Category Archives: Health tips

12 tips to help keep kids safe this summer

Wear a helmet every time you ride a bike, skateboard, scooter or use inline skates.

Children’s has one of the busiest pediatric emergency programs in the country, with about 90,000 visits each year. We love kids here at Children’s, but we’d rather see them safe at home. With warm weather upon us, we compiled a list of basic tips, with help from our injury prevention experts, to keep kids safe all summer. Together, we can make safe simple.

For more safety tips, read about Making Safe Simple.

Sun and heat

1. On hot days, make sure kids drink plenty of water to stay hydrated.

2. Make sure kids are covered. Apply 1 ounce of sunscreen to the entire body 30 minutes before going outside. Reapply every two hours, or immediately after sweating heavily.

3. When heat and humidity are high, reduce the level of intensity of activities.


4. Kids should wear life jackets at all times when they’re on boats or near bodies of water.

5. Never leave kids alone in or near a pool or open water. In open water, kids should swim with a buddy.


6. Don’t allow kids younger than the age of 12 to use sparklers without close adult supervision. Don’t allow them to wave sparklers or run while holding sparklers.


7. Always watch kids on a playground. Make sure the equipment is age appropriate and surfaces underneath are soft enough to absorb falls.


8. Kids younger than 16 shouldn’t be allowed to use riding mowers, and those younger than 12 shouldn’t use walk-behind mowers.

Bike and wheel-sport safety

9. Make it a rule: Wear a helmet every time you ride a bike, skateboard, scooter or use inline skates. Skateboarders and scooter-riders should wear additional protective gear.


10. Every rider should take a hands-on rider-safety course.

11. All kids should ride size-appropriate ATVs.

12. All riders should wear full protective gear including a helmet, chest protector, gloves and shin guards.

Food that gets kids required vitamin D

Molly Martyn, MD, is a pediatric hospitalist at Children’s.

Molly Martyn, MD

Getting enough vitamin D is an important part of staying healthy. Vitamin D helps with calcium absorption, and thus is a critical part of how our bodies make and maintain strong bones. Research shows that it also plays a role in keeping our immune systems healthy and may help to prevent certain chronic diseases.

Many of us get our vitamin D from the sun and drinking milk, but families often wonder how to help their children get enough vitamin D to meet daily requirements.

The American Academy of Pediatrics recommends that infants receive 400 international units (IU) per day of vitamin D. For children older than 1 year, the recommended amount is 600 IUs per day.

Vitamin D is found in a number of foods, some naturally and some through fortification. Foods that are naturally high in vitamin D include oily fish (such as salmon, sardines and mackerel), beef liver, egg yolks, mushrooms and cheese. Below are some estimates of vitamin D levels (per serving) of a variety of foods.

Salmon, 3.5 ounces 360 IUs
Tuna (canned), 1.75 ounces 200 IUs
Shrimp, 4 ounces 162 IUs
Orange juice (vitamin D fortified), 1 cup 137 IUs
Milk (vitamin D fortified), 1 cup 100 IUs
Egg, 1 large 41 IUs
Cereal (vitamin D fortified), ¾ cup 40 IUs
Shiitake mushrooms, 1 cup 29 IUs

subscribe_blogAll infants who are breast fed (and even many who are formula fed) should receive a daily vitamin D supplement.

In addition, the majority of children do not eat diets high in foods containing vitamin D, so a vitamin D supplement or multivitamin may be an important part of helping them meet their daily requirements. Talk to your child’s health care provider about recommendations.

National Institutes of Health (NIH) has more information on vitamin D, including vitamin D recommendations for all age groups.

Molly Martyn, MD, is a pediatric hospitalist at Children’s Hospitals and Clinics of Minnesota.

How to prevent, treat bug bites, stings

Erin Dobie, CNP

Minnesota summers bring warm weather and opportunities for our kids to go outside, exploring and playing in nature. Pesky insects often irritate or interrupt summer fun. Learn how to prevent insect bites, treat bites when they do occur, remove ticks and how to know when you should seek medical attention for your child.

subscribe_blogHow to treat bites

Insect bites and bee stings react because of venom injected into the skin. The severity of reaction depends on your child’s sensitivity to the venom. Most reactions are mild, causing redness, local swelling and irritation or itching. These usually will go away in two to three days. Calamine lotion or any anti-itch gel or cream may help soothe the itching.

