Category Archives: Parenting

Taking a proactive approach to preventing sexual abuse

Parents may become concerned about sexual abuse, particularly in younger children, due to behavior. (iStock photo)

Parents may become concerned about sexual abuse, particularly in younger children, due to behavior. (iStock photo)

Alice Swenson, MD

Parents worry about many things that might happen to their children when they’re in the care of others. Sexual abuse often is one of those concerns, so it’s important for parents to be aware of the risk of sexual abuse in young children and to take steps toward prevention.

  1. Teach kids from a young age that their bodies belong to them and that if someone touches them in a way they don’t like, they are allowed to say no. Model this behavior by allowing your child to say no to things like hugs.
  1. Children should be taught that the private parts of their bodies are just that, private, and that only specific people should be allowed to look at or touch those parts. This may include people who are changing diapers or helping with toileting, or, in older, more-independent children, only doctors or nurses who are making sure that their bodies are healthy. Children should know the proper anatomical terms for body parts so if something happens they can communicate to protective adults. Parents should have regular conversations under non-stressful circumstances with their children about who they can talk to if something happens to their bodies that they don’t like, naming specific people such as a parent, teacher, doctor or nurse.
  1. Talking to your children about secrets is important. Explain that families don’t keep secrets from each other and that if someone tells them not to say something to their parents they need to tell right away.

subscribe_blogThe most common way that sexual abuse is discovered is when a child discloses that it has occurred. When this happens, parents should refrain from questioning the child at length. At that point it is crucial that the concerns be reported to local child protection and law enforcement. Trained professionals can then investigate the allegations and help keep children safe.

Most children who are sexually abused have no physical findings on an exam, and exam findings that may cause concern for parents, such as redness of the genital area, are not necessarily associated with sexual abuse.

Parents may become concerned about sexual abuse, particularly in younger children, due to behavior. Sexual development begins in early childhood, and children by age 3 may express interest in their private parts and touch themselves to experience pleasure; this can be normal behavior. Other common sexual behaviors may include expressing interest in other children’s private parts, showing their private parts to others and trying to look at adults’ private parts.

There are, however, sexual behaviors that may be outside the “norm” (trying to put things into their private parts, simulating sex with other people), but these may indicate other problems such as exposure to pornography rather than indicating sexual abuse.

It’s the responsibility of everyone in the community to keep children safe and healthy and protect them from abuse. Children’s Hospitals and Clinics of Minnesota, including the Midwest Children’s Resource Center, is a community partner in this endeavor, offering services such as medical evaluation of child abuse and therapeutic resources.

Alice Swenson, MD, is a child abuse pediatrician at the Midwest Children’s Resource Center, a clinic which is dedicated to the medical evaluation of suspected child abuse and neglect.

Ensuring kids get enough exercise in every season

Games like hide and seek, building forts and even cleaning the house can get kids active and exercising. (iStock photo)

Games like hide and seek, building forts and even cleaning the house can get kids active and exercising. (iStock photo)

Samara Postuma

We all know that kids need exercise, but how much exercise should kids be getting? And how do we ensure they’re getting enough when those too-cold- (or too hot) to-play-outside days come around? Julie Boman, MD, a Children’s pediatrician, has some tips and ideas to share on making sure kids are getting the full 60 minutes a day of the exercise they need.

It’s important to note that while all kids need 60 minutes of exercise, the way that looks for your preschooler and the way that looks for your middle-schooler might be different.

“Younger kids need frequent bursts of activity versus an hour of activity straight, where an older child can get their exercise by being active for an hour,” said Dr. Boman.

So what about those days — those miserably cold days — where it’s deemed unsafe for kids to play outside? Or, as we dream of warmer days, those hot summer days where the heat index is so high it’s dangerously hot for kids to be outside?

subscribe_blogWell, according to Dr. Boman, it’s time to get creative.

Some of the more obvious options to get your kids active would be indoor parks, community centers, YMCAs and parks and recreation centers, most of which will offer special extended hours on the days that outside play might be limited.

“Younger kids just need a space to run,” Dr. Boman said, noting that this is when an unfinished basement can come in handy.

You don’t have to get too crazy to get kids active, though — games like hide and seek, building forts and even cleaning the house can get kids active and exercising.

The only time you’ll hear Dr. Boman suggest video games is when it comes to moving your body versus your thumbs, and there are plenty of games out there that do just that.

“Dancing games on the (Nintendo) Wii (or Wii U) are a good workout, even for adults,” she said.

