just kids | winter 2012

JustKidsWinter 2012ChildrensOmaha.org

CELIAC DISEASEShould Your Child Be Tested? 2

TEEN STRESSHow Parents Can Help 6

FRUITS AND VEGGIESTips to Get Kids Eating Healthy 7

new Year’s resolutions:

ready, Set, Goal! p4

Your Online Source for Health InfoFor the latest information and news, support groups, events, patient stories, recipes and perspectives from our physicians, check out these online resources:

Facebook.com/ ChildrensOmaha

YouTube.com/ ChildrensOmaha

Twitter.com/ChildrensOmaha

Pinterest.com/ChildrensOmaha

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. © 2012. All rights reserved. Printed in U.S.A.

➍ Ready, Set, Goal!

➏ Help Your Teen Cope With Stress

➐ Turn Ew! Into Yum!

➐ Healthy Kohl’s Kids Tackling Obesity

➑ New Advice on Preventing SIDS

➒ Intensive Care for Newborns Gets New Standards

➓ Gentle Imaging at Children’s

Creating Happy, Healthy Holidays Together

Contents

ChildrensOmaha.org JustKids Gary A. Perkins President and CEO Martin W. Beerman Vice President, Marketing

and Community Relations David G.J. Kaufman, MD Medical Advisor Dannee Schroeder Senior Editor

Nicole Brownell knew late last year that something was wrong

with her 3-year-old daughter, Anna. What at first had seemed to

be minor changes in her health and personality were growing

progressively worse.

“She was so worn down,” Brownell says. “She wouldn’t play

much. She wouldn’t talk much. She cried a lot and she slept a lot.

She wanted nothing to do with Christmas, which isn’t normal for

any child. And she only wanted to be with me.”

A Problem with GlutenBrownell and her husband, who live in Dakota Dunes, S.D., were

referred to Children’s Hospital & Medical Center’s new Celiac

Clinic, the only pediatric clinic of its kind in the region. Here, Pablo

Palomo, M.D., pediatric gastroenterologist with Children’s Specialty

Physicians, diagnosed celiac disease, a digestive condition caused

by sensitivity to the protein gluten. The gluten triggers an immune

reaction, which causes the body to create antibodies to eliminate

it. This can damage the small intestine and result in the reduced

absorption of important nutrients and long-term complications.

That was in January 2012. Within a week, Brownell says,

small changes were apparent in Anna’s health and personality.

By September, she says, the difference “was like night and day.”

The Road to Recovery“In nine months, she’d gained 10 pounds,” Anna’s mom reports.

“Her face had filled out and she’s healthier. The change in her

personality has been amazing. She talks with everyone. She plays,

she’s happy and she smiles all the time. I have a new little girl.”

The Celiac Clinic is just one facet of the Department

of Gastroenterology, Hepatology and Nutrition at Children’s. The

physicians and staff are experts in treating pediatric feeding and

growth disorders like celiac disease. Once a disease is diagnosed,

CELIAC CLINIC IS A UNIqUE REGIoNAL RESoURCE

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

What’sNew?CELIAC CLINIC IS A UNIqUE REGIoNAL RESoURCE

the clinic at Children’s goes beyond the

routine in explaining the nature of a gluten-

free diet, as well as providing support and

answering questions.

Because about 10 percent of patients with

celiac disease will have a first-degree relative

who also has the disease, Anna’s 4-year-old

sister, Olivia, was tested. She, too, has celiac

disease, although she showed no symptoms

before testing. Both girls are on gluten-free

diets and are doing very well.

Going Gluten-FreeAt first, Anna’s mother says the need to go gluten-free was daunting.

“There has been a lot of trial and error,” she says. “But Dr. Palomo and the

clinic at Children’s have been a great help. They are very reassuring and

patient in answering all my questions. They’ve really tried to make it a

positive experience for us.”

