Fall 2010

Children’s Hospital & Medical Center

justkids

Tips to Tame Obesity’s threats

• Your Baby’s Ailing—Now What?• Banish the Cabin Fever Blues

You know obesity is bad for kids. But do you know just how bad?

With nearly one in three children and teens overweight or obese, health problems that were once “adults only” now show up in children. Kids who weigh too much also have a heightened risk for weight-related problems as adults.

Here are some key threats:

heart DiseaseResearchers estimate three out of five

overweight 5- to 17-year-olds have at least one risk factor for heart and circulatory diseases. Those risk factors include:■ Abnormal cholesterol. Among 12- to 19-year-olds, surveys show 22 percent

of the overweight and 43 percent of the obese have high levels of “bad” cholesterol or triglycerides (blood fats) or low levels of “good” cholesterol.■ High blood pressure. In a study of more than 5,000 Texas children ages 10 to 19, 5 percent had high blood pressure. The strongest risk factor was obesity.■ Metabolic syndrome. This syndrome includes insulin resistance, high cholesterol and high blood pressure. Up to half of severely obese adolescents have metabolic syndrome, which worsens the odds for heart disease, diabetes and stroke.

bone DamageHealthy bones and joints are the

building blocks of a healthy body. Childhood obesity can have a devastating impact on a child’s musculoskeletal system. A child’s extra weight adds stress to growing bones. This can cause pain and interfere with normal growth and development.

Physicians are seeing a marked increase in fractures in children, as well as obesity-related musculoskeletal disorders such as Blounts disease at a much younger age, as a direct result of the increase in childhood obesity. Blounts disease is a growth disorder of the shin bone in which the lower legs

Obesity’s Threats & Tips to Tame Them

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

Act now to get rid of the extra pounds that can cause serious problems for kids

the brOwn-bag LunchPacking a punch against obesity

Pizza, cookies, soda, chips—these may be on your child’s lunchtime list, but they’re also culprits in a growing health concern: childhood obesity. In the last 20 years, the number of overweight children has increased more than 50 percent. In fact, one out of five children in the U.S. today is overweight. Obesity puts your child at risk for serious health conditions, such as type 2 diabetes, high cholesterol and high blood pressure.

Schools are working hard to provide healthier lunchtime options. But by packing a lunch for your child, you can make a difference in his or her health now—and into adulthood.

When planning a healthy lunch for your children, keep these tips in mind:■ Add eye-appeal. Children can be attracted to how foods are packaged. Choose bright, colorful foods like strawberries. Vary the shape and size of usual lunch fare. For instance, use a cookie-cutter on a sandwich or pack mini-bagels. ■ Go with grain. Select healthy whole-grain bread, tortillas, pitas or crackers.■ Lower the fat. Try low-fat versions of lunchmeat. Tuna packed in water instead of oil is another good choice. Use mustard instead of mayonnaise or opt for low-fat or no-fat mayo. ■ Vary the veggies. Add thinly sliced vegetables to sandwiches. Pack a little bag of carrots or pepper strips. Build a veggie kebab by putting vegetable slices on a skewer or toothpick.■ Favor fruit. Pack a banana or slice it onto a peanut butter sandwich. Send kids off with applesauce or a snack bag full of sliced kiwi, raisins, or dried apricots.■ Don’t forget dessert. Choose a healthy treat such as vanilla wafers, graham crackers or a low-fat granola bar.

turns inward, resembling a bowleg. “Families seem to have a better

understanding that obesity in children can contribute to heart problems or lead to diabetes, but we fear they’re overlooking the potential impact on their child’s joints, muscles and bones,” says Paul Esposito, M.D., orthopaedic surgeon at Children’s Hospital & Medical Center. “Children are continually growing and their skeletal systems are developing. The issues that can result cause significant pain and a risk of disability. In severe cases, surgery may be needed.”

Other DiseasesOther problems linked to children’s

increased weight include:■ Diabetes: Type 2 diabetes, once rare among children, has risen dramatically.■ Asthma: This common lung disease causes breathing difficulty.■ Liver problems: Extra weight causes fatty degeneration of the liver, or hepatic steatosis.■ Sleep apnea: Breathing stops repeatedly during sleep for at least 10 seconds.

social ProblemsOverweight children often have fewer

friends and face teasing about their weight. Social discrimination and isolation can lead to stress and low self-esteem that linger into adulthood.

