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U N I V E R S I T Y H O S P I TA L S O F C L E V E L A N D • R A I N B O W B A B I E S & C H I L D R E N ’ S H O S P I TA ...
Under the R AINBOW                        w w w. r a i n b o w b a b i e s . o r g

    How Does the                   ...
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Head Games

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    Hold the Latte?
    Is there ...
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“Stand Up Straight!”
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    Why Now?
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University Hospitals of Cleveland                                                                                         ...
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Rainbow Kids Fall 2006

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  1. 1. U N I V E R S I T Y H O S P I TA L S O F C L E V E L A N D • R A I N B O W B A B I E S & C H I L D R E N ’ S H O S P I TA L T H E L AT E S T IN C H I LDRE N ’ S H E A LTH N E WS • SUM M ER 2006 as a manageable chronic condition similar to asthma or diabetes.” Uncon- inside this issue: trolled epilepsy, however, and the need for multiple medications, can negatively Is Blood Conservation the impact a child’s educational and social Right Choice for Your Child? development. page 2 SHENANDOAH Epilepsy also may worsen with time ROBINSON, MD, and become life-threatening. It has been Prevention Is the Best Neurosurgeon, documented that some children with Medicine for Concussions Rainbow Babies & poorly controlled epilepsy lose several page 3 Children’s Hospital IQ (Intelligence Quotient) points every few years. New Treatments On a positive note, Dr. Robinson says, Straighten Out Scoliosis about 75 percent of kids achieve excel- page 5 lent seizure control with medications. But for that remaining 25 percent, finding a Ask the Doctor solution should be pursued aggressively page 7 When Is Surgery an because earlier seizure control optimizes a child’s development. SEARCH HEALTH INFO Option for Epilepsy? Surgery for intractable seizures offers children the opportunity to have a sig- ONLINE nificant reduction in seizure frequency For easy access to Rainbow physicians C hildhood epilepsy is a complex intractable, explains Rainbow Neuro- or even cure them. Surgery also can and in-depth health information for condition to manage. Some surgeon Shenandoah Robinson, MD. decrease or eliminate the need for medi- you and your child — including a new seizure disorders persist for “Parents of a child who has had seizures cation. With better seizure control, symptom checker — visit us online: unknown reasons, which can be both for more than two years that are not well children typically experience vast frightening and hard for parents to controlled by medicines should ask their improvements in their ability to learn understand. pediatrician to see a neurologist who and interact with others. Seizures that don’t respond to treat- specializes in epilepsy,” she says. At Rainbow, a dedicated pediatric ment by multiple medications are called Unfortunately, she says, many par- epilepsy team cares for children under- ents are still under the impression that going surgery for seizures in a family- their child will “outgrow” the seizures. centered environment, as part of the Seizures may resolve spontaneously, University Hospitals Comprehensive ask rainbow ... but they sometimes don’t. Epilepsy Center. Each child undergoes Children should be evaluated for an individualized presurgical evaluation Rainbow’s experts are here to epilepsy surgery if their seizures aren’t using the latest advances in clinical answer your health care questions! You can contact us by phone at under control after trying two to three management and technology. 216-844-RAINBOW anticonvulsant medications, Dr. Robinson “Our comprehensive approach strives or e-mail us at advises. to obtain better seizure control, improve, or visit “Seizures aren’t just an inconvenience,” the child’s quality of life, and optimize she says. “Some parents think of epilepsy the child’s future,” Dr. Robinson says. ■ CELEBRATING 140 YEARS of Caring for Cleveland.