Besides Anna and Olivia, the clinic is currently following about 90

patients ranging from infants up to young adults. In addition to

managing their treatment, the clinic is in the process of enrolling in

research models regarding the diagnosis and treatment of celiac disease

in the region, Dr. Palomo says.

In Anna’s case, it is clear that the proper diagnosis and diet greatly

improved the quality of her life, Dr. Palomo says. “When I first saw

Anna, she was an unhappy, angry child,” he says. “After we started the

treatment and I saw her again, the first thing she gave me was a smile.”

Should Your Child Be Screened for Celiac Disease?

For those with celiac disease, eating gluten causes the immune system to attack the lining of the small intestine. Eventually, people have problems absorbing nutrients from food. They can starve even if they eat a lot.

Celiac disease affects about 1 percent of all people. But for those with type 1 diabetes, the odds are about 5 percent

that they will develop this disease.Symptoms of celiac disease include:

• Stomach pain, gas and diarrhea• Feeling very tired• Losing weight

However, many people with type 1 diabetes and celiac disease have no signs of the celiac disease. Ask your

pediatrician if your child should be screened even if no signs are present.

If your child has celiac disease, the only therapy is a strict gluten-free diet. A dietitian can help you learn to avoid gluten. People with celiac disease need to avoid wheat, rye, barley, most grains, pastas, cereals and many processed foods.

To learn more, enter the search term “celiac disease” at our website at HealthLibrary.ChildrensOmaha.org.

HAve CeliAC DiSeASe QueSTiONS?

Pictured above: Nicole

Brownell with her daughters

Anna (front) and olivia.

ChildrensOmaha.org 3

feature story

Ready, Set,

Goal! HELP YoUR FAmILY SET

NEw YEAR’S RESoLUTIoNS

Each New Year provides a fresh start on setting resolutions and achieving goals. This year, take a family approach when creating wellness goals. Here are a few ideas.


tipS for SucceSS

whether it’s for you or your children, here are some helpful tips for setting and achieving goals:

• THiNK SMAll. Break down large, difficult goals into smaller ones that are easier to keep. For example, if your family has been inactive but wants to get fit, start by vowing to take a brisk, 10-minute walk together three days per week.

• Be ReAliSTiC. minor slip-ups are part of the process. Let’s say you resolved to increase the family’s consumption of veggies every day at dinner, but skipped monday and Tuesday. Don’t beat yourself up. Just get back on track wednesday.

• MAKe iT FuN. For example: To eat healthier, try a healthy recipe the family can make together. Visit HealthyKohlsKids.com for recipe ideas!

• KeeP TRACK. Each time the family meets a daily goal, circle the date on the calendar. Seeing tangible evidence of your progress is a great motivator.

Keep your Home Safe Falling furniture sends an average of 46 U.S.

children to emergency rooms each day, researchers

say. Many injuries take place as children pull over

or climb on furniture. Children ages 6 and younger

are most likely to be hurt—especially by televisions

—but desks and cabinets also account for injuries.

To minimize risks to children:

• Place TVs close to the ground and toward the

backs of stands.

• Strap televisions and furniture to the wall

with safety straps or L-brackets.

• Install drawer stops on chests of drawers.

• Buy furniture with wide legs or with solid bases.

• Place heavy items on shelves near the floor.

• Avoid placing items that might encourage

climbing, such as toys, high on top of furniture.

Other ways to keep little ones safe at home

include using locks to prevent windows from

opening more than 4 inches, installing a carbon

monoxide detector in each level of your house

and closing doors to extra rooms when not in use.

FiND THe RiGHT DOCTOR Selecting a physician who’s a good fit for your family is important. You—and your child—should feel comfortable with the physician. To find the right one for your family, call Children’s Find-A-Doctor service at 1-800-833-3100.

exercise as a Family

Both adults and children need about an hour

of physical activity per day. Children learn by

watching you. So plan ways to stay moving as a

family. Exercise makes you stronger, keeps your

weight in check, and improves your balance.

