Category Archives: Featured

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.

Children’s Susan Sencer named Top Cancer Doctor by Newsweek

Dr. Susan Sencer

Dr. Susan Sencer has been part of Children’s hematology/oncology program for 25 years.

Children’s Hospitals and Clinics of Minnesota congratulates Dr. Susan Sencer for her recognition as a “Top Cancer Doctors 2015” by Newsweek.

Dr. Sencer has been part of Children’s hematology/oncology program, the largest in the Upper Midwest, for 25 years. She has been the program’s medical director for the past 12 years. Dr. Sencer has a special interest in complementary and alternative therapies and has been instrumental in founding the integrative medicine and pain and palliative care programs at Children’s.

Dr. Sencer was one of 55 doctors in Minnesota named to the list, which is published by Newsweek in conjunction with Castle Connolly Medical Ltd. The list was compiled through peer nominations and extensive research led by Castle Connolly Medical Ltd. of nearly 100,000 nominations.

On behalf of Children’s, and our patients and families, we are proud to congratulate Dr. Sencer on this accomplishment.

Tell us why your child’s school year will be amazing

Share a picture of your child's first day of school, and he or she could be our Student of the Day.

Share a picture of your child’s first day of school, and he or she could be our Student of the Day and featured on our Facebook cover image.

For kids and parents, the first day of school is one of the most amazing days of the year. It’s the day when we all dream about the year ahead, about what kids will learn and experience. On our Facebook page, Twitter or Instagram, share with us a photo of your child going back to school, along with their grade, let us know why this school year will be amazing, and he or she could be featured on our Facebook cover image as the Student of the Day.

Click on, save and print out our school year signs below and snap a photo of your child on the first day of school. Then share! #Back2School

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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.

13 water safety tips for kids

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

Manu Madhok, MD

Manu Madhok, MD

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

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

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

Children ages 1-5

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

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

Children ages 5-12

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

subscribe_blogOpen water

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

Backyard pool

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

Children’s has one of the busiest pediatric emergency programs in the country, with about 90,000 visits each year. We love kids here at Children’s, but we’d rather see them safe at home. With warm weather upon us, we compiled a list of basic tips, with help from our injury prevention experts, to keep kids safe all summer. Together, we can make safe simple.

Additional resources

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

5 things you may not know about music therapy

Erinn Frees (right), a music therapist at Children’s, tells us five things you may not know about music therapy. At left is music therapist Kim Arter.

In honor of Music Therapy Week, music therapist Erinn Frees gives us a look at her job at Children’s Hospitals and Clinics of Minnesota.subscribe_blog

Stepping onto the Children’s elevators each day, guitars on our backs and instruments in hand, we tend to draw comments from fellow riders. They range from the typical “You must be the entertainment” to “Do you actually play all those instruments?” to “I wish I had your job.”

Although explaining the ins and outs of music therapy isn’t always possible by the time one of us gets off on the fourth floor, we do usually manage to smile and say, “I’m one of the music therapists.” After being in this field for almost seven years, I find that this doesn’t always provide a lot of clarification. So in no particular order, here are five things that you might not know about music therapy:

1. Music therapy isn’t just for fun. Don’t get me wrong, music therapy usually is funWhat kid or teen doesn’t enjoy music, especially when they get to play along on a shaker or fancy electronic drum set?  However, a casual observer may not notice that a music therapist has goals for each patient he/she works with, ranging from giving a 3-year-old an effective means of emotional expression when he doesn’t have the words, to giving a 15-year-old relaxation strategies using music during a procedure, to motivating a 10-year-old to get out of bed.  The point of music therapy is that we are using the musical experience as a means of reaching a non-musical goal.

2. A child doesn’t need to be a musician or have musical experience to benefit from music therapy. Our goal as music therapists is not to teach kids how to play an instrument, or sing better, or dazzle everyone with their harmonica stylings. Therefore, the child doesn’t need to be musical to benefit from music therapy. Even patients who are sedated can benefit from music therapy, as music therapy can lower heart rate and blood pressure, as well as increase oxygen saturations. Patients who are able to participate on a more active level can play drums, shakers, xylophones and even a special type of harp with little to no previous musical experience.  A music therapist may use teaching the guitar as a way to improve the child’s fine motor skills, or having a child blow through the harmonica as a way to encourage deep breathing, but learning skills on these instruments is never the goal of the session.

3. We always use patient-preferred music. Music therapists use music from all genres to effect positive changes in the patients we work with.  We wouldn’t use “Old MacDonald” in a session with a 16-year-old (unless he or she requested it!) and we probably wouldn’t use a song from the 1920s with a 5-year-old. One of the first things music therapists ask when getting to know a new patient is what kind of music the he or she prefers.  We then work to accomplish our goals using this or similar music. We can’t promise to know every song, (we’re not human jukeboxes!) but we can always use recorded music or find a similar song if need be.

4. Music therapists are not just musicians waiting to make our big break on “American Idol.” Across the board, the music therapists I know went into the field because they want to use their passion for music to make a difference in people’s lives. We went to school for four or six years to do exactly what we do: music therapy. We spent six full months doing an unpaid music therapy internship and worked hard for the jobs we have. Although some music therapists perform outside of their day jobs, we are not performing when we are working with patients. Just listening to us sing is not likely to accomplish very many therapeutic goals!

