Author Archives: ChildrensMN

Raising kids with the Internet as a co-parent

Every generation faces unique challenges in life, this generation is no exception. The main difference for new parents in 2015 is the Internet — offering a mixed bag of benefits and burdens to the ancient art of parenting. (Pimonova / iStock illustration)

Every generation faces unique challenges in life, this generation is no exception. The main difference for new parents in 2015 is the Internet — offering a mixed bag of benefits and burdens to the ancient art of parenting. (Pimonova / iStock illustration)

Jeri Kayser

While visiting my marvelous niece and her exceptionally marvelous newborn baby, she mentioned that women who have already raised their children don’t know what it’s like to be a parent in today’s world. This struck me as interesting on many different levels.

I remember having that same exact thought after having my first child; it’s only after that baby has grown a bit or you’ve had your second or third child that you can look back on this phase of your parental evolution and see that the change is less about the world and more about you. You have changed. Your priorities, your worries, your decreased expectation that sleep is something you get to choose. The world is now more demanding but infinitely more fascinating and filled with an indescribable love. Plus, you get to learn some awesome multitasking skills!

subscribe_blogSo, is it different to raise a child now?

Every generation faces unique challenges in life, this generation is no exception. I would argue that the main difference for new parents in 2015 is the Internet — offering a mixed bag of benefits and burdens to the ancient art of parenting. It’s a great place to find bargains for the stroller you want or show you how to install the car seat. But it’s equally a never-ending source of unsolicited advice and distorted parent bragging that can make any rock-solid parent feel insecure, questioning if it’s true: “Should I really only feed my child blue foods?”

When I was raising kids and standing in the checkout lane at the grocery store, the magazines would shout from their rack all of the things I could be doing to be a better parent: “How to create the perfect birthday party!” “Fun and easy Halloween costumes you can make at home!” “Teach your child 12 languages before they enter kindergarten.” Every title offering a suggestion came with the subliminal message that failure to follow the advice was evidence that you weren’t up to this whole parenting thing. It’s hard not to feel insecure when you’re so motivated to be perfect for your obviously perfect child while residing in the imperfect package of a human being.

I could step away from the parenting magazines in the checkout line, maybe read up on what alien has married what celebrity, but you can’t really avoid the Internet. Those photos of your friends and relatives in gorgeously orchestrated family bliss are still going to pop up in your feed.

Sigh.

Mining the Internet for truly helpful information that empowers your parenting mojo instead of inviting in trolls who create chaos with your self- esteem requires some thoughtful navigation.  The Internet is great for advice about things that have easily verifiable facts, like “where can I find an indoor playground?” Questions that have long-term consequences like “how do I get my kids to get along with each other?” are best answered by the posse of people closest to you — your friends and family as well as professionals educated in the field of question.

Important parenting advice should be gathered from people important to you, people who are invested in you for the foreseeable future who will be around to be held accountable for their advice. Sift through that advice and take from it what seems right to you. Trust yourself. Yes, others have sailed the parenting seas, but this is your journey and you are the captain. Respecting yourself and recognizing there is no perfect parent smoothes the waters and makes the trip so much more fun!

Jeri Kayser is a child life specialist at Children’s Hospitals and Clinics of Minnesota.

The importance of play — for kids and adults

Hands-on play, where a child uses his or her imagination and ideas to self-discover, creates the best learning environment. (iStock photo / Getty Images)

Jeri Kayser

When people try and remember the name of my profession, child life specialist, they often shorten it to “play lady.” That used to bug me when I was a young professional and ready to solve all of the world’s problems, but now I recognize the compliment. We breathe, drink and eat to stay alive – we play to bring forth a reason for all of that effort. Play is how we learn about our world, practice that knowledge and foster our sense of well-being and personal joy; it’s an honor to promote play in the world of health care, but it’s not without its challenges.

One current challenge is tied to the hot topic in popular culture about the value of gaming devices. Is playing a game on a smartphone when you’re 2 years old considered quality play? Short answer: No. The Academy of Pediatrics recommends no screen time for kids 2 and younger and only one to two hours a day for older children. The core aspect of the definition of “play” is that it’s self-directive. You’re deciding what you’re going to do with whatever you’re interacting with. One of the problems with electronic games is that game designers have done most of that for you.