Don’t think you have time to exercise? Think

about all the things you do already, then find a

way to fit in fitness. For instance, have everyone in

the family pick out a favorite upbeat song. Then,

dance to each song while preparing dinner. Turn

off the TV after the family meal and go for a walk

or rollerblade around the neighborhood. Ride

bikes instead of driving to the library or when

running errands.

Taking your family’s workout outside gives you

even more benefits. You can connect with nature

and so can your children. You’ll be happier, less

stressed and tuned in to the world around you.

Need help promoting fitness in your family?

We can help. Simply visit the website at

HealthyKohlsKids.com/fitness.

Schedule Wellness Visits It’s important for every family member to visit a

primary care physician once a year for a well-check.

When you schedule well visits for yourself and family

members, it sets a good example for everyone.

Some benefits of an annual wellness exam include:

• Counseling that may prevent some health problems

• Catching health problems early when they are

easier to treat

• Tracking important numbers, such as blood

pressure and weight; tracking these vital statistics

is just as important for children as it is for adults

• Reviewing that all vaccinations are up-to-date.

Even your healthy teenager should still visit the

pediatrician annually. Teens have developed a

relationship with their pediatrician over the years.

This allows the pediatrician the opportunity to

discuss potentially touchy subjects, such as behavioral

difficulties, social stresses, drug and alcohol use,

depression or anxiety disorders.

Don’t forget to schedule dental visits for all family

members as well. Babies need their first dental

checkup six months after they cut their first tooth

or by age 1, whichever comes first.


Everyone feels stressed from time to time.

You may vent to coworkers or call your

spouse to talk. But stress is often worse

for teens. When a teen is under pressure,

he or she can feel alone in the world.

You can’t make the pressures of life

disappear. As a parent, however, you play

a key role in helping your child cope.

Youth under PressureWith so much beyond their control, it’s

easy for young people to feel overwhelmed.

Sources of adolescent stress include:

• Schoolwork

• Trouble with friends, boyfriends

or girlfriends

• Changes in their bodies

• Peer pressure to engage in

risky behaviors

• Illness or death in the family

• Wanting to fit in

• Work and after-school activities.

Stress can cause your child to feel edgy,

tired, depressed or resentful. It can also

bring on physical symptoms, such as

stomachaches and headaches.

Successful Stress-Busting StrategiesStudies show teens’ brains actually process

stress differently. They have a harder time

telling minor troubles from real threats. That’s

why a parent’s perspective is so important.

Talk openly with your teen. Let him or

her know you’re there to listen and provide

support. Together, work on ways to deal

with stress, such as:

• listing the things that cause your

teen’s stress. Change the ones you can.

For instance, if your child’s too busy,

consider reducing part-time work hours.

• living a healthy lifestyle. Eating right,

exercising and avoiding drugs and

alcohol reduce the effects of stress.

• Recognizing accomplishments, instead

of dwelling on failures. At the end of

each day or week, help your teen think

about all he or she has achieved.

• laughing. Turn on a sitcom, tell

funny stories or search for silly

videos online. Laughter produces

good feelings that last beyond

a quick chuckle.

Watch for Warning SignsMost teens find healthy ways to

handle stress. Red flags include

changes in weight or personality,

a drop in grades, or talking about

killing or hurting himself

or herself.

iS YOuR CHilD ANxiOuS?

The Anxiety Disorders Clinic at Children’s offers specialized diagnostic services and treatment groups for children and youth who have fear or anxiety symptoms. If you think your child and family may benefit, call 1-800-833-3100.

Help Your Teen Cope with Stress


Healthy Kohl’s Kids Tackling Obesity

Childhood obesity is the top health issue affecting both children and adolescents in the omaha metro area. Three out of 10 school-age children in the metro area are overweight or obese.