  2. 2. Under the R AINBOW w w w. r a i n b o w b a b i e s . o r g How Does the ANTHONY VILLELLA, MD, Blood Conservation Medical Director, Program Work? Comprehensive Blood Conservation All new hospital patients are asked Program, Rainbow Babies & Children’s whether they would like to participate Hospital in the blood conservation program and those registered are automatically identified at any future point of entry into the system. Patients also may be registered in advance via phone. Your Child’s Own Blood Is Always the Right Type WHAT PARENTS SHOULD KNOW ABOUT BLOOD CONSERVATION OPTIONS A nurse will visit with your child to make sure the resources are in place Y to conserve blood. Once we identify ou know that blood is vital, but it never seems more “When any of these is low, it can have serious effects on which conservation method is best, so than when your child may need blood due to an the child’s heart, lungs, kidneys and brain,” he says. “Condi- we coordinate your child’s care with upcoming surgery, ongoing condition or medication. tions such as anemia can weaken a child’s overall health the entire team, including your At Rainbow Babies & Children’s Hospital, our Comprehen- and recovery.” pediatrician. sive Blood Conservation Program offers parents — through Treatment options offered by Rainbow’s Comprehensive If your child is already at the hospi- techniques that focus on minimizing blood loss, building up Blood Conservation Program include medications to stimulate tal, treatments for blood conservation your child’s own blood supply, or both — the safest alternative blood cell production, techniques to recycle blood during will take place in your child’s room. to blood transfusions. surgery and preparation for potential blood loss or blood Outpatient and consultation treat- “There are various reasons why families may desire to production experience. ments will occur by appointment on avoid the use of donated blood products,” explains Medical “No matter what the need, you can choose from among the the main campus of the hospital. Director Anthony Villella, MD. “This program is just one of alternate treatment options,” says Dr. Villella. “Your pediatri- Rainbow’s many innovative programs that blends in individ- cian can help you weigh the benefits and risks of each.” ual values and beliefs. We hold in high Rainbow’s blood conservation esteem the right of every family to TO LEARN MORE program was the first established at a receive quality health care that respects If you would like more informa- freestanding children’s hospital back their personal choices — whether for tion or want to enroll your child in 1998. Today, it serves more than religious or health reasons.” in Rainbow’s blood conservation 150 outpatients and 20 inpatients each When a child needs a blood transfu- program, please call: month, says Program Manager Amelia sion, Dr. Villella explains, it falls under 216-844-3492. Baffa. “This includes preparing chil- one of three categories: dren for a blood loss experience, like ■ Red blood cells, which transport oxygen surgery, and supporting those who are either anemic or are ■ Platelets, which stop bleeding undergoing therapy that affects the body’s ability to make red ■ Plasma, which supports circulating blood volume blood cells, such as chemotherapy and radiation therapy.” ■ 2
  3. 3. Find a physician online: Head Games MANY CONCUSSIONS ARE SPORTS-RELATED I t’s better to miss a game than a whole season. That’s the message from the U.S. Centers for Disease Control and Prevention (CDC) about concussions. A concussion is a broad term and can apply to a range of injuries, but Alan R. ALAN R. COHEN, MD, Chief of Pediat- Cohen, MD, Chief of Pediatric Neuro- ric Neurosurgery and surgery and Surgeon-in-Chief at Rainbow Surgeon-in-Chief at Babies & Children’s Hospital, says it’s a Rainbow Babies & a GREAT OFFER! Rainbow is brain injury associated with an immediate Children’s Hospital offering free copies of the booklet Facts and temporary loss of normal brain func- About Concussions and Brain Injury. Call tion. He says another name for concussion 216-844-RAINBOW for your free copy today. is a mild traumatic brain injury. The brain injury can range from mild to severe. Dr. Cohen says, the brain actually may Most concussions, Dr. Cohen says, The good news is the brain can repair According to the American Academy move around inside the skull, opening are caused by car accidents