Your toddler recognizes the status that phone holds, and it works for a bit to keep a child distracted from the fact that he or she is in the hospital or in a long checkout line at the grocery store.

subscribe_blogSo what can we use to help guide our decisions to promote healthy play? A great way to look at this is similar to how we all work to promote healthy choices for our diet. Potato chips are fine for an occasional treat, but we wouldn’t want to eat them all the time. If we did, we’d feel awful. Video games kind of are the junk food of play. The more the play requires from the child, the better the value and healthier the choice.

I notice this in the hospital when I come into a room to meet with a family about what to expect with surgery. People often are busy with an electronic device, but as soon as we start to talk, the interest is there to engage and the devices get turned off. When I bring a toy or some arts and crafts activities, kids always gravitate towards that; they want what they need.

I used to work in a summer daycare program for school-aged kids. We would spend the morning on a field trip and the afternoon at a beach. The director wanted us to provide structured activities for the kids in the afternoon, but we quickly learned that the combination of water, sand and friends led to a more-creative, imaginative and enriched play than anything with which we could have come up. Hands-on play, where a child uses his or her imagination and ideas to self-discover, creates the best learning environment.

I heard an interesting story on public radio on my long commute home. At the electronic show in Austin, Texas, at the South by Southwest conference, the big news at the conference was the “Maker Movement,” stressing the importance of hands-on play to promote understanding of how our world works. They interviewed an inventor, Ayah Bdeir, who created a toy of electronic bits that fit together with magnets, creating circuits. With this process, you can make all kinds of fun things. He explained the value of this explorative play by stating, “We need to remember that we are all makers and touching things with our hands is powerful and inspiring.”

In another century, another scientist noted the same thing. Albert Einstein declared, “Play is the highest form of research.”

Self-directed play offers the healthiest value for our play “diet,” and this extends throughout our lives. We all need to play. As I wrote this, I overheard a conversation between two anesthesiologists talking about how they used play to help them cope with life stressors. One likes his guitar, while the other enjoys making remote-control helicopters.

This important fact, one of the highest forms of self-care, needs to be part of the planning of how we provide health care. Play is important for all age groups, not just those adorable preschoolers. We need to incorporate this in everything we do, for teens, parents and staff.

Late Irish playwright George Bernard Shaw said it best: “We don’t stop playing because we grow old; we grow old because we stop playing.”

Jeri Kayser is a child life specialist at Children’s Hospitals and Clinics of Minnesota.

Former Children’s patient has brain tumor removed, wakes up a new person

Elizabeth Johnson Camozzi

Elizabeth Johnson Camozzi had a tumor removed from her right cerebellum in 1997 when she was 12 years old. (Photos courtesy of Elizabeth Johnson Camozzi)

Elizabeth Johnson Camozzi

I was a shy and awkward girl at 12. Sweet and uncomplaining, worried about what others thought, I was the picture of the normal “tween” identity. I also was quite sick.

Frequently, the routine was migraine, nausea and head to school after vomiting. My parents took me to see several specialists, some touting that I had allergies to chocolate, the sun, the color red. But I continued to be sick, and it seemed a natural part of my life.

There were parts of my daily routines that I believed everyone had. Every night, I would imagine hearing monsters thumping up the stairs to say goodnight to me.

Thump, thump, thump, thump.

Elizabeth with Dr. Mary Beth Dunn in 1997

Elizabeth with Dr. Mary Beth Dunn in 1997

As a musician, I would compose music to that steady thumping. During piano lessons, I would play at the same tempo, quarter note equaling 65 beats per minute. My music was always a very steady sound, driven by the thumping that I assumed everyone heard in their ears. During a math lesson in which we took our heart rates for one minute, I was confused as to why others had to hold their wrists and count what they felt for the time; I could hear my heartbeat plain as day!

After a family trip the winter of my seventh-grade year in 1996, my parents took me to get my eyes checked because I had double vision. As the eye doctor was peeking at my pupils, he paused and called an opthomologist, who referred me to a neurologist. I clearly remember the neurologist saying to her medical students, “You do not want to see this when checking your patients.” She called and scheduled me an MRI for that night, and we went straight over. Immediately after, my parents were called into a side room and quickly invited me inside. I had a pilocytic astrocytoma brain tumor that had taken nearly my entire right cerebellum. I was going to need surgery the next morning.

That night, I prayed for God’s will to be done — a hard prayer for a 12-year-old, but I knew that this was out of my hands. This brain tumor was why I was sick. Would I feel better afterwards? The doctors warned my parents that the chances of me coming out with disabilities would be high. I might lose right-arm and leg function as well as acquire a dropped eye and might not be able to function like a normal 12-year-old. My parents were beside themselves.

