On Jan. 26, the United States Department of Agriculture (USDA), with the aid of First Lady Michelle Obama, announced new requirements for the National School Lunch Program that feeds millions of children in U.S. schools each year.  We asked Le Bonheur Clinical Dietitian Katelyn Wolfe, MS, RD, LDN, to weigh in on the new requirements. Here’s what she had to say:

The new regulations will increase of the availability of fruits, vegetables, whole grains, and fat-free and low-fat fluid milk in schools. It will also reduce the amount of options high in sodium, saturated fat and trans fat.  Such changes help to align the National School Lunch Program standards with the Dietary Guidelines for Americans by providing nutrient-dense but lower-calorie meals.

These changes aim to help combat the increasing rate of childhood obesity.  According the Centers for Disease Control and Prevention (CDC), approximately 17 percent of children ages 2-19 are obese, a rate that has almost tripled since 1980.  A child that is obese is at an increased risk for chronic diseases such as hypertension, diabetes and heart disease. Because so many children participate in a school lunch program, the mid-day meal becomes a crucial point for intervention in the obesity crisis.

Currently, the healthfulness of school lunches may vary greatly between grades, school districts and states due to broad regulations at the national level and a varying degree of regulations at the state and local levels.  For example, one elementary school may offer whole milk and the option of one fruit or one vegetable, while another elementary school may offer fat-free milk or 2 percent milk and both a fruit and a vegetable.  This inconsistency should disappear when the new regulations go into effect as soon as July.

So what will the meals look like after the change?  Read a sample meu that compares meals before and after the new regulations are in place.  Kids will see more colorful vegetables and fewer potato-based vegetables as well as more whole grains, lean protein sources, more fruits and healthier options for dairy and condiments.  It may be a great contrast to what a child was eating the previous school year. 

Changing the school lunches is only one part of promoting a healthy lifestyle for our children.  What goes on at home also plays a huge role in a child’s health.  For ways that you can become more involved with your child’s health or the health of children in your community, check out our previous post Obesity Awareness.

At the Campbell Clinic Spine Center at Le Bonheur, our specialists offer some of the most advanced treatments for kids with a curvature of the spine, or scoliosis. Vertical Expandable Prosthetic Titanium Rib (VEPTR) implantation is one of those treatments. For kids for significant spine curvature, VEPTR implantation allows the child’s chest to grow, expanding their lung capacity and making it easier to breathe.  It also decreases the spine’s deformity.

Check out the story below of Le Bonheur patient Evonte Cathey, 14, who underwent VEPTR implantation at the age of 9. Evonte’s device was removed this past year, making him the first VEPTR graduate of the Campbell Clinic Spine Center.

Born with congenital scoliosis and fused ribs, Evonte Cathey began treatment for his scoliosis at age 2 and ultimately underwent an attempted in-situ convex growth arrest in an effort to slow or correct his curvature at the age of 3. The operation successfully prevented the curve’s progression, but his fused ribs and spine curvature made it difficult for his lungs to grow and expand. Doctors at Le Bonheur Children’s Hospital began to look at other options.

In the March 2007, Evonte, then 9, underwent another operation, this time to implant two Vertical Expandable Prosthetic Titanium Rib (VEPTR) devices. The device – a curved titanium rod that is attached to the ribs near the spine – helps decrease the spine’s curvature, while allowing the lungs to grow and develop.

The device is lengthened once every four to six months in a 45-minute surgical procedure, essentially growing as the child grows, said Pediatric Orthopedic Surgeon Jeffrey R. Sawyer, MD.  Without VEPTR, Evonte’s curve would have continued to progess, and his lungs would not be able to grow to their full capacity.

“For Evonte, having the option of VEPTR made his fusion safer,” said Sawyer. “In addition, he would have had permanent pulmonary compromise without this device.” The Campbell Clinic Spine Center at Le Bonheur Children’s is one of high-volume centers in the country that provide VEPTR implantation for pediatric scoliosis patients.

Evonte’s device was removed this past year, making him the first VEPTR graduate of the Campbell Clinic Spine Center at Le Bonheur. Evonte will visit the spine center once every six months for a check-up, but his prognosis is promising. His curve is now stabilized at 40 degrees, and his lungs have reached maximal growth.

“He’s actually looking like a normal 14-year-old,” said Evonte’s mom, Yolanda Cathey. “He’s taller and straighter. You wouldn’t be able to tell he has scoliosis.” Now 14 years old, Evonte wants to run track someday, says his mom.