or are sports- itself. A concussion shakes up the signal- of Pediatrics, 20 percent of the 1.5 mil- it up for an array of injuries, including related. Using seat belts in cars and wear- ing pathways of the brain, so it may take lion head injuries that occur in the United bruising and blood clots. ing the proper equipment while playing a period of days or weeks for everything States each year are sports-related. An A CAT scan typically looks normal, sports, including helmets, can help avoid to return to normal. A child who suffers even more sobering statistic is that 20 per- but those who suffer a concussion can a concussion. But even more problematic a significant loss of consciousness, con- cent of high school football players and feel the consequences for days, weeks or than a concussion is the so-called second fusion or severe headache, should be 40 percent of college football players even months. Symptoms can include a impact syndrome — an injury caused by checked out by a doctor immediately. will suffer a head injury at some point loss of consciousness, headache, dizziness, sustaining a second concussion. Symptoms that should raise red flags in their career. Those who have a head nausea, vomiting, balance problems, con- While there are a variety of scales to are persistent headache, nausea, vomit- injury are at two to four times greater fusion, memory loss, tinnitus or amnesia. measure when a child can return to full ing or the sudden onset of weakness, risk of having another. “The hallmark of concussion is a sud- activity after a concussion, the general seizure or abnormal pupil size. The brain is jelly-like and sits inside den and temporary impairment of brain rule of thumb is if the symptoms are mild “Most children make a good recovery the skull — the protective armor. It is function,” Dr. Cohen says. “Concussion and transient, it’s usually safe to return to and return to normal function. Some surrounded by clear, cerebrospinal fluid represents a diffuse injury to the brain. a game. If symptoms are severe and per- have persistent symptoms of headaches allowing the brain to float inside the The optimal treatment is to prevent the sistent, the child should be removed from and dizziness; these symptoms tend to skull. When someone is hit in the head, injury in the first place.” the game. resolve over time,” Dr. Cohen says. ■ Concussions: Expert Advice blurred vision or unequal The U.S. Centers for Disease pupil size Control and Prevention lists What to watch for after a Signs that immediate medical The American Academy of the following symptoms for head injury: attention is needed: Pediatrics divides concussions concussion: Normal signs in the first two 1. Marked change in personality, into three categories: ■ Nausea (feeling that days include: often with confusion and 1. Mild – confused but not you might vomit) 1. Fatigue and desire for extra irritability knocked out. May return to ■ Balance problems or sleep (but can be easily 2. Worsening headache, espe- play after 20 minutes if dizziness awakened) cially if accompanied by symptoms completely clear. ■ Double or fuzzy vision 2. Fairly mild headache that nausea or vomiting 2. Moderate – confused, with ■ Sensitivity to light or noise does not worsen 3. Numbness, tingling or weak- memory loss. May play after ■ Headache 3. Occasional nausea and ness in the arms or legs; one week if all symptoms ■ Feeling sluggish vomiting changes in breathing pat- clear completely. ■ Feeling foggy or groggy 4. Problems with thinking, con- tern; or seizure 3. Severe – knocked out. May ■ Concentration or memory centration and attention span 4. Eye and vision changes, play after one month if all problems (may persist for a year or more) including double vision, symptoms completely clear. ■ Confusion 3