Elizabeth Johnson Camozzi in 2014-15

Elizabeth Johnson Camozzi in 2014-15

The next morning, we met Dr. Mary Beth Dunn, who was to be my surgeon, as well as Dr. Joanne Hilden, my oncologist. On Friday night, both neurosurgeon partners, as well as both pediatric head surgical nurses, came in for my surgery on what would not normally be a surgery night. My surgery, considered an emergency, was that afternoon, and it lasted until early morning the next day when I was wheeled into my recovery room in the pediatric ICU.

My mother waited with me until I woke up. My first memory was my mom singing “Hush, Little Baby.” I began to wake as she began the song, “Hush, little baby, don’t say a word. Mama’s going to buy you a mockingbird. If that mockingbird don’t sing…” At this point she paused and I began to remember a comedian that my brothers and I had watched who sang the same song with silly lyrics. Before she could sing any more, I chimed in with my scratchy post-surgery voice, “Mama’s going to tear off its little wing.” Between laughter and tears, my family celebrated my awakening.

I awoke a new person. Not only did I remember my family and silly TV shows, I woke up smelling new smells, seeing colors better, hearing sounds clearer. When Dr. Dunn asked how I was feeling, I responded that everything just seemed better. Without a brain tumor pressing on my ear drum and threatening my life at every heartbeat, I felt lighter and more able to perceive the world around me. I woke up a happier, livelier version of myself, and have not stopped since waking up!

The scar left behind after Elizabeth Johnson Camozzi's surgery is her most beautiful feature, she says.

Elizabeth Johnson Camozzi said the scar left behind after her surgery is one of her most beautiful features.

subscribe_blogMy recovery was quick, and within 10 days I was back at school. Having staples down the back of my head made me a bit of an oddity in middle school, and I was teased relentlessly. Children’s Hospitals and Clinics of Minnesota stepped in with a social worker to explain what I had gone through and the medical background to my teachers (and to explain why I shouldn’t play basketball with an open skull). Our relationship with Dr. Dunn and the staff at Children’s continued to grow and flourish. I spent summers at Camp Mak-A-Dream in Montana among other children who were in the throes of, or recovering from, cancer and leukemia. At any point when the doctors informed us that I could not do something, I would do it — play the piano, balance on a balance beam, memorize sonatas. I did, however, cross skydiving off of my bucket list (scuba diving, considered dangerous, was offered in the safety of camp Mak-A-Dream!).

Now 30, I owe my life to Drs. Dunn and Hilden and the staff at Children’s. I feel as if a part of me did not begin until I went into the operating room. When I see Dr. Dunn to this day (18 years later!), she still looks at my scar and smiles. A perfect line down the part line in back of my head, my scar is one of my most beautiful features; it tells a story of survival and hope.

Sleep tips from Children’s Sleep Center

Children's Sleep Center in St. Paul specializes in identifying and treating the full gamut of sleep challenges. (iStock Photo)

Children’s Sleep Center in St. Paul specializes in identifying and treating the full gamut of sleep challenges. (iStock Photo)

subscribe_blogKaren Johnson, APRN

Parents know good sleep is essential for healthy growth and functioning. Parents also know that good sleep can be hard to come by.

Families seek out the Children’s Sleep Center for our experience in treating rare and common sleep disorders in infants, children and adolescents. At Children’s Hospitals and Clinics of Minnesota, we specialize in identifying and treating the full gamut of sleep challenges, ranging from difficulties falling asleep, staying asleep, or with breathing during sleep, to difficulties waking up and staying awake.



SLEEP TIPS FOR ALL CHILDREN

Random bedtimes breed bad behaviors in kids

Many parents have learned the hard way that late bedtimes make for cranky kids the next day. In one study, children who went to bed after 9 p.m. were rated as having more behavior problems. During the day, later bedtimes affected the child’s school performance. Irregular bedtimes cause worse behaviors than short amounts of sleep. Behavioral problems improve when children have regular bedtimes.1

Sleep tips for a better bedtime routine

1. The bedtime routine should take place in the child’s bedroom where it’s quiet — a great time to read two to three books to your child, developing a love for reading, too.

2. Your child will be calmed when the routine is done in the same order each night.

3. Younger children may benefit from a visual schedule (pictures, words, or both) to remind them of the steps.

4. Determine which events are calming and which are stimulating. Calming events are required for bedtime. For example, if bathing is stimulating instead of relaxing, move the bath time earlier in the evening or to the morning.

