Just Kids S H A R I N G O U R PA S S I O N F O R C H I L D R E N A N D FA M I L I E S
Ahead of the Game
Concussion management helps children and teens get back in play
INSIDE Is Cereal a Smart Breakfast Option? Where to Go When There Is a Health Emergency Nine Ways to Stay Safe on the Playground CHILDRENSOMAHA.ORG SUMMER/FALL 2017
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Contents TRENDING A cereal dilemma Keeping an eye on vision
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ChildrensOmaha.org
RICHARD G. AZIZKHAN, M.D.
President & CEO MARTIN W. BEERMAN, MHA, APR
Vice President, Marketing & Community Relations CELIA FERREL, MHA, APR
Director, Marketing & Public Relations DAVID G.J. KAUFMAN, M.D.
Medical Adviser DANNEE SCHROEDER
Senior Editor Just Kids is published by Children’s Hospital & Medical Center to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician. © 2017. All rights reserved. Printed in U.S.A.
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Run With the Ball This Fall: Make a Fresh Start on Wellness Goals It’s important for children to take time to eat well and exercise as schedules change and the days shorten The end of summer and beginning of the school year initiate such rituals as last-gasp summer vacations, excursions to the mall for fall clothes and try-outs for fall sports. It also represents a transition in the daily routine. Long, lazy summer days turn into regimented school days with early mornings and after-school activities. As the weather turns cooler and the pace of the day changes, so too might activity levels as children opt to stay indoors more and turn to the TV. Fall offers a good time to work on cultivating good exercise and eating habits. Exercise has enormous benefits for children. Besides helping to develop leaner bodies that are less likely to be overweight, it may lead to higher-quality sleep and a better outlook on life. To encourage exercise, consider putting limits on screen time, including TV, social media and video games.
Here are other ways: 1. Choose the right activities for a child’s age. Otherwise, the child may become bored or frustrated. 2. Give kids plenty of opportunity to be active. Provide equipment and take them to playgrounds and other active spots. 3. Keep the focus on fun. Along these lines, healthy eating should not be a chore. As fall ushers in apple, squash and sweet potato season, there are plenty of opportunities to eat tasty produce. To increase intake of fruits and vegetables, which are loaded with vitamins, minerals and dietary fiber, consider adding a fruit or vegetable with every meal.Here are some other delicious suggestions: Try vegetable kabobs with dinner, top pizza with spinach and mushrooms, or make a smoothie as a snack with fresh or frozen fruits. Done well as the seasons change, eating a healthy diet and exercising can be an enjoyable and integral part of the experience.
PRIMARY CARE Where to go when a health emergency strikes Proper treatment for concussions PLUS: Know when to seek help Antibiotic overuse Q and A: What can I do to help soothe my infant’s sore tummy?
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PREVENTION Playground safety tips Broccoli cheese omelette recipe
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LAST WORD Parenting U
Trending IN THE NEWS
Make sugary cereal breakfasts a special weekend treat.
Sizing Up Cereal Moderation is key, especially when it comes to sugary varieties Cereal is an easy and tasty go-to option for breakfast—for adults and children alike. Unfortunately, many kinds are chock-full of simple carbohydrates, which contribute to issues such as obesity and diabetes, as well as cavities and bad breath. While not all cereals are created equal, most brand-name
cereals you find on the market today are loaded with added sugar. A 2011 CBS News review of popular cereal brands by found that many cereals are more than 40 percent sugar by weight, with the sweetest cereal weighing in at 55 percent. What to do when children want cereal? The best option is to
give it to your kids in moderation. If they really want a particular type of cereal, make it a special Sunday treat. Plus, consider pairing the cereal with less sugary and more nutritious breakfast foods such as yogurt or cottage cheese with fruit. Other healthy, simple and tasty breakfast options are
COMPREHENSIVE CARE To find a
pediatrician, family physician or pediatric specialist for your child, visit ChildrensOmaha.org/Provider or call 1.800.833.3100 (TDD).
strawberry protein shakes, whole-grain blueberry muffins and broccoli cheese omelettes (see recipe on page 11). However, if cereal is a part of your daily routine, you can find ways to avoid overloading your children with sugar. First, find a cereal with no added sugar or as little added sugar as possible. The American Heart Association recommends that children eat less than 25 grams of added sugar per day. Beyond checking the nutrition facts for sugar (it will be under the nutrition line item, “total carbohydrate”), look for cereals that are whole grain and provide 5–6 grams or more of dietary fiber per serving. If the need arises to make a “boring” whole-grain cereal more appetizing to your kids, try adding fruit. Fresh fruits, such as strawberries or blueberries, can even help boost dental health and add some sweetness.