Their progress in school and on the job may suffer—and they may be prone to anxiety and depression.

how you can helpAsk your pediatrician if your child’s

weight is in a healthy range. “Have your pediatrician review your child’s BMI with you,” says Liz Walenz, M.D., a pediatrician with Children’s Physicians. “The BMI is a body mass index that is calculated using your child’s weight and

height. The BMI can help to identify if your child is overweight or obese.”

If your child’s BMI does put him or her in a high-risk category, these tips can help:

■ Offer children reasonable portions of well-balanced meals low in fat and sugar.■ Set specific snack times to discourage constant munching. Stock healthy snacks such as frozen yogurt, low-fat string cheese, nuts or fruit.■ Limit the amount of sugar-filled juices and sodas you give your child. Juice and soda offer only empty calories that

children do not need. Water is a great way to keep kids hydrated throughout the day.■ Add exercise, such as hiking or biking, to weekends and vacations. Help your child find physical activities that he or she enjoys. Your child may enjoy a hip-hop dance class or getting involved with a sports team at the YMCA.■ Limit TV watching to an hour or two a day. Screen time includes television, video games, computer or hand-held game systems. On average, children who watch at least four hours a day tend to be heavier than children who watch less than two hours.■ Practice what you preach. Children imitate their parents. If you eat well and stay physically active, your children are more likely to do the same.

Overweight children often have fewer friends and face

teasing about their weight. Social

discrimination and isolation can lead to stress and low self-

esteem that linger into adulthood.

ChildrensOmaha.org | 3

Is Your Child Overweight?Are you concerned that your child’s

weight could be hurting his or her

health? If so, talk with your primary

care provider. Need a physician for

your child? Call Children’s Find-A-

Doctor service at 1-800-833-3100.

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

As a parent, there’s nothing worse than seeing your child sick or in pain. When your child has a serious medical emergency, you want the best care available. That’s why bringing your child to Children’s Hospital & Medical Center, which has the state’s only emergency department (ED) designed especially for kids, is a good decision.

specially trained staffOur doctors and nurses are specially

trained in pediatric emergency medicine. They have additional expertise in easing the pain and anxiety that can come with emergencies. They are skilled at:■ Explaining what is happening to your child during treatment■ Understanding that children might react differently than adults■ Providing instructions on how to care

for your child when you get home■ Assessing the unique treatment needs of children and teenagers. Some treatments for adults aren’t appropriate for kids. Plus, medical research done with adults may not apply to teens.

Kid-sized and Kid-FriendlyCrowded adult EDs can lead to long

waits and a frightening atmosphere for young patients. But the Children’s ED staff is used to the conditions and ailments typical of children and teenagers. Children’s ED is specially outfitted with kid-sized equipment, beds and supplies, including:■ Lifesaving defibrillators customized for children■ Child-sized blood pressure cuffs■ Systems that quickly identify equipment and medicines appropriate for a child’s age and weight.

urgent care centersWhen your child or teen is seriously

ill or injured, Children’s ED is the best bet for prompt, thorough emergency care. But what if your child’s injury is less severe? Children’s two Urgent Care centers are staffed by the board-certified pediatricians and pediatric nurses from Children’s Hospital & Medical Center.

Each Urgent Care center is open seven days a week – on weekdays from 6 to 10 p.m., and on weekends and major holidays from noon to 10 p.m. While no appointment is necessary, you can call ahead to receive wait times at either location.

Benefits of using a Children’s Urgent Care center include:■ Staff experienced in all varieties of pediatric sports and other injuries■ Digital X-ray and lab services on site■ Cuts and lacerations can be treated with stitches or sealed with Dermabond®.

The Best Emergency Care for Your Child

When your child is sick or hurt, it can be difficult to determine whether an Urgent Care or Emergency Department (ED) is the best choice.

when urgent care is bestUrgent Care centers treat illnesses

and injuries that require medical attention, but are not life-threatening. They should be used when your primary care physician’s office is closed. Some common conditions that can be treated at Urgent Care centers include:■ Ear infections■ Sore throats■ Minor burns■ Minor asthma■ Sprains or minor pains■ Small lacerations

■ Fractures or broken bones that are not crooked and do not cause severe pain.

when the eD is bestIf you are ever unsure about

whether your child needs emergency care, treat it as an emergency. In general, take your child to an Emergency Department any time you think the problem needs immediate attention, including for the following:■ Shortness of breath or trouble breathing■ Blue or purple lips, skin or fingernails■ Chest or stomach pain or pressure■ Seizures■ Animal, snake or human bites■ Head, spinal cord or eye injuries■ Infants under 2 months of age with a fever

