l i b e r t y u p d at e
now a
full-service hospital
L i b e rt y C a m p u s e x pa n s i o n
a great success story The number of inpatients at Cincinnati Children’s Liberty Campus has more than doubled since a major expansion was completed last summer. “With the new inpatient facilities, I can now provide surgical care for many of my suburban patients on the same day,” says Eric Wall, MD, an orthopaedic surgeon. New amenities include a full-service cafeteria and a pharmacy.
Eric Wall, MD
Director of Orthopaedic Sports Medicine at Cincinnati Children’s
Above: With telehealth technology, the future is here. Each patient room at the Liberty Campus is equipped with live-video capabilities that directly connect patients and families with our medical experts. Patients can receive continuity of care from their surgeon/physician without having to be transferred to the Burnet Campus, whether as inpatients or for follow-ups.
>> t hr ee imp ortan t facts t hat m a k e Lib ert y a n ide a l ch oice for c a r e : n
Approximately 75 percent of patients who need to be admitted from
the Liberty Emergency Department are able to stay at Liberty without being transferred. Previously they would have been transferred to the Cincinnati Children’s campus in Cincinnati’s Avondale neighborhood. n
The expansion led to 200 new jobs at the facility. The new total
of 600 employees makes the hospital the largest employer in Liberty Township.
Learn more about telehealth For more information on telehealth at Cincinnati Children’s, visit our YouTube channel at https://www.youtube.com/watch?v=aBNNdnwgIo
The Cancer and Blood Diseases Institute
Outpatient Center is now seeing patients in its permanent location on the second floor of the Proton Therapy Center. Families can enter the new building through the first floor doors off the circle drive. Valet service and ground-level parking are both available. n
1
Denise Warrick, MD
ask the
pediatrician advocate for y o u r chi l d ’ s h e a lt h The Family Resource Center The center helps families, community providers and agencies find health information, community resources and support. Call 513-636-7606 for assistance.
Sp ec i a l Needs Res o u r ce Dire c t o ry Use this directory to find information, resources and advocacy strategies at www.cincinnatichildrens.org/ special-needs.
J oin S p ec i a l C on nec t i o n s Our new online community connects with others parenting a child with special healthcare needs: www.cincinnatichildrens. inspire.com.
join a
at Cincinnati Children’s
oh, the lessons
bab i es teach us Our pediatrician, a first-time mom, reflects on a year like no other
A
s the year comes to a close, I have been reflecting on many of the wonderful things that have happened in the past year. The best of these has been the birth of my daughter Madeline. The past seven months have been a whirlwind. They have been both the most rewarding and challenging months of my life. Madeline has taught me so many things about myself personally and professionally. The things I learned being a parent are things that I never learned in medical school or during my residency training. Yet, they are also things that are best learned by experience and not studied in a textbook. I would like to share some of the lessons that I have learned about the role of the pediatrician in a child’s and families’ life. Lesson 1: Be objective
As parents, we often are bombarded by so many other people’s opinions, from grandparents and friends to even random strangers in the grocery store. It is difficult to know who the right person to listen to is and what opinion is the best one for your child. Every child is different and what works for one child does not always work for another.
research
s t u dy
Brain wav e (EEG) Research Study
What: The purpose of this research study is to learn the best way to use EEG techniques with children who have auditory processing disorder (APD), listening difficulties or are being considered for the diagnosis of APD. An EEG is a test that measures and records the electrical activity of the brain (or “brainwaves”). Who: Infants, children and teens 0 to 17 years old who have APD and are not on medication for a neurologic condition may be eligible to participate. Pay: Participants will receive $50 for their time and travel. Contact: Hearing Lab at hearinglab@cchmc.org or 513-803-3252 2
Pediatrician, General and Community Pediatrics
White Noise Generator or Sleep Machine /Crib Stu dy
What: The purpose of this research study is to use an EEG test to examine how the brain responds to sensory stimuli such as sounds or pictures. An EEG is a test that measures and records the electrical activity of the brain (or “brainwaves”). Who: Healthy infants, children and teens up to 18 years old who listen or listened to a white noise generator/sleep machine while in the crib and have no history of mental illness or head trauma, may be eligible for participation. Pay: Participants will receive $20 for their time and travel. Contact: Hearing Lab at hearinglab@cchmc.org or 513-803-3252
have Questions?