  4. 4. Under the R AINBOW w w w. r a i n b o w b a b i e s . o r g Hold the Latte? Is there any harm in kids jumping on the Starbucks® wagon? A cup of coffee is a morning jump-start for many adults. But with the rise in spe- cialty drinks like iced caramel macchiatos, more kids are heading to their local Star- bucks® for their daily jolt. As a parent, should you be concerned? Rainbow dietician Adria Myeroff, RD, LD, says there is no compelling evidence that coffee stunts kids’ growth. Still, there are reasons to moderate how many cups of joe your child is consuming. a GREAT OFFER! Rainbow is offer- “Caffeine is a stimulant that affects the ing free copies of the booklet Living With central nervous system,” Myeroff explains. Irritable Bowel Syndrome. Call 216-844- “At lower levels, about two to three cups RAINBOW for your free copy today. per day, caffeine can increase alertness and boost feelings of energy. But too much caffeine can cause the jitters, upset stomach, headaches, difficulty concentrat- Is It Irritable Bowel Syndrome? ing, interrupt sleep, and increase both CHANGING HABITS CAN RELIEVE SYMPTOMS OF THIS DISORDER heart rate and blood pressure.” Another concern about kids jumping on I rritable bowel syndrome (IBS) is a confusing, yet com- While there isn’t a cure for IBS, the coffee bandwagon, Myeroff says, isn’t mon, gastrointestinal disorder that often is misdiagnosed. Dr. Splawski says that changes in diet related to the caffeine some of these gour- It can cause abdominal pain, bloating, gas, diarrhea and can help greatly. met drinks contain — but the calories. constipation — and affects both girls and boys equally. “IBS symptoms often occur right It’s also important to note, says Rainbow “IBS is not a disease — it is a syndrome, or rather a group after or even during meals,” she says. endocrinologist Sumana Sundararajan, MD, of symptoms that occurs together,” explains Judy B. Splawski, “Avoiding some of the common cul- that coffee drinks are not the only source MD, Interim Chief of the Division of Pediatric Gastro- prits, such as fatty or spicy foods and of caffeine or empty calories in many kids’ JUDY B. enterology at Rainbow Babies & Children’s Hospital. “So while caffeine, may help. Triggers vary from SPLAWSKI, MD, diets. “Soda, energy drinks and iced tea IBS can be uncomfortable, painful or embarrassing, it doesn’t patient to patient, so others will find Interim Chief of the also need to be factored into the equa- damage the intestines like some other digestive conditions.” relief avoiding other items like dairy Division of Pediatric tion,” she says. Gastroenterology at In people with IBS, the muscles in the colon that contract or foods that contain gluten.” Eating Clearly, the best choices for your child Rainbow Babies & regularly to move waste through the body don’t work smaller meals, adding more fiber to the are water, milk and 100 percent fruit Children’s Hospital smoothly. They are sensitive to triggers, such as particular diet and drinking more water also are juice. But, she notes, if your child insists foods or stress, which cause a flare-up of symptoms. recommended. on drinking coffee drinks, requesting a There isn’t a specific test to diagnose IBS, so a physician Stress also can play a role in IBS. “While stress doesn’t decaf, skim milk and forgoing the whip will usually make a diagnosis of IBS based upon a medical cause IBS, it can exacerbate flare-ups,” Dr. Splawski says. cream are smart options. history and physical exam, Dr. Splawski says. Generally, the “You may want to help your child or teen re-examine their diagnosis is based upon having abdominal lifestyle and see if learning some stress man- pain or discomfort plus any two of the SYMPTOMS agement techniques would be useful.” following: In more severe cases, laxatives and anti- ■ The pain is relieved by having a bowel Common symptoms diarrhea medications are sometimes used. But of IBS include: movement. it’s best to work together with a physician to ■ Gas ■ The onset of pain is associated with a discuss what treatment is right for your child. ■ Pain change in the frequency of stools. ■ Bloating “Helping your child focus on keeping their ■ The onset of pain is associated with a ■ Constipation symptoms under control is key,” Dr. Splawski change in stool consistency. ■ Diarrhea says. “By learning as much as possible These symptoms also must be present for ■ Nausea about their individual triggers, they can ■ Vomiting at least 12 weeks out of the previous year for reduce flare-ups and maintain an active, ■ Mucus in the stool IBS to be likely. healthy life.” ■ 4
