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News for  Families

Spring 2009

Vol. 33, No. 3

Too sick for school? How do you know when your child is too sick for school? “If children are ill and have symptoms of the flu, they should not go to class,” says Sherman Alter, MD, director of infectious disease at Dayton Children’s. The flu – including swine flu – and colds are often the culprits when kids don’t feel well. If your child has any of the following symptoms, keep him or her home from school: ●● Rapid onset of fever ●● Headache

Go back to school safely Back-to-school time brings many

Dayton Children’s thanks Kohl’s Department Stores for its support of the Kohl’s A Minute for Kids health and safety program.

changes in a family’s routine. Parents of young children may be confused about the contact information needed on emergency medical forms. Parents of an adolescent may be debating whether he or she needs a cell phone to stay in touch. And, parents of young athletes may wonder how to keep that child’s energy levels up throughout a long day of schoolwork and practices.

This issue of Growing Together contains practical advice from the experts at Dayton Children’s on these and other back-to-school topics. For more information on backto-school, such as the latest immunization schedule, walking to school, an emergency treatment form for children with special needs and more, visit us on the web at childrensdayton.org – Health Topics – Seasonal Health Alerts – Fall.

●● Muscle aches and fatigue ●● Cough

If you suspect your child has the flu, call the doctor right away. Early treatment will lessen the severity of symptoms. Some of the top reasons for school absences – colds, “stomach flu,” pinkeye, sore throat and ear infections – can be prevented by proper hand washing. Get in the habit now of frequently washing your hands continued on page 2…


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Three secrets to sports nutrition If your child will be playing sports this school year, take a moment to learn about the three secrets to sports nutrition from Leah Sabato, registered dietitian, Dayton Children’s. Have children: 1. Eat a high-carbohydrate meal two to five hours before exercise, game or practice. Examples include pasta with marinara sauce, turkey sandwich on whole-grain bread; beef stir-fry with vegetables and rice; baked potato topped with broccoli, chicken and cheese; or bagel with peanut butter.

Too sick for school? continued from page 1…

and teaching children how to wash their hands to prevent the spread of infection. Hila Collins, RN, infectious disease nurse clinician at Dayton Children’s, provides the following tips: ●● Use soap and warm water. ●● Scrub your hands very well. ●● Wash between fingers, under fin-

gernails, backs of hands and wrists. Wash for about 20 seconds or the amount of time it takes to sing the “Happy Birthday” song twice. ●● Rinse well. ●● Dry hands with a paper towel. ●● Use the paper towel to turn off

the faucet. Growing Together is published quarterly for parents and families in the Miami Valley area by The Children’s Medical Center of Dayton, One Children’s Plaza, Dayton, Ohio, 45404-1815. Visit our website at www. childrens dayton.org – your online source of child health and safety information.

If your child has been diagnosed with asthma or allergies, taking the medicines your doctor has prescribed will reduce school absences by keeping these conditions under control. Be sure that you understand how to use the controller medicines that have been prescribed for your child with asthma. Children’s self-esteem, as well as their grades, suffer when they frequently miss school.

2. Eat a small snack 30 minutes to

an hour before exercise. Examples include granola bar, light yogurt, apple or orange slices, pretzels or small bowl of cereal with milk. 3. Prevent dehydration. Not enough

water may cause cramps, headaches, sick stomach, poor athletic performance, dizziness, weakness, dry or sticky mouth, or irritability. “A child’s gulp equals about a half ounce of fluid. Kids should drink at least 10 gulps for every 20 minutes of play,” says Sabato.

The best emergency care When filling out the stacks of back-to-school forms, be sure to pay special attention when designating where your child will be cared for in case of an emergency. At Dayton Children’s, we believe the best care for infants, children and teens is provided by pediatric experts who treat children every day, not just now and then. Children respond differently than adults to traumatic injuries. In emergency situations, the availability of pediatric experts and life-saving equipment in all sizes is essential. The Regional Pediatric Trauma and Emergency Center at Dayton Children’s is the only trauma center in the region staffed by pediatric specialists. In the last year, Dayton Children’s trauma and emergency center cared for more than 54,000 infants, children and teens. On school forms ••Be sure to include current contact information for your pediatrician or family doctor and dentist. Doublecheck to make sure you have the latest contact information.

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••For emergency care, make sure your child

is taken to the Regional Pediatric Trauma and Emergency Center at Dayton Children’s. Many EMS providers will transport a child based on the parents’ or family’s preference. Be sure to make your preference known to the child care center, school or others responsible for your child. Remember, in an emergency situation, every minute is critical. Clear instructions or emergency forms will ensure your child’s care is not delayed. Also, be sure to discuss with school officials any medical conditions your child may have that require special attention.