Children’s Hospital & medical Center and Kohl’s Department Stores have teamed up to change these findings with a program called Healthy Kohl’s Kids. The program is the newest chapter in a more than decade-long partnership between Kohl’s and Children’s.

“we are extremely excited about the new Healthy Kohl’s Kids program,” says Gary A. Perkins, president and CEo of Children’s Hospital & medical Center. “we look forward to this new program educating children and their families on how to eat better and exercise more for a healthier lifestyle.”

JOiN THe FuN!Learn more about the Healthy Kohl’s Kids program at www.healthykohlskids.com. The website features how-to videos of young chefs making healthy meals and snacks, and it enables people to share recipe and exercise tips via Facebook, Twitter and Pinterest.

What parent hasn’t seen a child turn up his or her

nose at healthy food? Faced with a green vegetable or

unfamiliar dish, children are notorious for making a

fuss. Unfortunately, most children today only eat half

the recommended servings of fruits and vegetables.

To encourage your child to eat the recommended

4.5 cups—without a fight—try these tips:

TURN Ew! INTo YUm!Five strategies to get your kids to love (or at least tolerate) veggies

1 Be sneaky. Sneak fruits and veggies into foods your

children already eat. Add pureed broccoli or cauliflower to

pasta sauce. Chop up green peppers, carrots and celery and

mix them with water-packed tuna and fat-free mayonnaise.

2 Make it easy. When it comes to snacking, kids will usually

eat whatever food is on hand. Stock the front of the fridge

with snack-sized baggies or clear containers of grapes, carrot

sticks, bell-pepper slices and melons cut into bite-sized pieces.

3 Have some fun. Cut veggies into shapes (think hearts and

stars) and serve them with low-fat dip.

4 enlist their help. Children are more apt to eat meals they

help prepare. Get their input on meal planning and then

shop for and cook healthy foods together.

5 Be a role model. You’re not the only one who keeps tabs

on what you eat. Your children also are eyeing your food

choices. Set a good example by practicing what you preach.


Two decades ago, doctors sent moms and dads a message:

Put babies to sleep on their backs. In the years that

followed, the rate of sudden infant death syndrome

(SIDS) fell by half.

Now there’s a new call to action: More can be done to

save babies’ lives. Studies have found other risk factors

that also raise a child’s risk of dying from SIDS.

The New ResearchDoctors can’t always tell the specific causes of SIDS, the

sudden, unexplained death of a baby less than 1 year old.

The foremost risk remains the same. Babies who sleep

on their stomachs have double the chances of SIDS.

Infants can be born with certain risk factors, such as

being male, premature and having a mother who

smoked or used alcohol while pregnant.

But a study published in Pediatrics focused on other

key risk factors. They include babies sharing a bed

with an adult, sleeping on an adult mattress, being

overdressed for the temperature, having their faces

covered and being exposed to cigarette smoke.

Other Steps to TakeAvoiding the risk factors mentioned can help keep your

baby safe from SIDS. So can taking these precautions:

• Don’t put soft toys, pillows or loose blankets in

the crib.

• Breastfeed your baby.

• Give your baby a pacifier.

• Let your child’s doctor know if your baby ever

goes limp, turns blue or appears to stop breathing

for any period of time.

• Give your baby tummy time when awake.

A certain amount of tummy time while awake and

being observed by a caregiver gives a baby motor

development of the shoulders.

While not all SIDS deaths may be avoided, doing

what you can to reduce your child’s risks could save

his or her life.

While not all SIDS deaths may be avoided, doing what you can to reduce your child’s risks may save his or her life.

MORe TiPS ABOuT SiDS!

To learn more about SIDS, enter the

search term “SIDS” on our website

at HealthLibrary.ChildrensOmaha.org.

New Advice on Preventing

SIDS


New standards published by the American Academy of Pediatrics (AAP) establish Children’s Hospital

& Medical Center as the only Level IV Regional Newborn Intensive Care Unit (NICU) serving

Nebraska, western Iowa and South Dakota. Level IV is the highest level of care as defined by the AAP.