4 WAYS TO BEAT THE HEAT Follow these tips to ensure your kids stay cool in warm weather In hot weather and high humidity, children are more at risk of overheating because their bodies can’t adjust as well as adults to changes in temperature.
MAKE SURE CHILDREN DO NOT LET CHILDREN PLAY OUTSIDE DURING PEAK SUN HOURS, 11 a.m. to 4 p.m., if possible. That’s when ultraviolet (UV) light is at its strongest and can cause the most damage to skin.
drink plenty of fluids before going outside, and make sure they take drink breaks. Opt for water rather than beverages high in caffeine and sugar.
to parks and places where adequate shade is available, or bring umbrellas or tents if necessary.
PLAN TRIPS
DRESS KIDS IN LIGHT,
loose clothing, and apply broad-spectrum sunscreen with an SPF of at least 15.
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10 11 to hours
The recommended number of hours of sleep per night that children ages 7–12 should receive. Children ages 12–18 years old should sleep eight to nine hours per night.
A Closer Look When should children receive vision exams, and is the school exam enough? For growing children, vision plays an important role in development. “There have been studies that have shown that vision is related to learning, and having good vision helps brain development,” says Linda Morgan, O.D., FAAO, an optometrist at Children’s Eye Clinic. “Getting [children] checked can make sure their vision doesn’t impede the learning process.” Dr. Morgan and Tina ScottMordhorst, M.D., a general pediatrician at Children’s, recommend that children start undergoing vision acuity
INSURANCE OPTIONS Did you know that pediatric eye exams are covered by most insurance as part of the annual well child visit? And for people without eye insurance, there are options through the state that will help pay for eye exams and glasses for children. Talk to your pediatrician if you need more information.
tests at around age 3. Then, unless a child is found to have specific vision issues or other
WE’VE GOT OUR EYE ON YOU Learn more about the Eye Clinic at
ChildrensOmaha.org/Eye. To make an appointment at the clinic, call 402.955.5440 or 1.855.836.5300.
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growth
Urgent Care Now Open in Dundee
conditions, he or she should get tested again once a year. What about school eye exams versus tests in the doctor’s office? While both Dr. Morgan and Dr. ScottMordhorst explain that school exams are a great way to identify potential issues, they also note that less obvious issues like strabismus, or eye turning, may go unnoticed in the school exam. “The school is a great place to start, but it’s not as comprehensive as what we do in the office,” explains Dr. Scott-Mordhorst. Whether you take your child to your pediatrician, or to an optometrist or ophthalmologist for an exam is up to you. Optometrists and ophthalmologists will provide the most complete vision exams. However, pediatricians will be able to identify potential issues and refer you to an optometrist or ophthalmologist if they notice any problems.
Children’s Hospital & Medical Center recently opened its third after-hours urgent care location at 4825 Dodge St., where it shares space with Children’s Physicians, Dundee. Children's after-hours urgent care services are available Monday through Friday from 6 p.m. to 10 p.m., and on Saturdays, Sundays and holidays from noon to 10 p.m. The Dundee urgent care location joins Children’s two other urgent cares: Val Verde in La Vista (9801 Giles Road, Suite 1) and West Village Pointe in west Omaha (175th & Burke Street). Each Children’s urgent care location specializes in pediatric illnesses and injuries, and offers on-site digital X-ray and lab services. “One size does not fit all when it comes to caring for children,” explains Megan Connelly, DNP, APRN-NP, CPNP-AC/PC, Children’s Physicians’ vice president of operations. “Our urgent care providers and staff are specially trained in pediatrics and utilize child-appropriate medical equipment, so patients and families will receive the same level of pediatric expertise that they’ve come to trust and expect from Children’s.” No appointments are necessary. The number for Children’s Urgent Care at Dundee is 402-955-7650. Learn more about urgent care at ChildrensOmaha.org/Locations.
primary care EVERYDAY HEALTH
Pediatrician, Urgent Care or Emergency Department? Use this guide to make the right call—and choose the best destination— when your child is sick or injured
WHEN TO GO TO YOUR PEDIATRICIAN
WHEN TO GO TO URGENT CARE
WHEN TO GO TO THE EMERGENCY DEPARTMENT
As a general rule of thumb, turn to your pediatrician’s office first— even after hours. Most pediatrician offices have an after-hours call line to help parents decide whether their child needs to be seen right away or if the issue can wait to be treated the next day during regular hours by the primary care provider.
