Category Archives: Health tips

Facts on frostbite

Limit the amount of time spent outdoors during cold temperatures. (iStock photo / Getty Images)

By Erin Fritz, CNP

Minnesota winters offer many outdoor activities. While we can appreciate the fun of sledding, the thrill of skiing or the labor-intensive task of shoveling, these activities aren’t without risk. Specifically, prolonged exposure to the cold puts our skin at risk for frostbite, or — a lesser version — frostnip.

What is frostbite?

Frostbite is the damage to a body part caused by cold. While many instances are mild, frostbite can be quite severe. Typically the cold exposure occurs over minutes or hours, but frostbite can be instantaneous if exposed to cold metal. Frostbite is most common on the ears, nose, cheeks, chin, fingers, and toes.

What should I watch for?

It’s important to recognize the signs of frostbite as quickly as possible. Skin will feel cold, and may even be numb or tingling; it may have a gray or white appearance. Due to the numbness, the affected body part may feel clumsy or be difficult to move. Slightly worse symptoms may include blisters. Severe frostbite will have areas of black skin.

Q4_mighty_buttonWhat to do if I am concerned?

Once symptoms of frostbite or frostnip are identified, the affected area needs to be rapidly re-warmed. The American Academy of Pediatrics recommends that the water used to re-warm the skin should be warm, but not hot. Avoid rubbing the area as this could make the pain and tissue damage worse. Pain is commonly a factor with frostbite, and can be managed with over-the-counter pain medications or by health care professionals.

How can frostbite be prevented?

Most importantly, frostbite easily can be prevented. Limit the amount of time spent outdoors during cold temperatures. Dress in layers, and cover all areas of uncovered skin with a hat, mittens, face mask and goggles. Warm boots are important. And finally, stay dry. If clothing does get wet, seek shelter and remove wet clothes immediately.

Springtime will bring warmer temperatures. But until then, dress warmly, stay dry and prevent frostbite.

Beat the flu, get vaccinated

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The flu vaccination is the best defense against what can be a serious infection at any age.

The flu vaccine is the best defense against what can be a serious infection at any age.

By Patsy Stinchfield, PNP

Influenza is a complex, tricky virus that is nearly impossible to predict. From 2013-2014, more than 1,300 Minnesotans were hospitalized with influenza.

And we know that of the 174 kids who died from influenza during the 2012-13 season, 90 percent of them had not been vaccinated. We know that pregnant women are more prone to influenza complications and are a high priority for getting vaccinated, but only half of pregnant women are actually protected.

Q4_mighty_buttonThe flu vaccine isn’t perfect, but it’s still our best defense against what can be a serious infection at any age. It reduces your chance of getting sick. But if you do become sick, it helps reduce the severity.

If not for yourself, vaccinate on behalf of babies who are too young to receive the vaccine (under 6 months of age), women and those with immunity problems or who are undergoing cancer treatment. When you get vaccinated, you protect yourselves and others.

A colleague told me that when her mom was undergoing cancer treatment, she got influenza and died from the infection. My colleague and her entire family were vaccinated that year before flu season and will never miss a chance to protect themselves against the disease that took their loved one.

Patsy Stinchfield, PNP, is the director of infectious disease and prevention at the Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota.

Managing your child’s sleep when the clocks ‘fall’ back in November

Bright light in the morning helps a child’s internal brain clock to maintain a good rhythm, which helps the body transition easier from wake to sleep that night. (iStock photo / Getty Images)

Bright light in the morning helps a child’s internal brain clock to maintain a good rhythm, which helps the body transition easier from wake to sleep that night. (iStock photo / Getty Images)

By Karen K. Johnson, RN, CNP

On Nov. 2, clocks are turned back by an hour, marking the end of Daylight Saving Time. Any disruption to the sleep patterns caused by the time change will be temporary. But if you want to be proactive to minimize the disruption to your child’s sleep pattern, here are a few things to consider.

For babies

Two weeks before the time change, start to put your children to bed 10 minutes later than usual, increasing by 10 minutes every other night until they are going to sleep about an hour later than their normal bed time. It often takes a few days for a new sleep pattern to establish itself.