Bee stings cause immediate pain and a red bump, but usually the discomfort lessens within 15 minutes. More than 10 bee stings at once (extremely rare) may cause a more-severe reaction with vomiting, diarrhea and headache. Allergic reactions to bee stings can be severe and quickly get worse. These reactions include difficulty breathing, swelling of the lips, tongue or throat, or confusion. Children who have a severe reaction need immediate medical attention, and you should call 911. If the child has a known bee allergy and an Epi-pen is available, the Epi-pen should be administered in addition to calling 911. If a stinger is present, try to rub it off with something flat such as the edge of a credit card. Do not try to squeeze the stinger out or try to dig it out. If it does not come out easily, soak the area in water and leave it alone to come out on its own.

Tick bites don’t often cause much of a local reaction. They’re primarily concerning because they can transmit infectious diseases. Ticks are prevalent in Minnesota. They’re generally found on the ground in wooded or heavily bushy areas. Ticks can’t jump or fly. Generally they climb grass and climb onto someone to attach as we brush up against them. Ticks are most active during the spring and summer months.

There are a few different infectious diseases that can be transmitted by ticks, but the most common one found in the Minnesota-Wisconsin area is Lyme disease (Borrelia burgdorferi). To infect a person, a tick typically must be attached to the skin for at least 36 hours. The incubation period, the time from infection to being symptomatic, is anytime between three and 30 days.

Lyme disease can present in many stages. Early localized stage often includes a red ring-like rash (or may resemble a “bull’s-eye” target) that slowly expands. Other symptoms include headache, fever, joint or muscle aches and overall not feeling well or excessively tired. If your child develops these symptoms within a few days to weeks after tick exposure you should seek medical attention to evaluate for Lyme disease. Lyme disease is evaluated by medical history, physical examination and sometimes a blood test. It may take the body several weeks to develop antibodies and the blood test may not show up positive early in the disease. Most cases of Lyme disease are easily and successfully treated with a few weeks of antibiotics.

How to prevent a bite

Prevention is the key to avoiding insect bites. I recommend insect repellent that contains at least 20 percent DEET. The higher concentration of DEET does not indicate better repellent; it just means that the repellent will last longer. Most repellents can be used on infants and children older than 2 months. Other effective repellents contain permethrin, picaridin, oil of lemon eucalyptus and IR3535. Permethrin-treated clothing is an option if the child will be camping or on wooded hikes. Finally, showering or bathing soon after exposure to tick areas is important to check for and remove ticks. Parents should pay close attention and check children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist and especially in their hair on their scalp. Dogs should be treated for ticks, but also checked as the ticks can ride into the home on the dogs then attach to a person later.

How to remove a tick

If you find a tick attached to your child’s skin, there is no need to panic.

  1. Use a fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure. Do not twist or jerk the tick, as this often can cause the tick’s mouth to break off and remain in the skin. If the mouth breaks off, try to remove it. If it cannot be removed easily, don’t dig it out; just wash and allow it to fall out on its own.
  3. After removing the tick, clean the skin with soap and water or rubbing alcohol.

12 tips to keep kids safe around dogs

Teach kids to respect your animal’s space. (iStock photo / Getty Images)

Dex Tuttle

Even before the pitter-patter of toddler feet, our house was plenty busy. My wife and I jokingly referred to our dog, Sprocket, and cat, Harvey, as training for parenthood. By the time our daughter, Quinnlyn, came around, we already had learned to keep valuables out of reach and close the doors to the rooms where we didn’t want roaming paws. And we quickly learned the value of eating our meals after distracting the animals to avoid begging eyes.

In addition to providing safety challenges, animals have an uncanny way of creating rules for your house, with or without your approval. Regardless of your expectations of them, they almost always get their way. (Those with toddlers will recognize the similarity here.) In our case, for example, we insisted that Sprocket not be allowed on the furniture — and he most definitely would not be allowed to sleep in our bed. He had different plans, though, and now I’m regularly curled up in the only free corner of our king-sized bed and rarely leave the house without fur-covered pants.

