Author Archives: ChildrensMN

Tips for a safe Halloween trick-or-treating experience


When it comes to trick-or-treating, it’s important to prepare to immerse kids in an environment full of “fake” danger while teaching them to respect real danger.

Dex Tuttle

At 2 years old, it took my daughter, Quinnlyn, exactly one house to figure out how the whole trick-or-treating thing worked. That’s when I fell into a parenting crisis.

After much scrutiny, she chose to be Supergirl for Halloween in 2014. She had no clue who that was — and still doesn’t — but dang it, the costume looked cool. We went out in South Minneapolis with a friend of mine — whose daughter was a dragon — and had, in my biased opinion, the two cutest trick-or-treaters in the neighborhood.

It was fun to watch. We explained what she was going to do and sent her up to the first house. After that, she was in the zone and we had to reel her back in when she tried to approach houses without the front lights on. I was in true parental awe as I watched her embrace this new activity and basked in the glow of the girls’ laughter and smiles as we made our way down the block.

Suddenly, reality set in and I started wondering what I was teaching my daughter: “strangers + candy = AWESOME!” As I wondered how to explain to a 2-year-old that this is only a one-day-a-year thing — even though she didn’t know what a “year” is — and that she shouldn’t take things from strangers, though everyone is a “stranger” to her, I was awoken to the traffic whizzing by on the busy street behind me.

That’s one of many moments where the balance of parenting was woefully tricky; it’s easy to get lost in a child’s joy and happiness. I believe that I have a responsibility to protect Quinnlyn’s sense of imagination, and what better way to explore imagination than pretending to be a superhero for a day? Halloween shifted from just a fun day to an important moment in her development; how quickly I forgot to make sure she had boundaries and understood where risks existed.


(click image to enlarge)

It’s easy to get lost in surprise at how much their young minds understand and, in turn, forget about all the things they don’t. After all, it’s not easy to immerse them in an environment that’s full of “fake” danger — scary creatures hiding in the darkness that light up and move as you approach, or ghoulish costumes designed to turn the strongest of stomachs — while teaching them to respect real danger.

  • Talk to your kids about Halloween before they go out — give them boundaries and teach them that not everything out there is designed to be fun.
  • Wear reflective clothing and make sure everyone has a light with them.
  • Supervise children at all times and monitor interactions with people who answer the door.
  • Cross the street only at intersections and be sure drivers see you.
  • Inspect all candy and “treats” before they eat any and throw away anything that’s opened or looks suspicious.

These and more helpful tips

trick or treating M0297_PSA_MSS_Making Safe Simple Handouts_FA-3

(click image to enlarge)

This year, I’ll be taking my little zebra rider out into the neighborhood, but I’ll make sure our Halloween experience isn’t a total zoo.

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

Manage your child’s sleep when 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)

Karen K. Johnson, RN, CNP

On Nov. 1, 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.

subscribe_blogOn 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.

Mighty also has tips to manage your child’s sleep schedule when we “spring” the clocks forward in springtime.

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

Children’s Minnesota to host holiday bereavement event

The bereavement event will end with a short candle-lighting service to honor children who have died. (iStock photo)

The bereavement event will end with a short candle-lighting service to honor children who have died. (iStock photo)

We understand that preparing for the holidays can be challenging. The Children’s Hospitals and Clinics of Minnesota Bereavement Advisory Team (BAT), along with Children’s Minnesota staff, is hosting “Grieving Through the Holidays,” an event to help you connect with other bereaved families who are preparing for the holidays, from 3-5 p.m. Nov. 1 at Children’s – Minneapolis, 2525 Chicago Ave. S. Children and grandparents are encouraged to attend this evening.

subscribe_blogPlease join us for a time to connect with other bereaved families. Adults and children will be able to participate in remembrance activities. The evening will end with a short candle-lighting service to honor children who have died, followed by appetizers and hot chocolate.