Toddlers and older

  • Put them to bed a little later than usual the night of the time change. There are behavioral tools available to help with these schedule changes (Good Night clock).
  • If they wake up at their usual time (an hour earlier), you should encourage them to remain in bed until a set time. This may be a digital alarm clock or the visual cue of the night light.
  • When they remain in their bed until the “sun” appears on the clocks or when you inform them it is time to get up, they should be happily praised.
  • The following day, provide a generous amount of physical activity to tire them out and then put them to bed at the new earlier bed time.
  • The next morning, set the clock for the new morning wake time.

On the whole, it is easier for children to fall asleep in the winter months because it is darker and the environment is likely cooler at bedtime. The difference in light levels between day and night encourage the production of the sleep hormone melatonin in the evening when the light is dim, as there is a rise in melatonin and sleep is invited. Bright light in the morning helps a child’s internal brain clock to maintain a good rhythm, which helps the body transition easier from wake to sleep that night. Adjusting the sleep-wake cycle in November is easier to manage than when advancing the clocks forward in springtime.

In the spring, Mighty will have tips to manage your child’s sleep schedule when we “spring” the clocks forward March 8, 2015.

Karen Johnson is a certified nurse practitioner in the Children’s Sleep Center.

Serving up strategy at meal time

Kids are born wanting to eat. And they know when they’re hungry. It’s our job as parents to provide structure, support and opportunities.

Kids are born wanting to eat. And they know when they’re hungry. It’s our job as parents to provide structure, support and opportunities.

By Maggie Sonnek

We’ve tried peas. We’ve tried broccoli. We’ve even tried Brussels sprouts. Alas, our 2-year-old continues to ignore that pile of “green stuff” on his plate and reach for the carbs instead (just like his mother).

After chatting with Janie Cooperman, MS, RD, LD, CDE, Pediatric Clinical Dietitian at Children’s Hospitals and Clinics of Minnesota, I now can come to the table feeling a little more prepared to take on a toddler at dinnertime. (Sounds like a thrilling TV show, doesn’t it?). I feel so enthused with what I’ve learned that I just had to share. 

Keep offering

Cooperman suggests offering specific foods 12-15 times before retiring them from the household menu. That’s a lot of peas! She also touts variety when planning the weekly carte du jour. For example, instead of plain bread, try whole wheat tortillas or pita pockets.

Division of responsibility

Kids are born wanting to eat. And they know when they’re hungry. It’s our job as parents to provide structure, support and opportunities.

Cooperman sites Ellyn Satter, an expert on the topic of the division of responsibility in feeding. Basically, this means we the parents are responsible for what, when and where our kids eat. They’re responsible for how much and whether they eat.

Yep. I said “whether.”

Cooperman suggests offering three scheduled meals a day with two or three snacks in between. “Eventually the child begins to understand the schedule and expectations,” she said. “Since he is not receiving food other than at the scheduled meals and snacks, he will soon get hungry enough and realize that he has no other option but to eat what’s being offered.”

Subscribe to MightyMake it a non-issue

You know the old standby, “You can’t leave the table till your plate’s clean”? Well, turns out, forcing a clean plate prevents kids from learning to pick up on their own hungry and satiety cues. Apparently most of us unlearn the natural inclinations of when we’re full and hungry sometime between the ages of 3 and 5.

Cooperman suggests making the amount of food your child eats a non-issue. She dissuades from offering rewards for eating. “If they refuse to eat, let it go,” she said. “But keep offering it at future meals. Try not to let kids get power and control.” (Writer’s note: I’m totally guilty of bribing my son with a chocolate chip cookie for taking a bite of broccoli. Oops.) 

Eat mindfully 

Eating dinner together as a family has a lot of benefits. The Family Dinner Project, a grassroots movement driven by insights and experiences of families, says recent studies find regular family dinners can help lower rates of substance abuse, teen pregnancy and depression. Studies show that dinner conversation can help improve vocabulary more than reading.

But let’s focus on the obvious: eating together. Parents modeling healthy habits, like munching on fruits and veggies, provide a good example for kids. Cooperman touts the importance of eating mindfully.

“Slow down, connect and enjoy what you’re eating,” she said. “Appreciate the food and your time together; it’s a more-balanced way of eating and living.” 

Maggie Sonnek is a writer, blogger, lover-of-outdoors and momma to two young kiddos. When she’s not kissing boo-boos or cutting up someone’s food, she likes to beat her husband at Scrabble.

