young & healthy winter 2013
DESCRIPTION
Bringing you healthier, happier holidays from Cincinnati Children's.TRANSCRIPT
button batteriesTHE DANGERS OF TINY MAGNETS AND
Those tiny magnets that hold reminders to your fridge can cause big harm to a child who swallows them, says Wendy Pomerantz, MD, an emergency physician with Cincinnati Children’s. The magnets can stick to each other across the bowel wall and cause an obstruction or perforation that requires emergency surgery.
Likewise, the small toy magnets called “buckyballs” should be kept far from little ones who like to put things in their mouths.
And many parents aren’t aware that the small button batteries that play music when you open a holiday card can cause serious harm to a child if swallowed. So can the batteries that power grandpa’s hearing aid. Or your wristwatch. Or your TV’s remote control.
The injuries occur when kids swallow the batteries – many are no bigger than a fingernail, some are as large as a coin. Much of the time, they pass through the body without problems. But when they don’t, you need to take prompt action.
The batteries can emit an electrical current that burns. “If the battery gets stuck in the esophagus or stomach, it can take as little as two
hours before it starts to erode and cause damage,” says Pomerantz. If you think your child has swallowed a battery, don’t take chances. Get to the
emergency room right away. n
All button batteries are small
enough for a young child to
swallow. The batteries emit
electrical current that can burn
the esophagus and stomach if
they get stuck. If you think your
child has swallowed a battery,
play it safe and go to the
emergency room.
WENDY POMERANTZ, MD, MS
Professor of Clinical Pediatrics, Division of Emergency Medicine at
Cincinnati Children's Hospital Medical Center
your homeU N - B U T T O N
n Don’t leave musical greeting cards or storybooks around for little ones to tear open or chew on.
n Throw away any toys that are powered by button batteries unless they have covers that screw in place to keep the battery secure.
n Hunt through cabinets and drawers and move any button-battery items out of the reach of little hands.
n Remind grandparents and older family members not to leave hearing aids lying around.
child safetyT I P S O N H O M E
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p e d i a t r i c i a nASK THE JOHN BRUNS, MD , is a community pediatrician
affiliated with Cincinnati Children’s. He practices at
Queen City Physicians in Groesbeck/Ross-Hamilton
and is president of the Cincinnati Pediatric Society.
2
THE FAMILY RESOURCE CENTER
The center helps families,
community providers
and agencies find health
information, community
resources and support.
Call 513-636-7606 for
assistance.
SPECIAL NEEDS RESOURCE DIRECTORY Use this directory to find
information, resources and
advocacy strategies at
www.cincinnatichildrens.org/
special-needs.
JOIN SPECIAL CONNECTIONSOur new online community
connects with others
parenting a child with
special healthcare needs:
www.cincinnatichildrens.
inspire.com.
advocateFOR YOUR CHILD’S HEALTH Which should I give my child for fever – acetominophen or ibuprofen?
The charts below are professional
dosage schedules for administering
acetaminophen and ibuprofen.
It is extremely important that you use
either the dropper, syringe or medicine
cup that is provided with your
medicine to dispense to your child.
More information can be found at
www.cincinnatichildrens.org/
health/f/fever
doseGIVING THE RIGHT
Administer every 4-6 hours, do not exceed more than 5 doses in a 24 hour time period.
Children’s Tylenol (acetaminophen) with
New Concentration 2011
Infant's Suspension & Original Drops (Old
Concentration)80mg/0.8ml
Infant's Oral Suspension
(New Concentration)
160mg/5ml
Children’s Suspension
Liquid and Elixir
160mg/5ml
Children’s Chewable
Tablets
80mg each
Junior Strength Chewable Tablets/ Caplets
160mg each
WEIGHT AGE
dropper syringe teaspoon tablet tablet/caplet
6-11 lbs 0-3 mos 0.4 ml 1.25 ml
12-17 lbs 4-11 mos 0.8 ml 2.5 ml 1/2 tsp
18-23 lbs 12-23 mos 1.2 ml 3.75 ml 3/4 tsp
24-35 lbs 2-3 yrs 1.6 ml 5 ml 1 tsp 2
36-47 lbs 4-5 yrs 1 1/2 tsp 3
48-59 lbs 6-8 yrs 2 tsp 4 2
60-71 lbs 9-10 yrs 2 1/2 tsp 5 2 1/2
72-95 lbs 11 yrs 3 tsp 6 3
96 lbs & over 12 yrs 4
ABOUT THIS ISSUE WINTER 2013 | VOL26 ISSUE4
YOUNG AND HEALTHY is a quarterly publication from Cincinnati Children's Hospital Medical Center. For more health news and patient stories, subscribe to our monthly eNewsletter online at www.cincinnatichildrens.org/subscribe
© 2013 Cincinnati Children's Hospital Medical Center
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As we approach cold and flu season, I commonly get ques-tions about the use of acetaminophen and ibuprofen to manage fever. As parents, we don't like to see our children
sick and uncomfortable. And though many people worry about fe-vers, they are a natural part of our body’s defense. While monitoring the temperature is important, as or more important is the behavior of the sick child. A child with a low fever who is breathing fast, irri-table and acting sick concerns me more than the active, playful child who has a fever of 103.
