Each year, more than 100 children age 14 and younger die, and 2.5 million are treated in emergency rooms for injuries from falls. Among children who die, more than half are younger than 4 years old.

There are many different ways children are injured from falls. They can fall from windows, down stairs, off furniture and from bikes or outdoor play equipment.

Fall-related injuries and deaths often are seasonal. Window falls peak during the spring and summer when people leave their windows open. Children also are outside playing on swing sets, jungle gyms and other playground equipment. Most playground injuries occur when children jump or fall from equipment to hard surfaces below. More than 70 percent of playground-related injuries involve falls to the surface.

Parents and caregivers can prevent falls in the home with supervision and safety products. To prevent falls at home:
•    Never use baby walkers.
•    Never leave young children alone on changing tables, beds, sofas or other furniture.
•    Always strap children into highchairs, swings and strollers.
•    Move chairs, cribs, beds and other furniture away from windows and draperies.
•    Install window guards that can be opened by adults on the first six floors of residential buildings. Install permanent window guards on floors seven and above.
•    Remember that children can fall from windows opened as little as five inches. Never rely on window screens to prevent falls.
•    Never let children play alone on fire escapes, high porches or balconies.
•    Use safety gates at the top and bottom of stairs.
•    Keep hallways and stairs well lit and     clear of clutter.
•    Never let kids play on stairs.

To prevent falls at play:
•    Check the surface under playground equipment. Avoid asphalt, concrete, grass and soil surfaces. Safer surfaces include mulch, pea gravel and shredded rubber at least nine to 12 inches deep and extending at least six feet in all directions around equipment. Work with local officials to clean up broken glass and trash to maintain safe playgrounds.
•    Insist children wear their helmets correctly every time they ride their bikes or skates. Only buy helmets that carry a sticker indicating they meet safety standards.
•    Make sure children wear protective gear including helmets, kneepads, elbow pads and wrist guards while inline skating or skateboarding. Skaters should take lessons, avoid skating at night and skate on smooth, paved surfaces free of motor vehicles.

Bridget Clementi is executive director of Children’s Health Education Center, CHEC is the lead agency of Safe Kids Wisconsin and Safe Kids Southeast Wisconsin coalitions. Each offer resources and programs for children, parents, teachers and caregivers to help keep children healthy and safe. Safe Kids Wisconsin and Southeast Wisconsin specifically work to prevent childhood accidental injuries, the leading cause of death among children ages 14 and younger.


FAST FACT: In 2007, more than 2,600 children ages 1 to 12 were treated in the emergency department at Children’s Hospital of Wisconsin for injuries they received from a fall.

Artistic expression often is used as a therapy to help people who have lived through traumatic experiences work through the grieving and healing processes. People of all ages experiencing behavioral, emotional and medical problems can benefit from art therapy by increasing self-awareness, resolving life-changing events, improving coping skills and expressing difficult feelings.

Children’s Hospital of Wisconsin art specialists use art in the hospital setting to help patients cope, and find it’s a wonderful way to help them express what they are thinking or feeling. But you don’t have to be ill or suffer a traumatic event to benefit from art or creating art.

Children of all ages benefit from self-expression through the artistic process. This can be as simple as finger painting for a 2-year-old or creating a multimedia collage with markers, paper, fabric and found objects for a 6-year-old. The experience of creating art offers a way for children to develop reasoning and to express their emerging thoughts and feelings. And, it’s fun!

This is YOUR Children’s Hospital
In spring of 2009, Children’s Hospital will open its new west tower. The 12-story, 425,000-square-foot expansion will increase the 236-bed hospital to 294 beds with space for 72 more beds in the future. The state-of-the-art facility also will include a larger Pediatric Intensive Care Unit and an expanded Herma Heart Center. Many people including physicians, nurses and our patients and families have been instrumental in the planning and design. In addition to the most cutting-edge technology and nationally recognized pediatric care, this expansion will offer a brighter and well-thought out environment with many amenities that will help children and families heal.

What does YOUR Children’s look like?
Last year Children’s Hospital cared for more than 250,000 children—many of whom live in your neighborhood or go to school with your own kids. Perhaps your family has been cared for by Children’s Hospital as an inpatient or in one of our outpatient clinics, by a Children’s Medical Group pediatrician or at a Children’s Urgent Care. We invite all children and adolescents ages 3-18 to share the story of their experiences with us through their art. We hope to use some of the submitted artwork in the following ways:
•    On the walls of Children’s Hospital.
•    Showcased in a Children’s Hospital coffee table book.
•    As part of a traveling art exhibit.
•    At a grand opening event for the new Children’s Hospital west tower.

