Category Archives: Health tips

Define safe boundaries for kids and play

Encouraging the learning and exploration process will increase your child’s confidence and creativity, and defining safe boundaries and rules will keep you both happy. (iStock photo / Getty Images)

Encouraging the learning and exploration process will increase your child’s confidence and creativity, and defining safe boundaries and rules will keep you both happy. (iStock photo)

Dex Tuttle

One time I watched my toddler daughter, Quinnlyn, as she played with her favorite blocks. She picked one up, stacked it carefully on top of another, and repeated until she had a tower four or five blocks high. Without warning, she pummeled the tower while sounding her signature high-pitched battle cry, sending blocks flying in all directions. She immediately seemed to regret not having a tower and ran to pick up the blocks to start the process over.

Young children begin to understand their world by cause-and-effect experimentation. Psychologist Jean Piaget was one of the first to put this concept into organized thought.

This behavior is apparent with my daughter: “If I stick my hand in the dog’s water dish, my shirt gets wet. This pleases me and I must do this each morning, preferably after mommy helps me put on a clean shirt.”

Then, something occurred to me as I watched Quinnlyn build and destroy her tower; there is a trigger missing in her young mind that could change her behavior: She does not understand consequence, the indirect product of an effect.

I began to notice this in her other activities as well. At dinnertime, we would give her a plastic fork and spoon so she could work on her motor skills. If she was unhappy with how dinner was going, she threw her fork and spoon on the floor in a fit of toddler rage. She was then immediately puzzled by how to continue her meal with her utensils so far away.

subscribe_blogAs frustrating as toddler tantrums sometimes can be for parents, I would’ve loved to have been in my daughter’s shoes. Who wouldn’t want the satisfaction of taking all those dirty dishes that have been in the sink for two days and chucking them against the wall? That decision, of course, would be dangerous and reckless, and I have no desire to clean up such a mess. And, with no dishes in the house, I’d be forced to take a toddler to the store to shop for breakable things; not a winning combination.

There’s an important lesson here for safety minded parents: Kids will explore their environment in whatever way they can. It’s like the feeling you get when you find a $20 bill in the pocket of a pair of pants you haven’t worn in months, or when you discover the newest tool, gadget or fashion. For toddlers (and us adults), it’s fun finding new things and learning new skills; it’s motivating and creates a feeling of accomplishment. However, the cognitive skills of a toddler haven’t developed beyond that cause-effect understanding.

This is why we need to consider the environment in which our young children play. I recommend giving them plenty of space and opportunity to experiment without worry of the consequence:

  • Make sure stairs are blocked off securely and unsafe climbing hazards are eliminated; encourage kids to explore the space you define.
  • Create a space to explore free of choking hazards, potential poisons and breakable or valuable items; leave plenty of new objects for children to discover, and change the objects out when the kids seem to grow tired of them.
  • Allow children to fail at certain tasks; be encouraging and positive without intervening as they try again.
  • If possible, discuss their actions and consequences with them to help them understand the reason for your rules.

Encouraging the learning and exploration process will increase your child’s confidence and creativity, and defining safe boundaries and rules will keep you both happy.

At Children’s Hospitals and Clinics of Minnesota, we care for more pediatric emergency and trauma patients than any other health care system in our region, seeing about 90,000 kids each year between our St. Paul and Minneapolis hospitals. Children’s Hospital in Minneapolis is the area’s only Level I pediatric trauma center in a hospital dedicated to only kids, which means we offer the highest level of care to critically injured kids. When it’s critical, so is your choice – Children’s Level I Pediatric Trauma Center, Minneapolis.

Dex Tuttle is the injury prevention program coordinator at Children’s Hospitals and Clinics of Minnesota and the father of a curious and mobile toddler. He has a Master of Education degree from Penn State University.

13 water safety tips for kids

A common misconception is that kids only drown in deep water. A child can actually drown in only a few inches of water. Always keep children within arm’s reach. (iStock photo)

Manu Madhok, MD

Manu Madhok, MD

Every summer, we read and hear about children who die due to accidental drowning. Sadly, this summer has been no exception in Minnesota.

Drowning is the leading cause of accidental death among children ages 1-4. According to the Centers for Disease Control and Prevention, most drownings among children ages 1-4 occur in the pool at home. Drowning remains the second-leading cause of unintentional injury-related death behind motor vehicle crashes among children 1-14.

While drowning is a tragedy, it’s one that can be prevented. I’ve compiled a list of tips I commonly share with parents and caregivers to make sure their kids are safe in and near the water.