Acetominophen and ibuprofen both work to make children more comfortable, and are generally viewed as safe when you follow dos-ing guidelines. Infants under 2 months, however, require special consideration since they may not give any indication of the cause of their fever. Call your doctor if your young infant is running a fever over 100.5 or is acting sick.
As with all medications, be careful in using acetaminophen and ibu-profen. Each has a limited dose recommendation for a 24-hour period. I recommend keeping a log with the name, time and dose of medication given to prevent duplication and overdosing. If you give your child ad-ditional meds, read labels carefully, since multi-symptom cold medicines may already have acetaminophen in them. Too much acetaminophen can damage the liver. Ibuprofen may alter the blood flow to the kidneys and should not be used in dehydrated children or children with kidney disease. Due to its association with Reye’s Syndrome, we don’t recom-mend using aspirin to treat fever symptoms. n
PRODUCED BY
The Department of Marketing & CommunicationsCincinnati Children's Hospital Medical Center3333 Burnet Ave., MLC 9012, Cincinnati, OH 45229-3026Phone: 513-636-4420
Advisers: Chris Peltier, MD, and Zeina Samaan, MDEditorial Consultant: John Bruns, MDEditorial Staff: Mary Silva/managing editorPhotography: Tine Hofmann, tm photographyDesign: Christina Ullman & Alix Nothrup, Ullman Design
RESEARCHSTUDYJ O I N A
Researchers at Cincinnati Children’s conduct hundreds of studies each year to figure out why people get sick and what treatments might help them. Discoveries researchers make in the lab can lead to even better treatments and ways to prevent diseases from happening in the first place. Did you know you could be part of the process of helping our scientists solve medical mysteries? You can participate by joining a research study. Here’s what we’re recruiting volunteers for now.
2- TO 12-YEAR-OLDS WITH PSORIASIS NEEDED FOR A RESEARCH STUDY
What: We want to learn how the study drug, an ointment applied two times a day, is handled by the body in children with psoriasis.Who: Children, 2 to 12 years old, with plaque type psoriasis, may be eligible for participation.Pay: Participants may receive up to $600 for completing all of the study visits.Contact: Laurie Vanderah at [email protected] • 513-803-0003
If you have a question for the pediatrician, email [email protected] QUESTIONS?
HAVE YOU HAD OR ARE YOU AT RISK TO HAVE A PREMATURE BABY?
FETAL (Family and Environment in the Timing of Abnormal Labor) StudyWhat: This is a research study to determine if there is a pattern in some families of mothers giving birth prematurely, and if so, to explore a possible genetic link.Who: Women who have given birth to a premature baby (more than one month before their due date) or are at risk for giving birth prematurely may be eligible to participate.Pay: Participants will receive between $50 and $100 for their time.Contact: For more information, contact Dr. Louis Muglia at [email protected] • 513-803-7902.To take a survey to see if you are eligible for this study, go to www.cincinnatichildrens.org/fetalstudy.
facebook.com/cincinnatichildrensfans youtube.com/cincinnatichildrens cincinnatichildrensblog.org@cincychildrens
Children’s Motrin/Advil (Ibuprofen Suspension 100 mg/5ml)
Administer every 6-8 hours, do not exceed more than 4 doses in a 24 hour time period.
AGE WEIGHT DOSE
lbs kg 10 mg/kg
6-11 mos 13-17 6-7.9 1/2 tsp (50 mg)
12-23 mos 18-23 8-10.9 1 tsp (100 mg)
2-3 yrs 24-35 11-15.9 1 1/2 tsp (150 mg)
4-5 yrs 36-47 16-21.9 2 tsp (200 mg)
6-8 yrs 48-59 22-26.9 2 1/2 tsp (250 mg)
9-10 yrs 60-71 27-31.9 3 tsp (300 mg)
11-12 yrs 72-95 32-43.9 4 tsp (400 mg)
Adult 96-154 44-70 4 tsp (400 mg)
n u t r i t i o nFOCUS ON protect your child's health
foo d al l e rg y
If you are unsure about whether your child is allergic but he has shown some signs of a food allergy, pediatrician Charlie Cavallo, MD,
says to talk with your pediatrician and have your child tested.
