Yes, it's that time again. After a long summer of sleeping late, playing outside and flexible schedules, children and parents can be overwhelmed adjusting to busy back-to-school routines. But every morning does not have to turn into madness. The tricks to a stress-free morning are planning ahead and sticking to schedules.

Keep these tips in mind as you get your kids ready for school:

• To avoid last minute scrambling in the morning, keep book bags, stocked with completed homework assignments and other school necessities, near the door along with coats and shoes.
• Give your child a bath and choose his or her outfit the night before. Have the clothing pressed and ready to go.
• Decide on breakfast and lunch foods ahead of time, and have those foods easily accessible for cooking or packing in a lunch box. You may even want to make your child’s lunch the night before and refrigerate.
• Avoid distractions such as TV or video games. They only will captivate your child’s attention and cause him or her to rush later.
• Build cushions into your family’s schedule so you don’t feel frazzled.
• Keep your child from being rushed by providing gentle reminders. For example, “The school bus will be here in 10 minutes, so you’ll need to put your shoes on.”
• Avoid unnecessary morning chores like emptying the dishwasher.
• Hang the family calendar in a place where everyone can see it. Older children can be proactive and place their musical instrument or uniform next to the door.
• When you feel stressed, your family can sense it. Wake up 15 minutes earlier so you can have some alone time to wake up and feel energized before the rush.
  

Taking these tips into consideration can make your mornings run more smoothly. Here's to a great school year!

FAST FACT: 55 million students across the nation are enrolled in grades K-12 this fall. They will be taught by 6.8 million teachers.

Colleen Schultz is the education manager at Children’s Health Education Center. She is a certified health education specialist with a bachelor’s degree in community health. She also has a master’s degree in education. For more information on parenting tips, or for information about community education classes, call Children’s Health Education Center, a member of Children’s Hospital and Health System, at (414) 765-9355.

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Staying dry at night is a major milestone in a child’s physical and social development. Bedwetting is children is very common, but it can be embarrassing for your child and frustrating for you.

Bedwetting should not be considered abnormal until a child has reached 5 or 6 years of age. It is important to understand bedwetting is not done on purpose or because the child is lazy. Bedwetting many times is an inherited problem. If both parents wet the bed when they were children, there is an almost 80 percent chance that the child also will wet the bed.

Sometimes children who wet the bed have smaller bladder capacities than others, or their bodies do not produce enough of the hormone that decreases the amount of urine made at night. Controlling the bladder while asleep is complex and the timeline for physical development of this process varies from one child to the next.

If a child begins to wet the bed after having been completely dry for at least six months or more, a medical problem such as a bladder infection, diabetes or kidney disease should be ruled out. Sometimes an emotional issue is responsible, such as a school stress, or a problem with peers or family.

Parents can take their children to a pediatrician to rule out any medical problems that may be causing bedwetting. If there are no medical problems, there are many things that parents can do to help their child achieve dry nights:
•    Stay positive, and help your child keep a positive attitude. Tell your child to visualize getting up to go to the bathroom and having dry nights.
•    Limit foods and beverages that contain caffeine, especially after dinner.  Caffeine causes the body to make more urine.
•    Have your child use the toilet just before he or she goes to sleep.
•    Put a nightlight in the bathroom.
•    If your child wets the bed, have him or her take off wet sheets and put them in the laundry. Explain that this is not a punishment. It helps him or her take charge of the situation.

Where to go for help
If the bedwetting continues or you are concerned, talk to your child’s doctor or seek help from professionals with the Voiding Improvement Program at Children’s Hospital. This program provides comprehensive evaluation, diagnosis and treatment for children and teens with daytime and nighttime wetting or other voiding problems. Health care professionals can help improve self-esteem by educating families, children and teens about their condition and helping them choose and implement a plan that fits their needs.

FAST FACT:  Bedwetting affects 15 to 20 percent of 6-year-olds, 5 percent of 10-year-olds and 1 to 2 percent of teenagers and adults. There are many ways that you can help your child overcome this problem. The most important way is to offer love and support, so your child can have dry nights and sweet dreams. Remember, punishment does not help bedwetting.

Patti Ring, RN, is a certified pediatric nurse practitioner with the Voiding Improvement Program at Children’s Hospital of Wisconsin.



 

As summer vacation draws to an end, it’s important to help children re-establish a healthy back-to-school sleep schedule.

Children need more sleep than adults. Children ages 5 to 12 require 10 to 11 hours of sleep each night, while teens should have at least nine hours.

Chronic sleep deprivation has many serious consequences, including poor school performance. Lack of sleep also can be linked to behavioral, developmental and mood problems in children. Drowsy teens who get behind the wheel of a car can suffer even more dire consequences.

