Author Archives: Tim Kehoe

Yesica’s story: Living with diabetes


When Yesica started having to go to the bathroom frequently and was always drinking water, her family didn’t think anything was wrong.

Then, Yesica’s jeans stopped fitting.

“When I tried on some jeans, they fell right off,” said Yesica. “That’s something that’s not normal for my age. I should be gaining [weight], not losing.”

That’s when her mom took her to a doctor, and Yesica was ultimately referred to Children’s Hospitals and Clinics of Minnesota. Her symptoms were early signs of Type 1 Diabetes — a chronic disease in which there are high levels of sugar in the blood. While it’s often diagnosed in young children, it can be found at any life stage. One in 400 people under 20 years of age has diabetes, according to the American Diabetes Association.

“I had many questions. I was kind of nervous because I didn’t know what was going on and what I was supposed to do,” Yesica said. “It was a tough experience.”

The diagnosis has changed her life, and, most noticeably, her daily routine.

She injects insulin, which helps keep her blood sugar at a normal level, six times a day every day, said 11-year-old Yesica. She leaves class twice a day to see the school nurse and have her blood sugar checked. On days she’s not feeling well, she sees the nurse more often.

“It’s hard,” she said.

“Diabetes needs constant attention,” said Dr. Angela Tridgell, an endocrinologist at Children’s McNeely Pediatric Diabetes Center. “It’s something you can never take a vacation from.”

Those with Type 1 Diabetes often have to check blood sugar levels four to six times a day and take insulin four to six times a day, Tridgell said.

Children’s takes an aggressive and comprehensive approach to treating its patients, she said. They come in for at least four visits annually. The visit involves seeing a physician or nurse practitioner for a physical exam and analyzing blood sugar results to determine whether a change in insulin dosage is needed. A patient may also meet with a diabetes nurse educator, dietitian, psychologist or social worker – depending on needs.

“Our goal is to help a child be as normal as possible and be as healthy as possible,” Tridgell said.

Though the experience has been challenging for Yesica, she said she has found support by joining Children’s Youth Advisory Council where she can connect with other patients.

“I’ve learned that I should appreciate life and that I should stay strong no matter what,” Yesica said.

Five Question Friday: Kendall Munson

In our second installment of Five Question Friday — a feature every other Friday about the staff at Children’s Hospitals and Clinics of Minnesota — we introduce you to Kendall Munson, Family Resource Center coordinator. Munson has worked at Children’s for 31 years!

What do you do at the Family Resource Center? I provide system-wide coordination for the wide array of services available in the Family Resource Centers — including acquiring and cataloging materials for the consumer health and children’s libraries, assisting families with reference, resource and research questions, orienting staff and volunteers, teaming up with other departments and families to enhance, develop and promote services and also supporting Children’s fundraising efforts for patient/family-centered care initiatives.

You have worked at Children’s for 31 years. What keeps you here year after year? The shared sense of purpose and community among people who work at Children’s, as well as the resilience and courage of the patients and families we care for. Several years ago, I took a one-year “sabbatical” from Children’s. And, during that time, I quickly realized how much I missed the passion and dedication that staff and volunteers bring to their work here. It’s an ongoing source of inspiration!

Kendall Munson

What is your favorite memory from working at Children’s? In the late 80’s, I was invited to be a staff representative on the first Family Advisory Council. It was an honor and a privilege to be part of this pioneering group who saw the need to have a quiet, comfortable, library-type space for parents and adult family members of patients. They knew firsthand that having playrooms and a children’s library made a big difference in how patients coped with the hospital experience. And, they wanted to create something that addressed the needs of parents, as well.

Funding and lack of space were both obstacles that had to be overcome. But, thanks to the vision and determination of that Family Advisory Council, the first Family Resources “office” eventually opened in a small area that had at one time been an elevator landing. Twelve years later, through the continued perseverance of families who carried on the work of that first Council, the dream was fully realized when the Family Resource Center as we know it today opened in 1998.

And, I am enormously grateful for the opportunity I’ve had to be part of the Family Resource Center for the past 15 years. A lot of great memories have been created since the humble beginnings in that converted elevator landing!

What have you learned from families? I’ve learned how important it is to take life day by day and sometimes moment by moment. And, regardless of the circumstances, to find some element of joy and gratitude each day. I’ll never forget the mom who told me in a very heartfelt way how much she enjoyed and appreciated coming to the Family Resource Center for a daily cup of instant hot chocolate during her child’s two-and-a-half-month hospital stay. Families have shown me that little things can and do make a big difference here at Children’s.