“It’s important to take food allergies seriously,” Cavallo says. “Even if your child has only had a mild reaction to a certain food one time, the next reaction could be severe. Reactions can be unpredictable. The safest thing is to avoid the food altogether until you can get your child tested.”
Testing by an allergist can determine specifically what a child is allergic to, especially if he’s had a reaction after eating several foods and you’re not sure which one was the cause.
Do not try to test it yourself by giving a child small amounts of the suspected food, Cavallo says, and don’t assume that cooking or baking the food will make a difference. Skin or blood testing by an allergist is the only true way to tell. n
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When planning for the holidays, whether for parties
outside your home, school or daycare activities, or even
going to a restaurant, here are some tips from pediatrician
Charlie Cavallo, MD:
T I P S F R O M T H E P E D I AT R I C I A N
CHARLIE CAVALLO, MD. General Pediatrician with Pediatric
Associates of Northern Kentucky
D E A L I N G WI T H foo d al l e rg i e sD U R I N G T H E H O L I D AY S
Gatherings at this time of year almost always involve food. For parents of kids with food allergies, that can mean added worry about what they’re exposed to.
n Know what your child is allergic to.
n Always carry an EpiPen®.
n Inform your child’s school or daycare
teachers about his allergy.
n If you’re visiting, let your host know in advance.
n At a restaurant, tell the waiter.
n From an early age, make sure your child
knows what she is allergic to and why not to
eat that food.
For more information go to AAAAI.org American
Academy of Allergy, Asthma and Immunology
Foodallergy.org.
online
Go to Cincinnati Children’s blog to read about
one mom’s experience with food allergies during
the holidays.
calmKEEPING HOLIDAYS
Regardless of what traditions your family celebrates, for a child with an autism spec-trum disorder, the break from routine that holidays bring is especially challenging. Here are just a few ideas to help make holidays more enjoyable for your child, and your family.
n PREPARING IS KEYA little preparation goes a long way toward keep-ing things calm, says Judy Reinhold, RN, MSN, CPNP. Reinhold works with families at the Kelly O’Leary Center for Autism Spectrum Disorders at Cincinnati Children’s.
“During the holidays, routines go out the window,” Reinhold says. “Parents know best what their child will enjoy and what will be a struggle, so they should plan accordingly.”
Reinhold says one good way to prepare a child for holiday gatherings is with “social stories” – creating a story with pictures to prepare the child for what to expect in various situations.
n DECORATIONSLights and decorations, music – even new foods and smells – can be overwhelming to a child with autism. Limiting changes in routine and introduc-ing new things gradually, whenever possible, can help your child get comfortable with them.
n GIVING AND RECEIVING GIFTSPractice giving gifts and taking turns opening gifts. Role play with your child to prepare him for receiving a gift he does not want. Keep familiar toys nearby.
n FEELING OVERWHELMEDIf you are having visitors, designate a quiet, safe place in the house where your child can go when feeling overwhelmed. If you are away from home, ask your host to identify a spot where your child can go when things get hectic.
n TIPS FOR TRAVELBring your child’s favorite foods, books or toys along. This is especially helpful if there are delays. If you are flying for the first time, you might bring your child to the airport in advance to help him see what it is like. Or use stories and pictures to re-hearse what will happen when boarding and flying.
n ENGAGE FAMILY MEMBERSDon’t shield your child from extended family. With some help from you, family members can understand the challenges you face, and can even be a source of support.
n ABOVE ALL, TRUST YOURSELFThe most important thing, says Reinhold, is to trust what you know about your child. n
children with special needsPA R E N T I N G A D V I C E F O R
JUDY REINHOLD, RN, MSN, CPNP
Kelly O' Leary Center at
Cincinnati Children’s
Go to http://support.autism-society.org
to download a PDF of holiday guidelines.
online
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psychologyC H I L D L I F E A N D
Most people love celebrating holidays – time to be with family and friends, enjoy special foods and observe family traditions. But holidays can also bring the pressure to do more and spend more than we are willing or able.
If holidays leave you feeling stressed out, there are ways to set limits and make the time more mean-ing ful, says Lynn Sanner, a child life specialist and educator in the Department of Child Life at Cincinnati Children’s.
LYNN SANNER
Child Life Specialist and Educator,
Department of Child Life at Cincinnati Children’s
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Decide What’s Important to You“Most of us are already leading very full lives just taking care of our work and our families,” says Sanner. “The holidays can add another layer of responsibility to what we already do.”