If you have a question for the pediatrician, email youngandhealthy@cchmc.org
Ultimately, it is your decision as the parent. You are the one who knows your child best. Yet, you want to make the best decision for your child’s interest and it is often hard to separate emotional ties from rational decision-making. For example, I see parents who struggle with common things like infantile colic. Often, by the time I see the baby the family has tried countless overthe-counter therapies and perhaps even convinced themselves that something has worked. While I can certainly empathize about what it is like to deal with a screaming child, my main responsibility is to be a source of objective advice. They want to hear from me what works and what doesn’t. It is also important for parents to know that for some things there is very little evidence to support certain remedies we use in pediatrics. In some cases, it is OK to try some of grandma’s common home remedies as long as they are safe. baby madeline Then and now Madeline is 7 months old in family photo on facing page. Here she is, left, as a newborn. She is the Warricks’ first child.
t h e wa r r i c k fa m i ly Facing page: Baby Madeline with Mom, our “Ask the n
@cincychildrens
facebook.com/cincinnatichildrensfans
Lesson 2: Set realistic expectations
Parents love to compare their children to others. It seems as though there is a race for children to get to the “finish line” of developmental milestones. I am guilty of this myself. One day I picked up my daughter from daycare and noticed that one of the other babies was rolling, I asked one of the staff members “How old is she?” They told me she was a month younger than my daughter. At the time, I have to admit that I was a bit disappointed even though I knew that my daughter was still on track for normal development. Every child is different and every child progresses through their developmental stages at a different pace. Sure, there may be a child walking at 9 months but this is certainly not the case for all children. This is why it is important for me as a pediatrician to discuss what normal development is with families and set realistic expectations. If parents have realistic expectations, they are less likely to have a strong reaction when comparing their children with others. Lesson 3: Always be the cheerleader
Being a parent is one of the most challenging jobs in the world. Specifically for working parents, it is difficult to excel (or even to get by) in all things, both personally and professionally. We, as parents, are very hard on ourselves and set high expectations for ourselves, as well as our children. When things don’t go the way we want them to, we are quick to be hard on ourselves as parents and think how we could have done things differently. However, we seldom take time to celebrate the successes.
Pediatrician” expert, and Dad, Stephen Warrick, MD, also a pediatrician at Cincinnati Children's.
A Look at Siblings of Adole scents With Eating Disorders
What: This research study will look at how teens are affected, when they have a brother or sister with an eating disorder. Who: Children and teens (11 to 17 years old) who have a sibling (11 to 17 years old) who has been diagnosed with an eating disorder Pay: Participants will receive $50 for completing a survey during one study visit. Contact: Emily Copps-Smith at emily.copps-smith@cchmc.org or 513-636-2463
youtube.com/cincinnatichildrens
cincinnatichildrensblog.org
“As my parenthood journey continues, I plan to be open to each new lesson and in turn use it to better my skills as a pediatrician.” For example, I see many mothers who experience challenges with nursing. From my own experience, nursing a child is an incredibly rewarding experience but comes with challenges. I have found that is so important to be a cheerleader for these mothers. Even a small amount of encouragement, especially from someone who has been in their exact situation, can help them get through a very difficult time. In these situations, the medical advice takes a back seat to being a good listener and caring source of support. I can certainly say I have learned a great deal over the past few months. As my parenthood journey continues, I plan to be open to each new lesson and in turn use it to better my skills as a pediatrician. I could not have made it through the past few months without the support of my wonderful husband, family, friends, and colleagues. I am eternally grateful for their help, support and guidance. To all the other parents out there, I wish you and your family a very healthy and happy 2016.
a b o u t t h i s i s s ue W I N T E R 2016 Young and Healthy is a quarterly publication from Cincinnati Children's Hospital Medical Center. For more health news and patient stories, subscribe to our monthly e-newsletter online at www.cincinnatichildrens.org/subscribe © 2016 Cincinnati Children's Hospital Medical Center produced by
The Department of Marketing & Communications Cincinnati Children's Hospital Medical Center 3333 Burnet Ave., MLC 9012, Cincinnati, OH 45229-3026 Phone: 513-636-4420 Advisers: Chris Peltier, MD, and Zeina Samaan, MD Editorial Consultant: Denise Warrick, MD Editorial Staff: Tom O’Neill, managing editor Photography: Tine Hofmann, tm photography Design: Christina Ullman & Alix Northrup, Ullman Design
3
focus on
infection control
all coughs
are not created e q ual
N i c k D eBlasio, MD is a pediatrician in the Division of General and Community Pediatrics.