What is your favorite Starz Café meal? Freshly grilled chicken breast with a Caesar salad.


Easy Chicken with Mushrooms

Today, we’re serving up Easy Chicken with Mushrooms from Andrew Zimmern. We love this recipe because chicken is a budget-friendly source of high-quality protein that’s low in saturated fat. Reducing saturated fat in your diet can help prevent heart disease. If you serve this dish with quinoa, even better. It’s a gluten-free grain that’s also rich in protein, containing all nine essential amino acids. It’s also an excellent source of fiber, providing double the amount compared to other grains. — The clinical nutrition team at Children’s Hospitals and Clinics of Minnesota. 

Easy Chicken with Mushrooms

Serve this simple dish with sauteed spinach seasoned with garlic and a healthy grain like quinoa.

Total Time: 30 min

Serves 6


4 boneless chicken breasts, each weighing 6-7 ounces, lightly pounded and halved

1 cup flour seasoned with salt and pepper

12 ounces thinly sliced Cremini mushrooms

2 chopped shallots

1 sprig fresh rosemary

1 1/2 cup homemade chicken stock

2T canola oil


Place the oil in a large skillet (14 inches) over medium high heat.

Dredge the chicken in the flour and knock loose any excess.

Brown one side of the chicken (about 4-5 minutes), flip and brown the other side (about 3 minutes). Reserve chicken to a plate.

Add the mushrooms, rosemary and shallots to the pan. Once browned, add the stock.

Bring liquids to a boil, then simmer on low. Add the chicken back to the pan, cooking the liquids down around the chicken to a tight sauce. This will take roughly 10-15 minutes.

Season and serve.


Where the heart is

Mindy, several months pregnant with her second child, wore a used, silver bangle bracelet a stranger had given her: “With God all things are possible – Matthew 19:26.” Even though she instinctively knew something was terribly wrong with her pregnancy, she was sure her unborn child would be okay. She would have bet her life on it, she said.

She would soon learn that she was right – about everything. Something was wrong. Charlie had a complex congenital heart defect. Specifically, he had transposition of the great arteries. Dr. Amarjit Singh, a now retired pediatric cardiologist at The Children’s Heart Clinic at Children’s Hospitals and Clinics of Minnesota, diagnosed Charlie after a series of ultrasounds and wrong answers from other doctors. Mindy was right about something else, too. In the end, everything would turn out okay with her son.

Baby Charlie, hospitalized at Children’s, with mom, Mindy, looking on 

Charlie was born in 2005 at Abbott Northwestern Hospital. Immediately after entering this world, he was rushed through a quarter-mile underground tunnel to Children’s. His oxygen levels were dangerously low. Once at Children’s he immediately had an emergency surgical procedure known as a septostomy. A septostomy creates a hole between the heart’s chambers and allows for oxygen rich blood to mix within the heart, thus allowing oxygen to reach the body.

Following the septostomy, it was discovered that Charlie had a stroke. It’s unclear when it occurred – either during resuscitation following his birth, or during the septostomy, Mindy said. In the following days, he worked to recover from the traumatic events on the day of his birth. Eventually he became stable enough to undergo a complex lifesaving open-heart surgery.

Mindy has recorded this story for a book, “Embracing Charlie.” It’s a story about love, strength and faith. The love she and her husband shared as they built a family. The strength they showed when they learned their son had a heart defect. But mostly, the story is about Mindy’s faith despite the challenges she faced.

She is honest, giving outsiders a peek into her world as she and her husband, Paul, searched for answers and, when they got them, how they prepared for a son with a heart defect.

Mindy, who spent three years off and on writing, said she was inspired by a connection she made with a Boston family whose son also had transposition of the great arteries. As she prepared for Charlie’s birth, the family sent Mindy a photo of the boy. That photo gave her more reassurance than any doctor could, she said.

“When I first started thinking about writing, I wanted to be that to somebody else,” she said. “[The photo] gave me a sense of hope, to see what our life could still look like.”

Paul, Mindy, Charlie and Sophie

After several weeks in the hospital recovering from open-heart surgery, Charlie went home. Developmental milestones were delayed. He received speech, occupational, and physical therapies to address his challenges from the stroke and made great progress, Mindy said. For a long time, he favored his right side. Today, he’s right-hand dominant, and you would be hard pressed to notice that anything had ever happened to him.

