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Understanding Brain Development
last updated:
Thu, 3/29/2012 3:48 PM

The teenage brain is very different from the adult brain. In fact, our brains are only 80 percent developed by adolescence, says Dr. James Wheless, co-director of Le Bonheur Children's Neuroscience Institute. Our brains develop at different rates from birth to adulthood, and understanding typical brain development helps us comprehend why kids do and say the things they do. In connection with Brain Awareness Month, Wheless helped explain brain development.

First Few Years of Life
At birth the brain has 100 billion cells -- more than the number of stars in the Milky Way, says Wheless. By age 2, the brain has many connections as an adult brain, and by age 3, it has twice as many. The brain develops most rapidly between the ages of 2 and 3, so this is why it’s important for parents and caregivers to stimulate their child’s mind. Reading, singing and interacting with your child help strengthen these brain connections.

From ages 5 to 12-14 in girls (and two years later for boys) gray matter increases in the brain. Gray matter are the brain cells that do the work, or serve as the "hard drive." After age 14 (or 16 in boys), white matter in the brain increases. White matter forms the cabling or connections in the brain -- similar to wires in a computer -- so various parts of the brain can connect and communicate to each other). In the past, the brain was thought to have matured by age 10 or 12, but that’s not the case.

Teens have more neurons than their adult parents, which is why they can learn very complex material quickly. But the wiring or connections are not fully refined. This is why teens can make apparent poor decisions and differ in emotional response from adults. The prefrontal cortex, which has to do with judgment, organization and self-control, is the last part of the brain to develop.

Most importantly, as teens’ brains develop, they can be easily influenced. Getting adequate sleep and not overloading the brain allow it to make better connections during this critical time period in adolescence. Also, because final connections are being made, the brain is more susceptible to toxins (e.g., alcohol) than the adult brain. Teenage brains can take days to weeks to recover from the effects of alcohol, so drinking on the weekend can affect their test performance the next Thursday --  something that would not occur in an adult.

Low Muscle Tone
last updated:
Tue, 3/27/2012 4:36 PM

If your child is having trouble reaching certain developmental milestones, hypotonia may be to blame. A child is said to have low muscle tone — hypotonia — if muscles are on the loose, floppy side, says Danielle Keeton, MACCC-SLP, director of Le Bonheur Early Intervention and Development.  Children with low muscle tone often have delayed motor skills, muscle weakness and coordination problems. 

Hypotonia is often associated with diagnoses like Down syndrome, Hypothyroidism and other genetic or neurological impairments. This type of hypotonia is more easily identified. However, mild hypotonia, often noticeable to parents, may not be noticed by others.

The research is also mixed about the effectiveness of intervention for children with only mild hypotonia. Some pediatricians may prefer the “wait and see” strategy, while others may seek evaluations by professionals, like physical therapists.

As a parent, it’s always important to trust your instincts.  You know your baby better than anyone else and can have a “sixth sense” when something just doesn’t seem right. 

Early motor milestones to watch for include:

By 3 months

  • Lifting head and chest while lying on tummy
  • Wiggling and kicking arms and legs

By 6 months

  • Sitting with only a little support and holding head steady

By 12 months

  • Crawling on hands and knees
  • Pulling up to stand and moving around while holding on to furniture

By 18 months

  • Walking without any help
  • Running stiffly with eyes focusing on the ground

By 24 months

  • Bending over to pick up toys without falling over
  • Walking up steps without help

If your child’s floppy muscles are creating delays in early motor milestones, it may be beneficial to obtain an evaluation from a professional. An evaluation can provide you with a piece of mind; even if you discover during the process that there was nothing to worry about. You can discuss your preference for an evaluation with your pediatrician and can also contact the local early intervention system. Each state has an early intervention system for infants and toddlers that can assist you in finding a professional to evaluate your child’s condition. 

Recall: Push N' Snap Cabinet Locks
last updated:
Mon, 3/26/2012 3:54 PM

More than 900,000 Safety 1st Push N’ Snap cabinet locks have been voluntarily recalled by the manufacturer, according to the Consumer Product Safety Commission.

The recall was made following 200 reports of locks that failed to secure the cabinet. In three cases, children handled or swallowed household cleaning products after being able to open the locks.

Model numbers 48391 and 48442, manufactured between January 2004 and November 2010, are included in the recall.

How to Respond to Wasp or Bee Stings
last updated:
Thu, 3/22/2012 2:49 PM

Not only is spring in the air, but so are wasps and bees. With the weather just right for outside play, it's a great time to know what to watch for and what to do if your child is stung. We asked Dr. Christie Michael, an allergist/immunologist with Le Bonheur and The University of Tennessee about insect stings and possible allergic reactions. We’ve provided the answers below.