After we introduced the pets to Quinnlyn, Harvey disappeared for what seemed like the better part of a year while Sprocket was quite concerned about losing out on time with us. What remained to be seen was how these interspecies siblings would get along once Quinn became more mobile. We had two animals who thought they owned the house and a new queen who demanded nearly all of our attention. Naturally, there was some ruffled fur.

subscribe_blogOne instance was when Sprocket was lying comfortably on the couch while I was typing away in the recliner near him. Quinn recognized the quiet, relaxing vibe and felt it needed a little chaos. She grabbed her step stool, crawled up on the couch and tried to climb up on Sprocket’s back, hoping to get a free doggie ride. Sprocket alerted me with the warning signs — he first tried to move away then let out a little growl before licking Quinn’s face. Thankfully, I was able to intervene before he got increasingly upset, but his behavior understandably is confusing to Quinn, so she continued to try to climb aboard.

Therein lays the challenge: No matter how well trained, animals are instinctual beings that are territorial, protective and usually inflexible on changing the rules they created. Young children are curious beings who discover their world by poking, prodding, throwing, climbing and chasing. Pairing children and pets can be simultaneously developmentally rewarding and potentially dangerous.

Here are some tips to help keep your kids safe around dogs:

Household pets

  • Dogs typically don’t like hugs and kisses, particularly when it’s not on their own terms. Teach kids to respect your animal’s space.
  • Don’t stare at a dog in close proximity to its face as this can be interpreted as an act of aggression.
  • Dogs that are tied up, cooped in or curled up (sleeping or relaxing) may be more agitated if approached — they either want to get out or be left alone.
  • Know that dogs don’t only attack when they’re angry (growling, barking, hair standing up); they can attack because they’re scared; a dog with its mouth closed, eyes wide and ears forward may indicate that it’s scared or worried.
  • Recognize these behaviors in your family dog to know it’s time to stop playing and give your pet some space:
    • Avoidance: hiding behind something or someone or turning its head away
    • Submission: rolling on its back, licking, or leaving the room; even though the dog is giving up now, it may not some day
    • Body language: tail between legs or low with only the end wagging, ears in a non-neutral position, rapid panting, licking its chops, or shaking out its fur
    • Acting out: tearing up or destroying personal possessions such as toys or other items your family uses frequently, or urinating or defecating in the house; these may be signs that your dog should be seen by a behavioral professional — don’t delay!

Pets outside of your family (tips courtesy of Children’s Hospital of Michigan)

  • Always ask an adult’s permission before approaching or petting a dog. Start by letting the dog sniff you, then gently pet under its chin or on top of its head, but never its tail, back or legs.
  • Never run or scream if a dog comes up to you.
  • Never try to ride a bike away from a dog; they can run faster than you can bike
  • Always be calm around dogs and don’t look them in the eye; they may see this as an act of aggression.
  • Stand still like a tree or rock and let the dog sniff you. If a dog starts biting, put whatever you have (backpack, stick, toy, etc.) in its mouth.
  • Avoid dogs that are eating, playing with toys, tied up in a yard, or behind a fence; also avoid dogs who look ill or angry.
  • Never tease a dog by throwing things at it, barking at it, etc.

Dex Tuttle is the injury prevention program coordinator at Children’s Hospitals and Clinics of Minnesota.

Surgery for ear tubes common for kids

Lindsey Starsky's children, daughter Margie Claire (left), 4, and son Lewis, 10 months, had ear-tubes surgeries at Children's. (Photos courtesy of Lindsey Starsky)

Lindsey Starsky’s children, daughter Margie Claire (left), 4, and son Lewis, 10 months, had ear-tubes surgeries at Children’s. (Photos courtesy of Lindsey Starsky)

Lindsey Starsky knew exactly what to expect when her 10-month-old son, Lewis, underwent surgery for ear tubes earlier this year. Starsky’s oldest child, daughter Margie Claire, had gone through the same process not long ago.

Both kids had ear tubes put in by Barbara Malone, MD, at Children’s Hospitals and Clinics of Minnesota. Dr. Malone is a pediatric otolaryngologist, which means she specializes in ear, nose and throat (ENT) care.

“Children’s was very accommodating and great with the kids,” said Starsky, who was referred to Dr. Malone through her kids’ primary pediatrician. “Child life specialists were brought in to introduce what was going to be happening.”