Kids and electronics

Screen time can impact the quantity and quality of sleep. The American Association of Pediatrics recommends no more than one to two hours of screen time a day for children two years and older. The light from these screens suppresses melatonin, a hormone in the brain that signals sleep. Due to the usage of multiple electronic distractions (cellphones, computers, tablets) for tweeting, texting, social networking and entertainment, kids’ evenings are “lit up.” The light from these devices is keeping many kids awake long into the night, creating sleep deprivation. Losing one hour of sleep at night can negatively affect a child’s academic performance at school.

Tips for improving sleep

1. Implement an electronic curfew at least one hour before bedtime.

2. Remove all electronic devices from the bedroom.

3. Adjust your child’s schedule to accommodate for homework to be completed earlier in the evening when homework requires using electronic devices.

4. Consider doing homework in the morning, as the light from these devices helps your child wake easier.3,4

SLEEP TIPS FOR PATIENTS WITH OBSTRUCTIVE SLEEP APNEA

Can I get sick from my CPAP mask?

Unwashed CPAP/BiPAP masks may have an odor and harbor germs. Because you breathe through the mask for several hours each night — particularly if you use a heated humidifier in conjunction with the CPAP machine — you create a warm, moist environment inside your mask. Fungi, bacteria and viruses can thrive in this environment. These infectious agents then have direct access to your airway and can make you sick.

  • Wipe the CPAP mask clean each day with a mild detergent and allow it to air dry.
  • If you have any questions, call your equipment vendor or the Children’s Sleep Center for help.

Important things to know about CPAP/BiPAP and sleep

1. You should start to feel better during the day soon after you consistently start using your CPAP/BiPAP at night.

2. CPAP/BiPAP improves your health and well-being in many ways.

3. Not everyone finds CPAP/BiPAP easy, but there are things that you can do to make it easier. Ask your sleep specialist for ideas.

4. To succeed with CPAP, you need to be patient and stick with it. Since it generally will make you feel better the next day, taking a night off from using it is not a good idea.

5. It is not unusual to find your mask is off when you wake at night. What matters is being aware and putting the mask back on again when you notice it is off.

Treating sleep apnea in kids improves behavior, quality of life

Kids with untreated obstructive sleep apnea often are tired during the day, have trouble paying attention and other behavioral problems; these children are not getting enough quality sleep at night.

Obstructive sleep apnea (OSA) is marked by pauses in breathing while asleep. These pauses can occur through the night and disrupt sleep. Positive airway pressure machines help keep the airway open. The main message is that this treatment — although it may be difficult to tolerate — can result in a significant improvement in the child’s behavior and quality of life. One of the issues is that children may not want to wear the bulky mask while they sleep, but the study shows that even three hours a night is enough to make a big difference by improving attention, behavior, sleepiness and quality of life.5

PEDIATRIC PARASOMNIAS

Pediatric parasomnia refers to movement or experiences that take place during sleep as a child transitions from sleep to wake phases. A few common parasomnias include sleepwalking, sleep terrors and confusional arousals.

Parsomnias can be common in families and may be triggered by other sleep disorders, such as OSA and restless leg syndrome (RLS). Other triggers include certain medications, sleep deprivation, irregular sleep schedules, fever, sleeping in unfamiliar places, stress and separation anxiety.6

Sleep terrors occur during the first hours after falling asleep. The child wakes abruptly from sleep with loud screams, is agitated and frightened. The child is unresponsive to a parent’s efforts to calm and does not recall the event in the morning. It’s best to stand by during the event, observe and maintain the child’s safety. The terror is not traumatic for the child, only for the observer.

Nightmares occur at the last half of the night during REM sleep. They are disturbing dreams that wake the child, usually creating fears and anxiety. The child can recall the nightmare in the morning.

Sleepwalking occurs in about 15 percent of children, peaking between 8-12 years of age. Some may exhibit inappropriate behaviors at night, even urinating in strange places. Children have injured themselves by unconsciously carrying out dangerous behaviors such as leaving the house at night. Safety is the biggest concern in managing sleepwalking events. Second-floor bedroom windows should be locked and alarms placed on outside doors to alert parent if the child attempts to leave the home during the night.

Confused arousals may occur at any time during sleep. The child may sit up in bed, cry, whimper, moan and seem agitated and confused. Usually they do not respond to your interventions to comfort.