Despite these facts, the National Sleep Foundation has found that only 20 percent of adolescents get enough sleep.

Parents can help children adjust their sleep patterns for the upcoming school year by following these guidelines:

• At least two to three weeks before school starts, set a bedtime and wake-up time. Children with bedtimes before 10 p.m. are much more likely to get enough sleep than children with later bedtimes. If necessary, the schedule can be adjusted at a gradual pace (about 15 minutes every two days) to ease the transition.
•  In the last days of summer, wake your children early. Emphasize activity and bright light in the morning. For example, send them outside to play, rather than allowing them to watch TV. 
• Be consistent with your children’s sleep schedules, even if they don’t have school the next day.
• Establish a relaxing evening routine. Avoid exercise or stimulating activities in the last few hours before bedtime.
• Create a sleep environment that is cool, dark, quiet and comfortable.
• Limit caffeine, especially after lunchtime.
• Avoid having a TV or computer in the bedroom. 
• Make sleep a priority and set a good example.

 Back to school means early to bed

FAST FACT: The National Highway Traffic Safety Administration estimates that drowsy driving causes at least 100,000 police-reported crashes and kills more than 1,550 Americans each year.

Nan Norins, MD, is a pediatric sleep specialist at Children’s Hospital of Wisconsin and an assistant professor of Pediatrics (Pulmonary/Critical Care Medicine) at the Medical College of Wisconsin. The Sleep Center at Children’s Hospital offers a full range of diagnostic and treatment services, including the state’s only pediatric sleep laboratory accredited by the American Academy of Sleep Medicine.

Food-borne illness can occur in any home. Symptoms of food-borne illness resemble the flu and include nausea, vomiting and diarrhea. Because of their small body sizes, young children are even more at risk.

These tips about safe storage, handling and preparation of food will help you prevent the spread of bacteria in your kitchen:

• Always wash your hands and cutting boards or other food preparation surfaces with hot, soapy water before preparing any food and after handling raw meat, poultry, seafood and eggs.
• Always use a food thermometer when you cook. A food thermometer will help you make sure your food has reached a high enough temperature to kill harmful bacteria.
• Cook all meat and poultry at an oven temperature of at least 325 degrees.
• Do not thaw raw fish in the refrigerator for more than 24 hours. Raw poultry or ground beef will keep one to two days and raw red meat three to five days.
• Thaw frozen foods under lukewarm running water, in the refrigerator or in the microwave. Meats thawed in the microwave must be cooked immediately. Do not thaw foods on the countertop.
• Never put cooked food on a plate that was used for raw meat.
• Always refrigerate leftovers within two hours of eating.
• You can put the kitchen sponge, washcloth or scouring pad in the microwave for one minute or run it through the dishwasher to help prevent bacteria growth.

FAST FACT: Consult your child's doctor if your child has symptoms that include high fever, blood in the stools, prolonged vomiting or signs of dehydration, including a decrease in urination, a dry mouth and throat, and dizziness when standing up.

Heather Fortin, RD, CD, CSCS, CLC, is a registered dietitian with the NEW (Nutrition, Exercise and Weight Management) Kids Program™ at Children’s Hospital of Wisconsin.
 

Proper hearing is essential to a child’s ability to develop speech and language skills, as well as his or her cognitive, social and emotional development. The first few years of a child’s life are particularly important. During this time, children learn to make sense of sounds via their ears, working in conjunction with their brains. The importance of these early years is what prompted many states to initiate hearing tests for all newborns. Early detection and appropriate intervention are key factors in eliminating or minimizing the negative impact of hearing loss.

Despite the importance of early intervention, on rare occasions parents still are told their child is too young for a hearing test. Very young children can be tested. Here are some of the more common tests:
 
Visual reinforcement audiology
This is a behavioral testing technique typically used with children between 6 months and 3 years old. In a special booth, the child is seated on a parent's lap with speakers situated on either side. An audiologist transmits speech and different pitches of sounds through the speakers. When the child hears the voice or sounds and looks in the direction of the sound, an animated, lighted toy appears. Using this type of visual reinforcement, the child eventually learns to look toward the source of the sound when he or she hears it, allowing the audiologist to evaluate the child’s hearing.

Conditioned play audiometry
This test typically is used for children between 3 and 5 years old. While wearing headphones, the child is encouraged to play a listening game. Different sound pitches are introduced through the headphones, and the child is taught to perform a task, such as putting a block in a bucket every time a sound is heard. If the child is willing and able, his or her ability to hear and understand speech also can be assessed by using a picture-pointing task or repeating words. By having the child wear headphones, the audiologist is able to determine the level of hearing in each ear.