Every year, more than 500,000 kids receive ear tubes, making it the most common childhood surgery performed with anesthesia, according to the American Academy of Otolaryngology-Head and Neck Surgery. Of children who have tubes, 80 percent will need them once, said Dr. Malone.


Lewis had surgery for ear tubes, just like his sister.

Reasons for ear tubes

The two primary reasons kids need ear tubes are:

  • The recurrence of middle-ear infections
  • Persistent fluid in the ear, which usually creates hearing loss

Ages for ear tubes

The two most common ages kids need ear tubes are between:

  • 15 months and 3 years (usually due to ear infections)
  • 4 and 6 years (typically due to hearing loss from fluid buildup)

What are tubes? How do they work?

There are many different types of ear tubes. Two of the major types are grommets and T-tubes.

The grommet naturally falls out in six months to two years, on average. While it’s inside, it will allow the middle ear to maintain barometric pressure to help decrease rates of infection and fluid production.

The T-tube is shaped like it sounds; it has flanges that open behind the eardrum and remains in the ear indefinitely. T-tubes commonly are used for kids who have required multiple sets of tubes or have an anatomic predisposition to prolonged Eustachian-tube dysfunction, which has been seen in kids with Down syndrome or cleft palate, according to Dr. Malone.

Fluid can be trapped behind the eardrum. The human body’s Eustachian tube — named after 16th-century anatomist Bartolomeo Eustachi — typically works by allowing air in and fluid to drain out. If the tube can’t open, fluid can’t get out, leading to an infection or hearing loss — or both. Tubes allow the fluid to drain.

subscribe_blogDetermining a need for tubes

If you have concerns about your child’s recurrent ear infections or hearing, talk to your child’s doctor. Primary care physicians will refer your child to an ENT doctor when and if they think your child is a candidate for ear tubes. Hearing also should be evaluated, Dr. Malone said.

What to expect if your child needs ear tubes

If your child is referred to an ENT who decides ear tubes is the next step, the procedure is an outpatient visit, unless combined with another medical procedure that requires a hospital stay.

“When my daughter got tubes the first time (at 8 months), it was a fast procedure. By the time I got back to my waiting room it was less than five minutes and Dr. Malone was back,” said Starsky, whose daughter needed two procedures, the second one at age 2 to remove adenoids, a mass of soft tissue behind the nasal cavity. “The second time was a little bit longer. Dr. Malone walked us through everything and had given us information to read about what to expect; it was even easier when we had to bring in Lewis.”

Typically kids are back to themselves within the same day and don’t notice the tubes in their ears aside from better hearing and fewer ear infections. Starsky said Margie Claire’s hearing and sleep improved immediately, and trips to the doctor for ear trouble no longer are a regular occurrence.

“Being at Children’s was great,” Starsky said. “If we had to do it again, we’d go back and through the whole process.”

9 things to know about Lyme disease and other tick-transmitted diseases

Most of the time, ticks are just nuisance pests, but the bites of some species can cause serious illnesses. (iStock photo)

Most of the time, ticks are just nuisance pests, but the bites of some species can cause serious illnesses. (iStock photo)

May, appropriately, is Lyme Disease Awareness Month. When the weather turns nice, Minnesotans aren’t the only ones who emerge from hiding. Ticks come out, too, looking for their next meal. Most of the time, ticks are just nuisance pests, but the bites of some species can cause serious illnesses.

Follow these reminders to help prevent Lyme Disease and other tick-transmitted diseases:

  • Highest risk for tick-transmitted diseases generally is mid-May through mid-July but can stretch longer into the summer.
  • Wear tick repellant containing permethrin on clothing. Other effective repellents include products containing up to 30 percent DEET (diethyltolumide).
  • Walk in the center of the trail to avoid picking up ticks from grass and brush.
  • Wear light-colored long-sleeved shirts and long pants. Tucking your pants into the tops of your socks or boots creates a “tick barrier.” Light-colored clothing makes it easier to see ticks.
  • Check for ticks frequently and remove them promptly. Remember to check the hairline and behind the ears and points of clothing constriction (behind knees, waist line, arm pits, etc.).
  • subscribe_blogRemove by using a tweezers to grasp the tick by the head close to the skin and pulling the tick outward slowly and steadily. Do not squeeze the tick. Use an antiseptic on the bite site after removal.
  • If you live near the woods or in an area with ticks, maintain your property: keep your lawn mowed short, remove leaves and clear the brush around your house and at the edges of the yard, keep children’s playsets or swing-sets in a sunny and dry area of the yard, and make a landscape barrier (such as a 3-foot-wide border of wood chips) between your lawn and the woods.
  • Topical tick repellants are available for dogs and cats, and a vaccine to prevent Lyme disease is available for dogs. Check with your veterinarian to determine the best option.
  • Check dogs or cats for ticks before allowing them inside. For more information about tick-transmitted diseases, visit the Minnesota Department of Health and Centers for Disease Control and Prevention.