Try these tips to alleviate coughs, and understand the difference between the common cold and more serious illnesses As we are into the cold and flu season now, parents are often challenged by their child’s coughing – what is causing it and how long it will last. As a pediatrician, I can tell you the symptoms that come along with a child’s coughing often tell more about an illness than the cough itself. I’ll want to know if your child has a runny nose, is congested or has had a fever. I’ll also ask parents if there’s been shortness of breath or wheezing, if your child is turning blue while coughing, if the coughing is leading to vomiting. The related symptoms give us the best idea about the source of the cough, and how best to treat it. There are some exceptions — coughs that are very distinct to particular illnesses. The coughs associated with croup and pertussis differ from those that accompany the common cold or respiratory infection. 4
Here’s how the coughs differ: Croup
Croup is a viral infection causing a partial blockage of air as it flows through the larynx (voice box). The noise can be very frightening, and your child’s cough may sound like a seal barking. Pe r t u s s i s / W h o o p i n g C o u g h
Pertussis is a highly contagious illness caused by bacteria. It typically causes violent coughing spells. When a person breathes in after one of these spells, it can cause a loud “whooping” sound (hence the name “whooping cough”). For sicknesses other than these, your pediatrician likely will focus more on the related symptoms than on the cough itself. Take note of those symptoms so you know how to answer questions asked about them. Of course the next question typically is, “How can I help my child feel better?” The current recommendation is not to give any cough or cold medicine to children under the age of 6, although I personally don’t recommend them at any age. Often, these medications tend not to work well, regardless of the child’s age. There can be unfavorable side effects, and formulations for dosing can be tricky, especially in combination with other medications like acetaminophen or ibuprofen.
Instead, try these steps: n
Increase the amount of fluids your child is getting.
Use a saline nose spray to help clear your child’s nasal passages and help loosen up mucus.
n
Ease congestion by letting your child sit in a bathroom filled with steam from a hot shower.
n
Try a teaspoon of honey before bed to help with cough only if your child is over age 1.
n
n
Use a humidifier in your son or daughter’s room at night.
Soothe sore throats with throat lozenges if your child is old enough not to choke on them.
n
Beverly Connelly, MD, Director of the Infection Control Program at Cincinnati Children’s
Staying healthy
i s i n t h e p a lm of you r h a n d s
The most effective way to defeat viruses and bacteria: wash hands often with soap and water or sanitizer
ke e p i n mi n d Remember that with a respiratory illness, a cough can hang around for up to two weeks, sometimes even longer. Be patient and comforting.
And as always, if you have any concerns about your child’s condition worsening, don’t ever hesitate to contact your pediatrician and have your child examined.
As we approach mid-winter, one of the statistical high points of the cold and flu season, parents should remember that one great defense against viral and bacterial infections is g o o d a d v i ce also one of the most simple. Behold the wonders of handwashing. Top 5 tips to make handwashing Schools are a breeding ground for germs because of the concentration of children, but second nature for your child: home has its dangers lurking too. Think about tip 1 Set a good example by establishing a what surfaces your child touches in the course good hand washing routine at home. of a normal day: books, desks, door knobs, sink handles, and other people. Many of them tip 2 Emphasize its importance to your child’s health. harbor germs that can cause illnesses. Dr. Beverly Connelly, MD, director of tip 3 When washing hands with soap and water, make sure to scrub hands the Infection Control Program at Cincintogether for at least 20 seconds. Kids nati Children’s, says that handwashing is the might find it more fun to wash their number-one defense against many infechands while singing their ABCs or the tions. It’s especially important after using the Happy Birthday song. When using bathroom, sneezing or blowing the nose, and hand sanitizer make sure to rub the product over all the surfaces of the before eating. hands and fingers until hands are dry. Connelly says washing for 20 seconds with soap and water is best, especially after using tip 4 Include individual packets of hand the bathroom. Hand sanitizers and sanitizing sanitizer wipes in your child’s lunch for washing wipes also work well, especially when soap and hands before eating. water are not available “Germs get left everytip 5 Learn about hand hygiene practices at where,” she says. “Good hand hygiene practic- your child’s school. Are there soap dispensers es help prevent catching colds and respiratory in the bathrooms? Hand sanitizer bottles in the viral infections, stomach bugs and diarrhea, as classrooms? Do teachers make sure kids clean their hands before lunch or snack time? well as MRSA and other skin infections."