Between now and June 13, 2008, submit artwork created on the entry form. Children can use crayons, colored pencils, markers, paint or pastels for their hospital artwork, be creative! All entries will be considered, and families will be notified if their child’s artwork has been selected. Four grand prize winners will receive a stay in Wisconsin Dells for four. We look forward to receiving your entries.

Download your entry form

Amy Phillips, MA, Fine and Decorative Arts, is an art therapist at Children’s Hospital of Wisconsin.

FAST FACT: More than 800 pieces of children’s artwork are hanging on the walls of Children’s Hospital and Health System facilities.
 

 

There is an outbreak of measles in our community right now. Following is information regarding measles and what you should do if you are concerned about a possible exposure in your family.

It is important to know that children and adults who have been fully immunized are not considered to be at risk.

What should I do if I’m concerned my child might have measles? Consult your pediatrician or family practice physician immediately. If you are being referred to Children’s Hospital for a blood test, your pediatrician should contact the Emergency Department prior to your arrival. Then, please go directly to the Children’s Hospital Emergency Department. A testing station has been set up in the Emergency Department to help screen for measles.

Please do not enter the hospital or clinics building and risk exposure of other patients and people.
_________________________________________________________________________________________________________________________________________________________

What is measles? Measles is an extremely serious and highly contagious viral disease that can be prevented by routine childhood vaccination.

How is measles prevented? The measles vaccine is usually given in combination with rubella and mumps vaccine (MMR). The current vaccination schedule suggests a first vaccine between 12 and 18 months of age. A second vaccine should be given between 4 and 6 years of age. If you are not sure if your child has received the MMR vaccine consult your pediatrician or family practice physician.

Who can get measles? Measles virus can infect any person of any age who has not previously had the disease or measles vaccine.

How is measles spread? Airborne droplets, from coughing or sneezing, spread the virus. It spreads easily and rapidly.

What are the signs and symptoms of measles? The disease begins with cold like signs and symptoms including a cough, runny nose high temperature and red, watery eyes. By the second day after onset, a red blotchy rash appears at the hairline and spreads down the body to the arms and legs. The rash disappears in the same order of appearance (head to foot) in about 5-6 days.

How soon do symptoms appear after exposure? It takes from 8-12 days for the cold-like symptoms to appear and 14 days for the rash.

How can parents be sure that their child’s illness is measles? The only sure way to determine if an illness is indeed measles is through a blood test.

When and for how long is a person able to spread measles? Measles can spread from one day before the onset of cold-like symptoms through the fourth day of the rash.

What are the complications associated with measles? Among children with measles, about 10 percent develop ear infections, about 5 percent develop pneumonia, about 0.1 percent  (1 per 1,000 cases) develop encephalitis (inflammation of the brain that can result in deafness or mental retardation) and in approximately 1 in 1,000 cases people die from it.

Is there a treatment for measles? There is no specific treatment for measles.

Can measles be prevented? Yes. Measles vaccine is recommended for all children at 12-15 months of age and again at 4-6 years of age. The two doses of vaccine normally provide life-long immunity.

For more information consult your pediatrician or contact your local public health department.

FAST FACT: A measles hotline has been established by the Milwaukee Health Department. Call (414) 286-3616.

The spring months bring sunshine, warmer weather and sometimes a trip or two to your pediatrician. A trip to the pediatrician’s office can be stressful, but knowing how to make the most of your time there can make visits run smoothly.

Offer information:
•    It’s important your doctor be aware of any change in your family’s health history, including grandparents, aunts and uncles. Cases of heart disease, diabetes, high blood pressure and cancer are examples of things your doctor should know.
•    Tell the doctor if someone else has seen your child for an illness or injury, such as a visit to an emergency room, urgent care or a specialist.
•    Bring a list of all the medications your child is taking. This should include over-the-counter medications, vitamins and herbal supplements, as well as prescription medication.
•    If your child is sick, write down timelines of what symptoms began when. This is especially helpful if your child has a chronic or long-standing illness.

The more information you can offer your child’s doctor, the better he or she will be able to understand, diagnose and treat your child.