For more information about insect repellents and children, visit the American Academy of Pediatrics’ Healthy Children website.

Tanning turmoil: Why getting ‘bronzed’ is hazardous to teen health

For teens, one visit to a tanning bed increases the risk of squamous cell carcinoma by 67 percent. (iStock photo)

Gigi Chawla, MD

Every spring, many of us weary from a long winter head south to warmer climes; teens across the country attend prom with their sweethearts. And what do kids tend to do before events like these?

Hit the tanning salon.

Looking “pasty white” in a swimsuit or a new dress just won’t do, right? Think again.

Gigi Chawla, MD

Gigi Chawla, MD

Here’s a brief warning to help dispel the myth of “getting a base tan” before these events. Or ever.

Currently, 35 percent of 17-year-old girls in the U.S. are using tanning beds and 55 percent of college-aged kids have used one at least once.

In 2014, the Star Tribune reported “a third of white 11th-grade Minnesota girls have tanned indoors in the past year, according to a state survey … and more than half of them used sun beds, sunlamps or tanning booths at least 10 times in a recent 12-month period.”

What isn’t immediately clear to our kids is that during a tanning-bed session they may receive up to 12 times the ultraviolet (UV) exposure as they receive being outside in the natural sunlight. This UV radiation exposure from tanning beds is dangerous and linked to three types of skin cancer: melanoma, basal cell carcinoma and squamous cell carcinoma.

Here’s the potential damage that one tanning-bed session can cause a teen:

  • The risk of developing melanoma increases by 20 percent.
  • The risk of developing basal cell carcinoma increases by 29 percent.
  • The risk of squamous cell carcinoma increases by 67 percent

subscribe_blogFor people younger than 35 using a tanning bed, the lifetime risk of developing skin cancer of any type increases by 74 percent.

Specifically, it increases the lifetime risk of:

  • Melanoma by 75 percent
  • Basal cell carcinoma by 150 percent
  • Squamous cell carcinoma by a whopping 250 percent

Moreover, skin cancer now is the leading form of cancer in 25- to 29-year-olds.

Another startling fact: More skin cancer cases arise from tanning-bed use than lung cancer cases do from smoking; yet, in our culture, bronzed skin is seen as a form of beauty.

Some advice to parents: Remember to reinforce to your teens that they are beautiful or handsome no matter the shade of their skin. What’s important is what’s inside. I like to think that we live in an era in which we can look past skin color, where we are not judged by skin color and we should not see beauty based on skin color.

It’s time to remind your kids to “go with your own natural glow.”

Gigi Chawla, MD, is a pediatrician, hospitalist and the Senior Medical Director of Primary Care at Children’s Hospitals and Clinics of Minnesota. Her areas of interest are the care of complex special needs patients, premature infants, ventilator dependent children and care of hospitalized patients.

Sources: The Skin Cancer Foundation, U.S. Food and Drug Administration, Centers for Disease Control and Prevention


“Children’s Pedcast”: Dr. Gigi Chawla on well-child visits

On Episode 5 of “Children’s Pedcast,” Dr. Gigi Chawla, senior medical director of primary care at Children’s, joins the show to discuss all things well-child visits and the importance of finding the right pediatrician for your child from birth to adulthood. She answers a lot of questions and provides helpful information for parents with kids of all ages.

“Children’s Pedcast” can be heard on iTunes, Podbean, Stitcher, YouTube and Vimeo.

5 tips for home and neighborhood safety

Summer is around the corner, we promise. A steady helping of the warm weather isn’t far away.