Another more creative way to get kids active is by looking for active apps or videos such as the IronKids App, which was developed by the American Academy of Pediatrics and is available for iPhone or iPad for $3.99. The app has several different workouts for cardio and core, and kids can follow the app for five-minute bursts of circuit training and weightlifting using household items.

Don’t have a smartphone or tablet? No problem. A simple YouTube search will bring you thousands of workout videos for kids and adults.

“It’s all about exploring ways to keep kids interested,” Dr. Boman said.

What are your tried-and-true ways to keep kids active and exercising all year round?

For more information about Children’s childhood obesity efforts, contact Anna Youngerman at [email protected].

Read Samara Postuma’s blog Simplicity in the Suburbs, and follow her on Twitter.

’Tis the season – for injury?

The increase in toy-related injuries primarily is due to ride-on toys and scooters. (Children's Hospitals and Clinics photo)

The increase in toy-related injuries primarily is due to ride-on toys and scooters. (Children’s Hospitals and Clinics photo)

Dex Tuttle

Toddlers have a seemingly infinite amount of energy. This isn’t news to most of you, but as a new parent my expectations of my daughter’s energy level are always a significant underestimate of the stamina of which she’s capable. On a recent weekend, Quinnlyn and her “Namma” ran more than 50 laps around our kitchen and living room with little or no signs of slowing down.

As a result of this constant source of energy, I often struggle to keep my daughter occupied. My rationale is that she’s less likely to get into trouble if she’s busy with some toys or an activity; however, that may not be the case.

Q4_mighty_buttonA new study found that, nationally, toy-related injuries are sending another child to the emergency room every three minutes.

This increase in toy-related injuries primarily is due to ride-on toys and scooters. Nearly half of the kids injured by toys are hurt falling off of them, and of those, many of them break bones.

REPORT: Avoiding dangerous toys

Now may be a time of year that some of us are thinking about getting new toys for the little ones. Whether they play with new toys or hand-me-downs, it’s not likely we’ll ever totally protect our kids from injury, but this serves as a good reminder:

  • Always read the instructions and follow manufacturer guidelines on age and appropriate use.
  • Define a safe space for kids to use these high-risk toys, and always make rules about staying away from other hazards such as traffic, obstacles and other people.
  • It’s never too early to get kids in the habit of wearing helmets. If they’re on wheels, their helmets should be on – indoors or out.
  • Make sure the toys are in good repair and check the Consumer Product Safety Commission for recalls.

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

Flu vaccination more important than ever


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

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

Q4_mighty_buttonBy Patsy Stinchfield, PNP

Parents — heads up!

If you haven’t received your or your children’s influenza vaccine, now is the time. The flu has begun to circulate in Minnesota and is a strain (A-H3N2) that is known to cause more-severe illness in all ages, but especially in the very young and the very old. One child in Minnesota already has died this year from this usual, seasonal strain of influenza.

It takes about two weeks to make protective antibodies, so get in now for your shot or nasal mist before gathering with sick friends and relatives.

The flu vaccine contains A-H3N2, but the virus circulating now has changed a bit, making the vaccine not a perfect match. However, it still is critical to get a flu vaccine because there is cross-protection that will help prevent kids from ending up in the hospital or worse yet, the intensive care unit.

It’s a busy time for everyone, but right now there is nothing more important than protecting yourself (especially if you have a baby younger than 6 months who is too young to be immunized), and your children. The flu vaccine is available at most clinics and retail stores, but please call and make arrangements.

Have a happy and healthy holiday!

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.

Andrew’s Journey: A life of great purpose and meaning

By Nicole Schmidt

Excited to wear my cute boots for a post-Christmas brunch at my sister’s, I needed to use the bathroom one more time before we headed out. Let’s just say when I sat down I got more than I had expected.

(Photos courtesy of Nicole Schmidt)

Nicole and Paul Schmidt are the parents of Andrew Schmidt. (Photos courtesy of Nicole Schmidt)

My son, Andrew Jacob Schmidt, entered the world three weeks early and changed our lives forever. As a parent, you never forget the first time you look at your child. When I first locked eyes with Andrew, I knew something was not right but couldn’t put my finger on it. The phrase “coarse facial features” was used by our pediatrician, and we were encouraged to be evaluated by a geneticist.

Andrew Schmidt

Andrew visited Children’s when he was 4 months old.