Age-appropriate activity groups will be offered for kids ages 4 and older. Childcare will be provided for kids ages 18 months to 3 years.

For questions about the event, please contact Bereavement Services at [email protected] or (612) 813-7216.

BAT is a group of bereaved parents whose children also were cared for within Children’s Hospitals and Clinics of Minnesota.

Diagnosed with cancer as infant, 2-year-old Aili surviving and thriving

Two-year-old Aili, of Duluth, was diagnosed with stage 3 intermediate-risk neuroblastoma as an infant and treated at Children's Hospitals and Clinics of Minnesota.

Two-year-old Aili, of Duluth, was diagnosed with stage 3 intermediate-risk neuroblastoma as an infant and treated at Children’s Hospitals and Clinics of Minnesota. (Photos by Erin Sather / From the Woods Photography)

Kelly Kleven

I work in health care and deal daily in the unexpected. I’ve seen tough things happen to good people. I know that illness, and cancer especially, sometimes chooses its victims at random. Still, nothing prepared me for having our beautiful, sweet infant daughter diagnosed with cancer.

“Babies don’t get cancer,” I thought. But they do, and ours did. Our precious Aili (pronounced EYE-Lee), then only an infant, was diagnosed with stage 3 intermediate-risk neuroblastoma, with a large tumor compressing her airway, wrapping her carotid artery and spreading through her neck into her chest.

Thanks to the excellent team of oncologists, surgeons and nurses at Children’s Hospitals and Clinics of Minnesota, our family is blessed to say that Aili is still with us.

Every day, seven families in the U.S. say goodbye to their precious child due to cancer and its complications, and another 46 children are diagnosed and begin to walk a terrifying and painful journey.

Aili’s treatment — a combination of chemotherapy and surgical tumor resection — gave us the hard-won miracle of modern medicine: Our 2-year-old daughter is surviving cancer. “Cancer-free” is a term that sticks funny in my mouth; it’s misleading. Our family isn’t free, not really. No child survivor is truly free.

Aili’s future and her long-term health remain significantly at risk, not just from future cancers but also the long-term effects of her chemotherapy and surgery. Chemo often causes major medical problems years down the road. Adults often reach their elderly years before those problems develop; child survivors encounter problems in their 20s and 30s, big-deal problems like heart failure and additional cancers.

But we are surviving.

She is surviving.

Aili and mother Kelly

Aili and mother Kelly

The complications of her tumor and treatments make our days more challenging, but she is generous with her smiles and eager to explore this great world. She loves her brother and her family. She cheers wildly when she sees puppies, puddles, or babies. She’s a huge fan, it turns out, of politicians’ portraits (she is all-partisan, by the way). She lights up for back-to-school photos on Facebook, dances in the grocery store, and sings unabashedly to the echoing stalls of public restrooms.

We love when you celebrate her, ask about her health, ask us how we are doing. Be prepared for honest answers. We don’t know how to sugarcoat this for you, and we aren’t trying to make you feel awkward by talking about our baby with cancer. We don’t expect you to know what to say. We still don’t know what to say, either.

subscribe_blogDid you know: 1 in 300 kids will get cancer before age 20?

One in 300.

That’s as common as twins!

Childhood cancer is not rare; it’s the leading cause of disease-related death in children.

Each day, I honor all of the little fighters out there waging heroic battles with tiny bodies. My heart and soul, scarred as they may be from watching my family and so many others suffer from this terrible disease, alight with joy that we’ve been graced with this precious child. This girl — our girl — and every other child out there deserve more than just your awareness. They deserve to be celebrated and supported, cheered on, held and comforted.