The new standards were published in the September 2012 edition of the medical journal Pediatrics.

Children’s meets a number of strict criteria including:• Experience in the care of the most complex and critically ill newborns

• The availability of pediatric-trained subspecialists on-site and available 24/7, including heart

surgeons, pediatric surgical subspecialists and anesthesiologists

• The experience and expertise to provide

surgical repair of complex congenital

conditions including serious heart defects

• The ability to transport critically ill

newborns by ground, helicopter and

fixed-wing aircraft

• The ability to facilitate and provide

outreach education.

“The AAP has taken a significant step in

redefining these classifications of care,” says

Lynne Willett, M.D., clinical service chief of

Neonatology at Children’s. “It’s important to

understand all newborn intensive care units

aren’t alike. As the only Level IV NICU in

the state, Children’s is uniquely qualified to

care for the sickest babies. Neonatologists,

nurses, pediatric surgeons and specialists,

and a skilled critical care transport team

—we are all here and working together to

give these newborns the most comprehen-

sive care available.”

Since 2004, Children’s had been

recognized as a Level III-C unit, the highest

level as noted by past AAP standards. The

new classifications have been simplified

and no subdivisions exist. Units are

designated as one of the following:

• Level I, Well Newborn Nursery

• Level II, Special Care Nursery

• Level III, Newborn Intensive Care Unit

• Level IV, Regional Newborn Intensive

Care Unit.

“Children’s is widely recognized as a

regional resource providing advanced

diagnostics and treatments,” says Dr.

Willett. “Patients come to our unit from

other NICUs, hospitals and health systems

across the state and beyond.”

New National Standards Define Intensive Care for NewbornsCHILDREN’S omAHA IS THE oNLY LEVEL IV NICU

SERVING A mULTI-STATE REGIoN

FAST FACTiN 2011, THe CHilDReN’S NiCu CAReD FOR NeARlY 325 CRiTiCAllY ill NeWBORNS.

Scan this qR code to learn more about our NICU!


Physicians diagnose illness and injury each

day, but it can be difficult diagnosing babies

and very young children because they can’t

verbally describe their symptoms. While

x-rays, CT scans, MRIs or ultrasounds may be

necessary to determine a child’s ailment, they

can be extremely difficult to perform on a

young child.

Many young children don’t understand the

words, “hold still,” and even more have trouble

accomplishing it. That’s why the Radiology

Department at Children’s Hospital & Medical

Center offers a child-friendly environment,

uniquely qualified staff and specialized

equipment and procedures to help ensure the

best diagnosis.

Child-Friendly Staff and AtmosphereThe pediatric-trained specialists at Children’s

Hospital & Medical Center in Omaha have

extensive experience working with one patient

population – children. We excel at making them

feel comfortable in situations that can be a little

unsettling, and we thrive on collaborating with

your referring physician to determine the most

effective way to image your child.

Our staff physicians are fellowship-trained

pediatric radiologists. They only read pediatric

images and are specifically trained in disease

processes that are only seen in children. Our

radiologists have over 65 years of combined

experience reading pediatric studies and have

been recognized nationally for their efforts to

minimize radiation exposure while providing

diagnostic results.

little Touches for little Patients Any time a child has to go in for a procedure, it

can be stressful for them and their parents.

That’s why we encourage questions, foster

open communication and assign each of our

families a child life specialist, a professional

who is trained to hold a child’s hand (literally

and figuratively) through the process – from

talking to them about IV’s to discussing what it

feels like to be inside an MRI machine.

Our two MRI scanners are child-friendly and

unlike any other in the state of Nebraska. Not

only are they decorated in a calming underwater

theme on the outside, they are outfitted with a

unique TV/video system on the inside. It’s

technology you won’t find in any other MRI

scanner in the state of Nebraska. With a movie

playing, a child can, optimally, remain still and

quiet during the 30-to-60 minute study without

the need of a mild sedative.