When your primary care physician’s office is closed and you need some peace of mind, visit an urgent care. Urgent cares are set up to assist patients with injuries or illnesses that do not appear to be serious or life – threatening, but can’t wait until morning.
By contrast, emergency departments (EDs) are for people with life-threatening needs. Take your child to an ED anytime you think the problem needs immediate attention.
Common ailments that can typically wait until the next day when you’re able to make an appointment with your pediatrician include: •E ar
pain
•C ough •R unny
• Vomiting •D iarrhea
•E ye drainage nose •S ore throat •F ussy baby •F ever in children over 1 year
Common conditions that can be treated at urgent care include: •M inor
illness or injury or broken bones that are not crooked and do not cause severe pain •W orsening fever in infants ages 2 months to 1 year •S prains or minor pains •M inor burns •M inor asthma •S mall cuts •F ractures
Take your child to the ED for the following conditions: •S hortness
of breath or trouble breathing •B lue or purple lips, skin or fingernails •C hest or stomach pain or pressure •S eizures •A nimal, snake or human bites •S evere bleeding or burns •H ead, spinal cord or eye injuries • I nfants under 2 months of age with a fever •S igns of allergic reaction such as hives; swelling of the face, lips, eyes or tongue; fainting or trouble breathing •U ncontrolled pain
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primary care COVER STORY
Ahead Game OF THE
Concussion management helps children and teens get back in play
specialize in concussion treatment. These specialists—including athletic trainers, physical therapists, and speech and language pathologists— focus on creating individualized treatment plans. Treatment for concussions has changed significantly within the past decade, Dr. Moffatt points out. The standard advice used to be to get rest and go back to playing as soon as possible. Unfortunately, he notes, that led to numerous young people becoming profoundly injured, since a second concussion can be highly dangerous if it happens before the first has healed. Professionals also now know that concussions can appear very different from one another, depending on the person. One child might show no symptoms at all, while another could be experiencing physical, emotional and behavioral difficulties, according to Dr. Moffatt. “Concussions don’t show up on an MRI or other scans,” he says. “The brain will look normal. So diagnosis is done by history and physical exam.” “Age is also a factor,” adds Becky Docter, an athletic trainer with Children’s Sports Medicine program. “The brain is still developing in children and adolescents, and their concussion symptoms can last longer than teens.”
When a teammate on her soccer team accidentally kicked her in the head during a scrimmage last January, goalie Megan didn’t think much of it. Not only did she keep playing, she drove herself home. “I wish I’d known that the majority of concussions don’t involve blacking out,” Megan, 17, says. “I might have done things differently right away.” Instead, she developed an excruciating headache and struggled through the next day at school as light and sounds became unbearable. A member of the school band, she left practice early because the sound of a piccolo playing hurt her ears. Knowing something was definitely wrong, Megan finally went to see Kody Moffatt, M.D., medical director of the Sports Medicine Clinic at Children’s Hospital & Medical Center. Dr. Moffatt advised her to limit her activities and monitor her symptoms to understand the scope of her concussion. This data helped Dr. Moffatt determine the best course of treatment for her. While at home, the situation worsened for Megan as emotional reactions began. “I’m not someone who deals with depression or anxiety, but I ended up crying every day,” she says. “I was stressed out, and I still had the light sensitivity, the headache, and I couldn’t take any kind of noise.” To make matters worse, difficulties concentrating on homework and academic tasks heightened stress levels for Megan, normally a top student.
tip
Spectrum of Treatment Thankfully, she began to get back on track
with the help of Dr. Moffatt and other professionals at Children’s who
DON’T WAIT If you think your child may have a concussion, call Children’s Sports Medicine program at 402-955-PLAY (7529).
TREATMENT STEPS Although every concussion case is unique, here are some common steps that Children’s takes when diagnosing and treating a concussion 1
2 Take a patient history,
particularly of any head traumas or injuries.