He continues to have follow-up visits with a neurologist. He also goes to the Heart Clinic for regular check-ups. Future surgeries are possible. “He may need something, but in the scheme of heart surgeries, he’s been through the worst of it,” she said.

Mindy has “absurd gratitude” for her son’s care team, which included surgeons Dr. Francis Moga and Dr. David Overman. And she’s grateful for Dr. Singh for his incredible commitment to his patients and for giving her answers when others couldn’t.

“As a pediatric cardiologist, one of the joys of our job is that we get to see the babies with very complex health issues grow up into wonderful young people who still love us in spite of the pain and discomfort that we may have put them through,” said Dr. Singh. “The other is that we meet some incredible families. Charlie and his parents are one such family. I was very fortunate to care for Charlie and to know his parents. They are extraordinary people. It was my privilege to see him grow up to be happy loving child.”

Dr. Singh and Charlie

Charlie, 7, is delightful, Mindy said. He is an extrovert in an “oddly mature way.” He’s obsessed with artists Claude Monet and Vincent van Gogh.

“It’s like there’s an old man trapped in there,” she said.

Mindy often thinks back on the day she received the bracelet from a stranger and the faith that came with it. That day, she had prayed for a sign that everything would be okay.

She was working at a dental clinic when a colleague approached her with the bracelet. A patient had given it to Mindy’s colleague after she asked where she had gotten it because she wanted to get something similar for Mindy. The patient removed the bracelet and urged the colleague to give it to Mindy.

“I asked Jesus to show himself to me, and he responded, with jewelry,” she said.

She no longer wears the bracelet. She gave it to another mother of a newborn cardiac patient while Charlie was at Children’s.


The experience of her son’s heart defect has taught Mindy to “embrace the darkness and troubles.” There’s growth in that, she said.

“It changed our lives for better. I couldn’t have seen that at the beginning,” Mindy said. “It gave the gift of perspective.”

To read the first chapter of Mindy’s book, check out her blog.

Five Question Friday: Dr. Robert Segal

We’re kicking off a new series, Five Question Friday, a feature every other Friday about the staff at Children’s Hospitals and Clinics of Minnesota. Today, we introduce you to Dr. Robert Segal, chief of staff and medical director of the medical/surgical inpatient units on the Minneapolis campus. He has worked at Children’s for 22 years.

Why did you go into pediatric healthcare? I went into pediatrics because it seemed like a great way to blend my fascination with child development, my love of science, and my interest in toy cars and Crayola crayons.

What have you learned from the kids you’ve worked with? I’ve learned many things — to watch and listen mindfully and to understand the remarkable resilience of children and families.

What is your favorite memory from working at Children’s? I don’t have a favorite memory; there as so many.  Every day here at Children’s the children make me smile, and sometimes cry.

What do you love most about working at Children’s? The remarkable community of people I work with.  The ever present focus on combining the experience of children and families in our hospital, with a singular focus on safe and quality care.

What do you hope to accomplish as chief of staff? To share with hospital administration the professional staff’s perspective on the issues that affect our ability to provide the highest quality clinical care and to help oversee the professional staff’s responsibility to provide that care.


A heart mom is born

By Elin Neugebauer

Elin and Maija

Maija Jean was born on July 2, 2009, after an induction at 40 weeks and 3 days. She weighed 8 pounds, 4 ounces and scored an eight and nine on the Apgar test. It felt like a textbook pregnancy, labor, and delivery with a little Pitocin thrown in. After Maija’s birth I was filled with immense joy and love. Maija made me a mom. From that point forward, I would be a protector, a teacher and a friend.

A nurse took her measurements, weighed her and stamped her feet. I hear a murmur. Usually it is nothing. Don’t worry.

Our first night went smoothly. Bright and early the next morning, her pediatrician checked on her. I hear a murmur. Usually it is nothing, don’t worry. I’m going to schedule a heart ECHO just to make sure.

When the pediatric cardiologist came knocking on the door, I became concerned. This was no longer a textbook birth. I hear a murmur. Usually it is nothing, don’t worry. I am going to have your daughter admitted to the Neonatal Intensive Care Unit (NICU) just to be sure. We’ll run another ECHO in the morning.

