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|Wednesday, October 27, 2010
|When the Going Gets Tough
|by William Stratbucker, MD at 12:31 PM
Deborah Cloney, MD, is a pediatric gastroenterologist with Helen DeVos Children's Hospital. She is this week's guest blogger.
Constipation is one of those topics that parents generally don't choose to talk about. But it is such a common issue, that if they did talk more about it, particularly ways to avoid it, fewer children would have to suffer through it.
So, let's talk about kids and constipation. First, it helps to know that it is extremely common-as a pediatric gastroenterologist, at least once a day I treat a child who is dealing with constipation, and I've been doing so for the past 19 years. At Helen DeVos Children's Hospital, there are about 1,000 patient visits per year due to constipation.
Kids become constipated for many reasons. However, many times these reasons are related to behavior, based on their attempts to avoid large, painful bowel movements-if they've had one, they will likely try to avoid the next one.
As a parent, you often have an opportunity to help your child avoid constipation. In fact, a healthy diet and a calm, patient manner are often what help most in preventing constipation or preventing a more severe case of constipation from developing. Here are other ways you can help:
- Make sure your child is drinking lots of water and getting plenty of high fiber foods.
- Be aware of early warning signs. If your child complains of frequent stomachaches or has blood when he or she wipes, these may be signs that he or she is becoming constipated. If this is happening, you may also want to try a pediatric fiber supplement, but make sure your child drinks enough fluid with it, or else it won't work.
- Don't put pressure on a toddler who is potty training. They may hold back out of fear or anger. Also, don't allow your child to play video games or read books while they are on the toilet waiting for a bowel movement-it is important for a child to learn the signals their bodies send them, and concentrate on the task at hand. That said, I recommend spending no more than 5 minutes waiting on the toilet for a bowel movement. If it doesn't happen by then, let your child do another activity.
- Talk to your early school age child about using the bathroom at school. A child this age may be afraid or embarrassed to have a bowel movement away from home. Address their specific concerns, then talk to them about constipation and the importance of going when you have to go.
- Don't stop communicating with your older child about constipation. Older children can become used to constipation and no longer want to talk to you about it. However, they need to be reassured that you are there to help them and that communication is important. At the same time, they should be made aware that there are consequences to chronic constipation. For instance, over time, they can lose their ability to sense when they need a bowel movement and can accidentally leak fecal matter. Severe constipation can also cause urinary problems, as an impacted stool can press on the bladder.
If your child is already constipated, you may want to contact your pediatrician for advice-it's likely you will not even need to go in for a visit at first, but your doctor should be able to offer recommendations, such as a non-stimulant stool softener. If you follow your pediatrician's advice, and the constipation remains (or if it returns), you may want to schedule an office visit. If it continues, your pediatrician may refer you to a pediatric gastroenterologist.
One final note-in my practice, I often see children who have had chronic constipation, so they now leak fecal matter. Many parents think a child is doing this on purpose, but they are not. Their rectums have become full, and they really are not aware that it is happening. So if this has happened to your child at some point, please be gentle and patient with them. It isn't their fault.
Once, quite a few years ago, I treated a teen who was constipated. At the last visit, the mother and daughter told me that no longer having to deal with constipation literally changed their lives. I'll always remember this-even though it seems so simple, constipation is something that has a major impact on a person's life. Once it is treated, though, a child can focus on new things and rewarding activities.
- Dr. Cloney
|Monday, October 18, 2010
|Use Halloween as an Opportunity to Promote Year-Round Safety
|by William Stratbucker, MD at 10:23 AM
Jennifer Hoekstra is the Safe Kids Program Coordinator at Helen DeVos Children's Hospital and an injury prevention specialist. She is our guest blogger this week.
As an injury prevention specialist, one of the reasons why I like Halloween is I see it as a chance for parents to enjoy anticipating the holiday with their children, but also to use it as an opportunity to reinforce good safety habits that should be followed throughout the year.
To have a safe and enjoyable Halloween, first, I suggest you start brainstorming with your child in advance about his or her costume instead of trying to pull something together on Halloween Day-chances are greater that if you try to make a costume at the last minute, it won't be as safe.
Once you've decided on a character and are ready to make or buy a costume, keep the following safety guidelines in mind. Remember, most of these tips can also be used when choosing any type of clothing your child wears throughout the year.
- Make sure the costume is flame-resistant. If you're purchasing a costume-including masks, beards and wigs that go with them-check that they are labeled "flame resistant."
- Avoid costumes with big or long sleeves, flowing skirts or scarves. Many times people light jack-o-lanterns or have bonfires on Halloween, so having a close-fitting costume helps minimize the chance it will catch on fire.
- Check that your child's costume is short enough. This will help prevent your child from tripping and injuring him- or herself.
- Buy or make costumes that can be seen in the dark. If your costume is not reflective, add reflective tape that will glow when headlights shine on it.
- Make sure your child carries and uses a flashlight. Also, if you haven't used the flashlight in a while, test it before Halloween Eve.
- Wear good walking shoes. Walking in the dark is challenging and it is easy for children to trip and fall. Do not let your child wear high heels or other footwear that is not sturdy.
- Make sure your child can see. If your child is wearing a mask, make sure it is secured properly so it will not cover his or her eyes. Also, headwear should also be secured so it does not slip down over your child's eyes.