Home management

  • Maintain a regular sleep and wake schedule seven days a week. Getting the proper amount of sleep to feel well-rested will reduce the triggers for an event.
  • Precautions for safety during sleepwalking events need to be addressed. Alarms on doors and windows are advised.
  • Night terrors and confused arousals do not require the child to be comforted, as this will intensify the event. Parent should stand by to observe and maintain child’s safety.
  • Children will outgrow parasomnias as they get older.
  • If your child is having regular parasomnia events, an evaluation by your sleep provider may be required.

Karen Johnson, APRN, is a certified nurse practitioner at the Children’s Sleep Center in St. Paul. Get more information about the Children’s Sleep Center.

Resources
1. www.npr.org, 2003
2. Sleep for teenagers; www.nytimes.com, (2014).
3. Treating sleep apnea in kids improves behavior, quality of life; www.webmd.com, (2012).
4. Limiting screen time improves sleep, academics, behaviors, study finds; www.sciencedaily.com, (2014).
5. American Journal of Respiratory and Critical Care Medicine, 2012
6. Suresh Kotogal MD (2014). Sleepwalking and other parasomnias in children.

8 tips to prevent poisoning

With one of the busiest pediatric emergency medicine programs in the nation and more than 90,000 emergency department visits annually for a variety of reasons, you can trust we’ve treated just about everything. We love kids here at Children’s, but we’d rather see them safe at home.

In recognition of Poison Prevention Awareness Week (March 15-21), we’ve gathered tips from our experts. Share these tips with your kids and print them to share at their schools or with your friends. Together, we can make safe simple.

Keep all potential poisons up high and out of the reach of children — in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze. (iStock photo / Getty Images)

What is Poison Prevention Week?

National Poison Prevention Week was established by Congress in 1961 for annual, national recognition. The goal of the week is to educate the public about poisoning risks and what to do to prevent poisonings.

What you should know

Did you know that injuries are a leading cause of death in children? Each year, 5,000 kids die and another 6 million are hurt as a result of unintentional injuries. One in 4 children is hurt seriously enough to need medical attention. Most childhood injuries occur at home, and many of these injuries, including poisoning, could be prevented.

Facts about poisoning

  • More than 1 million accidental poisonings per year occur in children younger than 6 years old.
  • Approximately 1 in 10 poisonings involves cleaning products.
  • Approximately 1 in 10 poisonings involves indoor and outdoor plants.
  • Approximately 1 in 20 poisonings are caused by cosmetic and personal-care products.

Tips to prevent poisoning

  • Review the poison prevention home checklist from the Minnesota Regional Poison Center.
  • Keep all potential poisons up high and out of the reach of children — preferably in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze.
  • Keep medications and vitamins out of the reach of children. Never call medicine “candy.”
  • Keep foods and household products separated.
  • Keep products in original containers. Do not use food storage containers to store poisonous substances (i.e. plant food in a drink bottle).
  • Destroy old medications.
  • Identify all household plants to determine if poisonous.
  • Post the Poison Center phone number, 1 (800) 222-1222, near each phone in the home.

subscribe_blogWhat do you do if you suspect someone has been poisoned?

  • Swallowed poison: Remove anything remaining in the mouth. If a person is able to swallow, give about 2 ounces of water to drink.
  • Poison in the eye: Gently flush the eye for 10 minutes using medium-warm water.
  • Poison on the skin: Remove any contaminated clothing and rinse skin with large amounts of water for 10 minutes.
  • Inhaled poison: Get fresh air as soon as possible.
  • Call the Poison Center, 1 (800) 222-1222, immediately.
CROSSWORD PUZZLE: Poison Search

Cognitive-behavioral therapy for insomnia an option for kids with sleep trouble

Cognitive-behavioral therapy for insomnia (CBT-I) requires regular visits with a sleep provider who will work with you and your child to help change the way he or she sleeps. (iStock photo)

Cognitive-behavioral therapy for insomnia (CBT-I) requires regular visits with a sleep provider who will work with you and your child to help change the way he or she sleeps. (iStock photo)

Terese Amble, PsyD, LP

Insomnia is broadly defined as difficulty falling asleep, staying asleep and/or subjective, poor-quality (“non-restorative”) sleep.

Everyone has problems sleeping at times; however, a diagnosis of insomnia is made if sleep problems persist for more than one month and result in some degree of daytime impairment. Untreated insomnia can result in chronic sleep loss that can cause excessive daytime sleepiness and impact daytime functioning, which may range from fatigue, moodiness/irritability or mild cognitive or behavioral problems (difficulties with concentration/attention, hyperactivity) to significant effects on mood, behavior or school performance. Chronic insomnia also increases the risk of physical and mental illness.