5. We don’t just sing and play instruments. We do a lot of singing and instrument play with kids, this is true. However, we also work with kids doing songwriting (for emotional expression, processing, or a way to “tell your story”), lyric discussion (again to process emotions, facilitate coping, or put a new perspective on problems), music-assisted relaxation, procedural support, recording, and CD compilation.

So let’s go back to the elevator, so we can finish those conversations:

“You must be the entertainment!” – No, I’m not a performer. I do get to spend the day making great music with courageous, insightful and amazing kids, though!

“Do you actually play all those instruments?” Yes, I can… but I’d rather have the kids playing them!

“I wish I had your job!” – Yes, it is a wonderful and rewarding profession, and I wouldn’t want to be doing anything else!

Meet Katie

What Katie loves most about Children’s is the music therapy program.

What Katie loves most about Children’s is the music therapy program.

When exploring the impact of supporting a child’s tomorrow, we went straight to the source: our patients. We asked several to share how Children’s has played a role in their life today, and what they look forward to in their tomorrow. This is what we learned.

Q4_mighty_buttonName: Katie

Age: 5

Hometown: Eden Prairie

Katie was rushed from Abbott Northwestern Hospital to Children’s after she was born 15 weeks early. She only weighed a pound and had to stay in the neonatal intensive care unit (NICU) for 99 days. According to her mom, she is now happy, healthy and doing wonderfully.

When Katie grows up, she wants to be a dancer. She loves to dance.

What Katie loves most about Children’s is the music therapy program. Her brother, a member of our Youth Advisory Council (YAC), even helped to design a music cart for the music therapists at Children’s.

Five Question Friday: Terrance Davis

Five Question FridayIt’s Friday, and what better way to celebrate the end of the week than with a Five Question Friday profile? Meet Terrance Davis, who works on our Environmental Services team within the Minneapolis Surgery department.

Terrance Davis has worked at Children's for 25 years.

Terrance Davis has worked at Children’s for 25 years.

How long have you worked at Children’s?

I have worked here for 25 years.

Describe your role.

I clean surgery rooms between cases and stock supplies.

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

I have a few favorites:

  • The surgery staff surprised me with a 50th birthday celebration.
  • Each annual craft show, which is so much fun
  • Gathering for the Environmental Services Week events

What do you think make kids great?

I have a couple answers for this one. First, they can smile at you and make your entire day better. Second, they have great energy, which can be contagious.

What is one interesting fact about you?

I was married in Las Vegas at the top of the Stratosphere tower with local TV personality “Fancy Ray” McCloney standing with me as my best man.

Five Question Friday: Kelly Patnode

Five Question Friday

Meet Kelly Patnode, patient access specialist at our St. Paul hospital, who has a love for the Minnesota State Fair.

When she isn't working in our St. Paul hospital, Kelly Patnode enjoys reading and helping out at the Minnesota State Fair.

When she isn’t working in our St. Paul hospital, Kelly Patnode enjoys reading and helping out at the Minnesota State Fair.

How long have you worked at Children’s?

I have worked at Children’s in St. Paul for 36 years.

What drew you to Children’s?

I started in St. Paul when it was on “the hill” (across the highway from our current location) as a volunteer at the age of 13. I was a volunteer for four years. I went to school for medical office occupations, but there were no openings at that time. When I was talking to someone at Children’s, they said there was an opening for a health unit coordinator. I asked what that person did, and they explained that person works at the main desk on the floors. I asked if that was similar to a ward secretary, and they said yes. I said, “Well, I have done that job for four years, so I think I could do it!”

Subscribe to MightyWhat is a typical day like for you?

My typical day starts with making a coffee. It is just the right way to start of the day. I then clean and restart all the computers, restock supplies and then either sit at the emergency room desk and start answering the phone, make calls for the providers, put together a chart or break down a chart or start with registering patients who come to be seen in the ER.

What do you love most about your job?

Every day is a different day. What I did yesterday at my job may be totally different than the day before or today. If I can get a smile out of a patient and their parents, it just makes the day better.

What do you enjoy doing outside of work?

Usually I read books. But during the summertime I am busy because I also work at the Minnesota State Fair, selling box-office tickets for grandstand shows and pre-fair tickets. I have been working there for 38 years. So when I am not working at the hospital, I am at the fair. I am actually taking vacation from the hospital to work full time at the fair this year.

Children’s, Twin Cities Moms Blog host #MNvaxchat

Subscribe to MightyAugust is National Immunization Awareness Month, and Minnesota’s new immunization requirements take effect Sept. 1. With that and back-to-school mode under way, we’ll be co-hosting a Twitter chat with our friends at Twin Cities Moms Blog.

Join us for the live chat, using #MNvaxchat from 8-9 p.m. Monday, that will feature Patsy Stinchfield, PNP, director of Infection Prevention and Control and the Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota. Children’s and Twin Cities Moms Blog will be there, too. Participants who use #MNvaxchat in tweets during the live chat qualify for a chance to win a $50 Target gift card.

ALSO: Read the Children’s vaccinations blog archive on Mighty.

UPDATE: Participation strong, informative on #MNvaxchat