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3 Perform a comprehensive Concussion Symptom Checklist Assessment to help determine current struggles.
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Create a risk reduction plan that minimizes or eliminates the chance of a second concussion.
5 Develop an individualized treatment plan
based on symptoms, with referrals to specialists.
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Have each therapist create a specific
Communicate with school throughout the
treatment protocol based
process to determine what limitations the patient might have and how they can be accommodated.
on that specialty and further testing.
Megan, a high school senior, is thinking about joining the soccer team again after a concussion sidelined her in January.
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primary care COVER STORY, EVERYDAY HEALTH
CONCUSSION BY THE NUMBERS
30%
Traumatic brain injuries (TBIs) contribute to about 30 percent of all injury deaths.
x2
From 2001 to 2012, the rate of emergency visits for concussions doubled among children.
50% Falls are the leading cause of TBI and account for about half of all emergency visits and hospitalizations.
564, 000
This is the number of children each year who go to emergency departments for TBIs.
25%
This is the percentage of pediatric concussions seen in emergency departments that occur during athletic activity.
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Fortunately, complete recovery is possible with the proper treatment. Dr. Moffatt says that about 90 percent of children and teens will recover within a month as long as the head is protected from more injury.
Team Approach For young people who have more
severe symptoms or who are taking longer to recover, specialists address whatever challenges a patient might be facing—from speech issues to balance problems to mood changes.
Academics and the return-to-learn process are important pieces of the recovery puzzle. Children’s speech and language pathologists (SLPs) help identify cognitive deficits and implement strategies to correct them. Wardlaw, who also serves as the program’s academic liaison, works directly with the SLPs to help develop an individual learning plan based on what each patient needs. “For instance, a child may be struggling with math, science or a foreign language, so we suggest specific academic accommodations
“ It’s not like a broken bone,” says Mike Wellsandt, a sports physical therapist with Children’s Sports Physical Therapy Clinic. “There’s no straight path toward healing. You have to take each day as it comes.” For example, there may be dizziness, fatigue and nausea that supervised physical activity can actually help with, says Mike Wellsandt, a sports physical therapist with Children’s Sports Physical Therapy Clinic. “Research shows that with concussions, there’s benefit with activity that starts slowly and gradually increases over time,” he notes. “Athletes are able to stay in condition, but there are also big psychological and physical advantages as well.” Since symptoms can change, it’s important to modify activity, he adds. A patient may seem to be progressing, but then appears to go back to square one at subsequent appointments. “It’s not like a broken bone,” says Wellsandt. “There’s no straight path toward healing. You have to take each day as it comes.”
and serve as a communication bridge between the family and the school," she says. “We all work together in a team approach,” says Dr. Moffatt. “Coordinating with a patient’s primary care provider, we’re able to provide treatment that’s tailored to the individual.” Five months after her injury, Megan was finally feeling like herself again. She still has some progress to make, but she’s considering joining the soccer team again and looks forward to enjoying her senior year without the crippling headaches and depression the concussion brought. “I feel very fortunate to have gotten the treatment I did,” she says. “They worked to get me back into my life, and that feels absolutely great.”
10 SIGNS OF CONCUSSION Concussion doesn’t always involve loss of consciousness or obvious bruising or cuts. If your child has suffered an injury to the head, look for these signs of possible concussion: • FREQUENT or ongoing headaches or pressure in the head • CONFUSION, challenges with multitasking or difficulty concentrating
• LOSS OF MEMORY, particularly about the injury or what happened immediately afterward • DIZZINESS, along with nausea or vomiting • RINGING IN THE EARS and/or loss of balance • BEHAVIOR CHANGES that result in loss of interest in favorite activities • SIGNIFICANT SLEEP CHANGES, such as sleeping more or insomnia
• SPEECH PROBLEMS, either in being able to speak or by talking in nonsensical ways • ANXIETY, depression or lowered self-esteem • DIFFICULTY READING and writing Look for symptoms that indicate a shift in how your child feels and behaves usually. Even moodiness and irritability can be signs of a concussion.
expert opinion CHILDREN’S CLINICIANS ANSWER YOUR HEALTH QUESTIONS
Q:
What can I do to help soothe my infant’s sore tummy?