Should your child have a cell phone? As your child heads back to school,

●● Twenty percent of teens admit

using cell phones to send sexually explicit pictures of themselves or friends to others. “Teens are totally

The American Academy of Pediatrics (AAP), warns parents about other safety risks associated with cell phone use. A recent study shows that cell phones are a dangerous distraction for preadolescent cell-phone users. When children are texting and playing games as they walk, they may step into the street without looking, cross against the light or trip over objects. The AAP recommends children not have cell phones until they are around 11 or 12 years old. Dr. Ramey recommends that if you decide your child could benefit from a cell phone, consider these six factors:

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1. Have your child pay part of the cost. 2. Monitor text messages. 3. Limit phone use and text messaging. 4. Discuss respect and etiquette. Kids

should not say things in text messages they would not say in person. 5. Have a clear discussion about

sexting. Phones and cameras can be a dangerous combination. 6. Set privacy and safety

healthbeat

you may be considering purchasing a cell phone for the child to keep him or her safe. There are benefits, but cell phones also have risks. Gregory Ramey, PhD, a child psychologist at Dayton Children’s and Dayton Daily News columnist, discusses the risks of texting and sexting. ●● Children 8 to 12 years old make about 4.6 calls a day, but text message 14.4 times a day. “While texting can be an entertaining way to connect with others, it can also be used to gossip, bully and avoid real communication,” he says.

unaware that such pictures can be considered child pornography and result in criminal prosecution and designation as a sex offender,” Dr. Ramey says.

rules. For more advice from Dr. Ramey on cell phones and other topics, go to chidrens dayton.org – Advice from Dr. Ramey.

Heat risk doesn’t end with summer Children left in cars are at risk for serious injury or death even with relatively cool temperatures outside. Research shows that an outside temperature of 70 degrees F can cause the temperature inside a car to reach dangerous levels in just minutes. Last year, more than 42 children died of heat stroke after being left in a closed, parked car or by being trapped in a vehicle that was left unattended. Dayton Children’s and Safe Kids Greater Dayton suggest four ways to prevent this tragedy: 1. Teach children not to play in or around vehicles. 2. Never leave a child unattended

in a vehicle, even with the window slightly open. 3. Always lock a vehicle’s doors and

trunk – especially at home. Keep keys and remote entry devices out of a child’s reach.

4. Place something you’ll need at

your next stop such as your purse, briefcase, gym bag or cell phone on the floor of the backseat where a child is sitting. You may also want to put a child’s toy or stuffed animal on the front seat to remind you your child is in the back. These simple steps could prevent you from accidentally forgetting a child in the car. A change in routine or distracting cell phone conversations while driving puts children at risk for being left in a car by mistake. Pay special attention this school year when you may start driving a child to day care or kindergarten for the first time on your way to work. Make arrangements with your child’s day care provider or teacher to call you as soon as they notice your child is not there when expected.

We heard it through the grapevine Although the traditional grapevine is alive and well, the electronic grapevine is changing the way people connect. Dayton Children’s is now connecting with parents and families in the region through new grapevines such as YouTube, Facebook, Twitter and 937moms. Here are some recent comments about Dayton Children’s: On Twitter: “My kid just spent a week there! You all rock so hard. There’s a special place in heaven for you.” – Teri, Dayton On Facebook: “I can’t say enough about the hospital and the wonderful staff.” – Dayton mom Join the conversation or get connected. Here’s how:

••Twitter: www.twitter.com/daytonchildrens ••Facebook: www.facebook.com Visit pages for

Wally B. Bear and The Children’s Medical Center of Dayton

••YouTube: www.youtube.com/daytonchildrens ••937moms: Dayton Children’s partners with

www.937moms.com to answer questions, post health and safety information and serve as the region’s child health and safety expert.


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Dayton Children’s Regional Level III Newborn Intensive Care Unit

Total care for the tiniest patıents Carrie Campbell of Beavercreek was 23 weeks into a “perfect pregnancy,” when she noticed a problem with her amniotic sac, which had dropped down. She was rushed to a local hospital and had emergency surgery to deliver a 1 lb, 6 oz baby girl on August 29, 2007.

Carrie Campbell and Layla. Carrie credits Dayton Children’s NICU with “giving me a baby I can hold every day.”

Layla’s newborn foot- and handprints shown actual size.