  5. 5. Find a physician online: “Stand Up Straight!” SURGICAL AND NONSURGICAL TREATMENTS HELP STRAIGHTEN SCOLIOSIS F or most of us, hearing the a growing child with a spinal curvature charge from our mothers made between 25 and 40 degrees. Plastic braces us throw our shoulders back and are worn at night for two to three years stick our chests out. But for 4 percent of to prevent curves from worsening. If a us, an unnatural curve in our spines can curve is more than 45 degrees, surgery make it difficult to stand up straight. may be recommended. Scoliosis is a sideways curvature of A major problem is a severe defor- GEORGE H. the spine that makes it look more like mity in a very young child. Braces are THOMPSON, MD, an “S” or “C.” It can cause the bones not very helpful, but a body cast can Director of the of the spine to turn so that one shoulder frequently control the curve for several Division of Pediatric Orthopaedics, or hip looks higher than the other. The years. When the child is older, growing Rainbow Babies & spinal deformity can run in families, but rods can be very useful. Dr. Thompson Children’s Hospital in most cases the cause is unknown. The has inserted two stainless steel rods in curve can appear at any age, but is most children younger than 2, but the average commonly seen after age 10 or in early age is 5 or 6. adolescence. The incidence of scoliosis is about Scoliosis can cause the bones the same for boys and girls, but girls are five times more likely to require treat- of the spine to turn so that ment. That being said, only about 7 per- one shoulder or hip looks cent of children with scoliosis require treatment, according to George H. higher than the other. Thompson, MD, Director of the Division of Pediatric Orthopaedics at “What it really means is you have a Rainbow Babies & Children’s Hospital. long rod that attaches to the top and The vast majority of children with bottom of the spine,” Dr. Thompson scoliosis, he says, are monitored by explains. “Every six months you go in X-rays and regular trips to the doctor. and loosen the hooks or screws and Bracing can be moderately effective for lengthen the rods again.” in correction, Dr. Thompson says. The READ ABOUT ONE GIRL’S Last fall, Rainbow researchers found spine, in the area of the rods, is fused TREATMENT AND RECOVERY FROM SCOLIOSIS. Log on to the most effective surgical treatment for and the correction is permanent. SIGNS OF SCOLIOSIS young children with severe scoliosis is the While the dual growing rods are a to read “Scoliosis: Samantha’s Story.” Scoliosis can go unnoticed in insertion of two growing rods. Tradition- superior treatment to the single rods for children because it rarely is pain- ally, orthopaedic surgeons inserted only children with severe spinal deformities, ful. Parents should watch for the one rod, but the dual growing rods allowed Dr. Thompson says a great deal of work following “tip-offs” to scoliosis better correction and improved growth remains to be done in the field. Two beginning around 8 years of age: of the spine with fewer complications. areas his department continues to exam- ■ Uneven shoulders Dr. Thompson launched the growing ine are autofusion — when the spine ■ Prominent shoulder blade or shoulder blades rods program at Rainbow about 10 years spontaneously fuses — and crankshaft ■ Uneven waist ago. The procedure enables young — where the front of the spine contin- ■ Elevated hips patients with severe spinal deformities to ues to rotate and twist as it grows, even ■ Leaning to one side develop more normally and reduces the with the implantation of growing rods. Any one of these signs warrants adverse affects of their spinal deformities “Although we can control the defor- an examination by the family phy- on lung development and breathing. mity to a certain degree, patients still sician, pediatrician or orthopaedist. Once a child reaches a suitable age or end up with a moderate deformity,” he School screenings for scoliosis also size — usually after age 10 for girls and says, adding that Rainbow doctors are can alert parents to the warning 12 for boys — the pediatric growing constantly looking at ways to improve signs in their child. (American Academy of Orthopaedic Surgeons) rods are removed and adult-sized rods treatment outcomes for its youngest are inserted, offering another big boost spinal patients. ■ 5