5
Taking a different approach SPEECH-LANGUAGE
development and communication
ki d s a n d el e c t r o n i c s
quiet cost the
of electro n i c devices
Ann Kummer sees children staring down who would benefit greatly from looking up – and opening up. The heartbreaking irony is that these children are in the waiting room in the Division of SpeechLanguage Pathology at Cincinnati Children’s. Their eyes are glued to the electronic devices that take over their attention spans – and cause them to miss verbal communication opportunities that help develop speech and language skills.
6
Use of gadgets and games, especially at younger ages, can prevent kids from developing healthy speech skills and the art of communication
The parents’ faces are also often buried in their smartphones, iPads and tablets. As happens in many facets of life, children mimic the behaviors of their parents. As a speech language pathologist, Kummer sees this lack of verbal communication every day. “They pass time together but are worlds apart,” Kummer says. “I even see it in the elevators. These kids have language disorders, and there’s no interaction with the parents.”
the impact
of technology with children Ann Kummer, PhD, CCC-SL P
The findings of a recent American Speech-LanguageHearing Association survey of 1,000 parents:
n
communication
Senior Director of Speech-Language Pathology at Cincinnati Children’s
“Even with children who aren’t speech-delayed, Kummer sees a generational divide. “They don’t have the social skills they could have, and that’s a subtle part of language development.”
Just over half of parents (52 percent) say they fear that
t e c h n ology a n d
technology is hurting the quality of their conversations with
She says the problem worsens when children at the early stages of speech development – even younger than age 2 – spend too much time looking at electronic devices. It’s largely passive learning, like watching TV. “Communication — real communication,” she wrote in an op-ed article in the Cincinnati Enquirer, “is nowhere to be found.” Even with children who aren’t speech-delayed, Kummer sees a generational divide. “They don’t have the social skills they could have, and that’s a subtle part of language development,” she says. “How do you learn to maintain eye contact and have a conversation if you are focused on an electronic device rather than the people around you?” She also emphasizes that interactive, voice-activated electronic programs can have a role in speech development. They even use iPads in speech therapy at Cincinnati Children’s. The key difference is that the programs are educational and require a child to verbally respond back and forth. And it’s time-restricted. “Watching videos on YouTube or TV is passive,” she says. “Some games are educational and valuable, but you don’t want to let the child do this all day long. You have to have a balance.” She explains the difference between passive and active learning this way: “It’s like the difference between listening to someone play the piano, and being able to do it yourself.” The art of human interaction, Kummer says, is an invaluable part of healthy speech and language development. And it starts with parents.
their children.
n
he a r i n g l o s s
72 percent of parents suspect that loud noise from technology might cause hearing loss in their kids. This number follows the World Health Organization's campaign – Make Listening Safe – intended to draw attention to what it sees as dangerous paths to "irreversible hearing loss" in young people around the world.
n
development
early development
When they say young people are using technology, they mean young. Nearly 70 percent of parents say t-year-olds use tablets, while nearly two in three use smart phones.
learn more
Fascinating fact about Ann Kummer
more about the program
She works in a building located on the same site as the building where she lived when she was an infant. Her dad was a resident in otolaryngology at the University of Cincinnati. That’s an ear, nose and throat specialist.
Cincinnati Children’s has the largest speech-language pathology program in the U.S. To learn more, visit us at: www.cincinnatichildrens.org/service/s/speech/services/.
7
inside
t h i s i s s ue
3333 Burnet Avenue, MLC 9012 Cincinnati, Ohio 45229-3026
kids and electronics The potential negative impact of devices on children’s speech development and communication skills
cold and flu season How to detect and minimize the spread of viruses, bacteria and related illnesses
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wi n t e r 2016
healthy
young and
A guide to your child’s good health
Tips to keep kids
well
throughout the winter months