Is Your Child Vitamin D Deficient?

justkidswinter 2010

Children’s Hospital & Medical Center

• Is Your Teen Addicted to the Cell Phone?• Avoid a Family Food Fight

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

POSBFFa/s/l

LOL PRW

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 like those with

Children’s Hospital & Medical

Center’s Behavioral Health.

Need a physician or behavioral

specialist for your child? Call the

Children’s Find-A-Doctor service at

1-800-833-3100.

If your teens’ and tweens’ ears aren’t glued to cell phones, their thumbs probably are. But research suggests too much cell phone use could signal a surprising problem: addiction.

A Hong Kong study found the symptoms of young cell phone addicts resemble those of problem gamblers. Among the issues: inability to control cravings for the cell phone, feeling anxious and lost without it, using it to escape loneliness and isolation and decreased productivity tied to its use.

Most U.S. teens and nearly half of 8- to 12-year-olds have cell phones. Outgoing kids are more apt to become addicted to them because they like to socialize and have more friends.

Boredom and Self-EsteemBored by leisure time that lasts too

long, doesn’t excite them or doesn’t vary enough, youth are more likely to turn to cell phones to break the monotony. Boredom worsens as self-esteem falls, and low self-esteem worsens the problem. Low self-esteem can cause people to behave in self-defeating ways—so cell phone addicts keep talking and texting despite the downside.

Preoccupied with their phones, children worry they’ll miss calls if they’re out of range. They stay on the phone longer than they intended. They constantly check for and reply to messages. Cell phones themselves make it easy to become addicted by offering numerous functions—as phone and camera, and for e-mail, games and the Internet.

When use turns to abuse, some kids can’t control their cravings. They find it hard to hide from family and friends the extreme amount of time they spend on the phone. They feel lost, restless, moody, depressed or irritable.

The more kids talk and tap out messages, the less productive they are in other areas of life and the less attention they pay to issues they should face. They may lose interest in social, occupational and recreational activities as they rack up cell phone bills.

A Word of Caution“‘Addiction’ is a confusing term, and

everyone views the word a little differently,” says Reo Newring, Ph.D., a psychologist with Children’s Behavioral Health. According to Dr. Newring, there are four major areas parents should consider when determining if a child has a serious problem: 1. Does cell phone use directly interfere with how the child is doing at school or at home? For example, if a child spends all night talking or texting instead of sleeping, then falls asleep or continues to text in class, there may be a problem. 2. Does the child talk or text when he or she could get hurt? Teenagers frequently have trouble focusing and staying on task. This is even more of a problem when using a cell phone, especially if texting while driving. 3. Does the child have legal problems due to cell phone use? This could include sending inappropriate texts, requests or pictures. 4. Does the child continue to misuse the phone? If the child has misused his or her phone privileges, suffered serious consequences and then continued the misuse, there may be a problem.

What Can Be Done?Here’s some advice to help children (or

anyone else) develop a healthy perspective and balance about cell phone use:

■ Address the cell phone’s adverse effects without losing sight of its advantages. ■ Teach kids to take time making decisions and educate them about the factors involved, so they can consider the potential risks of their behavior. ■ Help them control their impulsive use of cell phones by developing coping skills, setting limits and rules about use and providing good modeling.

The cell phone is not necessarily an enemy; it is a tool. If a child is doing well at school and home, there is probably no reason for concern. If a child is not doing well at school or home, options may include limiting cell phone use, speaking with other parents about their discipline and parenting procedures or therapy. With appropriate limits and boundaries in place, and teaching proper coping skills, cell phone use should not be a problem.

Meet Our ExpertReo Newring, Ph.D.Children’s Behavioral Health psychologist

Dial “A” for Addiction?Cell phones may lend themselves to overuse and abuse for some kids

ChildrensOmaha.org | 3

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Do You Speak Textese?Listed below are some of the acronyms and abbreviations that your teen might use when texting on their cell phone.