There are so many ways to help families with a child with cancer:

  • Run a 5K in support of the cause, donate money toward cancer research, or find a local nonprofit. In Minnesota, we have great groups, including Children’s Cancer Kids Fund, that provide financial assistance to families affected by childhood cancer.
  • Attend a benefit — you don’t need to know the family, just trust me; your presence and support would mean the world.
  • Make a meal for a family in need, wash and fold a load of laundry, or even unload their dishwasher. That time that you commit allows valuable time for their family to be together. (And can I give you some more unsolicited advice on behalf of special-needs families? Make a specific offer — because as many times as you tell us to “call if we need anything” — we won’t call. We feel like we shouldn’t burden you with our problems. Asking what time this week you can offer your services is much more likely to elicit a family’s acceptance of your help.)

I know we all lead busy lives, and it’s so easy to scurry about in our own little worlds, but there are so many children affected by this disease. Childhood Cancer Awareness Month is in September, but for some families it’s every month. It’s every day, and it’s the rest of their lives.

Kelly Kleven, of Duluth, is a physician assistant and mother of a childhood-cancer survivor.

McNeely Diabetes Center, Child Life offer support group for kids, families

The Diabetes Connect child support groups connect through play and peer interactions with support of staff in the Child Life department in order to help them understand diabetes while experiencing a typical childhood.

The Diabetes Connect child support groups connect through play and peer interactions with support of staff in the Child Life department in order to help them understand diabetes while experiencing a typical childhood.

The McNeely Diabetes Center and the Child Life department at Children’s Hospitals and Clinics of Minnesota offer Diabetes Connect, a network for kids with diabetes and their families to connect with others on the same journey.

Diabetes Connect overview

The program provides family support and practical help for the daily journey and challenges of diabetes, as well as an opportunity to have fun, learn about incorporating diabetes into daily life and meet with peers of similar ages, for parents and children.

Child groups

The child groups connect through play and peer interactions with support of staff in the Child Life department in order to help them understand diabetes while experiencing a typical childhood.

  • Grades K-2
  • Grades 3-6
  • Grades 7-12
  • Sibling group: All ages, must be potty-trained

Parent group (including extended family)

The parent group shares thoughts and ideas about raising a child with diabetes. Speakers are brought in to share in the dialogue of parenting a child with diabetes. The group strives to provide education on parenting and living with diabetes.

subscribe_blogDates and times

The group meets 6:30-8 p.m. on the second Tuesday of the month from October through April.

  • Oct. 13: Kickoff event
  • Nov. 10
  • Dec. 8
  • Jan. 12, 2016
  • Feb. 9, 2016
  • March 8, 2016
  • April 12, 2016
  • July 12, 2016: Summer meet-up


Child groups meet in the Child Life Zone on the third floor, and parents meet in room 4057 on the fourth floor of the Garden View Medical Building (347 N. Smith Ave.), at Children’s – St. Paul.

Contact the McNeely Diabetes Center at (651) 220-6624 or [email protected] for more information. Learn more about the diabetes and endocrinology program at Children’s Minnesota.

Children’s Minnesota: For the most amazing people on earth

Today, Children’s Hospitals and Clinics of Minnesota is introducing a refreshed logo, look and feel. The change is centered on a promise that we are Reimagining health care for the most amazing people on earth. Our organization exists to better the lives of kids. And we want to help everyone understand just what makes them so amazing.

We have a unique view of children because we see them under the rarest and most challenging of circumstances. We know kids aren’t just small adults; they have a lot to teach us about optimism, resilience and strength. We celebrate them not for the adults they will be, but for the inspiring people they already are. And to do that, we’re changing the way we talk about who we are, why we exist, what we stand for and the people we serve.

So what’s changing?

  • We’re introducing a new logo: Children’s Minnesota. This logo proudly recognizes the people we serve and the place we call home.blog_logo_650x366
  • We’ve also refreshed how we portray ourselves and our patients – you’ll see new colors and photographs in advertisements, on our website and other places.D0025_BRN_VIS_brand_refresh_851x315_indigo
  • And a new micro site,, allows us to celebrate what makes kids amazing. It’s a place where we champion and share stories about the most amazing people on earth.

What’s not changing is our commitment to providing the safest, highest-quality clinical care and services to kids and families across the region.