“I’m truly thankful for the VEPTR procedure,” said Yolanda. “I was worried that it wouldn’t work, but it has.”

One of the most memorable moments as a parent is the first time you hear your child use a curse word. How should you, as a parent, react to this behavior? We asked Child Life Director Thomas Hobson for some advice. He shares his insight below.

I remember the first time my son said “damn it.” Now, in my family, that phrase is a rite of passage, passed down (unofficially) from father to son. It’s gone on for generations. For my son and me, it started on a Wednesday night before going to a church function. I had gotten home from work to find a new DVR machine had gotten to the house, and I wanted to set it up before leaving. As I worked on setting it up, my son, who was 3 at the time, was playing all around the house, and I was focused on the task at hand. As I struggled to get the cables connected, I let “the” phrase slip, and that was all it took. I didn’t even realize my son was around until he repeated it … and then started running around the house saying it … right before going to church. Let’s just say, I was in trouble.

But fear not. If your child says a curse word, he or she is not destined for a life of shock radio. In fact, most young children don’t know what the words mean. They usually are simply playing around with the word, repeating it and saying it to try it out. Though they do probably recognize that the word has some kind of meaning with frustration or anger, chances are they are doing this with other words, and you haven’t noticed it.

Here’s my advice for helping your child:

• Create “the list.” Are there certain words that you don’t want your child to say? Create a list of them, and try to remove them from your own language. If you are not modeling the language, it will be harder for them to learn it. And, as I learned, you need to practice this new rule all the time, not just when you think they’re not listening.
• Don’t respond. So your child has learned a curse word and said it in front of you. There are two immediate responses that most parents have. The first is to yell at him or her, warning to never say it again, and the second is to laugh. Here’s the hard part: both of those responses reinforce the use of the word, either giving the word “gravity” or suggesting that it’s funny. Instead, plainly tell your child that your family doesn’t use language like that, and ignore it if they keep using the word. They’ll eventually get bored with it.
• Try another word. Another option is to give your child a different, “silly” word. If your child is trying out words, this is a great way to give some kind of nonsense word that will be fun to say. Just make a word up like “bigly higgly” or “palomino,” which was a favorite in our house.
  

In yesterday’s Commercial Appeal, a Memphis teen was featured after she volunteered at Le Bonheur Children’s Hospital during the Thanksgiving holiday to cheer up patients. Erin Aulfinger, a former Le Bonheur patient herself, said in the article “Being on the receiving end of help feels good, but is different. It makes me want to help others even more.”

In 2010 at the age of 14, Erin collapsed in her home from a seizure as she and her brother were playing a video game. She was taken to Le Bonheur where within hours, Pediatric Neurologist Dr. Namrata Shah diagnosed her with juvenile myoclonic epilepsy. Since the diagnosis, Erin has relied on friends, family, music and helping others as her way of “owning her twitch” - which is how she jokingly describes it on her Facebook page.

The article goes on to talk about Erin’s volunteer work at Le Bonheur and how her family members, friends and school teachers have adjusted their lives also to deal with her epilepsy. 

Read the entire article here.

Last November, Le Bonheur ran a series of blog posts on epilepsy and the Neuroscience Center housed at the hospital. Check it out here.

Every year, many children are injured or even killed due to falls from home windows. It’s an easy thing to dismiss, but safety and awareness on the parental end is a must in this area. Safe Kids Mid-South, led by Le Bonheur Children’s Hospital, offers these tips to prevent window falls:

• Install window guards to prevent children from falling out of windows. For windows above the first floor, install window guards with an emergency release device in case of fire. 
• Install window stops so that windows open no more than four inches. 
• Keep windows locked and closed when they are not being used. 
• Keep furniture away from windows so kids cannot climb to the ledge. 
• If you have double-hung windows — the kind that can open down from the top as well as up from the bottom — it is generally safer to open the top pane, but growing kids may have enough strength, dexterity and curiosity to open the bottom pane. 
• Do not rely on window screens to prevent falls. 
• Keep windows locked when they are closed. 
• Supervise children at all times, especially around open windows. 
• Never try to move a child who appears to be seriously injured after a fall — call 911 and let trained medical personnel move the child with proper precautions

More than 18,000 kids in the United States are diagnosed with Type 1 or Type 2 diabetes each year, according to the Centers for Disease Control (CDC). Le Bonheur Diabetes Educator, La Tonya Ivy, RN, MSN, answers some questions about the disease below.