Given the negative impact of chronic poor sleep, it is important to have sleep problems evaluated and treated. Behavioral treatments are the first line treatment for insomnia and involve improving sleep without the use of medications, as there are no medications that are FDA-approved for the treatment of insomnia in youth. Cognitive-behavioral therapy for insomnia, commonly referred to as CBT-I, is a safe and effective treatment that aims to help children and adolescents identify and replace thoughts and behaviors that cause or worsen sleep problems with thoughts and behaviors that promote sound sleep.

CBT-I requires regular (usually weekly or biweekly) visits with a sleep provider who will work with you and your child to help change the way he or she sleeps. The frequency of treatment may vary from as few as two sessions to as many as eight of more sessions, depending on the specific sleep concerns and progress. At the beginning of treatment, a comprehensive sleep evaluation will be conducted to determine factors that are underlying or contributing to sleep difficulties and to help develop an effective treatment plan. As part of this initial evaluation, you will be asked to keep a sleep log of your child’s sleep patterns for one to two weeks and your child may be asked to wear an actigraph, a portable wristwatch-like device which records and stores more objective information about body movements and sleep-wake patterns.

subscribe_blogAfter this initial evaluation, treatment is individualized and each session is focused on learning specific cognitive and behavioral strategies to improve sleep. The cognitive part of CBT-I involves teaching your child techniques to quiet his or her busy mind at night to relax and fall asleep. Your child will learn strategies to recognize, modify or eliminate unhelpful/negative thoughts or worries that interfere with his or her ability to sleep, including unrealistic beliefs and attitudes about sleep and the possible daytime consequences of poor sleep (e.g. “I’ll never be able to fall asleep tonight,” “If I can’t fall asleep, I won’t be able to get up in the morning and I’ll miss my test”).

The behavioral part of CBT-I involves identifying and changing behaviors that may keep your child from sleeping well and developing good sleep habits to promote quality sleep. Treatment is tailored to each child or adolescent and may include some combination of the following techniques:

  • Sleep restriction: This strategy involves temporarily restricting the total time in bed to current amount of sleep each night to decrease the amount of time spent in bed awake. Being extra-sleepy can help your child fall asleep quickly and stay asleep. Once sleep has improved, the amount of time in bed is gradually increased until desired bedtime is reached.
  • Stimulus control: This technique involves eliminating any activities in bed that are not conducive to sleeping to disrupt the association between being in bed and wakefulness (and strengthen the association between being in bed and sleepiness). Stimulus control instructions often include only going to bed when sleepy, leaving the bed (and possibly bedroom) to engage in a quiet activity if not asleep within 15-20 minutes and only using the bed for sleeping both during the day and at night (not watching TV, doing homework, worrying, etc.).
  • Sleep hygiene: This involves learning positive sleep practices and habits that are important for getting sound sleep, such as establishing an optimal sleep environment, implementing a developmentally appropriate and consistent bedtime and wakeup time (no matter how much sleep you got the night before!), avoiding naps, establishing a calming, consistent bedtime routine, decreasing stimulation near bedtime (caffeine, physical activity, conflict/stress) and removing electronics from the bedroom.
  • Relaxation training: Increased mental activity at night (such as worrying or not being able to “switch off” an active, busy mind) or stress about not being able to fall asleep leads to increased activity and tension in the body, which further interferes with the ability to unwind and fall asleep. Relaxation strategies, such as deep breathing, visual imagery, progressive muscle relaxation, autogenics, meditation and mindfulness can be used to help quiet the mind and calm the body at night and improve sleep.

Given the potential negative consequences of chronic sleep loss, it’s important to actively treat sleep problems. CBT-I is a safe and effective way to treat insomnia in children and adolescents without the use of medications. CBT-I is generally short term, but the skills learned during this treatment can lead to lasting, improved sleep if positive habits are maintained.

Terese Amble, PsyD, LP, is a pediatric psychologist in the sleep center at Children’s Hospitals and Clinics of Minnesota.

Children’s welcomes new neurologist

five_question_friday111In recognition of Brain Injury Awareness Month and our focus on neurology, we’d like you to meet Douglas Hyder, MD, in this edition of Five Question Friday.

Douglas Hyder, MD

Douglas Hyder, MD

What is your job at Children’s? Describe your role.