Addy – address

A3 – anytime, anywhere, anyplace

a/s/l – age, sex, location

brb – be right back

bf or b/f – boyfriend or best friend

gf or g/f – girlfriend or good friend

g2g – got to go

(l) mirl – (let’s) meet in real life

lol – laugh out loud

paw – parents are watching

pos – parent over shoulder

s2r – send to receive (pictures)

Almost everywhere you turn online today, you can find

pediatric health information, but how do you sort through

it all to get what you need? Simply turn to health-e kids,

the new online newsletter from Children’s Hospital &

Medical Center.

Unveiled in January 2010, this free e-newsletter offers

monthly articles on relevant health topics, plus links to

further information, recipes, quizzes and more. All this

information is available with the click of your mouse and

delivered to your inbox each month.

To sign up to receive the monthly e-newsletter, visit

ChildrensOmaha.org and click on the e-newsletter icon

located on the right side of the home page.

Easy Access to Health Information

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

Children’s Hospital & Medical Center serves as the primary hub for the treatment and care of critically ill infants and children in the region. One reason we are able to provide such a high level of care centers on our critical care transport team.

The team is available 24 hours a day to transport patients utilizing a dedicated ground ambulance or by helicopter, both of which are designed and equipped to provide pediatric critical care.

A neonatal nurse practitioner and critical care nurse, both specifically trained in the care and transportation of critically ill infants, go on each trip. Their special training and experience includes stabilizing and transporting:■ Premature infants■ Newborns requiring immediate surgery■ Children in respiratory distress■ Children who have ingested poison■ Children with critical heart disease■ Critically ill or injured children.

Team members also are certified in basic life support, pediatric advanced life support and neonatal resuscitation.

Ground TransportThe critical care transport team’s dedicated ground ambulance

is designed and equipped to provide specialized care to critically ill and injured newborns less than two months of age. Our ground transport team serves primarily Nebraska, western Iowa, northern Missouri, northern Kansas, eastern Colorado and South Dakota.

Helicopter TransportDepending on your child’s condition and immediate

needs, your physician and the admitting Children’s pediatric critical care physician will determine the most appropriate and beneficial form of emergency transportation for your child. Our emergency helicopter service is available to provide transportation to newborns and children needing more rapid transport within a 150-mile radius of Omaha. The helicopter is staffed by our critical care transport team.

Newborn Intensive Care Unit (NICU)The majority of our transport patients are cared for in

Children’s Newborn Intensive Care Unit (NICU). Children’s NICU provides the most advanced level of neonatal care available. It is a place where a medical team dedicated to tiny patients and anxious parents gives support and hope in a caring and compassionate atmosphere. 

Radiology viewing rooms on each floor help speed diagnosis and treatment.  An education room offers space for staff to teach families how to care for and nurture their newborns.  Isolation rooms, a procedure room, pharmacy support and office space allow physicians and staff to remain close to the most critically ill patients. 

The ability to treat infants weighing as little as 1.2 pounds is testimony to the skills of Children's specialists and staff, combined with the latest technology and medical advances.

Critical Care Transport Saves Lives

Stay Healthy TogetherHelp your child establish

healthy living habits early.

Practice healthy eating and

cooking at home, or better

yet, plan healthy meals

together. Cooking together

in the kitchen is a great

way to stay connected with

your child and promote a

healthy lifestyle. Need

ideas? Visit our Nutrition

Center on our Web site at

ChildrensOmaha.org/Library/NutritionFacts.

ChildrensOmaha.org | 5

Does your child come home, grab a soda and plop down in front of the TV or computer? Shunning milk and the sun is more and more common for children, and the result is a lack of vitamin D.

In fact, a study recently reported in the journal Pediatrics found that 6.3 million U.S. children—almost one in five—had blood levels of vitamin D below the minimum levels recommended by the American Academy of Pediatrics (AAP). The study also found that taking multivitamins with vitamin D improves levels, but multivitamin usage remains low among children.

“Vitamin D deficiency often is a silent disease until it is far progressed,” says Michelle Mogenson, D.O., a pediatrician with Children’s Physicians. “Starting your child on the right path early by encouraging good eating and exercising habits, plus starting multivitamins early, can have a huge impact on their future bone development.”