  6. 6. Under the R AINBOW w w w. r a i n b o w b a b i e s . o r g Why Now? Trying Times You and your partner’s lives have no WHY AM I HAVING TROUBLE GETTING PREGNANT doubt drastically changed since your first THE SECOND (OR THIRD, OR FOURTH) TIME AROUND? pregnancy, and may include some health factors that cause secondary infertility: W hen your beautiful daughter turned Age. As women reach their late 30s and 3 years old, you decided it was time early 40s, fertility declines due to egg for another addition to the family. quantity and quality. But this time, things aren’t going as planned. Why can’t you get pregnant again? Ovulation problems. Some women don’t “Secondary infertility is the term FRANCISCO develop and release an egg monthly. used when a couple who already have ARREDONDO, Reasons include stress, recent illness MD, Reproductive a child can’t get pregnant or carry a and polycystic ovarian syndrome — a Endocrinologist, pregnancy to term again,” explains condition in which women develop small University Hospitals University Hospitals MacDonald MacDonald cysts on their ovaries. Women’s Hospital OB/GYN Susan Women’s Hospital Endometriosis. This condition, in which Lasch, M.D. “It’s actually quite the tissue that lines the uterus is found common — affecting about 20 percent of all couples.” elsewhere in the abdomen, can cause infertility. “Secondary infertility is the term used when Fibroids. These usually noncancerous a couple who already have a child can’t get tumors in the wall of the uterus can pregnant or carry a pregnancy to term again. longer than a year, or six months if the woman is over 35 cause infertility, depending on their size years old, they should be referred to an infertility specialist. It’s actually quite common — affecting about and location. Dr. Weil says initial evaluations typically include a semen 20 percent of all couples.” analysis, a blood test to evaluate ovarian function and an Fallopian tube damage. Complications examination of the fallopian tubes — all of which are typically during a first pregnancy or a recent pel- Its prevalence, however, doesn’t mean that it’s any less pain- covered by insurance. vic infection can cause damage or block ful or easier to accept. Couples facing secondary infertility face “Another important aspect is a thorough patient history to the fallopian tubes. the same feelings of confusion, frustration, grief and depres- determine if anything has changed since the first pregnancy,” sion as couples that have primary infertility. she adds. Uterine adhesions. Bands of scar tissue “It can be a shock to couples if they can’t get pregnant After the couple has completed fertility testing, physicians from a C-section can interfere with again, especially if they did so the first time without much can typically determine what is preventing couples from con- conception. trying — or perhaps any at all,” Dr. Lasch says. ceiving in about 90 percent of cases. Sperm count. Low sperm count, poor People shouldn’t dismiss the grieving that accompanies Treatments depend on the determined cause of infertility, motility or defects can all cause infertility. infertility, even if they already have a child, says Francisco Dr. Weil says. When the fertility problem is due to a female Arredondo, MD, a reproductive endocrinologist at MacDonald problem (in about 50 percent of cases), treatments can include Women’s Hospital. medications to induce ovulation, surgery to repair damaged “A lot of people, including physicians, believe that people fallopian tubes or in-vitro fertilization. For male infertility, who have secondary infertility should not go through the same options can include intrauterine insemination to ensure only emotions because they already have a kid,” he says. “But emo- good quality sperm are used, as well as intracytoplasmic tionally, it’s the same. It’s not a matter of not being grateful sperm injection for men with very low sperm counts. for your first child, rather the fact that the dream you have for Knowing that coping with infertility can be one of the a larger family hasn’t become a reality.” toughest challenges couples face, Dr. Arredondo recommends This emotional distress is compounded by the fact that that they develop a plan that addresses how much time, emo- there are no easy answers. “The causes of secondary infertility tional and financial investment they’re willing to make in are just as varied as with primary having another baby. infertility,” explains Stacie Weil, MD, “While most couples with second- TO LEARN MORE a reproductive endocrinologist with ary infertility are successful in growing MacDonald Women’s Hospital. For an appointment with a their family, determining how far you Your first plan of action should be a MacDonald Woman’s Hospital are willing to pursue treatments can fertility specialist, please call trip to your OB/GYN. If a couple has help give couples a sense of control,” 216-844-1514. been struggling to get pregnant for he says. ■ 6