After the cardiologist left, I was discharged and my daughter was taken to the NICU. My saving grace was the graciousness the staff blessed upon me by letting me stay one more night as an “invisible patient.” The next morning after the ECHO we were sent home, together. Her discharge included strict instructions to come into the cardiologist’s office first thing in the morning for another ECHO. But I didn’t worry at the time. These things were usually nothing.

I could never have imagined experiencing the kind of emotional pain I felt just four days after giving birth. Numb from the waist down, bursting with love from the waist up. I had just given birth to my daughter. It was the most beautiful and intense moment of my life. I held her close and whispered my love and admiration for her. What I did not know upon the doctor placing her in my arms was that I also became a heart mom.

The murmur was pulmonary valve stenosis. Her lungs weren’t getting enough blood, and she needed surgery. That is when my whole world shifted.

Before Maija’s birth I had no idea she had a Congenital Heart Defect (CHD). Ultrasounds didn’t detect pulmonary valve stenosis, atrial septal defect or right ventricular hypertrophy.

I had skipped the chapters in pregnancy and baby books that covered any type of special need. After her diagnosis, my life changed. I became a stay-at-home mom armed with anti-bacterial lotion, wipes and sprays. Maija sat in a plush cart cover at the store. The job as protector took on a much greater meaning than I was expecting. I quickly became one of those helicopter moms.


Now, three-and-a-half years later, I am a proud heart mom. And the leash is a little bit looser. Maija is in preschool while I work outside the home, and she enjoys ballet classes throughout the week. We no longer use a cart cover.

Though her surgery at 5 days old to fix the restricted valve was a success, she now has significant pulmonary valve regurgitation. The flow of blood through her valve leaks back into her heart. A similar flow takes place in the hole between her atria. The right ventricular hypertrophy is still a concern. She will need surgery again someday, and even though I will hopefully know in advance, I’m still scared. The idea of your baby, no matter their age, going under anesthesia and having heart surgery is terrifying.

Congenital heart defects affect tens of thousands of babies every year. They are the most common birth defect. As a heart mom, I have a responsibility to share my story – my daughter’s story – with others. She participates in fundraising and awareness events with me, and I am endlessly reading and sharing news with my family and friends. As we enter Congenital Heart Defect Awareness Week, I encourage others to share their stories as well. We can all help our heart babies, young and old, together.

On July 7, 2009, I handed over my baby to the surgeons. It was the single most terrifying moment I have experienced. Her life, and my heart, were in their hands.  We now celebrate our Heart Day every year on July 7. We celebrate her life and her heart. A beautiful beating heart with a special extra whoosh to it.

Maija, 3, takes ballet lessons



Elin Neugebauer is a heart mom to 3-year-old Maija Jean. Elin works at Children’s Hospitals and Clinics of Minnesota as a Health Unit Coordinator and is actively engaged with the community on Twitter. Follow her here

New payment model values quality over quantity

At Children’s Hospitals and Clinics of Minnesota, we pride ourselves in getting the best outcomes for our patients. That includes keeping patients healthy so they don’t require extra visits and expensive procedures.

We have a long-standing commitment to innovative care delivery, which triggered our willingness to partner with the Minnesota Department of Human Services to test a new delivery and payment model aimed at better health outcomes and lower costs for our state’s Medicaid program. The shift in approach is to tie payment to delivering higher quality outcomes rather than relying on the historic model of publicly-funded health care programs in Minnesota where health care providers were paid for the procedure.

By participating in this new payment model, our job at Children’s will be to manage the care of 14,000 patients. Rather than a system that creates an incentive for more visits and procedures, the total cost of the care model creates an incentive for us to advance methods that keep people healthy so they don’t have to use expensive services.

The cool news is that we’ve already been doing this for nearly a decade. Children’s established the state’s first Medical Home in 2004 and this care coordination model has resulted in reduced hospitalization and fewer readmissions, among other outcomes.

“With nearly a decade of experience to draw on, Children’s is pleased to partner with the state on an approach that financially rewards better health outcomes,” said Maria Christu, General Counsel and Vice President of Advoacy and Policy at Children’s. “We are confident we’ll deliver on the quality outcomes the state and, more importantly, our patients expect.”

Children’s joins five other major health care providers. They include Essentia Health, CentraCare Health System, North Memorial Health Care, Federally Qualified Health Center Urban Health Network (FUHN) and Northwest Metro Alliance (a partnership between Allina Health System and HealthPartners). In all, we’ll be responsible for 100,000 Minnesotans enrolled in publicly-funded programs.