The Importance of DVitamin D helps the body absorb

calcium and keeps bones strong. Research indicates that even a mild vitamin D deficiency can stunt growth

and decrease a child’s ability to meet peak bone density—which can increase the risk for osteoporosis later in life. A true deficiency can cause rickets, a condition that softens the bones and may lead to fractures or deformities.

The AAP now recommends 400 IU of vitamin D per day for children up to 18 years of age. Putting skim or low-fat milk on fortified cereal is your best bet, according to the American Dietetic Association. Multivitamins or orange juice fortified with vitamin D also are options, but milk should be your first choice. Children who are lactose-intolerant can drink lactose-free milk. Due to the established link between sun exposure and skin cancer, the AAP does not recommend unprotected sun exposure to increase vitamin D levels.

Infant NeedsStudies show breast milk lacks

sufficient amounts of vitamin D to provide breast-fed infants with the required amounts needed to keep their bones healthy. That’s why the American Academy of Pediatrics now recommends providing supplemental vitamin D for all breast-fed babies. Liquid multivitamin drops with vitamin D are available.

Infants who are fed infant formula do not require supplements.

In addition to adequate vitamin D and calcium, children and teens also need adequate exercise, including impact activities such as running, gymnastics and ball games, to build strong bones. The impact on the major bones in these sports signals the bones to boost their strength. The bones are able to do this if they have enough vitamin D and calcium available.

Milk IdeasIf your child doesn’t drink plain milk,

get creative.■ Use milk in place of water when you make oatmeal or soup.■ Make fruit smoothies with milk.■ Serve chocolate milk.■ Prepare hot chocolate or pudding with milk.■ Use fortified soy milk.■ Offer cheese that is high in calcium as a substitute for milk.

Is Your Child Vitamin D Deficient?

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

Most children depend on recreational and school sports for exercise and fun. But too many young athletes suffer needless injuries. Each year, more than 3.5 million children suffer sports-related injuries severe enough to require emergency-room treatment.

While any physical activity involves some risks, baseball, basketball, football, soccer and softball account for almost 40 percent of all sports-related injuries in children ages 5 to 14. Injuries become more severe as children get older and play at higher levels of competition.

“The benefits of participating in sports far

outweigh the risks,” says Patrick Specht, M.D., a pediatrician with Children’s Physicians. “One of the best things parents can do is set a good example for their children. It doesn’t have to be organized sports, either. It’s as simple as playing a game with them. Freeze tag, hide-and-go-seek or a nice walk will get your blood pumping and improve your family’s health, both physically and psychologically.”

Ask QuestionsIf your children do play organized

sports, make sure that the coaches are able to handle their teams safely. Unfortunately, only a small percentage of volunteer coaches have any training in safety or

coaching skills. Before your children sign up for a sports league, make

sure you know a few facts.■ At minimum, coaches should be certified in first aid and CPR.■ A well-equipped first-aid kit, a checklist for what to do in emergencies and a cell

phone should be taken to practices and games.■ Coaches should require young

athletes to wear appropriate safety gear that meets national safety standards.

■ Coaches should lead team members through warm-up routines before games and practices, and stretching routines and cool-downs afterward.

■ Young athletes should play with and against others of similar age, weight and skill levels.■ Coaches should stress skill development and fun. No child should be forced to play when tired or in pain.■ Before hiring any coach, league managers should do a background check to make sure the person has no criminal record.

Play Your PartEven the best coach can’t do it all. As

a parent, you can also play an important role in making sure your children’s sports experience is a safe and happy one.■ Offer to help. Your presence shows you care, and it can give a coach valuable help in maintaining control.■ Play with your children. Help them stay fit by making physical activity part of everyday family life. Go biking, running or walking together.■ Value good sportsmanship. When children respect the game and one another, they’re less likely to behave in ways that put them at needless risk. Parents need to instill the principles of good sportsmanship in themselves and their children.

Protecting Your Child from Sports Injuries

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

No Matter the Emergency, We Can Help

Children’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 and just to the south

and west of Village Pointe at 110 N. 175th St. For more

information on our emergency and urgent care services, visit

ChildrensOmaha.org/Services or call 1-800-833-3100.

Meet Our ExpertPatrick Specht, M.D.Children’s Physicians pediatrician

Learn more about avoiding “food fights” 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.