A:
Think Twice About Antibiotics Overuse of powerful drugs can cause bigger problems When your child is sick, it can be an exhausting and stressful experience for the child and his or her parents, so it’s natural to look for a solution in the form of a medication. Often this solution involves a prescription for an antibiotic, whether or not the child actually needs it. Antibiotics are most effective when they are used to treat illnesses caused by bacteria, such as ear infections or pneumonia. “We’re not saying your kid isn’t miserable,” points out Jessica Snowden, M.D., associate professor of Pediatric Infectious Disease at Children’s. "But parents might not realize that the antibiotics can be doing more harm than good.” For viral illnesses—usually characterized by fever, sore throat or a wet nose with green or yellow mucous—it is generally better to let children heal on their own. This is because overuse of antibiotics can cause multiple issues for the children that take them. “When
we use antibiotics, only the bacteria that can survive hang around,” Dr. Snowden says. “And the more we use antibiotics, the less well they work because the bacteria build up resistance.” Beyond hampering the efficacy of antibiotics down the road, overuse of antibiotics can also kill good bacteria in your child’s gut, which can increase the risk of food allergies, inflammatory bowel disease, obesity or even a lifethreatening bacterial illness called clostridium difficile, or C. diff., which would normally be fought off by the good gut bacteria. So what’s the answer? The next time your child is sick, be sure to bring him or her to the doctor so the physician can determine if your child has a virus or a bacterial illness that warrants an antibiotic. Not only will you receive a proper diagnosis, but you will have the peace of mind knowing that your child is receiving the most appropriate medical treatment for his or her ailment.
A sore stomach is common among infants. It can be a sign of numerous minor problems, such as constipation, gas, heartburn, colic, food allergies or even anxiety. Symptoms can include being more fussy than usual, pulling their legs up toward their stomach or having issues with eating. While your baby is most likely not at risk for any serious illnesses due to a sore stomach, it’s still important to soothe the pain. Here are some strategies you can try for different sore stomach situations: • Colic. Try swaddling your baby or giving him or her a pacifier. Sometimes, normally loud noises, such as a vacuum cleaner, will help calm a colicky infant. A white noise machine might also quiet a colicky baby by providing a distraction. • Constipation. For infants over 6 months of age, try introducing more water in the diet. If the problem persists, try adding 2 to 4 ounces of apple-prune juice daily. If your infant is 12 months of age or older and drinking cow’s milk, consider trying an alternative milk product. Never give your baby or child a stimulant laxative unless instructed by your pediatrician. • Heartburn. Symptoms of heartburn in babies include refusing to eat, frequent vomiting, or gagging or choking. If you think this might be an issue for your baby, ask your pediatrician about feeding positions that may alleviate heartburn. For severe heartburn problems, your pediatrician may even suggest medicine. TUMMY TROUBLES? Find a pediatrician, family physician or pediatric specialist who is right for your child. Visit ChildrensOmaha.org/Provider or call 1.800.833.3100 (TDD).
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prevention IDEAS FOR HEALTHY LIVING
Play It Safe
Remember these nine playground safety tips as you head out to play Playgrounds offer a great way for kids to get outside, exercise, socialize with friends and have fun both in summer and during the school year. However, each year more than 200,000 children ages 14 and under are treated in emergency departments due to playgroundrelated injuries, according to the U.S. Consumer Product Safety Commission. Fortunately, accidents and injuries can be prevented with the proper precautions.
1
Be present; actively supervise kids at all times. There’s no substitute for parental supervision.
2 Make sure your kids are using ageappropriate equipment. Younger children playing on equipment designed for older kids can lead to injury because the equipment sizes and proportions won’t be right. There should be separate play areas for kids under age 5 and for older kids. 3
Be sure guardrails and protective barriers are in place on elevated surfaces. Most injuries on playgrounds are associated with climbing equipment and monkey bars.
5
4
All equipment should be secure, unbroken and free of rust, splinters, exposed nails/bolts and missing parts.
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Check for wet and hot surfaces. Never use playground equipment that could be slippery or too hot from the sun.
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Ensure there is safe surfacing beneath and surrounding the equipment. Look for soft, thick protective surfaces. Mulch, shredded tires, rubber mats, sand or synthetic turf should be under all equipment. Avoid hard impact surfaces, such as asphalt, concrete, grass, dirt or gravel.