Ask questions. At regular check-ups:
•    Ask what you might need to know about caring for your child between this visit and the next one. Make sure you know when the next scheduled visit should take place.
•    Ask what changes your child might go through before your next visit such as growth, development and feeding stages. Your doctor can provide helpful nutritional and safety advice no matter your child’s age.
•    Ask where else you can get good information on parenting, safety and other related topics, such as Internet sites, books and magazines.

It is helpful to come with questions written down so you don’t forget to ask them. Also, make sure you understand the answers and information your doctor gives you, and don’t be afraid to ask for further information or clarification. Remember, these questions are best for well-child visits. When your child is sick, that visit should be focused on the current illness.

Come prepared. Make sure you bring the following to every visit:
•    Health insurance information.
•    Any changes in demographic information such as address and phone number or emergency contact information.
•    A game, book or favorite toy that can help keep your child entertained if there is a wait in the office. This also can help comfort your child and ease some anxiety.
•    Antiseptic wipes if your child plays with toys or has contact with other children in the waiting room.
•    A blanket and extra diaper for infants.
•    Unfortunately, waiting to see the doctor often is inevitable. Ask front office staff if you can call before your visit to find out if appointments are running on time. Being on time is a mutual responsibility between the doctor and patient. Sometimes a little advanced planning can lessen frustration and help visits run on time.

Most importantly, enjoy the time with your pediatrician. The two of you are talking about the most precious, unique and wonderful gift – your child.

Michael Gutzeit, MD, is a pediatrician and chief medical officer at Children’s Hospital of Wisconsin. For more information about Children’s Hospital call (414) 266-2000 or visit www.chw.org.

 
FAST FACT: Did you know that Children's Hospital and Health System has 17 pediatrician practices throughout Southeastern Wisconsin? For more information about Children's Medical Group visit the Web site at www.childrensmedicalgroup.org. 

This time of year almost everyone gets the “common” cold. Symptoms can include:
•    Fever.
•    Cough.
•    Runny nose.
•    Poor sleep.
•    Decreased appetite.
•    Crabbiness.

Treating cold symptoms
Colds are caused by viruses. There are no medicines that kill viruses like antibiotics kill bacteria, so the best plan is to treat the symptoms. To treat symptoms of the common cold, try these suggestions:
•    Tylenol® and ibuprofen work as fever reducers. If your child has persistent fevers above 101 degrees, alternating doses of Tylenol and ibuprofen every four hours will help keep the fever down and make your child more comfortable.
•    For coughing and runny noses, use saline nasal drops and nasal suctioning for younger kids. For older kids use saline nasal spray and nose blowing. The saline loosens the mucus and makes suctioning and nose blowing more effective. For younger kids, suction one nostril at a time, first filling it with saline drops and waiting 15 to 20 seconds before using the bulb to suction the mucus. Repeat this process multiple times throughout the day. You are probably thinking, “There is no way my child will let me do this.” But if you are persistent, it will work, and your child will feel better.
•    At night, elevating the head of the bed will alleviate some of the post-nasal drip that contributes to nighttime coughing. Use an extra pillow for older kids and a phone book under the head of the mattress, elevating it to a 30 to 45 degree angle for younger kids. Running a cool-mist vaporizer at night will help, too. Most colds last for 10 to 14 days.

As always, call your doctor if you have concerns. For more information about treating the common cold, visit the Children's Hospital Web site at chw.org.

David Melbye, MD, FAAP, is a pediatrician at Children’s Medical Group-Bayshore Pediatrics.

FAST FACT: Children’s Medical Group physicians provide primary and behavioral care for children in 18 clinics throughout southeastern Wisconsin. In addition, CMG oversees school-based health centers located in central city Milwaukee Public Schools. Find a local pediatrician at www.childrensmedicalgroup.org

 

Spring cleaning is an annual ritual. This year, as you clean and organize your home, keep poison prevention in mind.

Wisconsin Poison Center answers more than 50,000 calls each year concerning potentially hazardous substances and situations. More than 90 percent of poisonings occur at home. Though unintentional poisoning can affect people of all ages, children age 6 and younger and elders who take multiple medications are at high risk. The most common hazards for children include: personal care products and cosmetics, household cleaners, plants and pesticides, and over-the-counter medications such as pain relievers, cough/cold products and multivitamins.

