. Around 9 months, babies should be sitting on their own with a straight back. As they learn to crawl, they should use both sides of their bodies equally. Babies placed in a standing position at this age should put weight equally through both legs.

If you feel that your baby has developed a preference to use one hand more than the other, is stiff and has difficulty moving arms or legs, tends to arch backward or has difficulty holding the head (appears floppy), talk to your child’s physician. These may be signs that your baby’s delay warrants review by a medical professional.

If your child does have a more serious issue, there are many resources available to help. Your child’s physician can refer you to a physical, occupational or speech therapist to address your concerns.

How to Monitor Your Baby’s Development

Have concerns about your child’s

development? Talk to your child’s

physician, who may refer you to

Children’s Hospital & Medical

Center’s Rehabilitative Services

Department. Rehab specialists

practice at the 84th and Dodge

location, as well as at our West

Village Pointe facility located at

175th and Burke Streets. Need a

physician or pediatric specialist for

your child? Call our Find-A-Doctor

service at 1-800-833-3100.

Postmaster: Please deliver between October 12 and 16.

just kids | fall 2009

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