An ‘Egg’-cellent Option
Give your children the right nutrition from the get-go with this healthy breakfast
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The playground surface should be free of trash and other tripping hazards such as tree stumps and rocks, or other dangerous materials such as glass or metal. Report any hazards to the school, park authority or city council.
BROCCOLI CHEESE OMELETTE
Serves: 2 Ingredients
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Avoid clothes with drawstrings, as well as loose jewelry. These items can catch on playground equipment, causing injury or strangulation. Flip-flops should not be worn on the playground. Even helmets can be dangerous on a playground, so save those for riding bikes.
tip
SPEAK OUT
If you believe a playground is unsafe, report the problem to the owner or local park district.
9
Talk with your children about playground safety. Teach them the importance of taking turns using the equipment properly and to never push or shove.
Nutrition Facts
½ onion, chopped 1 cup broccoli (cut into about 1-inch pieces) 6 egg whites 1 egg ¼ cup low-fat milk ¹/8 tsp salt Black pepper to taste ¼ cup reduced-fat shredded cheddar cheese
½ omelette 155 FAT: 4g SATURATED FAT: 1g CHOLESTEROL: 98mg SODIUM: 458mg CARBOHYDRATES: 7g FIBER: 2g PROTEIN: 21g
SERVING SIZE:
CALORIES:
Preparation Preheat the broiler. Lightly coat a medium ovenproof nonstick skillet with nonstick cooking spray. Add the onion and cook over medium heat for three minutes, or until softened. Add the broccoli and cook for one to two minutes, or until softened. Reduce heat to medium low. In a medium bowl, whisk together the egg whites, egg, milk, salt and black pepper to taste. Pour the egg mixture into the skillet. Cook until the eggs are set, about eight minutes. Sprinkle with the cheddar cheese. Place the skillet under the broiler and cook until the surface is golden, about one to two minutes. Serve immediately.
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Non-Profit Org. U.S. Postage
PAID
Children’s Hospital & Medical Center
8200 Dodge Street Omaha, NE 68114 402-955-5400
CHM-002
last word COMMUNITY CONNECTION
Take a Free Parenting U Class Webinars allow people from out of town to attend online and participate in Q and A sessions We all could use some help with parenting. Fortunately, Children’s offers Parenting U, free classes taught by professionals with expertise in caring for children. Subjects range from everything from understanding fussy eaters to disciplining toddlers. Don’t live in the immediate vicinity? No problem. Live webinars held during the presentations allow anyone to listen and participate in the class at home from a computer or mobile device. Each webinar is free and includes an interactive Q and A session. To register to attend an upcoming Parenting U class in person or online, visit ChildrensOmaha.org/Parenting
or call 1.800.833.3100. The classes are held in the Glow Auditorium of Children’s Hospital & Medical Center, 8200 Dodge St., in Omaha. Space is limited in the auditorium, so register today!
Topic: Healthy Smiles for Babies and Toddlers EXPERT:
Jennifer Smith, M.D., Children’s Physicians
PLUS!
DATE: THURSDAY, SEPT. 21, 6 P.M.
don’t miss it!
Topic: Raising Resilient Children EXPERT:
Michael Vance, Ph.D.
DATE: MONDAY, OCT. 16, 6 P.M.
BABY LOVE BABY FAIR
Topic: Mastering Potty Training
WHEN: SUNDAY, OCT. 1 WHERE: BAXTER ARENA, 2425 67TH ST.
EXPERT: Cheryl Calabro, ARNP, Children’s Physicians
Preparing for Your Newborn
DATE: THURSDAY, OCT. 26, 6 P.M.
10:30 A.M. EXPERT:
Brandi Reeve-Iverson, M.D., Children’s Physicians
Baby’s First Years 11:30 A.M. EXPERT: Katie Vollmuth, M.D., Children’s Physicians
Preparing for Your Newborn 12:30 P.M. EXPERT: Kristin McGregor, M.D., Children’s Physicians
Healthy Nutrition for Toddlers 1:30 P.M. EXPERT: Joseph Straley, M.D., Children’s Physicians
tip
FIND THE RIGHT HEALTH CARE PROVIDER Selecting a provider who’s a good fit for you and your family is important. You—and your child—should feel comfortable with the provider. To find the right one for your family, call Children’s Find-A-Provider service at 1.800.833.3100 (TDD) or visit ChildrensOmaha.org/Provider.