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ittle Layla Musgrove was first treated in a local high-risk pregnancy unit, but was soon moved to Dayton Children’s Regional Level III Newborn Intensive Care Unit when doctors at the other hospital noticed she had spinal fluid on the brain and would need the care of a pediatric neurosurgeon. Dayton Children’s has the only NICU in the region with easy access to all the pediatric subspecialists needed to address the complex medical needs of premature and sick newborns. Layla first had a reservoir put in her head to drain the spinal fluid off her brain. A shunt was the next step, but doctors needed to wait until Layla weighed three pounds since this was a more involved procedure. She was only halfway there. The specialists at Dayton Children’s also learned that Layla needed heart surgery and eye surgery to correct some medical conditions common in premature infants. Layla’s brain and heart surgeries were performed when Layla was just 11 days old. Her eye surgery was performed soon after. “We were devastated that Layla was born so early and that she had all these complications, but were also relieved that there was a hospital with the pediatric surgeons that could help her,” Carrie says. Carrie felt welcome the minute she arrived at the NICU. “The staff was wonderful. I quickly learned that premature babies have many ups and downs; many good and bad days. The nurses in the NICU sat


we see there. It’s never negative, everyone is always very positive.” Because of Layla’s complex medical needs, Carrie has been happy to have all the specialists involved in her care in one location. “Dayton Children’s has a really good team. Whether it’s the staff in the NICU or the cardiologist or the eye specialist, you have everyone there that works together,” she says. Layla is now crawling and learning to stand. Earlier this year, Carrie was a little concerned that Layla only “army crawls.” She mentioned this to the physical therapist at Dayton Children’s. “The therapist told me ‘this is normal for Layla. There’s nothing wrong with that’. That made me feel better.” Layla was fitted for leg braces in May 2009 to help her walk. “Some of my friends thought I would be devastated to have a child in leg braces. I tell them, it’s wonderful. If it helps her walk, I think that’s great. This is a child they thought might never be able to walk.”

Dayton Children’s cares for approximately 420 premature and sick newborns every year in its NICU. Every parent of a child admitted to the NICU has fears and concerns similar to Carrie’s. Her advice to other parents is straightforward: “Stay positive. It’s hard, but don’t let bad news bring you down.” Carrie and Layla’s father Rob look forward to their child’s continued progress. “I really don’t care about the things she can’t do. I see amazing progress, and I have a baby I can hold every day,” Carrie says.

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with you on the bad days, telling you everything would be OK. They celebrated the good days,” she remembers. “They didn’t just do this with me. They did it with all the parents. You could see their compassion.” Layla left Dayton Children’s NICU on December 17, 2007, 111 days after she arrived. During her stay, she had seven surgeries performed by the hospital’s pediatric subspecialists. Layla is almost 24 months old. She and Carrie are familiar faces at Dayton Children’s as they continue with Layla’s followup care in rehabilitative services. “When doctors at the other hospital discovered Layla’s brain bleed, they said she would probably be a vegetable. When I got to Children’s, they knew exactly what needed to be done, but they didn’t lie to me. Going into surgery they said she had a 50-50 chance of surviving the brain and heart surgeries since she was so tiny. But they also told me that every baby is different and she might do OK,” Carrie says. Doctors told her that if Layla survived, there would be many challenges ahead. “I told the doctors I didn’t care about the challenges – I would take Layla however God gave her to me.” So far, Layla has exceeded expectations. “Everyone is amazed at how far she’s come. The people at Children’s say ‘Layla’s in charge. Just take it one day at a time and see what she can do’.” And that’s what Carrie has been doing. “I never think about what she can’t do. In my mind, she’s as normal as can be,” she says. Layla is at Dayton Children’s almost weekly for physical and occupational therapy. She also sees Robert Bloom, MD, a pediatric ophthalmologist, because Layla’s vision is very limited; another problem associated with her prematurity. “Dr. Bloom is always positive and that’s true of all the other specialists

More about our Regional Level III NICU The Regional Level III Newborn Intensive Care Unit at Dayton Children’s offers the high level of care needed to care for premature and seriously ill newborns. As the regional referral center, Dayton Children’s cares for infants from all areas of the hospital’s 20-county region.