This week you’ll begin to see our new logo and visuals throughout the greater Twin Cities and, over time, within our hospitals and clinics. Take a moment to check out to learn more or share your story using #AmazingIs.

Working together with families and our community, we will continue to improve the health and well-being of the most amazing people on earth.

Written by Bjorn Gunnerud
Children’s Minnesota Vice President, Marketing and Communications

Getting ready for school… 5 years in advance

(iStock photo / Getty Images)

Eighty percent of brain growth occurs by age 3. (iStock photo)

Gigi Chawla, MD

Gigi Chawla, MD

Gigi Chawla, MD

As summer winds down and kids start filling desks and lining hallways at school, it’s a good time to talk about child development. And while this year is the first year that all children will have access to all-day kindergarten, I’m also reminded that not all children arrive to school ready to learn. In fact, getting a healthy start begins long before kids step onto a school bus. As a mom and pediatrician, I know that healthy development and school readiness occur well before children are reading and writing. They occur in those early years, as children are beginning to experience all of their firsts — first smile, first word, first step.

As advocates for children, Children’s Hospitals and Clinics of Minnesota recognizes that health and wellness play a critical role in being ready to learn and that we have a part to play in helping children get a strong start — not only in school but in all areas of life.

We have embarked on an even more deliberate focus on early childhood development, and know that it’s the earliest years in life when the most difference can be made. Consider:

  • Eighty percent of brain growth occurs by age 3.
  • In early childhood, physical, cognitive, emotional and social development occur at a rate that far exceeds any other stage of human life. This has a significant impact on long-term health and wellness.
  • Toxic stress — including poverty, poor nutrition, inadequate housing, exposure to violence and the absence of attentive caregivers — can be devastating to an infant’s developing brain, thus setting children far behind before they’ve had a chance to start.

subscribe_blogGiven the obstacles to healthy child development, we at Children’s decided we needed to venture beyond our walls to address these issues and work with others engaged in protecting the health and well-being of children. We’ve engaged in an effort to build greater awareness about the importance of a child’s development in the earliest years and are working towards identifying collaborative methods to reach more children at this critical time in life.

Every day, I have the privilege to care for children when they are sick and to support ways to make them healthy. And that includes engaging in and elevating the discussion around the value of investments in programs that give kids the start in life that they deserve; please join us.

Read more about the importance of early childhood development and our investment in our children. Read our paper, “Foundation for Life: The Significance of Birth to Three,” to learn more about our efforts.

Gigi Chawla, MD, is senior medical director of primary care for Children’s Hospitals and Clinics of Minnesota.

Consequences of vitamin K refusal at birth devastating, irreversible

Lisa Irvin, MD

In the past few years, there has been an increase in parents refusing to have their children receive the vitamin K shot at birth. The result of this trend has been an increase in cases of vitamin K deficiency bleeding (VKDB).

Lisa Irvin, MD, is pediatrician at Children’s Hospitals and Clinics of Minnesota.

Lisa Irvin, MD, is pediatrician at Partners in Pediatrics.

Reasons usually cited for refusal are a fear of pain or stress for the baby due to the shot, or increased risk of leukemia. Many studies show there is no increased risk of leukemia, and the pain is minimal and brief.

Vitamin K is needed by our bodies for blood clotting. We’re born with blood-clotting factors, but vitamin K is needed for activation. Older kids and adults make vitamin K from the bacteria in their gut and from their diet.

Newborns, however, are born with little vitamin K, and fewer clotting factors than adults. Vitamin K doesn’t cross the placenta, and newborns don’t have bacteria in their gut yet to make it. Breast milk has low levels of vitamin K, so breastfed babies have low levels of the vitamin for a few weeks. Newborns are given vitamin K immediately following birth to activate these clotting factors and prevent hemorrhagic disease of the newborn, or VKDB. 