How do I know if my child is allergic to insects like wasps or bees?
“There is no way to know if your child is allergic prior to being stung. However there are tell-tale sings that will immediately let you know that your child is having a reaction. If any of these symptoms occur, immediately call 9-1-1.”

What’s the first sign I should look for?
“The first red flag is a large local bump accompanied by a rash that occurs within seconds or minutes of the sting. The rash tends to spread from the sting or large bump and cover the entire body. That is your first indicator to call paramedics, and I emphasize; do not waste any time in doing so. These signs suggest your child might have anaphylaxis, a life-threatening allergy to environmental factors, including insect venom (bees, wasps). Other symptoms that could follow quickly are hives and wheezing.”

Should I administer Benadryl before I call 9-1-1 if my child presents the warning symptoms?
“No. Never delay calling paramedics. This is the No. 1 reason people with anaphylaxis can die. Anaphylaxis is like a snowball; it comes on quickly and becomes rapidly worse in very little time. If the warning markers begin, call 9-1-1.”

If my child is stung and doesn’t experience any problems, what is the best path of treatment?
“Check out the affected area to make sure that the stinger is out. If it’s left in, it could lead to an infection. If the bump looks normal, (with the exception of some red, puffiness) just use general practice for wound care. Wash the area, apply liquid Benadryl (Dipehydramine) and a local antiseptic if needed.”

Smoke Alarms
last updated:
Mon, 3/19/2012 3:05 PM

We mentioned recently that Daylight Savings Time is a good time to check your home’s smoke alarms and carbon monoxide detectors. Having a working smoke alarm reduces a person’s risk of dying in a fire by half.

Safe Kids Mid-South provides more information about smoke alarms below.

Where should I place smoke alarms?
Alarms should be located on each level of your home, especially outside all bedrooms or sleeping areas.
A closed door provides protection from smoke outside the room, but will also prevent smoke from reaching (and therefore sounding) a smoke alarm. This is particularly a problem in bedrooms. If you sleep with your bedroom door closed, you should add a smoke alarm in the bedroom; particularly if there is a TV, air conditioner or other major appliance in the bedroom that might start a fire.  If you sleep with the bedroom door open, the alarm in the hall outside will detect a fire in the bedroom or elsewhere.

There are a few places where a smoke alarm should not be placed.  These include kitchens and garages (cooking fumes and car exhaust are likely to set them off) and unheated attics and crawl spaces (where it can get too cold or hot for the electronics to work properly). 

What kind of smoke alarm should I get?
There are two types of home smoke alarms available: the ion type and the photoelectric type. The ion type reacts faster to open flaming fires and is usually the least expensive. The photoelectric type reacts faster to smoldering fires and is less likely to react to cooking.  Both types provide good protection and can be used without worry.  If you need more than one alarm, you might get one of each.  There are also multiple ways to power smoke alarms.  Most operate by a battery (usually 9 volt), which should be replaced at least once a year.  When the battery needs changing, the smoke alarm will begin to "chirp" every 20 seconds or so, and this will persist for a month.  This is most likely to start in the middle of the night (when the temperature in the house drops) causing you to get up and remove the battery so you can sleep.  To prevent this nuisance, you should pick a certain time each year to replace your alarms’ batteries.   Always make sure that you use the right battery. The required battery type is marked on the alarm near where the battery goes.

Smoke alarms installed in a house may operate from the household electrical power and not need battery replacement.  This type of alarm has a "power on" light to tell you that the alarm has power.  Smoke alarms that run on house power but also have backup battery protection are available.  Both types of alarms need to be tested monthly, and batteries should be replaced yearly just as with the battery-operated type.

Kids and Spring Allergies
last updated:
Thu, 3/15/2012 3:10 PM

Spring has sprung a little early this year, and along with spring comes seasonal allergies. Le Bonheur allergist Dr. Christie Michael offers our readers some helpful tips for dealing with allergies. Many children suffer from seasonal allergy symptoms especially in the spring when pollen counts can be exceptionally high.  Here, Dr. Michael has addressed some commonly asked questions regarding allergies.

How do you know symptoms are from allergies?
Sometimes it is hard to know without seeing a specialist and undergoing some allergy testing.  However, there are circumstances that increase the risk of allergic disease.  If your child gets symptoms of itching, sneezing, nose dripping/draining the same time every year or, for example, every time they are around a cat, allergies may be implicated.  Usually the common cold will last about a week, so another sign is congestion that lasts longer than a week.  A family history of allergies, a personal history of eczema or a food allergy also increases the risk. Eye itching and swelling are more common in allergies as well.