Minnesota is the first state in the country to implement this new payment model. “This new payment system will deliver better health care at a better price. By changing the way we pay health care providers we can incentivize reform, help Minnesotans live healthier lives, and slow the rising cost of health care in our state,” Gov. Mark Dayton said in a statement.

This model is being implemented at the same time as Minnesota’s Medicaid population is expected to increase. Gov. Dayton’s budget proposal, which we wrote about last week, includes expanding Medical Assistance to 145,000 more Minnesotans, including 47,000 kids.


#TwitterTour: The Mother Baby Center

The Mother Baby Center — A sneak peek

The Mother Baby Center doesn’t open until Feb. 4. But, we wanted to give the public a special preview. We consider it our crowning achievement — a great place to have a baby and a great place to be a baby. In case you missed the virtual tour, here are some highlights:

Storified by Children’s Hospitals and Clinics of Minnesota· Thu, Jan 31 2013 12:03:04

If you want a sneak peek of The Mother Baby Center, join us for a #TwitterTour today at noon. Details:’s Minnesota
Thanks for joining us for a sneak peek of @TMBCenter! During the next hour, we’re going to share info, photos and more! #TwitterTourChildren’s Minnesota
Got questions during the hour about @TMBCenter? You can fire away now and we’ll answer them at the end of the #TwitterTour!Children’s Minnesota
First, we’d like to give a shout out to @AbbottHospital. Together we’re able to make @TMBCenter a reality! #TwitterTourChildren’s Minnesota
The #TwitterTour is underway. Follow @ChildrensMN for the next hour to get a sneak peek of our center.Mother Baby Center
Opening its doors this Monday at 7AM, @TMBCenter is the only birth center of its kind in MN #TwitterTour’s Minnesota
From traditional to alternative to high-risk pregnancies, @TMBCenter is equipped for all birthing situations #TwitterTourChildren’s Minnesota
10% of 4k annual births at @AbbottHospital involve high-risk pregnancies or complications requiring add’l newborn care #TwitterTourChildren’s Minnesota
Currently @AbbottHospital delivers more babies than any hospital in MN. With @TMBCenter there’s capacity for up to 5k births! #TwitterTourChildren’s Minnesota
Before @TMBCenter, high-risk newborns were transported a 1/4-mile from @AbbottHospital to Children’s, separating mom and baby #TwitterTourChildren’s Minnesota
This separation happened to the Stoltz and Windschitl families. Read more: and #TwitterTourChildren’s Minnesota
[Video] Jim and Jodi Muelken had a similar story: #TwitterTourChildren’s Minnesota
With @TMBCenter, our Neonatal Intensive Care Unit (NICU) is just steps away from labor & delivery! #TwitterTour’s Minnesota
A reminder, you can jump in with questions about @TMBCenter during or after the #TwitterTour! We’re happy to answer them.Children’s Minnesota
Our NICU is the 4th largest in the United States, with more than 1,900 admissions per year #TwitterTourChildren’s Minnesota
The NICU has private rooms where parents can sleep #TwitterTourChildren’s Minnesota
There are 3 operating rooms for cesarean sections and open (in utero) fetal surgeries #TwitterTour’s Minnesota
Connected to the OR is a resuscitation room for the safety of high-risk babies that’s a short hallway from the NICU #TwitterTourChildren’s Minnesota
[Photo] Resuscitation room: #TwitterTourChildren’s Minnesota
The Special Care Nursery @TMBCenter has 24 rooms with 31 bassinets, including rooms for twins and triplets #TwitterTourChildren’s Minnesota
Good question. @TMBCenter is located only in Minneapolis. RT @babyfactory6: @ChildrensMN does this include St. Paul campus? #TwitterTourChildren’s Minnesota
The Special Care Nursery rooms have privacy curtains, breast pump, pull-out sofa and a recliner #TwitterTour’s Minnesota
Let’s get to the labor delivery rooms! There are 13 L&D rooms, with private bath and shower! #TwitterTour’s Minnesota
The L&D rooms have 3 levels of lighting, a flat screen TV, DVD player and iPod docking station #TwitterTour’s Minnesota
It does! MT @babyfactory6: @ChildrensMN I meant to ask if the stat about the NICU being 4th largest includes St. Paul NICU? #TwitterTourChildren’s Minnesota
There’s a waterbirth room featuring a 96-gallon tub. There are 3 add’l portable tubs #TwitterTour’s Minnesota
There are 34 providers @TMBCenter including physicians and midwives who can perform waterbirths #TwitterTourChildren’s Minnesota
Expecting? You can find a provider here: #TwitterTourChildren’s Minnesota
There are 3 family sleep rooms for those experiencing adoption or surrogacy #TwitterTour’s Minnesota
Families and guests can visit our Celebration Plaza, which includes a play area for kids #TwitterTour’s Minnesota
Expecting moms will be evaluated at the Maternal Assessment Center. We have 6 rooms #TwitterTourChildren’s Minnesota
Dads often ask about parking and where to drop off the mom-to-be. The main entrance has a circle driveway for easy drop-off #TwitterTourChildren’s Minnesota
There are 4 short-term stork parking spaces in the ramp. Directions: #TwitterTourChildren’s Minnesota
People can also enter @TMBCenter through the second floor of Children’s #TwitterTourChildren’s Minnesota
Expecting and plan on guests? Find visitor guidelines here: #TwitterTourChildren’s Minnesota
We’re about to wrap up soon, but we want to share this fun video of @TMBCenter: #TwitterTourChildren’s Minnesota
We also want to share this beautiful story about @TMBCenter from @MyFOX9: #TwitterTourChildren’s Minnesota
For those unable to follow the entire #TwitterTour today, we’ll share a transcript soon.Children’s Minnesota
Thanks for joining us! We hope you enjoyed the #TwitterTour. For more info about @TMBCenter, visit:’s Minnesota