The 3 types VKDB 

  • The early type occurs in the first 24 hours and is uncommon. It usually is the result of the mother taking medication that interferes with vitamin K.
  • The classical type occurs between the second and seventh days of life, when vitamin K levels are the lowest in a newborn. Bleeding occurs most commonly in the intestines, umbilical cord, skin, nose, and circumcision site.
  • Late VKDB occurs when the infant is 3-8 weeks old and happens only in breastfed infants. These bleeds typically occur in the brain, intestines and skin. If bleeding occurs in the brain, the mortality rate can be as high as 20 percent.

subscribe_blogThe risks of VKDB are real and serious if vitamin K is declined at birth. Although it’s not a common event, the outcome can be devastating and irreversible. It’s preventable with one dose of intramuscular vitamin K at birth.

There are oral preparations of vitamin K that can be given, but because the absorption and compliance are variable, the recommendation for all infants is to receive the intramuscular dose.

Lisa Irvin, MD, is pediatrician at Partners in Pediatrics.

Back-to-school sleep tips: Getting kids’ sleep habits back on track

(iStock photo)

Once the school sleep schedule is set, keep that same sleep-wake schedule seven days a week. (iStock photo)

Karen Johnson, APRN, CNP

Summer is winding down, and the new school year is just around the corner. As we start to prepare students for going back to school, it is important to adjust to a regular sleep routine. Transitioning from a carefree summer schedule to a school schedule can be difficult. An adequate amount of sleep is beneficial to help your child be successful during the school day. Here are a few key tips that will to help your child ease into his/her school sleep schedule:

  1. About two weeks before school starts, begin to put your child to bed 15-30 minutes earlier and as well as waking him or her earlier; working toward a school wake time as the goal.
  2. Once the school sleep schedule is set, keep that same sleep-wake schedule seven days a week. Your child will be more alert and function better on a consistent sleep schedule.
  3. School-age children should avoid afternoon naps as this will disrupt the nighttime sleep schedule.
  4. No screen time 90 minutes before bed; this includes all electronic devices. The light from these devices keeps your child alert and awake at bedtime.
  5. subscribe_blogEstablish a relaxing and structured bedtime routine such as one to two books, a song and hug goodnight.
  6. Eat a healthy snack before bed and avoid caffeine.
  7. Make the sleep environment dark, comfortable and cool.
  8. Dim the lights in the evening before bedtime to promote sleepiness.
  9. Use bright light in the morning to wake easier: sunlight is the brightest source, so open the curtains and turn on a light.
  10. Provide your child with the opportunity to get the adequate amount of sleep to feel alert and refreshed for the school day.

Contact the Children’s Sleep Center at (651) 220-6258 for a sleep evaluation if you have concerns about your child’s sleep.

Sleep duration recommendationsKaren Johnson, APRN, CNP, is a certified nurse practitioner at the Children’s Sleep Center at Children’s Hospitals and Clinics of Minnesota.

The danger of overusing antibiotics

Overprescribing antibiotics has resulted in the development of resistant bacteria, which are bacteria that don’t respond to antibiotics that may have worked in the past. (iStock photo)

Every year, your family probably faces its share of colds, sore throats, and viruses. When you bring your child to the doctor for these illnesses, do you automatically expect a prescription for antibiotics?

Many parents do. And they’re surprised, maybe even angry, if they leave the doctor’s office empty-handed — after all, what parent doesn’t want their child to get well as quickly as possible? But your doctor could be doing you and your child a favor by not reaching for the prescription pad.

antibioticsHow antibiotics work

Antibiotics, first used in the 1940s, certainly are one of the great advances in medicine. But overprescribing them has resulted in the development of resistant bacteria, which are bacteria that don’t respond to antibiotics that may have worked in the past. Plus, whenever kids take antibiotics they run the risk of side effects, such as stomach aches and diarrhea or even a possible allergic reaction.