I am a pediatric neurologist. Pediatric neurology is a medical field focusing on the growth and development of the central nervous system, peripheral nervous system, and muscles. There is significant overlap with developmental pediatrics, psychiatry, psychology, neurosurgery, orthopedics, physical medicine and rehabilitation (PM&R), ophthalmology, genetics, physical therapy, speech therapy and occupational therapy. My job is similar to a detective. I look for clues in a patient’s history and physical exam to find out why something is happening and what can be done about it. Not all of the symptoms we see are necessarily abnormal.

We’re fortunate that there has been tremendous progress in diagnosis and treatment of neurological conditions over the past few decades. The work is far from complete, but we can offer so much more to patients today than when I first started in neurology 20 years ago.

How long have you worked at Children’s?

I’ve only been here a couple of months, but I’m originally from the Midwest, so the Twin Cities already feels like home.

What do you love most about your job?

I most enjoy teaching. Many of the conditions we diagnose need to be explained well in order for parents to understand what is going on with their child. I try to do that with all of my patients, but those light-bulb moments are especially gratifying.

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

Everything; a cowboy, scuba diver, race-car driver, drummer, police officer, astronaut, president, boxer, baseball player!

I still want to be a race-car driver.

What do you enjoy doing outside of work?

Bicycling. I try to ride every day when it’s not too cold.

Prepare your child’s sleep for daylight saving time

Four days before daylight saving time starts, get your child to bed 15 minutes earlier the first night. (iStock photo)

Four days before daylight saving time starts, get your child to bed 15 minutes earlier the first night. (iStock photo)

Karen Johnson, APRN

Preparation is the key to minimize the impact of daylight saving time on your child’s sleep patterns. It’s a good idea to get your child into bed a little earlier in the week leading up to the time change.

subscribe_blogChange the child’s body clock

Four days before daylight saving time starts — it takes place at 2 a.m. Sunday, March 8 — get your child to bed 15 minutes earlier the first night. Your child may not actually go to sleep earlier, but by getting him or her to bed sooner, you are encouraging the body to relax earlier than usual. This will lead to falling asleep earlier, too. Make the child’s bedtime progressively earlier by 15 minutes each of the four nights before daylight saving time until it adds up to an hour the night of the time change.

Daylight saving time sleep tips

Make sure that the bedroom is dark. The big challenge for parents during daylight saving time is having the child go to bed when the sun is out. Sleep is influenced by having a dark environment, as this allows for the natural secretion of melatonin that is needed to invite sleepiness.

Calm bedtime routine

Take extra care to ensure that the bedtime routine is calm and as relaxing as it can be. A calm and regular bedtime routine is best, without debates and arguing to promote sleep.

Waking too early

Ensure that your child understands that it’s not time to get up for the day. Encourage him or her to go back to sleep. Some parents put a clock beside their child’s bed and explain what time it has to be before the child can get up for the day. If you have a toddler or young child, use a sleep clock such as the Good Nite Lite. The light is a cue that informs your child to stay in bed until the sun shines on the clock in the morning. This isn’t just effective for time changes; it also can help you train an early riser not to wake Mommy and Daddy too early in the morning and may help with bedtime battles.

Get some sun

Besides making sure to get the proper amount of sleep, early morning bright light exposure also can help set a regular sleep-and-wake pattern called a “circadian rhythm.” Eating breakfast in a bright part of your house or going for an early morning walk outside in the sun will help you and your child wake easier as well.

Daily physical activity is recommended for all children, but don’t try to wear your child out in an effort to get him or her to sleep earlier. Overtired children often take longer to fall asleep and may even resist sleep completely.

Be consistent

While your child is getting used to the new sleep schedule, stick to your usual bedtime rules and routine.

Be patient during this time adjustment as you may have a tired and grumpy child on your hands in the days after the time change. It generally takes about a week after the clocks have changed to be in a new sleeping pattern. Prepare to feel unfocused in the days after you set clocks forward. You might want to keep your family’s schedule more open in the days after daylight saving time in case you aren’t well rested.

Other tips

  • Newborn babies usually are not affected by the start and finish of daylight saving time.
  • Change clocks Saturday evening before going to bed.
  • Check the smoke alarms. Changing the batteries as a good safety rule.
  • If your child has difficulty sleeping, please contact the Children’s Sleep Center.

Karen Johnson, APRN, is a certified nurse practitioner at the Children’s Sleep Center.

Meet a familiar face from Children’s

five_question_friday111If you’ve visited Starz Café at Children’s – Minneapolis, there’s a good chance you’ve seen Latisa Tyus. She and her smile are a Starz staple. Get to know Latisa in this edition of Five Question Friday.

Latisa Tyus has been with Children's for 17 years.

Latisa Tyus has been with Children’s for 17 years.