Key facts about Dayton Children’s NICU

• The unit is staffed by full-time, board-certified neonatologists as well as neonatal nurse practitioners, pediatric nurses and respiratory therapists certified in neonatal care. • We offer a full complement of pediatric subspecialists in cardiology, gastroenterology, neurosurgery, pediatric surgery and other specialty areas as well as other specially trained staff. This enables us to be a level III facility and care for infants in our 20-county region. • Newborns who reach our center have a very high survival rate and have low incidence of complications in comparison with other centers, even though we care for the region’s sickest babies with severe conditions. • High satisfaction scores from the families of NICU patients placed Dayton Children’s NICU in the top five percent in the country for customer satisfaction. • If needed, our newborn intensive care transport team is available 24 hours a day, seven days a week to attend high-risk deliveries and to stabilize and, if necessary, transport premature or seriously ill infants to Dayton Children’s NICU. • Our level III NICU is nationally recognized for its innovative design and quality.


Saved by a

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helmet

Ten-year-old Noah Peterson was enjoying a spring evening riding his bicycle when he accidentally bumped wheels with one of his friends. Noah quickly lost control, causing his bicycle to tip over and pin him to the ground.

(Bottom right) Noah Peterson and his mother Toni. “I always encourage Noah to wear his helmet. It’s not a choice, but a rule.”

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is parents, Toni and Robert, saw the entire accident and immediately yelled his name. As they ran over to help him, Toni noticed marks across his chest from the handlebars, scratches on his legs and his cracked bicycle helmet. “We think Noah may have blacked out for a couple seconds, but he quickly came to,” says Toni,

Dayton Children’s is a not-for-profit organization. As part of its advocacy mission, we share our pediatric expertise with the community. One of the ways we do this is by partnering with community groups to provide bicycle helmets and car seats, conduct car seat checks and distribute child health and safety information. We track these activities and others as part of our community benefit efforts. A complete listing of community benefit activities is available on our website at childrensdayton.org.

“however, at first it seemed like he had lost his hearing.” The Petersons first drove to Dayton Children’s Urgent Care in Springboro and were routed to the Regional Trauma and Emergency Center at Dayton Children’s in case Noah needed a CT (computerized tomography) scan. “By the time we reached the emergency room at Dayton Children’s, Noah had his hearing back and was already joking around and in good spirits,” says Toni. After his visit with the emergency department doctor, Noah was treated for a broken arm by one of Dayton Children’s orthopedic surgeons. His parents were told to watch for nausea, dizziness, confusion or headaches, all signs of a mild concussion. The doctors in Dayton Children’s trauma and emergency center confirmed that Noah’s injuries could have been much more severe without his helmet.

“Although his helmet cracked, he didn’t even have a scratch on his head.” says Toni, “This time, the helmet literally saved him.” According to Jessica Saunders, injury prevention and health promotion coordinator, “A bike helmet is


Dayton Children’s ambassadors selected The ambassador committee at Dayton Children’s has selected the following patients to be Dayton Children’s ambassadors for the 2009-2010 fiscal year. These young adults will represent Dayton Children’s at community events. Adrianna Scott

is an active 12-year-old girl from Xenia. Adrianna participates in cheerleading competitions and does not let cystic fibrosis (CF) slow her down. She is seen by Robert Fink, MD, and Gary Mueller, MD, in the pulmonary medicine department at Dayton Children’s. Adrianna’s 10-year-old twin sisters also have CF and have been coming to Dayton Children’s their entire lives, beginning in our Regional Level III Newborn Intensive Care Unit (NICU). Mitchell Franzer

was told as a child that he would never walk after he was diagnosed with spina bifida. He spent the first few months of his life in the NICU at Dayton Children’s. Now 11 years old, Mitchell loves to play baseball, soccer and football and work on the family farm in St. Henry. Mitchell and his parents make frequent trips to Dayton Children’s to be seen in our rehabilitative services department and the

myelomeningocele and urology clinics. According to Donald Nguyen, MD, a pediatric urologist, “Mitchell has had many major operations, yet has maintained a positive outlook on life.” Casey Mowen

of Eaton was diagnosed with a brain tumor in 2006. Now 15 years old, Casey has completed all of his treatment and aspires to be a doctor someday because of the treatment he has received at Dayton Children’s. Casey is active in marching band and recently traveled to Walt Disney World to represent Eaton High School. Casey and his mom Dawn are very thankful for Emmett Broxson, MD, and the hematology/oncology staff in Dayton Children’s Cancer Care Center. Justin Ferrence

is a charming, bright young man with a passion for life. Justin was first seen at Dayton Children’s in our NICU and was diagnosed with cerebral palsy. Justin says he has practically lived at Dayton Children’s his entire 20 years of life. Justin and his mom Pamela consider Dayton Children’s their beloved, second family. Justin is frequently seen in our neurology and cerebral palsy clinics and in the orthopedic department. Justin graduated from Xenia High School in 2008 and plans to go to college to become a teacher.