When Andrew was 4 months old, we visited Children’s Hospitals and Clinics of Minnesota. With thick stacks of paperwork in hand, the questioning and assessment of our son and his coarse facial features began. We worked with Dr. Nancy Medelsohn and the genetic counselor that day and over the next few months. After a multitude of tests and referrals, they concluded that that Andrew had Beckwith-Wiedemann syndrome. This rare disorder is characterized by pre/postnatal overgrowth, neonatal hypoglycemia, congenital malformations and a higher risk for tumors and cancer.

Andrew Schmidt

Andrew initially was diagnosed with Beckwith-Wiedemann syndrome shortly after birth.

Over the next few years, Andrew continued to struggle. He was not meeting basic developmental milestones and was suffering from low-muscle-tone seizures called myoclonic jerks and was diagnosed as deaf and blind. Oddly enough, none of these symptoms were associated with Beckwith-Wiedemann syndrome. There were frequent phone calls from Dr. Mendelsohn’s office, most often from herself to guide us to the next course of action, set up early intervention, refer us to other specialists or relay lab work or ultrasound findings.

Q4_mighty_buttonAfter attending a Beckwith-Wiedmann syndrome medical conference and sharing Andrew’s case with several people including Dr. Beckwith himself, my husband, Paul, and I decided to reach out to Andrew’s superstar, Dr. Mendelsohn. We shared what we had learned and she reopened the case. Soon after, she recommended that we test for an extremely rare genetic disorder called Pallister-Killian syndrome.

I was certain the test would prove negative, until I looked up this syndrome the night before the test. I couldn’t believe my eyes; it was like Andrew was plastered all over the website: broadened eyes, turned-up nose, myoclonic jerks, severe cognitive delays, deafness and blindness. Andrew met almost every characteristic. We weren’t surprised when Dr. Mendelsohn called to confirm Andrew’s diagnosis. Pallister-Killian syndrome occurs for no known reason. With only 300 diagnosed worldwide, Andrew was the first diagnosis in Minnesota.

Andrew was diagnosed with Pallister-Killian syndrome.

Andrew was diagnosed with Pallister-Killian syndrome, an extremely rare genetic disorder.

We finally had an answer. We had milestones to look forward to and compare. For the first time, we were looking at our son with all of the things he had accomplished versus all the things he hadn’t. We had a diagnosis. We had a doctor who listened to me, a doctor who trusted me, and I trusted her. Mutual respect for knowledge and skill, her wisdom from education and practice combined with my 24/7 observations, commitment and love for my child made us a great team, Team Andrew.

pksWith this diagnosis, my grieving and healing had already begun. I started forgiving myself for a syndrome over which I had no control. I started taking some deep breaths and learned we were in a marathon. There were no quick fixes, no miracle drugs, no special cures.

As we approach Andrew’s 10th birthday, he can walk with a walker and says “mama” and “more”; our dreams obviously have changed, but the journey to help him become part of this world now is supported with the resources we have gathered along the way.



Without the open mind of one doctor, who knows where we would be today?

As far as the cute boots? I still have them. My marathon might not be running in Duluth, but it’s a marathon that requires a unique set of training. It is a life most fear and one that I wouldn’t wish on any of you. But it’s a life with great purpose and meaning and sweet silver linings along the way.

Mother of Children’s heart patient writes book

Charlie was born in 2005 with a congenital heart defect. (Photo courtesy of Mindy Lynn)

Charlie was born in 2005 with a congenital heart defect. (Photos courtesy of Mindy Lynn)


Charlie and Mindy Lynn

Charlie and Mindy Lynn

Embracing Charlie, a book by Minneapolis author Mindy Lynn about her son, a young Children’s patient born with a congenital heart defect, was named a finalist in the Christian Inspirational category of the 2014 USA Best Book Awards.

In the book, Mindy Lynn writes about her family’s emotional journey since Charlie’s birth in 2005.

Embracing Charlie is available in paperback; for the Amazon Kindle, Barnes & Noble Nook and at Smashwords.


Healthy childhood development important for all

Mike Troy, Ph.D,

Mike Troy, Ph.D, LP, is Children’s medical director of Behavioral Health Services.

Mike Troy, Ph.D, LP

I had the honor this past week of participating in a panel discussion about the importance of early childhood development to healthy communities. Hosted by Healthy States, an initiative of American Public Media and Minnesota Public Radio, the topic of the evening was “Community Responses to Toxic Stress.” As readers may know from our recent report and community engagement work, the subject of early childhood development is near and dear to my heart and a significant focus of Children’s Hospitals and Clinics of Minnesota.