Conventional audiometric testing
Most people are familiar with this test. It typically can be used with children age 5 and older. With headphones on, the child is asked to raise his or her hand every time different sounds or pitches are heard. In addition, the child’s ability to detect and understand speech is evaluated by having him or her repeat words.

Newborns, very young infants and some children with special needs, such as visual difficulties, cognitive or physical impairments, and/or behavioral issues, may not be able or willing to perform some of these tests. In these situations, audiologists rely on electrophysiological tests that do not require any responses from the child. These tests include auditory brain stem response evaluations and auditory steady state response testing. During these noninvasive and painless tests the child typically is sedated. Headphones generate a series of clicking sounds, and electrodes attached to the child’s head record neural responses. Using these tests, audiologists are able to obtain very good, objective estimates of a child’s hearing status.

If you have concerns about your child’s hearing, discuss them with your pediatrician. Masters Family Speech and Hearing Center at Children’s Hospital of Wisconsin offers comprehensive hearing tests by audiologists who specialize in working with kids.

FAST FACT: If you have concerns with your child’s hearing, don’t dismiss them just because he or she passed a newborn hearing screening. It is not uncommon for children to develop temporary hearing problems, such as fluid behind their eardrums, which require medical attention. On rare occasions, a progressive, possibly permanent hearing loss may develop that was not present at birth.

Catherine Holland, MS, CCC-A, is a pediatric audiologist with Masters Family Speech and Hearing Center at Children’s Hospital of Wisconsin.

 

Fourth of July activities can provide a fun-filled time for families. But, fireworks needlessly injure children every year.

Children ages 10 to 14 suffer from fireworks-related injuries more than any other age group. Sparklers, often considered the safest of fireworks, are most frequently linked to injuries among children age 5 and under.

To prevent accidents, keep these firework safety tips in mind during the Fourth of July:

• The best way for families to enjoy the holiday's festivities is to leave the fireworks to the professionals. Attend public firework displays where your whole family can watch the show from a distance.
• If your family has purchased fireworks, make sure your children do not use them, including sparklers.
• Discuss the dangers of fireworks with your children. Tell them never to purchase fireworks or accept them from friends, and to stay away from those who are using fireworks.
• Always have water handy–a hose or bucket of water–when using fireworks or sparklers.
• Never make your own fireworks.
• Don’t allow your child to pick up pieces of fireworks after an event. Some still may be ignited and can explode unexpectedly.

FAST FACT: Children, age 5 and younger, account for one third of all firework injuries. Keep your children away from fireworks, especially sparklers, because they can reach temperatures up to 1,800 degrees Fahrenheit.

Elizabeth Cleek, RN, MS, APNP, is an advanced practice nurse with the Trauma Program at Children’s Hospital of Wisconsin.




 

Summer is nearly here, and a family trip may be in your future. Whether it is a short visit to Grandma’s house or a trip across the country, traveling with children can sometimes be challenging. When embarking on a family trip, consider selecting a destination that is geared toward children.

Whether you are traveling by car, plane, train or bus, the key to an enjoyable trip with your child is to plan ahead. Advance planning will ensure a successful, fun vacation and reduce the stress associated with traveling as a family.

What parents can do:

• Talk to your child about the trip. Tell your child where you are going, who you will see and how long you will travel. Order brochures and get visual aids to help explain the trip to your child.
• Try staying at family-oriented Bed & Breakfasts, which usually have spacious rooms and suites with special amenities for children.
  
• Visit the library and check out children’s music tapes, books on tape and DVDs for portable DVD players.
• Allow your child to choose the toys he or she wants to take on the trip.
• Create a travel art kit. Fill a large zip-top bag with art supplies, such as crayons, stickers, paper and coloring books.
• Pack plenty of healthy snacks for the trip.
• Make goody bags. Collect items from dollar stores or party stores such as small toys, games and snacks to surprise your child when boredom or irritability set in.
• Keep you child’s sleeping and eating routine as normal as possible. Children will behave better if they follow their regular routines.
  

Car travel:

• Allow extra time to reach your destination and stop often to let your child stretch.
• Plan fun stops along the way, such as visiting a park.

Air travel:

• Carry current photos of your children in case they wander away from you.
• Plan activities during the flight in 10-minute segments. This is the approximate length of a child’s attention span. Be sure to bring enough activities in case of delays and time in the airport.
• Bring something age appropriate for your toddler or child to chew or swallow to help with air pressure changes.
  

Ronald Pupp, PhD, is director of Counseling for Children’s Service Society of Wisconsin.

FAST FACT: Children make great travel companions. According to the Travel Industry Association, one in four household trips in the U.S. include children. Popular activities on trips with children include visiting a historical site, attending a social or family event, engaging in an outdoor activity, going to the beach or going to an amusement park.