Break for breakfast: Tips for a healthy start

With the school under way, your child may be in a hurry to get ready in the morning – and that includes trying to fit in time to eat breakfast and pack a lunch.

Since diet plays a huge role in childhood obesity, it’s important to make sure a child is eating right even when you’re not there to supervise or cook. Four out of five kids from 12 to 19 years old have “poor diets” – high in salt and sugar-sweetened beverages and low in fruits, vegetables, fiber and lean protein.

In Minnesota, nearly one out of four kids has weight problems. Among Minnesota adolescents ages 10 to 17, about 11.1 percent are obese.

Subscribe to Mighty“Beginning your day with a healthy breakfast is a good way to wake up your body and brain,” said Julie Boman, MD, a pediatrician at Children’s Hospitals and Clinics of Minnesota.

How do you make sure your child gets a healthy start? Boman weighs in with these four tips:

  1. Stock the cupboards and refrigerator with healthy choices. They can include whole grain cereal, fresh fruit, yogurt and eggs.
  2. Make it convenient. If you buy strawberries, wash and slice them up so they’re ready for your child to grab and go.
  3. Whenever possible, encourage your child to sit down and have breakfast.
  4. If your child is older, plan the menu for the week together.

Trauma: When it’s critical, so is your choice

Why would you take your child to Children’s emergency room over any other hospital? Our team members are on staff, not on call. Your child gets treated immediately.

When it’s critical, so is your choice. Children’s Level I Pediatric Trauma Center, Minneapolis.

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Minnesota spring means ticks, health risks

Deer ticks are tiny – about the size of a pencil tip – and brown-black in color. Wood ticks are larger and do not carry Lyme disease.

Erin Fritz, RN, CNP

The snow has now melted and the temperatures are rising, allowing our energy and activities to bring us outdoors. Spring weather brings sprouting trees, blooming flowers – and creepy crawly ticks that lurk in the woods, grass and marshy areas.

Whether you are heading up north to the cabin or playing in your backyard, ticks may be present and a tick bite may occur. Due to the extreme seasonal temperature changes and high humidity, Minnesota has a lot of ticks and high rates of tick-borne illness such as Lyme disease, and the risk remains high. Lyme disease is an infection caused by bacteria that is carried by some deer ticks. Deer ticks are tiny – about the size of a pencil tip – and brown-black in color. Wood ticks are larger and do not carry Lyme disease.

Prevention

Playing outdoors increases the risk of encountering a tick, but there are ways to prevent a tick from attaching and biting. The American Academy of Pediatrics recommends the following for tick and Lyme disease prevention:

  • Cover arms and legs by wearing long-sleeved shirts and pants tucked into socks
  • Wear a hat to cover hair
  • Wear light-colored clothing in order to see ticks more clearly
  • Wear enclosed shoes, use insect repellent with DEET
  • Stay on cleared trails whenever possible
  • Routinely check for ticks immediately after coming indoors

When you find a tick

Most ticks are noticed when crawling around on clothing or skin and easily can be removed by taking it off before it attaches to the body. If a tick already has attached, removal is rather easy and should be removed as soon as possible. While prompt removal is important to decrease the risk of developing Lyme disease, be aware that most medical experts agree that the tick must be attached for at least 24-36 hours before Lyme disease is transmitted.

In order to remove the tick:

  • Simply grasp the tick with a tweezers as close to the skin as possible
  • Without squeezing the tick’s body, slowly pull the tick away from the skin
  • Clean the bitten area with soap and water
  • Apply an antiseptic ointment

Be on the lookout

After tick removal, it’s important to monitor the site for expanding redness that might suggest a “bull’s eye” rash. This particular rash can be the first and most obvious sign of Lyme disease.  The rash usually doesn’t cause other symptoms, but burning or itching is a possibility. Further examination by a health care professional is needed if there is a bull’s eye rash, headaches, chills, fever, fatigue or muscle aches. If Lyme disease is suspected, a health care professional probably will prescribe an oral antibiotic for treatment. There’s no benefit in testing for Lyme disease at the time of the tick bite; even people that become infected will not have a positive blood test until approximately two to six weeks after the infection post-tick bite. Early identification and treatment is important to reduce the risk of worsening illness.

While ticks and tick-borne illness easily can be overlooked, prevention is vital. This is the time of year to take full advantage of the long-awaited summer. Get outside and play safely.