What are some of the signs and symptoms of diabetes in kids?
The signs and symptoms of diabetes, or hyperglycemia, for children are very similar to the signs and symptoms expressed in adults.  They include increased thirst, frequent urination, extreme hunger, unplanned weight loss, blurred vision, tiredness/weakness and irritability (change in behavior).  Another classic sign is ketonuria, or ketones in the urine.  The most common symptoms that prompt parents to seek medical attention are extreme weight loss, tiredness/weakness (change in child’s level of activity) and bedwetting after their child has been potty trained.

How common is diabetes in kids?
Diabetes is a very common chronic disease in childhood.  In fact, there is an increasing incidence and prevalence of both Type 1 and Type 2 in the 0- to 20-year age group.  Approximately 13,000 youths in the United States are diagnosed with Type 1 diabetes and 3,700 youths are diagnosed with Type 2 diabetes annually, according to the 2010 CDC report.

What’s the difference between Type 1 and Type 2?
Diabetes is a condition that causes elevated blood glucose (sugar) levels.  It is an imbalance of blood glucose and insulin.  Insulin is the key that allows glucose to be used by our body properly.

Type 1 and Type 2 are two common forms of diabetes.  Type 1 diabetes occurs when the pancreas, the organ responsible for insulin secretion, does not make any insulin.  Whereas, Type 2 diabetes occurs when insulin resistance is present and when the insulin secreted by the pancreas is not enough to meet the body’s demand.

The way I’ve often described it to parents is that persons with Type 1 diabetes have a pancreas that stops making insulin, and those with Type 2 have a pancreas that makes some insulin, but that insulin just does not work like it should.

How do you help kids with diabetes manage their diabetes?
Diabetes management requires support from family and friends, health care providers and the community.  As a diabetes educator, I provide training, counseling and support for the child with diabetes and his/her family during outpatient clinic visits and during the outpatient diabetes self-management education program.  The same service is provided in the hospital, as Le Bonheur has three diabetes educators (two inpatient based and one 1 outpatient based). Specific to the pediatric population, our educators reach out to both public and private schools in the tri-state community.

The educators, in collaboration with other health care providers, have the ultimate goal of empowering persons with diabetes and their families to self-manage their condition, motivate them to successfully meet personal goals, and equip them with the knowledge of diabetes basics, healthy coping skills, techniques to reduce risk of complications, problem-solving strategies, and proper utilization of diabetes devices.

Cases of sudden cardiac death in teenagers can be scary stories to hear on the news. These young adults are typically healthy and have no indication of heart-related problems. In many cases, the athletes received standard sports physicals. Is this something parents with athletic children should be concerned about?

Dr. Ryan Jones, a cardiologist in the Heart Institute at Le Bonheur Children's, says not necessarily. Undergoing an echocardiogram (an ultrasound of the heart) prior to playing is not practical for every competitive athlete. The single most important risk factor is a family history of sudden cardiac death.

“Sudden cardiac death is noted more in athletes, but this is more from the fact that these stories make the news. Sudden cardiac death is also seen in drownings and single car accidents; however, it is harder to prove what the causes of these deaths are,” Jones said.

According to the American Academy of Pediatrics, athletes most at risk are African American males. These deaths are extremely rare: 1 in every 400,000 athletes.

With the increased presence of automated external defibrillators (AEDs) in schools and in public settings, more young athletes are surviving sudden cardiac death. AEDs are not recommended for use on children less than a 1 year old.

However, there are some signs that a young athlete’s heart might need to be checked out. Those signs include:
- Fainting or nearly fainting
- Chest pain while exercising
- Diagnosed heart murmur

Talk to your child’s pediatrician if you are concerned about your young athlete.

We’ve talked about the benefits of breastfeeding before, but haven’t discussed what mothers can do with their milk if they have extra supply. At Le Bonheur, we have the option of providing donor milk for infants if their own mother’s milk is unavailable, and we get that milk from a certified milk bank. So what can you do if you’d like to donate breastmilk? Read what Le Bonheur Lactation Consultant Ruth Munday, BSN, RN-BC, IBCLC, has to say about the topic.