You can lead kids to water, but can you get them to drink?

By Jeri Kayser

We all know drinking water is important. After air, it is pretty much what we need to survive. We mostly consist of water and everything in our bodies work better with an adequate amount of water in them. Try explaining this to a toddler. Try explaining this to a toddler who is sick or has just had their tonsils out. Now try explaining this to a toddler who has discovered they can clamp their mouth shut and no one can make them drink, not even Mom. And whoa, this is so cool to have power over Mom!

This daunting task is universal throughout time and cultures and is more easily dealt with when you plan ahead rather than try to persuade your child to drink when they’re at risk of getting dehydrated. Also, dehydration can cause irritability and a killer headache, which brings out the best in absolutely no one. So, I’ve prepared a few tips for parents:

Drink water: Your child watches you closely. They’re going to be more inclined to drink if they see you drink, and they will be more inclined to drink water if they see you drink water. Plus, your body will appreciate it!

Serve it up cold: Water tastes better cold. Add some ice cubes because they’re fun. You can also add a little juice to the water in the ice cube tray to make the cubes even more fun with a splash of color.

Add slices of fruit: if it’s age appropriate, fruit adds just a touch of freshness and may also encourage more exploration of different fruits.

Find a fun water bottle: There are tons of water containers to choose from. Letting your child pick out a water bottle will help encourage their water intake. They might be inclined to pick one with a fun character, something “pretty,” or, if they’re older, something that fits best in their backpack or clips easiest on their sports bag.

Start early: Habits are best developed and maintained when started early. Have your child’s first beverages be milk or water so they begin to associate water with the way to quench thirst.

If your physician has directed you to encourage your child to drink because they are at risk of being dehydrated, here are some additional tips:

Encourage them to talk: When you say a few words, you swallow your saliva without thinking about it to be better understood. This is especially helpful if they are choosing not to swallow because of pain from a sore throat.

Licking feels less overwhelming than drinking: This is partially why Popsicles work so well. Frozen Popsicles are frozen liquids.

Use sibling rivalry: If there are other children in the household, let them have the popsicles as well. No kid wants a sibling to get something they aren’t getting.

Blenders are a giant toy: They have buttons, smash stuff and make a lot of noise—a really awesome toy! Experiment with smoothies.

Schedule tea party time: Drink out of novel containers, tea party dishes, syringes–whatever is appropriate and fun.

Use sticker charts: For kids, it is hard to understand why they need to drink, especially when they don’t feel well, so sticker charts can work great. We are all well motivated when we can easily see how we will benefit from our choices. Make a chart with your child and give them a sticker for whatever amount a fluid swallowed seems reasonable. Create a “sticker store” where they can “buy” things with various amounts of stickers. These items could be something like a coloring book or maybe an activity like choosing a book to be read to, whatever works best in your family.