Here’s what to look for:
In the kitchen:
• Keep medications and cleaning products in their original containers with labels intact. Child-resistant caps help, but parents should not depend solely on these. Many children can open them.
• Do not store any medicines on the kitchen windowsill, countertop or top of the refrigerator where children can see or try to reach them.
• Make sure all household cleaning products are stored high, out of children’s reach.
• Install child safety devices on all cabinets as an added measure of protection.

In the bathroom:
• Throw out old medicines by tying them tightly in a nonsee-through bag. Take them straight out to the trash on pick-up day.

In the bedroom:
• Look for any flaking paint on furniture, walls and windowsills. Flaking paint may contain high levels of lead. When considering home renovations, make sure to protect yourself and your family from inhaling or eating leaded paint dust.
• Make sure all perfumes and cosmetics are stored out of reach.
• When guests stay over, ask them to keep their medications out of a child’s reach.

In the laundry room:
• Store soaps, detergents and other products in high, locked cabinets.
• Keep open products with you when using them. If the phone or doorbell rings, take the product with you.

Remember, there are hazards outside the home, too. Outdoor poison exposures increase in warmer months, when children are outside more often and are at greater risk of coming in contact with pesticides, toxic plants, insects and more.

If you suspect your child has come in contact with a poisonous substance, call Wisconsin Poison Center immediately at 1-800-222-1222.

David Gummin, MD, is the medical director of Wisconsin Poison Center, located at Children's Hospital of Wisconsin. The center provides 24-hour, toll-free poison information for all individuals in Wisconsin. Anyone who has had direct contact with a known or potential poison can receive immediate advice on what steps to take to prevent injury from that exposure by calling 24 hours a day, seven days a week toll-free 1-800-222-1222. Translators are available.

FAST FACT: In 2007, the Poison Center answered a total of 52,834 calls for help and information. Nearly 85 percent of the calls were regarding a poison exposure. Accidental poisoning in the home accounted for 3 out of 4 cases.


 

About 2.2 million school-aged children, and one in every 17 children younger than 3, have food allergies. Food allergies often are more common in individuals who have family members with allergies.

With a true food allergy, a child’s immune system will overreact to an ordinarily harmless food. Once the immune system decides that a particular food is harmful, it creates specific antibodies to it. The next time the child eats that food, the immune system reacts in order to protect the body.

Six foods account for 90 percent of food allergies:
•    Milk.
•    Eggs.
•    Peanuts.
•    Wheat.
•    Soy.
•    Tree nuts (walnuts, cashews, pecans are examples).

Symptoms of allergic reactions
The most common reaction to a food is hives. Asthma symptoms, such as coughing, wheezing or difficulty breathing also may be triggered by food allergies, especially in infants and children. Symptoms may appear within minutes or up to two hours after the child has eaten the food. As they get older, some children may tolerate foods that previously caused allergic reactions. However, less than 25 percent of individuals with peanut allergy will outgrow it.

Severe allergic reactions
In some cases, eating certain foods can cause a life-threatening allergic reaction called anaphylaxis. Symptoms of anaphylaxis are temporarily reversed by treatment with injectable epinephrine, antihistamines and other emergency measures. It is essential that anyone with symptoms of anaphylaxis gets immediate emergency treatment.

Staying safe
Be informed, check ingredients carefully. Following is a checklist to help avoid foods that may affect your child’s allergies:

•Always read labels. Ingredients can change unexpectedly.
•    To avoid eating a “hidden” food allergen away from home, always ask about ingredients when eating out. Taking the ingredient out of a dish that is about to served is not a solution. In addition, cross contamination may occur if the same utensil is used to prepare other foods. Food allergens also can be airborne, especially in steam.
•    Tell your family, friends and your child's school or daycare about your child’s food allergies. Remind them that strict avoidance is key when managing food allergies, and even one little bite can hurt.
•    If your child’s food allergies are severe, be prepared for emergencies. Carry and know how to use injectable epinephrine and antihistamines to treat unexpected reactions.

Diagnosis
If you think your child may have food allergies, an allergist/immunologist is the best-qualified professional to diagnose and care for your child.

Asriani Chiu, MD, is an allergist/immunologist in the Asthma and Allergy Center at Children’s Hospital of Wisconsin. Asthma and Allergy Center staff includes 12 allergists with international reputations in the fields of allergy, asthma and immunology, who treat both children and adults. Other clinic staff includes nurse practitioners, a nurse education specialist, registered nurses, licensed practical nurses and respiratory care practitioners.

FAST FACT:  Not eating the foods your child is sensitive to is the only proven therapy for food allergies.