Children ages 1-5

A common misconception is that kids only drown in deep water. A child can actually drown in only a few inches of water.

  • Always keep children within arm’s reach.
  • Inflatable aids are not substitutes for adult supervision.
  • Enforce pool safety rules. That means no running or pushing.

Children ages 5-12

  • Don’t allow horseplay.
  • Make sure your child never swims alone and always is within view of an adult.
  • Children should receive swimming lessons from a qualified instructor.

subscribe_blogOpen water

  • Never allow a child to dive in without first checking the depth.
  • Choose a swimming area that is under a lifeguard’s supervision.
  • A child always should wear a life jacket while riding in a boat.

Backyard pool

  • The pool needs to have a 4-foot-tall fence surrounding it on all sides.
  • Use a rigid cover for the pool.
  • Install compliant, anti-entrapment drain covers.
  • Pool owners should know CPR.

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.

Additional resources

Manu Madhok, MD, specializes in pediatric emergency medicine at Children’s Hospitals and Clinics of Minnesota.

Don’t leave kids in the car

Cracking a window does little to reduce the heat inside a car. Never leave your child unattended in the car. (iStock photo / Getty Images)

Cracking a window does little to reduce the heat inside a car. Never leave your child unattended in the car. (iStock photo)

Dex Tuttle

I’ve often surprised myself by how forgetful I am as a parent. It’s possible I’m the only dad who has nearly forgotten that his daughter needs to eat and, more specifically, that he’s responsible for making sure that happens. I know for a FACT, however, that I’m not the only dad who has forgotten the diaper bag in the car and been forced to speed-run the grocery shopping to get a stinky child out of the store as fast as possible. On tired days after sleepless nights, I’ve forgotten that my keys are in the ignition of the car I’m driving and seriously debated being late for work to turn around and go get them.

I’m exposing a vulnerable part of myself a little when I admit this type of fault, but I know I’m not alone. As the injury prevention program coordinator at Children’s, I feel even more responsible to be mistake-free in providing a safe environment for my child, and I feel that much more silly when I fail to do so.

subscribe_blogWhen my daughter, Quinnlyn, was learning to walk, she pulled herself up on me as I sat in my “dad chair” in the living room. (I’ll admit, realizing that the recliner was a crucial part of fatherhood was a huge part of my excitement for becoming a dad, but I digress.) She grabbed my hands and smiled at her accomplishment. After a few happy moments, she started to turn and walk away, and I forgot that she wasn’t yet able to stand on her own. I let go of her hands and down she went, flat on her back. Thankfully, she was OK. She actually laughed it off (her reaction to near-injury that would soon give me anxiety) and got herself back up.

So far, my follies have been rather benign. Still, I live in eternal fear of finding myself in that vulnerable, forgetful moment when something more serious happens.

As the summer ramps into full swing, one such mistake I’m determined NOT to make is forgetting Quinn in the car. This can happen for one of two reasons: we don’t realize the danger, or we find ourselves in a moment of distraction and leave out one extremely hypimportant detail.

Let me first convince you that this is extraordinarily dangerous:

  • Children have lower water reserves, so their body temperatures rise three to four times faster than an adult.
  • The temperature inside a car can rise 50-60 degrees Fahrenheit every 15 minutes (on a 70-degree day, the temperature inside a car can reach 116 degrees).
  • Since 1998, more than 580 children in the United States have died from being left in vehicles.
  • In car seats, children are insulated, making it more difficult for their bodies to regulate overheating.
  • Signs of hyperthermia set in when body temperature reaches just 100.9 degrees, which children will surpass in only a matter of minutes; internal organs can begin to fail at 104 degrees, and death can occur when body temp reaches 107.
  • Cracking a window does little to reduce the heat inside a car.

On most days, strapping my daughter into her car seat easily could be the final challenge on a reality game show that tests strength, patience and fortitude. Therefore, I’m admittedly hesitant to take her in and out of the car more than I need. However, you never know what will happen; on an average day, there are so many things that are out of your control and could delay a quick stop or create catastrophic failure of your car’s air conditioning. Please take control of what you can and never, ever leave your child unattended in the car.