Each session will be held in the Glow Auditorium at Children’s Hospital & Medical Center from 6 to 7 p.m. Space is limited, so call 1-800-833-3100 or log on to ChildrensOmaha.org today to register for one or more of our upcoming educational sessions.

Tuesday, March 2Facts & Myths Surrounding Vaccines Rachel McCann, M.D., Children’s Physicians

Tuesday, March 9 Preparing for Your Newborn Melissa St. Germain, M.D., Children’s Physicians

Tuesday, March 16 Mommy, I Can’t Go LeAnne Vitito, A.P.R.N., Children’s Gastroenterology Clinic

Tuesday, March 23 Single Parenting Rene Pretorius Parks, L.M.H.P., and Colleen Cusick Brown, C.M.S.W., L.I.M.H.P., Children’s Behavioral Health

Tuesday, April 6 Potty Training Bernard Douglas, M.D., Methodist Physicians Clinic

Tuesday, April 13 Surviving the Trying 2’s Lars Vanderbur, M.D., Children’s Physicians

Tuesday, April 20 Avoiding Food Fights Greg Severson, M.D., Methodist Physicians Clinic

Tuesday, April 27 Preparing for Your Newborn John Andreson, M.D., Children’s Physicians

ChildrensOmaha.org | 7

Adults often view a child’s eating behaviors as a problem. However, in reality, childhood food binges, food strikes or other habits are part of normal development. Children use the table as a stage for showing their independence. Sometimes, food is not the issue at all. The eating process is just one more way children learn about the world.

Experts say the most important thing parents can do is be a role model for healthy eating. Parents are the best judge of what children should eat. Children are the best judge of how much they eat.

To help prevent mealtime from becoming

a battleground, try these simple steps:

■ Be a smart gatekeeper. Buy only the foods you want your child to eat.

■ Don’t worry if your child skips a meal.

■ Set a good example by eating nutritional foods yourself.

■ Let children make their own food choices, when possible, from the good foods you provide. ■ Serve regular meals and snacks.■ Teach good table manners and keep mealtimes pleasant.

Remember, food should be used as food, not as a reward or punishment. In the long run, food bribery usually creates more problems than it solves. Happy encounters with food at any age help develop sensible eating habits.

We Know ChildrenAvoid a Family Food Fight

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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. © 2010. 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 Schroeder, Marketing Coordinator

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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

Wearing a properly fitted bike helmet reduces the risk of head and brain injury by 85 percent. Learn more about bicycle safety at the Kruizin’ with Kohl’s bike safety event on Saturday, April 24, 2010, from 10 a.m. to 2 p.m. The family-friendly fun starts at the Kohl’s Store located at 909 S. 72nd St. (on the corner of 72nd and Pacific streets). The bike safety event will be held near the Keystone Bike Trail so that families can bring their bikes and enjoy a ride on the trail.

Free bike helmets will be provided and properly fitted for children ages 4 to 14 for registered participants and while supplies last (restrictions may apply). Parents and children will be taught how to properly fit a bike helmet.

The event is part of the Kohl’s Keeps Kids Safe program, a partnership between Kohl’s Department Stores and Children’s Hospital & Medical Center.

Bike safety information, food, prize giveaways, face painting and more will

make it a fun-filled and informative day. The event kicks off National Safe Kids Week, April 25 to May 2, and National Bike Safety Month in May.

Kohl’s Keeps Kids Safe offers child injury prevention programs through Children’s Hospital & Medical Center. Since 2000, Kohl’s has donated more than $856,000 to Children’s in support of child injury prevention programs. Every time you purchase a plush toy and accompanying book offered at Kohl’s Department Stores in the Omaha area, Kohl’s shares the sales proceeds from this merchandise with Children’s Hospital & Medical Center.

Children’s Hospital & Medical Center teams with Kohl’s for Bike Safety

Postmaster: Please deliver between February 15 and 19.

For Kruizin’ with Kohl’s

registration information, visit

ChildrensOmaha.org/Kohls or call 1-800-833-3100. Registration is required for free

bike helmets, so act now because

quantities are limited.