How can you get relief?
If you know your child's triggers for symptoms, avoiding them when possible and practical is ideal.  If your child has been outside, showering and changing as soon as you come in will help. Also, rinsing your child's nose or sinuses with a saltwater rinse (available at drug stores without prescription) can help. As far as medication, many children with allergies can get relief with over-the-counter antihistamines. These medicines are safe, effective and the dosage is by age so they are easy for parents to use. Diphenhydramine (Benadryl) is an older medication that can cause some sedation but is very effective.  The newer antihistamines - like loratadine (Claritin) and cetirizine (Zyrtec) - are also very good and less likely to make you sleepy. 

If your child has a lot of congestion, your pediatrican can prescribe a nose spray.  Over-the-counter nose sprays should be used for only a few days at a time as they can be addicting and cause worse “rebound” congestion.  Ask your pediatrician which ones are safe to use and for how long.  For eye symptoms, your child's doctor can prescribe eye drops to be used once or twice daily.  If there are only a few days out of the year that your child suffers from eye symptoms, the over-the-counter allergy eye drops are fine (usually have a capital A at the end of the name).  Artificial tears can provide relief from irritation, especially if refrigerated, and are a great alternative to rubbing.  Again, if you are not sure, ask your pediatrician or pharmacist.

When should you see a specialist?
If the usual measures above do not adequately relieve your child's symptoms, then you should see an allergy/immunology specialist for further evaluation.  Also, if your child suffers from asthma you should consider a specialist evaluation as allergies can trigger asthma attacks and lead to more frequent asthma symptoms, both interfering with daily life and putting you at risk for a severe attack requiring hospitalization. Your allergy doctor may recommend a course of "allergy shots" to desensitize you to the things that trigger your allergy symptoms.

What are the signs and symptoms of asthma?
Family history of asthma and personal history of allergies again increase the risk of asthma.  The cough and wheeze are “cousins,” so any bad spells, especially with exertion or during the night, may be a sign of asthma. Chest discomfort or atypical shortness of breath (occurring with little or no exertion or causing a child to seek rest long before peers) should always be discussed with your child's pediatrician.

MyPlate: Celebrate Nutrition Month
last updated:
Wed, 3/14/2012 2:06 PM

March is National Nutrition Month, and this year’s theme is “Get Your Plate in Shape.” 

“Before you eat, think about what goes on your plate or in your bowl,” said Katelyn Wolfe, MS, RD, LDN, clinical dietitian at Le Bonheur Children’s. Using the new MyPlate concept can help you to get your family’s plates in shape.  Katelyn has helped explain the MyPlate concept for parents.

To start, it helps to understand the MyPlate layout.  You can see that half of the plate is filled by vegetables and fruits.  This helps us to fill up on foods that provide a variety of nutrients without a ton of calories.  The other half of the plate is divided between grains and protein-rich foods.

Here are some smart strategies to strengthen your plate:

Make half of your plate fruits and vegetables.  Your best bet will be to choose a variety of colors – much like a rainbow.  Encourage your kids to eat bright colors, too.

Make at least half your grains the whole grain version.  Look on the food label for 100 % whole grains or at least make sure that the first ingredient on the list says “whole grain.”

Switch to fat free or 1% milk.  These types of milk have the same amount of calcium and vitamin D as other types of milk but are lower in fat and calories.

Vary your protein choices.  Get out of the chicken and beef rut!  Mix things up by serving fish, beans, eggs or nuts for protein punches.

Recall: Gerber Infant Formula
last updated:
Mon, 3/12/2012 1:31 PM

Gerber Products Co. recently recalled a batch of its Good Start Gentle powdered infant formula because of an odd odor, according to the U.S. Food and Drug Administration (FDA).

The batch of formula – from a 23.2-ounce plastic package from lot GXP1684 – poses no health risks, Gerber said. Consumers have complained of an off-odor from the formula, which has an expiration date of March 5, 2013. A few consumers have also reported cases of spit-up or other gastrointestinal issues from the formula.

For more information and to find out how you can get a replacement, visit the FDA’s recall section of its website.

Spring Forward, Check Smoke Alarms
last updated:
Fri, 3/09/2012 2:21 PM

This Sunday, March 11, don’t forget to “spring forward” and change your clocks.

It’s also a good time to check your smoke alarms and changes the batteries if you haven’t done so recently.  According to Safe Kids USA, having a working smoke alarm reduces a person's chance of dying in a fire by half?

Safe Kids says that for the best protection, install smoke alarms on every level of your home, outside every sleeping area and in every bedroom. Smoke alarms should be mounted high on walls or ceilings and tested monthly. And a reminder: smoke alarms last a maximum of eight to 10 years.  After that time, the entire unit should be replaced. If the unit does not respond properly when tested, it should be replaced immediately.