But as I’ve already admitted, I’m forgetful. Here are some tips on making sure you don’t forget your most-precious package:

  • Place an important item in the backseat. My recommendation is to leave your phone there – thus removing a major distraction while driving – but it can be a purse, wallet, computer, jacket or any other item you know you’ll need when you arrive at your destination.
  • If you don’t carry items often and you drive a car with an automatic transmission, take the shoe off the foot you don’t use for the pedals and put it in the back seat. This can be a fun game where everyone in the family participates.
  • Leave yourself a note on the dashboard: “BABY IN BACK!”
  • Put a stuffed animal or doll in the car seat when your child isn’t in it. When you strap your kid in for a trip, put the stuffed animal in the seat next to you up front – a reminder that something is out of place.
  • If you have a GPS-enabled device, set location reminders when arriving at your favorite locations – the grocery store, work, restaurants, etc. Kars 4 Kids is developing an app that works with your car’s Bluetooth capabilities to remind you as you walk away from the vehicle.

Make arrival habits

  • Always do a walk-around of your vehicle to ensure you’re a safe distance from other hazards and make note of items that will help you remember where you parked.
  • Always use the passenger-side doors to load and unload for trips. This will force you to walk around the car to collect your items.
  • Make a game with your child where you always sing a song, say a phrase, do an activity each time you stop at a destination. Even if your child is sleeping, the habit will keep your mind thinking about the little person in the backseat.

Other resources

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

6 tips to stay hydrated in hot weather

Follow these quick tips to keep your kids safe from dehydration when they’re out playing in hot temperatures.

Summertime definitely is here, and what kid can’t wait to get outside and play? But staying safe in the sun, and avoiding dehydration, is important.

We believe in Making Safe Simple. Here are some quick tips to help your kids avoid dehydration:

  • subscribe_blogOn hot days, make sure you drink plenty of water to stay hydrated. The human body requires at least 1 liter of water, daily.
  • Dehydration means that a child’s body doesn’t have enough fluid. Dehydration can result from not drinking; vomiting, diarrhea, or any combination of these conditions. Sweating or urinating too much rarely causes it.
  • Thirst is not a good early indicator of dehydration. By the time a child feels thirsty, he or she may already be dehydrated. And thirst can be quenched before the necessary body fluids have been replaced.
  • Signs of dehydration in children include the following: sticky or dry mouth, few or no tears when crying, eyes that look sunken into the head, lack of urine or wet diapers for six to eight hours in an infant (or only a small amount of dark yellow urine), lack of urine for 12 hours in an older child (or only a small amount of dark yellow urine); dry, cool skin; irritability, and fatigue or dizziness in an older child.
  • If you suspect your child is dehydrated, start by replenishing his or her body with fluids. Plain water is the best option for the first hour or two. The child can drink as much as he or she wants. After this, the child might need drinks containing sugar and electrolytes (salts) or regular food. Also, the child should rest in a cool, shaded environment until the lost fluid has been replaced.
  • Call your doctor immediately or take your child to the nearest emergency department if there is no improvement or condition is worsening.

At Children’s Hospitals and Clinics of Minnesota, we care for more pediatric emergency and trauma patients than any other health care system in our region, seeing about 90,000 kids each year between our St. Paul and Minneapolis hospitals. Children’s Hospital in Minneapolis is the area’s only Level I pediatric trauma center in a hospital dedicated to only kids, which means we offer the highest level of care to critically injured kids. From the seriously sick to the critically injured, we’re ready for anything.

Join Children’s trauma expert for Twitter chat

mn_Trauma_chat_880x440_Twitter

David Hirschman, MD

David Hirschman, MD

David Hirschman, MD, co-medical director of Children’s Hospitals and Clinics of Minnesota’s emergency department, will answer the questions you have about trauma, emergencies and the emergency room in a Twitter chat, courtesy of Children’s and the Twin Cities Moms Blog.

The hour-long Minnesota Trauma Chat takes place at noon Wednesday, July 8. The chat’s hashtag is #MNTraumaChat. Dr. Hirschman will tweet from Children’s account (@ChildrensMN), and the Twin Cities Moms Blog will host from its account (@TCMomsBlog).

A $50 Starbucks gift card will be given at random to one chat participant. Be sure to use #MNTraumaChat in your questions and comments to be eligible. Feel free to RSVP to the event and check out some Twitter chat 101 from the Twin Cities Moms Blog.

At Children’s, we care for more pediatric emergency and trauma patients than any other health care system in our region, seeing about 90,000 kids each year between our St. Paul and Minneapolis hospitals. Children’s — Minneapolis is the area’s only Level I pediatric trauma center in a hospital dedicated to only kids, which means we offer the highest level of care to critically injured kids. From the seriously sick to the critically injured, we’re ready for anything.

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.

Water

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.

subscribe_blogFireworks

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.

Playground

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

Lawnmowers

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.

ATVs

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.

TYPE OF FOOD IUs OF VITAMIN D PER SERVING
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

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.”