Erin Fritz is a certified nurse practitioner at Children’s Hospitals and Clinics of Minnesota.

Stress test: Helping kids lessen testing anxiety

To combat testing anxiety, students should have some go-to solutions such as engaging in a brief relaxing activity, outlining notes or playing a memory game. (iStock photo / Getty Images)

Guest post by Maggie Sonnek

Mae Hyser is one smart cookie. At 12 years old, she already has her career planned out: become a writer and an illustrator. And mom Beth couldn’t be prouder.

“She’s kind of a Type-A personality,” Beth Hyser laughs. But, as end-of-the-year finals and projects approach, sixth-grader Mae is aware of the extra pressure. And so is her mom.

Are your kids stressed over tests? Here are some tips to help kids like Mae – and their parents – decrease stress and improve results.

Set up good study habits at an early age

It sounds obvious, right? Michelle Goldwin, MA, doctoral psychology intern at Children’s, says developing effective study habits earlier is a way for kids to feel more confident about their abilities to study and take tests.

“We’re noticing kids are becoming nervous about tests earlier and earlier,” she explains. “There are more standardized tests sooner; kids are learning that they have to do well in order to get good grades…to get into a good college…to get a good job.”

To combat that anxiety, students should have some go-to solutions at the ready, such as engaging in a brief relaxing activity, outlining notes or playing a memory game.

Create a positive bedtime routine

Bedtime can be the hardest time of the day for parents. But, it doesn’t have to be. Mary Sheedy Kurcinka, MA, writes about practical strategies for getting a good night’s sleep in her book, Sleepless in America.

“Researchers have discovered that the sleep/wake cycle, or what researchers like to call the circadian rhythm, runs on a cycle closer to 25 hours than 24,” she writes. “In order to bring your child’s cycle into line with a 24 hour day, you have to set it with cues, like light and a regular sleep-and-wake schedule.”

Create a calming end-of-day routine, whether it’s quiet music, dim lighting or a scented candle.

Here are more ways to help your kids get a good night’s sleep.

Take breaks and use incentives

Even at the college level, students are still encouraged to take breaks. MIT supports several scheduled breaks throughout the day, saying, “Our minds need an occasional rest in order to stay alert and productive, and you can look forward to a reward as you study.”

For 12-year-old Mae that reward is a few coveted minutes on the iPad, which mom will gladly hand over after she practices her spelling words.

Value your child’s self-worth

Both Goldwin and Beth Hyser expound on the importance of valuing kids beyond the report card.

Goldwin says, “Parents can remind their kids, ‘I like that you’re working hard on this and giving it your all.’ But, be sure to remind them that they’re also a great artist or bowler. There are lots of special things about each child.”

Beth Hyser agrees. “If a C is your best, then that’s great.”

Change the way you think

Goldwin and the rest of the team in Psychological Services at Children’s utilize Cognitive Behavioral Therapy as a way to help patients with anxiety.

“We encourage students to pay attention to their negative thoughts, like ‘I’m not going to do well on this test’ and replace them with more helpful thoughts, like ‘I’ve studied and I feel confident that I know this material.’ ”

Practice self-care

This means eating a hearty breakfast the morning of a test, staying away from caffeinated beverages and paying attention to breathing.

“Before the day of the test, I encourage kids to practice deep breathing by placing a hand on their bellies,” Goldwin says. “Then, slowly breathe out and notice that their belly deflates.” She adds that sometimes she draws the analogy of the stomach being like a balloon that’s filling with air and then emptying.

Lessening testing anxiety may not always be easy for kids, but these strategies can get them started on the path to a less stressful testing season.

In what ways do you work with your kids to lessen anxiety before tests or other stressful times? Share in the comments.

More information: Psychological Services at Children’s

Maggie Sonnek is a writer, blogger, lover-of-outdoors and momma to two young kiddos. When she’s not kissing boo-boos or cutting up someone’s food, she likes to beat her husband at Scrabble.

Sleep health in children

Teaching kids to fall asleep on their own at the beginning of the night without your presence is an important skill for them to learn. (iStock photo / Getty Images)

By Karen Johnson, RN, CNP

Getting enough sleep is essential for your child’s growth and health. Studies show that many children don’t get enough sleep each night. This can result in behavioral problems, mood swings and poor school performance. A lack of sleep also can cause problems with memory, concentration and problem solving.

