Category Archives: Health tips

Facts on frostbite

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

By Erin Fritz, CNP

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

What is frostbite?

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

What should I watch for?

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

Q4_mighty_buttonWhat to do if I am concerned?

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

How can frostbite be prevented?

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

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

Beat the flu, get vaccinated

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

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

By Patsy Stinchfield, PNP

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

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

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

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

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

Patsy Stinchfield, PNP, is the director of Infection Prevention and Control at the Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota.

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

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

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

By Karen K. Johnson, RN, CNP

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

For babies

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

Toddlers and older

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

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

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

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

Serving up strategy at meal time

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

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

By Maggie Sonnek

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

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

Keep offering

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

Division of responsibility

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

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

Yep. I said “whether.”

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

Subscribe to MightyMake it a non-issue

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

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

Eat mindfully 

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

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

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

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

Break for breakfast: Tips for a healthy start

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

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

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

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

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

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

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

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

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

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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 / Getty Images)

By Dex Tuttle

Not long ago, 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 give her a plastic fork and spoon so she can work on her motor skills. If she’s unhappy with how dinner is going, she throws her fork and spoon on the floor in a fit of toddler rage. She is then immediately puzzled by how she’ll continue her meal now that her utensils are so far away.

Subscribe to MightyAs frustrating as toddler tantrums can sometimes be for parents, I’d love to be 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.

Don’t forget kids in cars

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 / Getty Images)

By 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 to MightyWhen 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 very important 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 Fahrenheit, 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.

Stay safe and avoid dehydration in hot weather

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

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

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

  • On hot days, make sure you drink plenty of water to stay hydrated. The human body requires at least one 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.

How to prevent and treat bug bites and stings

By 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.

How 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 different 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.