  7. 7. Find a physician online: Q ASK THE DOCTOR: HOW CAN I TRAVEL SAFELY WITH MY KIDS THIS SUMMER? Q A My daughter is fair-skinned and has freckles and moles. She loves to play outside all day during the summer. What is the best way to protect her while she’s in the sun? “The majority of sun exposure occurs within the first two decades of life, so it’s espe- cially important for parents to JOAN E. TAMBURRO, DO, Pediatric Dermatologist, Rainbow Babies & Children’s Hospital teach children sun safety,” says Rainbow pediatric International trips require much more plan- ning, such as checking if your child needs vaccina- tions or medications to prevent diseases such as malaria. “If you’re unsure of what’s needed, the medical team at Rainbow’s Child Travel- ers’ Clinic (216-844-RAINBOW) is able to help families make certain their children have the proper pretravel Community Calendar Rainbow Babies & Children’s Hospital is proud to sponsor a variety of programs throughout the year that foster learning and encourage family fun. Be sure to mark your calendars for the following events: The Children’s Museum of Cleveland — Bridges to Our Community Exhibit When: Ongoing through Dec. 31, 2006 Where: Children’s Museum of Cleveland 10730 Euclid Avenue Cleveland, OH 44106 dermatologist Joan E. Tamburro, DO. care,” Dr. McComsey says. “We also give families desti- Children with fair to light complexions, moles, Event Information: nation-specific advice on common diseases, as well as freckles or a family history of skin cancer are even tips on safe eating and drinking habits. After your child more vulnerable. But, Dr. Tamburro says, with the 216-791-7114 has returned home, we can evaluate and treat your right precautions, all kids can safely play in the sun. child for any post-travel concerns, if needed.” ■ “Try to avoid her being in the sun between 10 a.m. 3rd Annual Teddy Bear Day and 4 p.m., when the sun is the strongest,” she advises. Presented by Rainbow Babies Q I’m confused about & Children’s Hospital “Make sure to generously apply a sunscreen with an what I hear on the When: Saturday, Sept. 30, 2006 SPF of 30, even on cloudy days, a half hour before news about West Nile 11:00 a.m.–3:00 p.m. she heads outdoors. Be sure to reapply every two to virus. Can my kids catch it Where: Cleveland Metroparks Zoo three hours, or after swimming. It’s also a good idea from a mosquito bite? Event Information: to have her wear a hat and sunglasses, or even a loose long-sleeve T-shirt and longer shorts or pants. There’s ETHAN LEONARD, A West Nile virus has MD, Infectious even sun protective clothing now available. Or, you 216-661-6500 spread rapidly across Disease Expert, can add a sun protective laundry treatment to your Rainbow Babies & the United States in the regular wash, such as Rit Sun GuardTM, to boost her Children’s Hospital Boo at the Zoo past four years, including north- protection against harmful UV rays.” ■ When: Thursday, Oct. 19– east Ohio. It is one of several germs that can cause Sunday, Oct. 22, 2006 encephalitis, an infection and swelling of the brain. Thursday, Oct. 26– Q We’re preparing to take our However, says Rainbow Infectious Disease expert Sunday, Oct. 29, 2006 first real vacation as a family Ethan Leonard, MD, children are less likely to become 5:30 p.m.–8:30 p.m. with two young kids. Do you ill with West Nile virus than adults. “The frequency of Where: Cleveland Metroparks Zoo have any travel tips? serious symptoms increases with age, peaking in those Event Information: over 50 years old,” he says. A Traveling with kids is GRACE MCCOMSEY, People who do get symptoms experience the follow- 216-661-6500 both fun and challeng- MD, Chief of ing: a flu-like illness (fever, aches and pains), rash, eye ing. But planning Infectious Diseases, redness, confusion, sleepiness, and neck and back pain. Rainbow Babies & ahead for safe travel can help you Dr. Leonard notes that most people infected with the Children Hospital avoid any potential health prob- virus have no symptoms – and only one in about 150 to lems, says Grace McComsey, 300 infected people become ill. MD, Chief of Infectious Diseases at Rainbow. However, there are several precautions you can take “For a healthier vacation domestically or abroad, to protect your family, he says. He suggests you limit parents should always bring along their child’s immu- outdoor activity during dusk — when mosquito activity nization record and medical history, including any is the highest — and wear long sleeves and long pants. medication or food allergies,” says Dr. McComsey. You also should make sure your window screens are For car trips, be sure to be equipped with a good “bug tight” and drain or change standing water on your supply of water and snacks, alcohol-based hand sani- property. Lastly, he says, use DEET-containing insect tizer, hand wipes, sunscreen and insect repellent. repellents according to manufacturer’s instructions. ■ 7