Is That a Wart?
last updated:
Thu, 3/08/2012 3:27 PM

Finding a wart on your child might be an unsettling moment for any parent. But according to Dr. Kip Frizzell, Le Bonheur’s director of Coordination of Care and a local pediatrician, warts are quite normal.

“Warts are caused by viruses from the human papillomavirus (HPV) family and are most commonly found on the upper extremities of the body. They are usually diagnosed by their appearance. There are many methods of treatments parents can pursue that range from a visit to the pediatrician to over-the-counter (OTC) medicine. Salicylic acid is one of the most common ingredients in OTCs, so parents should be mindful of that,” said Frizzell.

According to the American Academy of Pediatrics, skin warts are dome shaped with a rough appearance. Most often they are found on the hands, toes, face and around the knees. They can also occur on the soles of the feet where they are often painful. These are known as plantar warts, and your child may describe these as feeling like walking on a pebble.

“Treatment methods vary. There is no harm in trying the over-the-counter remedies first, which I’ve found to be successful. But if you’re child complains of pain from the wart it’s best to visit your pediatrician,” said Frizzell.  

Some of the methods of treatment parents might want to research include:

  • A doctor’s recommendation to remove the wart by cauterizing or freezing;
  • Over-the-counter treatments that contain salicylic acid;
  • Antacids such as Zantac, administered orally;
  • Duct tape – this is a process that involves placing duct tape on the wart for several days then removing the tape to scrape the tissue with an emery board. The parent is advised to repeat the process until the wart is gone.
How To: Helping Kids Who Stutter
last updated:
Tue, 3/06/2012 1:28 PM

Many children stutter, and often times stuttering will go away on its own. But when should you seek help for your child who has trouble communicating clearly? Le Bonheur Speech Therapist Cara Mohundro, SLP, has helped us answer the questions below. She and her team of specialists at Le Bonheur refer to the Stuttering Foundation of America’s guidelines and tips for parents.

What is stuttering?
It’s a communication disorder in which the flow of speech is broken by repetitions, prolongations or abnormal stoppages.

What causes stuttering?
A variety of factors can cause stuttering. In some cases it’s genetic. In fact, almost 60 percent of kids who stutter also have a family member who has stuttered. Some children with developmental delays or other speech problems will stutter. It can also be a result of the child’s neurophysiology, and some studies show that people who stutter process speech and languages different than those who don’t stutter.  Family dynamics (fast-paced lifestyle, high expectations) can also affect a child’s speech.

Is stuttering normal? When should I seek a therapists help?
It’s not uncommon for children’s ages 2 to 3 to go through a stage of stuttering, said Cara Mohundro. This is typically a time when children's vocabularies are rapidly increasing, and sometimes they begin to stutter as they think of things to say more quickly than they are able to talk.  I recommend speech evaluation if the stuttering continues more than three to six months.

According to the Stuttering Foundation of America, parents can first try the following to help their child:

  • Speak with your child in an unhurried way, pausing frequently.
  • Reduce the number of questions you ask your child.
  • Use your facial expressions and other body language to convey to your child that you are listening to the content of her message and not how she’s talking.
  • Set aside a few minutes at a regular time each day when you can give your child undivided attention.
  • Help all members of the family learn to take turns listening and talking.
  • Above all, convey that you accept your child as he is.


Swim Lessons: Right Age to Start?
last updated:
Thu, 3/01/2012 1:45 PM
Starting to think about enrolling your child in swim lessons for the summer? Swim lessons – whether they’re through a school, church or independent program – are valuable and help keep children safe in and around water. 

The American Academy of Pediatrics (AAP) used to recommend that children begin swim lessons at the age of 4 – the age at which they’re considered to be developmentally ready to learn to swim. But now more children are starting lessons as young as 1 to 2 years old, and that’s OK says the AAP.

“While the AAP still recommends that all children who are 4 years old and older begin to take swimming lessons, pediatricians are no longer against swimming lessons for younger toddlers and preschoolers between the ages of 1 to 4 years old,” Susan Helms, director of Injury Prevention and Safe Kids Mid-South, said.

Safe Kids reminds parents swim lessons don’t make kids “drown proof.” Parents should still keep a constant watch over little ones when they’re in and around water. Swim lessons do not necessarily reduce the child’s risk of drowning.

Le Bonheur and Safe Kids helped launch Make a Splash Mid-South, a community-wide, volunteer initiative created to give more children the opportunity to learn to swim. Make a Splash has partnered with area aquatic centers to offer free and low cost swim lessons to at-risk children ages 6 to 12 years old.

For information about water safety, check out our post that explains what parents can and should do to keep their kids safe near water.


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