My colleague and friend, Dr. Megan Gunnar, of the University of Minnesota’s Institute of Child Development presented scientific research on the essential role of a safe and nurturing social environment for healthy brain development. She also described how high levels of environmental stress in infancy and early childhood can lead to enduring problems in learning, physical well-being and social development. We know that birth to age 3 is an incredibly formative time for a developing mind, with 700 new neural connections made every second. But if a child lives in an environment with persistent challenges (toxic stress) such as poverty, poor nutrition and inadequate housing without the buffer of positive caretaking relationships, it prevents those connections from forming in an effective and efficient manner. Experience shapes brain architecture, and a poor early foundation affects development throughout the lifetime.

Q4_mighty_buttonPanelists MayKao Hang, president and CEO of the Wilder Foundation, and Sondra Samuels, president and CEO of Northside Achievement Zone, and I discussed how our organizations are helping to mitigate toxic stress and foster healthy child development. I left this lively discussion energized to continue Children’s work with community partners to help foster healthy development in children. Some of my thoughts include:

  • One way parents and community leaders can help is to encourage consistent monitoring of child development. At each well-child appointment and over time, we screen our young patients for normal development and identify challenges. Early intervention is key and can change the trajectory of a child’s life.
  • We can motivate leaders and others to action by educating them about the science of early brain development and the unequaled opportunity for healthy development that is presented during the first few years of life. Behavioral and emotional problems often have their roots in unhealthy conditions (toxic stress) in early, foundational stages of life.
  • What babies need is essentially the same across all communities: attentive and loving relationships, safe and stable environments, healthy food and developmentally appropriate activity.

Healthy development happens in the home and in the community through relationships with families, friends and neighbors. We all can play a role in supporting a strong start. Our collective focus must be on healthy development for all children.

Mike Troy, Ph.D., LP, is medical director of Behavioral Health Services at Children’s Hospitals and Clinics of Minnesota.

New mom reflects on her premature birth

Kirsten DesMarais was born at 28 weeks in 1988, weighing 2 pounds, 14 ounces.

Kirsten DesMarais was born at 28 weeks in 1988, weighing 2 pounds, 14 ounces.

Her pregnancy  and now, motherhood  gives Kirsten DesMarais perspective on what her parents experienced when she was born prematurely.

Kirsten DesMarais and husband Phillip welcomed daughter Lena Caroline on Nov. 5, 10 days beyond her due date and after 20 hours of labor.

Kirsten DesMarais and husband Phillip welcomed daughter Lena Caroline on Nov. 5, 10 days beyond her due date and after 20 hours of labor.

DesMarais, 26, was born at 28 weeks at Abbott Northwestern Hospital in Minneapolis. Her early arrival came as a surprise. Her mom was at the hospital for testing when a nurse told her she wouldn’t be leaving until she gave birth. The next day, DesMarais arrived, weighing 2 pounds, 14 ounces.

In an interview before the recent birth of her daughter, Lena Caroline, DesMarais said, “Even though I’ve been pregnant for over eight months, it’s still unreal that there’s going to be a baby to come out of this. It gives me a greater appreciation for what my parents and other parents went through having a baby so early.”

DesMarais and her husband, Phillip, welcomed Lena Caroline on Nov. 5, 10 days beyond her due date and after 20 hours of labor. Lena weighed approximately 7 pounds and was 20 inches long.

“I felt like we had extra time to mentally and physically prepare,” DesMarais said. “I couldn’t imagine having a baby three months early and not having any of that preparation for your first child.”

She also was able to hold and feed her daughter right away  experiences for which her mom had to wait. Becoming a mom is the “coolest, most-overwhelming thing ever; overwhelming in a good way,” DesMarais said.

Q4_mighty_button“Everyone tells you to sleep when they sleep, but all you want to do is look at them. You can see them changing right in front of you,” she said. “I feel like I can see her growing every time I look at her.”

For a long time, DesMarais wanted to share her story to show others that babies who are born early still can thrive, as she has. Becoming a mom seemed like the right time.

“As young as I could understand, any time anyone talked about a baby they would talk about how I was born so little and that I was so lucky to get the care I did,” DesMarais said, adding that it was a miracle she survived being born so early 26 years ago.

Thanks to medical advances, new state-of-the-art facilities like The Mother Baby Center and philanthropy, outcomes for premature babies continue to improve since DesMarais was born.

For a long time, DesMarais wanted to share her story to show others that babies who are born early still can thrive.