Communicate with your doctor: They need to know how much your child is drinking so they can best care for your child. They will also be helpful on letting you know what the goals should be for the amount of fluids your child needs.

Communicate with your child: Don’t underestimate your child’s capacity to understand that drinking is important. Even at a very young age children are actively involved in taking care of their bodies: baths and brushing teeth are good examples. They are able to understand that drinking is one more thing they can do for themselves to feel their best.

Jeri Kayser has been a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota since 1985. Her educational background is in child development and psychology. She has three children who have been a great source of anecdotes to help illustrate developmental perspective. They’re good sports about it.

Has the flu reached your home? Here’s the 411.

By Patsy Stinchfield

Patsy Stinchfield

Flu season arrived early this year and with more severity than in recent years. According to the U.S. Centers for Disease Control and Prevention (CDC), 48 states had reported influenza during the week of Jan. 6-12. There were nine influenza-related pediatric deaths during that week, bringing the total to 29.

We have seen a record number of influenza cases at Children’s Hospitals and Clinics of Minnesota. We’re seeing lab-confirmed influenza cases at rates higher than our highest week during H1N1. We’ve taken steps here to help prevent spreading the flu, including updating our visitor guidelines.

The No. 1 way to prevent the flu is to get vaccinated. And it’s not too late for that. We have more tips on preventing the flu here. In case the flu has reached your family, here are some helpful tips for taking care of your child.

What’s the difference between the cold and the flu and how can I tell?

Sometimes it’s hard to know whether a child has a cold or the flu because she may cough, have a runny nose, sore throat and fatigue with both. With the flu, a child tends to have a high fever. It comes on more suddenly with more severe fatigue and body aches.  Colds come on more gradually, and many kids may feel well enough to keep playing and going to school. Clinics use a rapid nose swab test to determine if someone has influenza.

What should I do if I suspect influenza?

Most cases of influenza are mild and can be managed at home with rest, plenty of fluids, and fever-reducing medicines.  Tender-loving care is good medicine, too. Most over-the-counter “cough and cold” medicines do not help a sick child get better faster and won’t have much effect on influenza. Sometimes, the flu can make a child very ill and a visit to the clinic or emergency room is necessary.

When should I take my child to the Emergency Department?

Take your child to be checked if there is difficulty breathing (fast, grunt-sounding, noisy breathing or small breaths), the color looks bad (pale or bluish), they aren’t drinking fluids often or urinating at least once every eight hours or just aren’t themselves and you’re worried.  Signs of dehydration are dry lips, sunken eyes, sleepiness or crankiness.  Children who seem like they’re getting better and then suddenly get worse should be taken to the Emergency Department immediately.  This could mean they have another infection in addition to the flu.

What are the best ways to get my child’s fever down when she has the flu?

Fever is one of the tools our immune system uses to kill germs.  However, children with high fever can feel quite miserable, get crabby, have trouble waking up and may drink less fluids causing dehydration. If you can’t keep the fever down with a fever-reducing medicine such as Tylenol or Ibuprofen, then the child should be taken to the clinic or Emergency Department.

Is there anything else I can do to help make my child more comfortable?

You can keep your child home from day care, school, sports or other activities and have them rest early in their illness and until they show signs of getting back to “their normal.” If your child doesn’t want to eat regular meals, don’t insist, but do make sure they drink small amounts of fluids every hour to prevent dehydration.

Is there anything I can do to help my child recover more quickly?

There is an anti-viral medicine called Tamiflu that can be given to children as young as 2 weeks of age. This is used if the child has moderate or severe influenza and works best if given in the first two days of illness.  Tamiflu usually cuts the severity and number of days of illness in half.

How long will my child be contagious?

Influenza is most contagious the day before symptoms present through about day five of illness. Your child should stay home from school during this time. After viral illnesses, kids can have lingering muscle or body aches and really do need time to rest and recover before rushing back to school. Depending on the severity of the flu, this may be a few days to a few weeks.  Most kids recover within a week. Most schools require that your child be fever-free (without the help of medicines) for two days before returning to school or day care. For more information, visit the CDC.

Patsy Stinchfield is a nurse practitioner and the director of the Infectious Disease Division at Children’s. Follow her on Twitter and watch her videos on Clear.MD.