What is your title? Describe your role.

I’m a dietary aide in Nutrition Services. Currently I work as the cashier in Starz Café.  I ring up customers, set up food and beverages and clean the tables in the café.

How long have you worked at Children’s?

I have worked at Children’s for 17 years.

What do you love most about your job?

The thing I love most of all is putting a smile on people’s faces when they are having a tough day. Whether it’s a patient’s family, staff or a visitor, I love being able to make people smile.

Do you have a favorite memory from working at Children’s?

subscribe_blogI remember when I started here and had been here only three days. Christine from the lab came in to collect a prize from the café, and I told her I was new and had to find someone to give her the prize. She was just so nice to me, and I still remember what she was wearing. To this day we still talk about how nice it is to work in such a great community here at Children’s.

How do you spend your time outside of work?

I enjoy spending time with my family and friends. I love going to sporting events and love watching them on TV. I enjoy reading thriller books and am a music fanatic. I especially like music from the ’70s-’90s.

Mindfulness a technique to relieve stress

Many teachers of mindfulness suggest visualizing thoughts as leaves floating down a stream or as clouds drifting by in the sky. (iStock photo / Getty Images)

subscribe_blogLeslie Partin

Whether you’re a busy, working parent or a teen trying to balance a full social calendar and school, life can be stressful at times. Mindfulness, otherwise known as mindful meditation or mindfulness-based stress reduction (MSBR), is a tool any one of us can use as we navigate through the demands of our days.

The basic tenet of mindfulness is paying attention to the present moment. So much of the time we’re thinking ahead to the next task or mulling over something that happened in the past. For example, have you ever driven past the exit you intended to take, only to realize you missed it because you were thinking of something else? When we are caught up in our thoughts, we miss what is happening around us like that missed freeway exit.

Our minds are powerful, and we can harness that power to help us manage difficult experiences and distressing (or afflictive) emotions. When we are in the midst of a strong emotion or physical sensation like anger, sadness, disappointment or physical pain, it can feel like things will never get better. But if we’re able to step back and observe our distress, we may notice that it changes, ebbs and flows. Noticing and recognizing that the intensity varies, whether it’s an emotion or physical sensation, offers hope and reassurance that it won’t always be so hard. And when we focus on what we’re experiencing right now, instead of what’s going to happen — “I don’t want to have a headache at the dance,” “I don’t want to be stressed out at my child’s game,” etc. — then we don’t add the additional suffering of anticipation or worry. We suffer when we focus too much attention on what may happen in the future.

Mindfulness doesn’t mean trying not to think or making one’s mind blank. Instead, mindfulness teaches us to watch our thoughts, observe them while not attaching to them. Many teachers suggest visualizing thoughts as leaves floating down a stream or as clouds drifting by in the sky. Practitioners of meditation say that having a regular “practice” — a time set aside to practice meditation — allows us to develop our capability to be mindful in times of distress. It’s like building our mental muscles in the same way we build physical muscles by lifting weights or working out. Committing to a meditation or mindfulness practice helps us develop those muscles so we have the ability to use them when we need them most.

Neuroscience studies show us that the brain develops neuro-pathways as a result of our thinking habits and patterns. Similar to the way a trail through the woods is developed by animals and people following the same path over and over, our neuro-pathways, or thought habits, are made as we repeatedly take the same path of worry, fear, joy, happiness, etc. Mindfulness is one technique we can use to help form new neuro-pathways or mental habits. When we practice mindfulness we increase awareness of all of our thoughts and emotions, the positive as well as the afflictive ones. We then can choose which thoughts, emotions and sensations we want to focus on and nurture, and of which ones we want to let go. Remembering that we have this choice can help us cope when we hit stressful times.

If you’re interested in learning more about mindfulness, here are few links that can help you and your family get started (the first six links are centers that are located in the Twin Cities):

The Kiran Stordalen and Horst Rechelbacher Pediatric Pain, Palliative and Integrative Medicine Clinic at Children’s – Minneapolis has medical providers that work with children to teach relaxation techniques that can include the use of mindfulness. These strategies are helpful for chronic conditions such headaches and abdominal pain or problems with sleep and anxiety.


[1] Jon Kabat-Zinn developed Mindfulness Based Stress Reduction programs in Massachusetts and has several books and CDs, which provide a good starting point. “Everyday Blessings” is his book on mindful parenting, with Myla Kabat-Zinn.

Leslie Partin is a social worker at Children’s Hospitals and Clinics of Minnesota.