In other exam rooms, projectors throw

pictures on the wall and ceilings for the sake of

distraction, and many have televisions.

imaging Gently: The Children’s DifferenceChildren’s is committed to providing the safest

and most effective radiology and imaging

services for your child. Whenever radiation is

involved in a procedure at Children’s, our

pediatric-trained specialists take every

precaution to ensure that the amount of

radiation used is the bare minimum necessary

to achieve an accurate result.

Our Radiology Department supports and

adheres to the recommendations of the Image

Gently Campaign, an initiative of the Alliance

for Radiation Safety in Pediatric Imaging. The

campaign goal is to increase awareness of the

opportunities to promote radiation protection

in the imaging of children. Children’s has been

“imaging gently” since 2008, embracing

guidelines from the American College of

Radiology (ACR) and the motto of “as low as

reasonably achievable” when it comes to the

amount of radiation used in our studies.

In addition, we only use CT scans when

absolutely necessary (emergent trauma cases,

for example), deferring to ultrasound or MRI,

whenever feasible, to minimize radiation

exposure. When CT scans are required, our CT

doses are “child size,” carefully calculated to

decrease the long term cancer risk to children.

Children’s is also a national advocate for the

use of sonography to diagnose pediatric

appendicitis as another element in our effort

to minimize childhood exposure to radiation.

A PICTURE oF SAFETY AND ComFoRT

Gentle imaging at children’s


Gentle imaging at children’s

For more information on the radiology department at Children’s, visit www.Childrensomaha.org/radiology.

Our MRi scanners are child-friendly.

They are decorated in a calming

underwater theme on the outside,

and outfitted with a unique Tv/video

system on the inside.


Non-Profit Org.U.S. Postage

PAIDChildren’s Hospital & Medical Center

8200 Dodge StreetOmaha, NE 68114402-955-5400

881M

While the holidays can be a great source of lasting

childhood memories, they can also be a time of

stress and anxiety. As parents, it’s important for

you to take control. The best way to do this is to

plan ahead, stick to priorities and let your child

come first.

Follow these tips to help ensure a happy holiday season:• Drive safely and follow fire safety rules.

• Avoid latex balloons. An uninflated balloon can

be easily swallowed, as can pieces from a

popped balloon.

• If you have small children, avoid ornaments

and decorations that resemble food or are

breakable.

• Be sure to keep snacks and appetizers that

could cause choking, like nuts, grapes and hard

candies, out of reach of small children. Clear

away ashtrays and alcoholic beverages at the

end of a get-together.

• Don’t leave food requiring refrigeration out at

room temperature for longer than two hours.

• Dispose of plastic bags as soon as you get home.

Small children can suffocate using them.

Don’t Toy Around with SafetyBe sure to choose toys that are appropriate for a

child’s age and abilities. Check the toy’s packaging

for safety information and age guidelines. In

addition:

• Beware of pull toys with strings longer than

12 inches, which can pose strangulation

hazards to young children.

• Teach older children to keep their

toys away from little siblings.

• Don’t give younger children toys

with sharp edges, small parts

or sharp points.

• If you give skateboards, bicycles,

scooters, or inline skates to

your children, make sure

they always wear helmets and

other safety gear, such as wrist,

hand, and shin guards, when using them.

Remember to take time for hugs and

quiet family time during the holidays.

A child’s wonder and delight are

yours to share if only you take

the time to enjoy it.

ChildrensOmaha.org

SuBSCRiBe NOW To subscribe to health-e kids, our free monthly e-newsletter, visit ChildrensOmaha.org and click on the e-newsletter icon located on the right side of the home page.

eNewsletterSign-up

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

CREATING HAPPY, HEALTHY HoLIDAYS ToGETHER

just kids | winter 2012

Documents