■ Signs of allergic reaction such as hives; swelling of the face, lips, eyes or tongue; fainting or trouble breathing■ Uncontrolled pain.

we can helpChildren’s Hospital & Medical

Center has the only dedicated pediatric Emergency Department in the region. It provides services around the clock. The Urgent Care centers are located just north of 144th and West Center Road at 14421 Dupont Court (402-955-7200), and southwest of West Village Pointe shopping center off 175th and Burke at 110 N. 175th St. (402-955-7300). Hours are Monday through Friday from 6 to 10 p.m., and weekends and holidays from noon to 10 p.m.

urgent care vs. the emergency Department

ChildrensOmaha.org | 5

Parents are well-aware of the importance of using car seats for infants and toddlers, but some are not as strict when it comes to using booster seats for school-aged children. Experts agree that children should use a booster seat until the seat belt fits the child correctly. This usually happens when the child reaches 4 feet 9 inches in height, which is usually around age 8 or 10.

Why do older children need booster seats? Booster seats get their name because they boost the child up so the vehicle’s seat belt fits correctly. A properly-fitted lap belt should lie across a child’s hip area and not the softer stomach area. The shoulder belt should hit the middle of the child’s collarbone and not cut into the neck. Children will often place an improperly fitting shoulder belt behind their back. Plus, in event of an accident, an improperly fitting seat belt can cause internal damage to a child’s abdomen or neck.

types of booster seatsThere are two types of booster seats:

high back and backless. You are required to use a high back booster if the back seat of your vehicle doesn’t have built-in head support or has bench seating that is flat across the top. Backless boosters can only be used in cars that have built-in head support.

Other important reminders■ Always place booster seats in the back seat of a vehicle. ■ After purchase, mail in the booster seat registration card or fill out the form online to be notified of any recalls or manufacturer’s defects.■ Always read the manuals, both for the seat and for your vehicle, to ensure proper installation. ■ Look at the expiration date on your booster seat. Don’t use the seat after this expiration date because the plastic used to make the seat can become brittle and break easily.

Always CommittedChildren’s Hospital & Medical Center is committed to the health and well-

being of all children. The Kohl’s Keeps Kids Safe program, a partnership

between Children’s Hospital & Medical Center and Kohl’s department stores,

is dedicated to reducing the number of accidental injuries in children. Since

2000, Kohl’s has donated more than $1 million in support of child injury

prevention programs. For more information on safety programs sponsored by

Children’s Hospital & Medical Center, visit ChildrensOmaha.org. Simply click

on Health and Safety, then on SafeKids.

School-Aged Children Still Need Booster Seats

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

a legacy of CaringThe expertise and compassion of the

physicians, specialists, nurses and other medical professionals of the Newborn Intensive Care Unit (NICU) at Children’s is remembered by parents and families long after they leave the hospital. Sometimes, for generations.

When Cathy Dickerson gave birth to her daughter Jayne in 1976, her joy was

quickly replaced by fear. The baby’s inability to swallow led to the discovery that Jayne’s trachea and esophagus were connected, a condition known as a tracheoesophageal fistula, or TEF. She needed special care—and surgery—to correct it.

With Cathy hospitalized, Jayne was transferred to the Newborn Intensive

Care Unit at Children’s. Worried that she may not survive, Cathy and her husband asked that Jayne be baptized in the hospital. The nurse caring for Jayne, Lucy O’Hanlon, RN, served as a witness.

Jayne made it through surgery and grew up to fall in love and be married. During her first pregnancy, she

Children’s NICU Trusted for Compassion and Expertise

banish the cabin Fever blues

When it’s cold or rainy and your kids are stuck inside, what do you do? It’s easy to run out of ways to keep them occupied. You can help squelch cabin fever (and the whining that comes with it) with these ideas.

surf’s upPoint your children to educational and

fun resources on the Internet. Visit www.kids.gov, a children’s portal managed by the U.S. government, and click on “Fun Stuff.” It contains dozens of links to reputable websites designed just for children. For example, follow the clues and help solve a make-believe mystery with the Smithsonian National Portrait Gallery. Or build your own rocket with the National Aeronautics and Space Administration (NASA). Just make sure you limit your child’s screen time to an hour a day.

get MovingJust because your children are stuck

inside doesn’t mean they have to be couch potatoes. Suggest these ideas to get them moving:■ Choreograph a dance to your favorite song.■ If there’s enough room, get out the jump rope and count how many times you can jump without missing.■ Bat a balloon back and forth and try not to let it hit the ground.

break OutIf the weather isn’t too nasty, why not go

outside with your kids for a while? Bundle up and embark on a nature hike to look for animal prints. If it’s snowing, warm up by starting a game of tag, building an igloo, making snow angels or going sledding.