Occasional bouts of sleeplessness or restless nights are normal for kids as their bodies and brains develop, and the tips below can help you ensure your kids are getting enough rest.

But sometimes your child may not be getting enough sleep due to a sleep disorder. One of the most common sleep disorders in children is Obstructive Sleep Apnea (OSA). Signs of OSA in children are loud snoring, restless sleep, gasping and hyperactivity when awake. Risk factors for having OSA in children are having enlarged tonsils or adenoids, being overweight or certain other genetic or health disorders. Speak with your child’s health care provider if you think that your child might have OSA.

Here are some tips for helping your kids get a good night’s sleep:

Create a soothing and regular routine for sleep: A routine can help your child get ready for bed much easier. Studies show that children who have a bedtime routine wake up fewer times during the night. The bedtime routine should be the same every night, such as reading one book and singing one song, not lasting more than 15 to 20 minutes.

Maintain a consistent bedtime and wake time: Keeping the wake time and bedtime the same, even on weekends and vacations, is important to help maintain circadian rhythm.

Be conscious of light and darkness: Both are very influential in sleep-wake cycles. Bright light in the morning is influential in setting the circadian rhythm and helping children wake easier. Opening the curtains in the morning to let in the sunlight is the most powerful source of light; artificial light can be helpful as well. Dim the lights in the evening prior to the bedtime routine to cue your child’s internal clock that it’s time for sleep.

Keep electronics out of the bedroom: The light from televisions, computer screens, video games and mobile devices like cellphones can prevent your child from sleeping. It’s best to turn off all electronics at least one hour before bedtime, and in their place, do a calming activity such as reading or coloring.

Naps are important: Younger children need regular and predictable naps during the day. When your child is napping only once a day, don’t let him or her nap late into the afternoon, as this will interfere with the child’s ability to fall asleep at the regular bedtime.

Teach your child how to self-soothe: At an early age, put your child into his or her crib or bed when he or she is drowsy but still awake. Teaching kids to fall asleep on their own at the beginning of the night without your presence is an important skill for them to learn. Children naturally wake two to six times a night, and if they do not know how to self-soothe, they will cry to alert you that they are awake. Not only does that disrupt their sleep, but yours as well.

No caffeine allowed: Caffeine is not recommended for kids, but if you allow your child any, make sure it is before 3 p.m., as it can delay the onset of sleep at bedtime.

Consistency is key to success: Be patient and persistent, as the investment is well worth it when your child is sleeping better.

Make sleep a priority for your child and family: Teach your child about the importance of sleep by being a good role model in your own sleep habits.

Karen Johnson, RN, PNP, is a nurse in the Children’s Sleep Center at Children’s Hospitals and Clinics of Minnesota. Her interest in pediatric sleep medicine stems from her passion to assist children in improving their sleep. She views sleep as a necessary function so that children can be alert, focus in school, reach their learning potential and have energy to play and be kids.

The Children’s Sleep Center is one of the only pediatric-centered programs in the region and one of only a handful that is nationally accredited by the American Academy of Sleep Medicine.

Signs and symptoms of a concussion

(iStock photo / Getty Images)

March is Brain Injury Awareness Month. As part of that, we’re sharing some concussion safety tips.

What is a concussion?

A concussion is a type of traumatic brain injury caused by a blow to the head or body. Symptoms can show up right after the injury or may not be noticed until hours or days later.

Signs and symptoms to watch for:

  • Headache or dizziness
  • Drowsiness or sleepiness
  • Focus or concentration problems
  • Blurry or double vision
  • Balance or coordination problems
  • Disorientation or mental confusion
  • Memory loss
  • Slowed thinking or speech
  • Blank or vacant look
  • Loss of consciousness
What to do if your child displays concussion symptoms:
  • Immediately remove your child from activity
  • Seek medical attention
  • Tell your child’s coach or teacher
Children’s Concussion Clinic

651-220-5230
8 a.m. to 4:30 p.m. Monday-Friday

Children’s Specialty Center (ground floor)
2530 Chicago Ave. S.
Minneapolis, MN 55404

Garden View (third floor)
347 N. Smith Ave., Suite 300
St. Paul, MN 55102