The season brings neighbors together for all kinds of outdoor activities. While your local barbecue or block party is a great time to reconnect with neighbors and enjoy a potluck, it’s also a great chance to review home and neighborhood safety tips with your children.

Here are five tips to bring up with your kids ahead of summer:

1. Post important personal and contact information in a central place in your home.

  • Include parents’ names, street address, mobile, home and work phone numbers, 911, poison control, fire department, police department, and helpful neighbors.
  • Use a neighborhood party to help children to familiarize themselves with their neighbors and identify whom they can go to for help.

2. Teach your child how and when to call 911.

  • Discuss specifics of what an emergency is and when 911 should be used.
  • Role play different scenarios and make sure kids know what information to give to the 911 operator.
  • For younger kids, discuss the different roles of emergency workers and what they do.

3. Discuss “stranger danger.”

  • Talk with your kids about who is allowed to pick them up from school or activities.
  • Talk to your kids about the importance of walking in pairs.
  • Ensure they always take the same route home from school and do not take shortcuts.

4. Practice proper street safety.

  • Have kids practice looking both ways before stepping into the street, using the crosswalk and obeying the walk-don’t walk signals.
  • Teach kids what different road signs mean, such as a stop sign.
  • Remind children about the importance of biking with a helmet and reflective light.

5. Talk to your children about fire safety.

  • If fire trucks are present at the neighborhood party, use their presence as an opportunity to discuss what to do if there were a fire.
  • Plan and practice escape routes in your home and designate a meeting spot in case you get separated.

It’s never too early to talk to your children and family about ways to stay safe.

Advice for first-time marathoners from Coach Antonio Vega

Coach Antonio Vega of Zoom Performance will guide Team Superstars with an online training plan, weekly training tips and two group runs and presentations. (Photo courtesy of Antonio Vega)

Coach Antonio Vega of Zoom Performance will guide Team Superstars with an online training plan, weekly training tips and two group runs and presentations. (Photo courtesy of Antonio Vega)

Earlier this year, we launched our first-ever charity endurance program. With Coach Antonio Vega’s help, Children’s Team Superstars will participate in the Medtronic Twin Cities Marathon in 2015. Because many of our runners will be lining up for 26.2 miles for the first time, we asked Antonio a few questions.


RELATED: Add a Children’s race to your calendar


How do you start training for your first marathon?

Starting to train is always the hardest part of training. Keeping yourself accountable and motivated can be challenging when starting to train for a marathon. The best way to get started is to make a schedule of days and times when you will dedicate time to getting your run in. Find a friend who is willing to keep you company during your training. Keep your running fun by finding new places to run, join a running club or meeting a group of friends for a run and then going out for brunch, post-run.

Do you recommend doing any races while training and gearing up for a marathon?

Racing during marathon training is a great way to break up the monotony of training, and it’s a good time to gauge your fitness. I recommend adding in a couple of 5Ks and 10Ks before the marathon.

What is the best cross training?

Cross training is a great way to give your body additional time for recovery while still working your aerobic system. Any form of cross training that you enjoy is a value toward your marathon training.

What do you recommend for fueling before, during and after training runs?

Fueling can be one of the most important aspects of your marathon training. Having a good meal about two hours before a run is important. Keep with foods that you are used to and sit well in your stomach. During training runs, practice taking fluids and some form of nutrition. With the athletes with whom I work, we use a diluted sports drink and a gel during long runs. Post-run, it is just as important to replenish the calories that you lost during your long run. A 16-ounce glass of chocolate milk has the right balance of fats to protein and is a great way to replenish the calories you lost.

subscribe_blogTo stretch or not to stretch before and after runs?

I like to stretch after doing a run. This allows me to focus on areas that were tight during my run. I find that before doing a run I like to do more of a dynamic warm-up. A dynamic warm-up is a way to get your heart rate up and stretch out the muscles that you will be using during your run.

What is normal pain versus bad pain while running?

It is always tough to determine what is considered pain and what is just regular training soreness. My rule of thumb is if you start running and the pain starts to go away the more you warm up, this is usually a sign of training soreness. Training soreness is to be expected and not something to worry too much about. However, if you start to run and the pain stays the same or gets worse the more you run this can be the start of an injury, and it might be wise to take some time off.

There’s still time! Join Team Superstars by contacting Brady Gervais at [email protected] today!