ChildrensOmaha.org | 7

developed severe preeclampsia. Daughter, Cate, was delivered by cesarean section in October 2008 – three months before her due date. Weighing just 1 pound, 11 ounces, Cate was immediately placed in Children’s NICU.

As when she was born, Jayne asked that her daughter be baptized. Cate’s nurse stood at her side, serving as a witness.

Again, it was Lucy O’Hanlon.“When my husband Duke went to

introduce Lucy to my mom, he didn’t have to,” Jayne says, tears welling in her eyes as she recalls the moment. “They recognized each other.”

A nurse for nearly 39 years, O’Hanlon has spent her entire career at Children’s, all but two years serving the babies of the 46-bed NICU.

“What brings me to work every day is the fact that we live the Children’s mission here in the NICU, ‘so that all children may have a better chance to live.’ I love that. I love that any child who needs care comes here and gets the best available.”

O’Hanlon says her fellow caregivers share her strong feelings for the NICU and for Children’s.

“This is a sacred place,” she says. “You feel it when you walk into a church or a library, and that’s how we feel about Children’s. Big things happen here.

They’re not all miracles, but they are very special.”

The quality of care extends to each and every newborn in the unit.

“You have to treat every baby as if it were your own,” says O’Hanlon, the mother of two daughters, one a nurse. “That way, you keep your standards high. What you need to do becomes very simple. Not easy, but simple.”

That level of personal involvement means everything to the babies’ families.

“Lucy was more than a nurse to us,” Jayne says. “She was our counselor and our coach. She had her goals for the day and she never sat down.”

“Children’s is wonderful,” Jayne says. “The doctors, nurses and everyone we met, they all truly love what they are doing. They listen, they understand and you can tell they care.”

Saving the Tiniest PatientsTo learn more about the NICU at

Children’s Hospital & Medical

Center, visit ChildrensOmaha.org

and click on NICU under Featured

Services. Or, call us toll-free at

1-800-833-3100.

Living Our MissionWith nearly 39 years of experience as a nurse, Lucy O’Hanlon, RN, takes pride in her work in the Newborn Intensive Care Unit (NICU) at Children’s. “What brings me to work every day is the fact that we live the Children’s mission here in the NICU, ‘so that all children may have a better chance to live.’ I love that,” she says. “I love that any child who needs care comes here and gets the best available.”

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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. © 2010. All rights reserved. Printed in U.S.A.

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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

Having a baby is exciting—and overwhelming, especially for a new mom.

But here’s something you may find even more stressful: trying to figure out if your baby’s symptoms are cause for concern. “Don’t hesitate to contact your pediatrician during the first 2 months of life if your child shows any signs of illness,” says Kari Krenzer, M.D., a Children’s Physicians pediatrician.

These tips may help when your baby isn’t feeling well:

cold-Like symptomsMany children have 8 to 10 colds by

the time they turn 2. In fact, kids often have more colds than any other illness. Those in day care will likely have more colds than those at home.

New moms whose babies are 3 months old or younger should call the pediatrician when the first signs of respiratory problems appear. Cold symptoms can progress to croup, pneumonia or other serious conditions.

There’s no cure for the common cold. Antibiotics won’t work against the viruses that cause colds. Make sure your baby gets more sleep and drinks more

fluids than usual. Nasal saline drops, a suction bulb and a cold-mist humidifier can help with nasal secretions.

FeverFevers can be serious in young babies.

Even if your baby doesn’t seem sick, call the doctor if the baby is 3 months of age or younger and has a rectal temperature higher than 100.4 degrees. If your baby is 3 to 6 months of age, call the doctor if your baby has a fever of more than 101.

Vomiting and DiarrheaViruses, bacteria, and other culprits

can cause vomiting and diarrhea in children. It’s important to keep your baby hydrated if he or she suffers from vomiting or diarrhea. Your baby may need to see a doctor if he or she:■ Is younger than 6 months of age■ Has a dry mouth, decreased urination, or other signs of dehydration■ Has blood in his or her vomit or stools■ Is lethargic or excessively sleepy

Handling your baby’s first illnesses isn’t always easy. The good news is you’ll get more experience—and more confidence—as your baby gets older.

Your Baby’s Ailing—Now What?

Your Baby’s HealthIf you’re worried about your baby’s

health, speak with your primary

care provider. Need a physician for

your child? Call Children’s Find-A-

Doctor service at 1-800-833-3100.