For a long time, DesMarais wanted to share her story to show others that babies who are born early still can thrive.

November is Prematurity Awareness Month. Learn more.

Five Question Friday: Dr. M. Jennifer Abuzzahab

five_question_friday111November is American Diabetes Month, so we caught up with M. Jennifer Abuzzahab, MD, to learn more about her role at Children’s and what families should know about childhood diabetes.

M. Jennifer Abuzzahab, MD, is a pediatric endocrinologist.

M. Jennifer Abuzzahab, MD, is a pediatric endocrinologist.

What is your role at Children’s and where do you work?

I am a pediatric endocrinologist. This means that I study hormones (the text messages that run around in your blood). My primary clinic is at the St. Paul campus, but I also see patients at the Woodbury location and at the Minneapolis clinic.

How did you decide to go into pediatrics?

I love the resilience of kids and the positive energy that they exude; it helps me get through the busy days. I also really like seeing kids grow up.

What are some of the conditions you treat?

I see kids with conditions such as diabetes (high blood sugar), hypoglycemia (low blood sugar), thyroid problems, multiple hormone deficiencies following cancer treatment, and growth and puberty disorders. Basically anything that would fit into a Dr. Seuss book: “too much,” “too little,” “too tall” or “too small.”

November is American Diabetes Month. What’s one thing you want families to know about childhood diabetes?

Q4_mighty_buttonAlthough there is more type 2 (adult) diabetes in teenagers, the majority of kids still have type 1 diabetes. This means that they have to check their blood sugar several times a day and take a shot of insulin every time they eat – every day, even on vacation. It also means they can have cake and ice cream at birthday parties, but just like everyone else, shouldn’t have cake and ice cream every day.

When you were a kid, what did you want to be when you grew up?

A doctor… family legend is that I wanted to be a “baby doctor” when I was 3. Both my parents stand by this (and their decision to give me the first name of Mary, but never, ever use it).

Helping kids make sense of Ebola

(iStock photo / Getty Images)

(iStock photo / Getty Images)

By Jimmy Bellamy

Your young child has seen or heard news coverage about Ebola, which has led to questions or noticeable worries from your little one. What do you do?

Mike Troy, Ph.D., LP, medical director of behavioral health services at Children’s Hospitals and Clinics of Minnesota, provides some helpful tips for parents confronted with questions from their kids.

Answer questions asked

“It’s important for parents to respond to what their child is asking rather than making assumptions about  what you think he or she needs to know,” Dr. Troy said. “Make sure you’re addressing your child’s concerns, talking in ways that match their development level.”

READ (from AAP): What parents need to know about Ebola

“Be honest and reassuring in a way that’s developmentally appropriate and consistent with how you would typically talk about other concerning issues,” Dr. Troy said. “For very young kids and preschool-age children, they can imagine a lot of things, so they need reassurance and basic information without excessive detail. For this age group, reassurance from a trusted adult is more important than a logical, fact-based explanation.

“Whereas a school-age child in second, third or fourth grade may need reassurance as to why they personally are safe. For these children, accurate facts and a simple, logical explanation may be helpful. You can say things like, ‘It’s hard to actually get the disease’ and ‘So far it hasn’t been detected in Minnesota, and it’s safe to go to school.’ ”

Here are a few other facts that you can share with your children if they have concerns:

  • Although Ebola is a real problem in some parts of the world, they remain safe.
  • Our health care system is among the best in the world for taking care of sick people.
  • Ebola is rare and does not exist everywhere. When cases are found, the person with the infection is taken to a safe place to be cared for so that they can get better and not make anyone else sick.
  • Ebola is difficult to spread and is not an airborne virus, unlike the common cold. It does not spread through air, food, water or by touching things like a keyboard, desk or money.
  • Doctors and scientists who know a lot about Ebola are working hard to find ways to prevent or cure this illness.

Monitor what the child sees, hears and reads

“It’s absolutely reasonable to monitor your child’s news and social media consumption,” Dr. Troy said. “Because the coverage has been pervasive and often sensationalized, it’s prudent, especially with younger kids, to limit how much they’re exposed to it.”

Make your child feel at ease

The goal for adults caring for children is to help them feel safe without needing frequent reassurance. If reassurance is necessary, then the most important thing to emphasize is how rare the disease is in the U.S.

READ: Minnesota Department of Health’s FAQ about Ebola

Jimmy Bellamy is social media specialist at Children’s Hospitals and Clinics of Minnesota.