  8. 8. University Hospitals of Cleveland NONPROFIT Rainbow Babies & Children’s Hospital ORG U.S. Postage 11100 Euclid Avenue PAID Cleveland, Ohio 44106 Permit N. 694 Effingham, IL ASK RAINBOW! Rainbow’s experts are here to answer your health care questions! You can contact us by phone at 216-844-RAINBOW or email us at When Is It No Longer Baby Fat? START TEACHING YOUR CHILD HEALTHY EATING HABITS DURING PRESCHOOL E veryone’s always teasingly make up 30 percent of the diet for most pinched Junior’s extremely children, according to American Acad- pudgy cheeks and declared them emy of Pediatrics guidelines. absolutely darling. But now that he’s a Carolyn Landis, PhD, a clinical psy- toddler, you’re starting to worry about chologist who heads Rainbow’s Fit his still-chubby frame. How can you tell Futures program for young children MARK the difference between healthy growth who are overweight, emphasizes that the PALMERT, MD, Endocrinologist at and an overweight child? preschool years are an optimal time to Rainbow Babies & “Usually parents shouldn’t be too teach healthy eating habits. Children’s Hospital concerned about their child’s weight or “Evidence shows that overweight restrict fat intake until they turn 2 years children have a greater likelihood of old,” says Rainbow Babies & Children’s becoming overweight adults,” Dr. Landis Hospital Endocrinologist Mark Palm- says. “So, it’s extremely important to lay TIPS TO PROMOTE HEALTHY GROWTH ert, MD. “During that time, your child the groundwork in these formative ■ Limit sugary snacks, excessive amounts of fruit is still growing very quickly and needs years, when you still have juice, junk food and fast food. fat for proper brain development.” a considerable say about ■ Offer healthy foods. “Don’t be discouraged if they However, in rare cases where early what your child eats.” ■ don’t immediately like carrot sticks or banana CAROLYN LANDIS, PhD, weight gain is very high, diet changes slices,” Dr. Landis says. “You will likely need to Clinical Psychologist may be needed even before age 2. a GREAT OFFER! offer foods many times before they’ll accept them at Rainbow Babies & After your child’s second birthday, Rainbow is offering free in their diet.” Children’s Hospital you can more easily reduce the fat in his copies of the booklet ■ Encourage plenty of physical activity. diet — for example, switching from whole Healthy Snacking. Call ■ Set a good example. “If they see Mom or Dad snack- ing on grapes or whole-grain crackers, they’re more to 2 percent milk. But, Dr. Palmert says, 216-844-RAINBOW likely to ask for some for themselves,” she adds. fat still remains important and should for your free copy today. Time to Choose? If you are choosing your family’s health plan, remember Under the Rainbow is published by Rainbow Babies there is no better place for children than Rainbow Babies & Children’s Hospital. Articles in this newsletter are & Children’s Hospital. written by professional journalists or physicians who Your health plan should provide a wide range of cover- strive to present reliable, up-to-date information. But no publication can replace the care and advice of age; allow options for care close to home; easy access medical professionals, and readers are cautioned to to the care that you need; promote wellness; provide a seek such help for personal problems. ©2006 StayWell Custom Communications, 780 Township Line Road, comprehensive benefit for preventive care at a low or Yardley, PA 19067, 267-685-2800. Some images in no cost; and have reasonable out-of-pocket costs. this publication may be provided by ©2006 PhotoDisc, Most important, ask if your plan includes Rainbow. Inc. All models used for illustrative purposes only. Some illustrations in this publication may be provided For clarification, call 216-844-7246 or log on to our by ©2006 The StayWell Company; all rights reserved. website at and click on the (306) Ask Rainbow tab and link to insurance plans that include Rainbow.