To understand how antibiotics work, it helps to know about the two major types of germs that can make people sick: bacteria and viruses. Although certain bacteria and viruses cause diseases with similar symptoms, the ways these two organisms multiply and spread illness are different:

  • Bacteria are living organisms existing as single cells. Bacteria are everywhere, but most don’t cause any harm — and in some cases may be beneficial. Lactobacillus, for example, lives in the intestine and help digest food. But some bacteria are harmful and can cause illness by invading the human body, multiplying, and interfering with normal bodily processes. Antibiotics are effective against bacteria because they work to kill these living organisms by stopping their growth and reproduction.
  • Viruses, on the other hand, are not alive and cannot exist on their own — they are particles containing genetic material wrapped in a protein coat. Viruses “live,” grow and reproduce only after they’ve invaded other living cells.Some viruses may be fought off by the body’s immune system before they cause illness, but others (colds, for example) must simply run their course. Viruses do not respond to antibiotics.

subscribe_blogWhy it’s harmful to overuse antibiotics

Taking antibiotics for colds and other viral illnesses not only won’t work, but also has a dangerous side effect: over time, this practice helps create bacteria that have become more of a challenge to kill.

Frequent and inappropriate use of antibiotics can cause bacteria or other microbes to resist the effects of antibiotic treatment. This is called bacterial resistance or antibiotic resistance. Treating these resistant bacteria requires higher doses of medicine or stronger antibiotics. Because of antibiotic overuse, certain bacteria have become resistant to some of the most powerful antibiotics available today.

Antibiotic resistance is a widespread problem, and one that the Centers for Disease Control and Prevention (CDC) calls “one of the world’s most pressing public health problems.” Bacteria that once were highly responsive to antibiotics have become increasingly resistant. Among those that are becoming harder to treat are pneumococcal infections (which cause pneumonia, ear infections, sinus infections and meningitis), skin infections and tuberculosis.

Taking antibiotics safely

So what should you do when your child gets sick? To minimize the risk of bacterial resistance, keep these tips in mind:

  • Treat only bacterial infections.Seek advice and ask questions. Letting milder illnesses (especially those thought to be caused by viruses) run their course to avoid the development of drug-resistant germs may be a good idea — but it’s still best to leave what constitutes a “mild illness” up to your doctor. Even if the symptoms don’t worsen but linger, take your child to the doctor. At the office, ask questions about whether your child’s illness is bacterial or viral, and discuss the risks and benefits of antibiotics. If it’s a virus, don’t pressure your doctor to prescribe antibiotics, but ask about ways to treat symptoms.

If your child is prescribed antibiotics, be sure to:

  • Use antibiotics as prescribed.
  • Don’t save antibiotics for next time.
  • Never use another person’s prescription.

Ask your doctor about ways to treat the symptoms that are making your child uncomfortable, such as a stuffy nose or scratchy throat, without the use of antibiotics. The key to building a good relationship with your doctor is open communication, so work together toward that goal.

Use the medication properly. Antibiotics are only effective against a bacterial infection if taken for the full amount of time prescribed by the doctor — and they take time to kick in, too, so don’t expect your child to feel better after taking the first dose. Most kids take one to two days to feel a lot better. Similarly, don’t let your child take antibiotics longer than prescribed.

And most important, never use antibiotics that have been lying around your home. Never take antibiotics that were prescribed for another family member or adult, either — doses for kids vary, and if your child did have an illness requiring antibiotics, you’d want to make sure you were treating it correctly.

Saving antibiotics “for the next time” is a bad idea, too. Any remaining antibiotic should be thrown out as soon as your child has taken the full course of medication.

Help fight antibiotic resistance by taking simple steps to prevent the spread of infections. Encourage hand washing, make sure your kids are up to date on immunizations, and keep kids out of school when they’re sick.

Doctors are aware of increasing antibiotic resistance and trying to solve the problem. New antibiotics might be on the horizon, but antibiotics will continue to need to be prescribed and used appropriately.

Material reviewed by Yamini Durani, MD; © 1995-2015 KidsHealth ®