- Consider non-toxic face paints or cosmetics instead of a mask. Masks pose a safety risk because they can slip and restrict breathing or obscure vision. If a mask is used, make sure it has large eyeholes and fits securely.
- Check all costume accessories. Make sure all materials used are soft or flexible, including any type of weapon, such as a sword.
Now, here are a few important safety precautions to go over with your child before he or she goes trick or treating:
- Young children should stay with an adult.
- For older children, plan and review a trick or treating route that is acceptable for them to navigate alone. Agree on a specific time when they should return home.
- No running. Also, do not walk between parked cars, in the street or in other people's yards.
- When going to the door to trick or treat, watch for jack-o-lanterns, Halloween décor or any furniture that might present a danger.
- Do not to eat any candy or treats before an adult has carefully examined them at home.
- Only trick or treat at homes where you know the residents and make sure their outside lights are on, so you know trick-or-treating is welcome.
- Teach your children how to call 9-1-1 if they have an emergency or become lost.
Unfortunately, almost every year we see at least one Halloween related injury at Helen DeVos Children's Hospital. This year, let's follow these safety tips and enjoy the planning, preparations, and parties.
|Thursday, October 07, 2010
|A Safe Ride Every Time
|by William Stratbucker, MD at 11:25 AM
Jennifer Hoekstra is the Safe Kids Program Coordinator at Helen DeVos Children's Hospital. She is our guest blogger this week.
How often do you drive in a car with your child? If you're like most parents, each and every day you leave your home and go somewhere together. And if you're like most parents with young children, chances are your child's car seat is improperly installed-four out of five car seats are.
As the Safe Kids Program Coordinator for Helen DeVos Children's Hospital, one of the things I do is coordinate safety inspections at our four different car seat inspection stations. We carefully track data at these sites, and have found that locally, the misuse rate of car seats is 94.6 percent. Let's work together to change this statistic. The biggest errors we see in Kent County include:
1. Loose harness straps
2. Loose installation
3. The chest clip being placed too low
Do you think you might be part of the 94 percent? You have a chance to find out. Join me on Saturday, October 23 at Kohl's Rivertown in Grandville between 10 a.m. and 2 p.m. for a car seat check up event. The event is sponsored by the Kohl's Cares for Kids Program. Kohl's has supported Helen DeVos Children's Hospital and Safe Kids over the past 10 years and sponsors the local program, Birth to Booster: "Kohl's Kids Ride Safe at Every Stage".
Throughout the week, Kohl's Rivertown and Helen DeVos Children's Hospital will be offering:
"Ask the Expert"
Although the actual event is just one day, the week is dedicated to educating the community about child passenger safety. Our team of certified child passenger safety experts will be available just outside the mall entrance to Kohl's. Our schedule includes:
October 18 from 10 a.m. to 1 p.m
October 19 from 5 p.m. to 9 p.m.
October 20 from 10 a.m. to 1 p.m.
October 21 from 10 a.m. to 1 p.m. and from 5 p.m. to 9 p.m.
Booster seat voucher
Parents who visit us during the week and who have a child that fits the appropriate booster seat range (must be between 40 and 100 pounds and shorter than 4'9") can receive a voucher for a free booster seat. This voucher can be redeemed on Saturday at the event at Kohl's Rivertown. Your child must be with you on Saturday at the event to receive your free booster seat.
Monthly Car Safety Inspections Offered at Four Sites
If you aren't able to make it on Saturday, I hope you will take advantage of our car seat safety inspection sites-they are free and offered monthly at four convenient locations. When you come with your child and car seat, we will show you how to properly adjust the straps, secure your child and lock the car seat into your vehicle.
Choosing and Using Your Car Seat
In the meantime, I want to make sure your child is as safe as possible now. Therefore, here are some tips and suggestions.
When choosing a car seat:
Choose a seat based on how well it fits in your car and how easy it is to use. If a car seat is easier to use, you are more likely to use it correctly.
Look closely at the front adjustment. Can you tighten and loosen the harness straps from the front of the car seat? I prefer seats where you don't have to take the car seat out of the car to adjust the straps.
Look for multiple harness slots. This allows a wider variety of children to use the seat, and also can accommodate your child as he or she grows.
When using the car seat you have purchased:
Know that what the law says, and what we consider best practices (and encourage through our Safe Kids program) are not necessarily the same. Best practices are the practices that will give your child the best chance to be safe if he or she were ever involved in a crash. Consider the following:
The law says children can turn forward facing once they reach 1 year and 20 pounds. However, the best practice is to keep kids rear facing as long as possible - to the maximum limits of each car seat (usually 30-35 lbs.). Kids are five times safer rear facing than they are forward facing and rear-facing seats are 71 percent effective in reducing infant death.
The law says children under 4 must remain in the back seat. The best practice, however, is that children under 13 stay in the back seat. This is because the seat belt does not usually fit them properly and their body structures are not fully developed or equipped to take the impact of a frontal airbag if it deploys.
The law says kids can stop using a booster once they are 8 years old or 4'9" (57"). But the best practice is to use a booster seat until the child is 4'9" and the seat belt fits the child correctly. Note that children ages 4-8 riding in boosters are 45 percent less likely to sustain injury than those riding using just the vehicle seat belt.
Take that extra step and use your car seat as safely as possible.
- Jennifer Hoekstra