Here at Le Bonheur, we are fortunate to have the option of providing donor human milk for hospitalized infants if their own mother’s milk is not available. Because there is no local bank, we use the Mother’s Milk Bank of North Texas in Fort Worth.  The Human Milk Banking Association of North America (HMBANA) milk banks are non-profit organizations that provide a safe way to offer donated breastmilk for infants.

To be a donor, a mother should be in good health and have a surplus of breastmilk available.  Donors go through a health-screening process before their donation is accepted.

Screening criteria includes:

• Blood test to rule out communicable diseases (The milk bank will usually cover the cost of the lab work.)
• No regular use of medications except for progestin-only birth control, thyroxin, insulin, prenatal vitamins, iron or calcium
• Free from smoking, illegal drug use and regular alcohol use
• Tested negative and not at risk for HIV, HTLV, Hepatitis B, Hepatitis C and Syphilis

Once approved, the milk bank will notify the mother and work out a plan for shipping the milk to the milk bank at no cost to the donor. Donated milk is pasteurized to kill bacteria or viruses.  It is then frozen for up to one year and is then available with a doctor’s prescription for hospital or home use.

Regulated milk banks are the safest way to ensure a baby gets what he or she needs without the fear of milk contamination or communicable disease. Check out the HMBANA website and the Mother’s Milk Bank of North Texas for more information.

Do not purchase human milk off of eBay or any other website that is not a regulated milk bank.  Mother-to-mother sharing of breastmilk that has not been screened and pasteurized is not recommended.  Even using milk from a trusted friend can be risky.  If you do choose to use one of the Internet milk-sharing sites or “borrow milk” from a another mother, ask if the donating mother would be willing to share a copy of her latest lab work from her doctor’s office and discuss this matter with your baby’s pediatrician before using unpasteurized human milk that is not your own.

Many times, parents report that their children and adolescents complain of a racing heart. Is this something parents should be concerned about and what does it mean? We asked Ryan Jones, MD and pediatric cardiologist at Le Bonheur Children’s Hospital. Here’s what he had to say. 

“Heart racing is completely normal during aerobic activities, like running or playing a sport. It’s even normal if your child has recently taken a stimulant medication such as a cough or cold over-the-counter medicine. Anxiety, stress and fear can also cause the heart to race.

Parents can also take their child’s pulse to determine the heart rate. To do so, place two fingers near the bony part of your child’s wrist and count the pulses per second. If you count 140 beats per minute – or fewer – that’s normal for a child or teen. If the heart rate is high, have him or her take slow, deep breaths, and see if that normalizes the heart rate.

Parents should consult their child’s pediatrician if the heart racing is occurring at a rest position or if it’s accompanied with symptoms like trouble breathing, chest pain or fainting. Even then it might not be heart related. These symptoms sometimes occur in children with asthma or those who are prone to a panic or anxiety disorder. But it’s best to have a pediatrician do an exam to be sure. He or she can perform an electrocardiography, or EKG, to determine if there’s a heart-related problem.”

Have you and your family made any resolutions for the New Year? It’s not too late. Le Bonheur Child Life Manager Jenny Shelton shares some helpful tips for helping your little ones set goals for 2012.

It is that time of the year again when we start thinking about the New Year and resolutions that we want to make in the coming year.  Now is a great time for parents to start to talk with their children about goals they want to make for the year ahead.

A good age to start this conversation is when your child is at least preschool age – around 3 to 5 years old. It’s a simple way to help challenge your child to gain independence in a task, like putting clothes in the hamper daily, or helping him or her learn to develop a healthy lifestyle, like eating fruits and vegetables as a snack after school. 

One way to start this conversation is to talk about this past year and look at pictures of things that you have done as a family and as individuals.  Reviewing the past helps children see how many things happen in a year and that growth and change happen when they are not even aware.  After reviewing the current year start your conversation about what things they would like to learn or do in the coming year.  Make this a brainstorming time with the sky being the limit.  After you have all the possibilities on paper, start narrowing down and making the goals more realistic and age appropriate. 

With school-aged children and teens, this is a perfect time to talk about a plan to reach their goal.  Sometimes it is easier to take a large goal and make it into several smaller goals, so there are successes long the way. Help them set goals they can accomplish both individually and as a family, like eating dinner together as a family at least four or five nights each week.

Remember resolutions/goals for everyone should be simple and realistic, so they can be accomplished.  Also, as parents remember to share your resolutions with your children; they can help you be more accountable.  Good luck with your resolutions and best wishes for 2012!