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essential safety gear. Helmets could prevent an estimated 75 percent of fatal head injuries and up to 45,000 head injuries to children who ride bikes each year.” Noah received his helmet at the Kettering Volunteer Festival one summer earlier when he went to have his helmet checked and learned he needed a different size. The Kettering Safety Section provided a new helmet which was properly fitted. At that event Noah also received valuable information from Dayton Children’s about the importance of wearing a helmet to prevent brain injury. “I always encourage Noah to wear his helmet; it is not a choice but a rule,” says Toni. “And we know the importance of having the helmet fit properly.” Noah was lucky because he was wearing his helmet properly – it was level with his eyes, buckled and secure on his head. “I think it’s important for my children to always wear their helmets,” says Toni, “We can fix bumps and bruises, and even a broken arm, but the head is more important and we have to protect it.”


inside

Nonprofit Organization U.S. Postage Paid Permit Number 323 Dayton, Ohio

this issue The Children’s Medical Center of Dayton One Children’s Plaza Dayton, Ohio 45404-1815

3 6 rules for teen cell phones

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Free health and safety tips for every age

NICU – Total care for the tiniest patients

If you haven’t checked out Dayton Children’s e-newsletter lately, take a moment to get your trial issue. We know you’re busy, so we have made it shorter and more targeted to practical parenting needs. FamilyWise is delivered monthly to your e-mailbox and is absolutely free. Each issue includes parenting advice from Dr. Greg Ramey, child psychologist at Dayton Children’s and Dayton Daily News columnist, health and safety tips from our injury prevention experts, new services and more.

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Join hundreds of other parents who receive FamilyWise. Go to childrensdayton.org – E-newsletter or call 937-641-3620.

Saved by a helmet

newsbriefs

Growing Together is published quarterly for parents and families in the Miami Valley area by The Children’s Medical Center of Dayton. The purpose of Growing Together is to show how Dayton Children’s and families are working together to keep all children healthy and safe. Additional copies of Growing Together are available by writing to Dayton Children’s, c/o Marketing Communications, One Children’s Plaza, Dayton, Ohio, 45404-1815 or by calling 937-641-3666. Your suggestions and comments are also appreciated. For more information: Cert no. XXX-XXX-XXXX 937-641-3666 childrensdayton.org

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Dayton Children’s PICU recognized for safety The pedi-

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atric intensive care unit (PICU) at Dayton Children’s has been awarded the Ohio Patient Safety Institute Best Practices Award for its outstanding record of decreasing the incidence of ventilator-associated pneumonia (VAP). VAP affects children on mechanical ventilation and is the second most common hospital-acquired infection. Because VAP can lead to poor outcomes and even death, preventing this complication is critical. In addition, there is a high cost associated with treating VAP – estimates range from $5,000 to $40,000 per episode. Dayton Children’s accepted this award on June 15 from Senator Sherrod Brown. Medical imaging recognized by ODH Dayton Children’s medical

Cert no. XXX-XXX-XXXX

imaging department passed its recent Ohio Department of Health (ODH) inspection with high marks. ODH praised medical imaging for being a leader in “kid-sizing” radiation doses for infants, children and teens. This means that children receive the lowest radiation doses possible.

month. In addition, minor procedures such as removal of stitches, staples, wound dressing changes, treatment of ingrown toe nails and small lesions, burn care, etc can be performed at this location. Talk to your child’s doctor if you wish to use these services for your child’s care.

New services offered

New physician joins urgent care in Springboro 

●● Adults needing basic imaging services such as x-rays are now

welcome at Dayton Children’s community testing centers in Springboro, Vandalia, Beavercreek and Kettering. For a list of community locations and directions, go to childrensdayton.org – Patient & Visitor Info – Community-based services. ●● The surgery clinic is now available at the Specialty Care Center – Warren County. Pediatric surgeons from Dayton Children’s provide evaluation and follow-up care every second and fourth Friday afternoon of each

Ranjana Sinha, MD, is medi-

cal director of Dayton Children’s Urgent Care – Springboro. She is a member of the hospital’s emergency services department. Dr. Sinha comes to Dayton Children’s from Louisville, Kentucky. She is board certified in pediatrics. Dayton Children’s urgent care centers are the only urgent cares in the region staffed by doctors from Dayton Children’s Regional Pediatric Trauma and Emergency Center.


Dayton Children's Medical Center - Growing Together Newsletter