Talk with your family about what is most meaningful and beneficial about your holiday observance, she suggests. “Choose two or three things about the holiday that your family cares about most, and limit your activities to those things.”
Take Time for Your HealthSanner says it’s especially important to take time for healthy activity during the holiday season. “Eating well, exercising, getting enough sleep – all of those things are threatened if we overdo it during the holidays,” Sanner says.
And make sure kids stick to predictable routines and regular schedules, especially while school is in session. “School holiday concerts and parties can be great fun, but they can also be disruptive to homework and home routines.”
Rethink Your GivingEveryone enjoys giving gifts to those they care about. Gifts can take many forms, says Sanner. “The most valuable gifts come from creativity – things
we’ve made or words we give to people,” she says. A handmade note to a teacher from your child about something he really enjoyed doing in school, or doing something thoughtful for a neighbor or friend, can be precious gifts.
VolunteeringGiving back to the community is a great idea. “But agencies get a lot of offers of help at holiday time, and what they need is help in August,” she says. “For a young child, it is probably most effective to provide service specifically at holiday time. Older children may be happy to consider what they can do later in the year.”
Give Kids an 'Out'To help children set limits during the holidays, a little creative license may be in order, says Sanner. You may help your child decline invitations to become too busy, perhaps by using a response such as “My mom says I’m not allowed to.” “This phrase provides a really good shelter for kids,” Sanner says.
It Doesn't Last ForeverMost important, she says, “Know that whatever you do for your family’s holiday is enough. Enjoy the parts of your holiday that you care about the most and let go of the things that don’t really matter.” n
Putting more meaning into your
HOLIDAYS
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psychology Seeing holidays through the eyes of a child is one of life’s great joys. Help keep your holidays joyful by taking a few precautions.
“It’s difficult to imagine that some of the fun and festive things we do could pose risks to young children, but they can,” says Melissa Klein, MD, a pediatrician in the Division of General and Community Pediatrics at Cincinnati Children’s.
Klein offers a few tips to help keep children safe and holidays happy.
hazardsT O Y
Pay attention to age-appropriate
labels on toys, and keep a special
lookout for tiny parts from older sib-
lings’ toys that babies might swallow.
See the article about button batteries
and magnets on page 1.
safetyT R E E
If your holiday traditions include a
tree, be sure to secure it from tip-
ping over. If you have an active tod-
dler, you might want to think about
blocking the tree from little hands
with a safety gate. Don’t place
ornaments or lights on the bottom
portion of the tree, where toddlers
(and pets) can reach them.
decorationsH O L I D A Y
Poinsettias are not poisonous, as is commonly
believed, but mistletoe berries are. It’s a good
idea to keep all flowers and greenery out of reach
of children. Wrapping paper, ribbons, and bows
can be choking and suffocation hazards. And
watch out for foam peanuts and other plastic
items used in packaging.
hotlinePOISON CONTROL
If you’d rather be safe than sorry, keep the poison
control phone number handy. The Drug and Poison
Information Center at Cincinnati Children’s has a
24-hour hotline, 1-800-222-1222.
safetyK I T C H E N
Busy, crowded kitchens are part
of most holiday households.
“Burns and scalds are a major
holiday hazard,” says Klein, so be
extra cautious when cooking and
carrying hot foods or liquids from
one room to another – especially if
there are little ones in the house.
candlesL I G H T I N G
If your holiday traditions involve light-
ing candles, keep the lit candles out
of reach of children. Avoid placing
lit candles on tablecloths that can be
pulled down. In fact, pass on table-
cloths altogether – crawling toddlers
can tug at them, sending dishes, hot
food, and candles flying.
MELISSA KLEIN, MD. General Pediatrician, Division of General
and Community Pediatrics at Cincinnati
Children’s Hospital Medical Center
T I P S F O R A S A F Eholiday
S A F E AT H O M ETips on keeping your child
safe during the holidays.
insideTHIS ISSUE A L L I S C A L M
Helping children with autism
enjoy the holidays.
3333 Burnet Avenue, MLC 9012Cincinnati, Ohio 45229-3026
Our newly-opened Seacrest Studio will make it possible for Cincinnati Children’s patients to enjoy kid-friendly music, game shows, celebrity interviews and more, right from their hospital rooms. The closed-circuit television and radio station WKID 33 operates from the multimedia broadcast facility on our Burnet campus, developed in partnership with the Ryan Seacrest Foundation.
W I N T E R 2 0 1 3
VOL26 ISSUE4
How to make the most of seasonal celebrations with your child.making holidaysmeaningful
A guide to your child’s good health
healthyyoungand
CINCINNATI CHILDREN’S LAUNCHES WKID 33