button batteriesTHE DANGERS OF TINY MAGNETS AND

Those tiny magnets that hold reminders to your fridge can cause big harm to a child who swallows them, says Wendy Pomerantz, MD, an emergency physician with Cincinnati Children’s. The magnets can stick to each other across the bowel wall and cause an obstruction or perforation that requires emergency surgery.

Likewise, the small toy magnets called “buckyballs” should be kept far from little ones who like to put things in their mouths.

And many parents aren’t aware that the small button batteries that play music when you open a holiday card can cause serious harm to a child if swallowed. So can the batteries that power grandpa’s hearing aid. Or your wristwatch. Or your TV’s remote control.

The injuries occur when kids swallow the batteries – many are no bigger than a fingernail, some are as large as a coin. Much of the time, they pass through the body without problems. But when they don’t, you need to take prompt action.

The batteries can emit an electrical current that burns. “If the battery gets stuck in the esophagus or stomach, it can take as little as two

hours before it starts to erode and cause damage,” says Pomerantz. If you think your child has swallowed a battery, don’t take chances. Get to the

emergency room right away. n

All button batteries are small

enough for a young child to

swallow. The batteries emit

electrical current that can burn

the esophagus and stomach if

they get stuck. If you think your

child has swallowed a battery,

play it safe and go to the

emergency room.

WENDY POMERANTZ, MD, MS

Professor of Clinical Pediatrics, Division of Emergency Medicine at

Cincinnati Children's Hospital Medical Center

your homeU N - B U T T O N

n Don’t leave musical greeting cards or storybooks around for little ones to tear open or chew on.

n Throw away any toys that are powered by button batteries unless they have covers that screw in place to keep the battery secure.

n Hunt through cabinets and drawers and move any button-battery items out of the reach of little hands.

n Remind grandparents and older family members not to leave hearing aids lying around.

child safetyT I P S O N H O M E

1

p e d i a t r i c i a nASK THE JOHN BRUNS, MD , is a community pediatrician

affiliated with Cincinnati Children’s. He practices at

Queen City Physicians in Groesbeck/Ross-Hamilton

and is president of the Cincinnati Pediatric Society.

2

THE FAMILY RESOURCE CENTER

The center helps families,

community providers

and agencies find health

information, community

resources and support.

Call 513-636-7606 for

assistance.

SPECIAL NEEDS RESOURCE DIRECTORY Use this directory to find

information, resources and

advocacy strategies at

www.cincinnatichildrens.org/

special-needs.

JOIN SPECIAL CONNECTIONSOur new online community

connects with others

parenting a child with

special healthcare needs:

www.cincinnatichildrens.

inspire.com.

advocateFOR YOUR CHILD’S HEALTH Which should I give my child for fever – acetominophen or ibuprofen?

The charts below are professional

dosage schedules for administering

acetaminophen and ibuprofen.

It is extremely important that you use

either the dropper, syringe or medicine

cup that is provided with your

medicine to dispense to your child.

More information can be found at

www.cincinnatichildrens.org/

health/f/fever

doseGIVING THE RIGHT

Administer every 4-6 hours, do not exceed more than 5 doses in a 24 hour time period.

Children’s Tylenol (acetaminophen) with

New Concentration 2011

Infant's Suspension & Original Drops (Old

Concentration)80mg/0.8ml

Infant's Oral Suspension

(New Concentration)

160mg/5ml

Children’s Suspension

Liquid and Elixir

160mg/5ml

Children’s Chewable

Tablets

80mg each

Junior Strength Chewable Tablets/ Caplets

160mg each

WEIGHT AGE

dropper syringe teaspoon tablet tablet/caplet

6-11 lbs 0-3 mos 0.4 ml 1.25 ml

12-17 lbs 4-11 mos 0.8 ml 2.5 ml 1/2 tsp

18-23 lbs 12-23 mos 1.2 ml 3.75 ml 3/4 tsp

24-35 lbs 2-3 yrs 1.6 ml 5 ml 1 tsp 2

36-47 lbs 4-5 yrs 1 1/2 tsp 3

48-59 lbs 6-8 yrs 2 tsp 4 2

60-71 lbs 9-10 yrs 2 1/2 tsp 5 2 1/2

72-95 lbs 11 yrs 3 tsp 6 3

96 lbs & over 12 yrs 4

ABOUT THIS ISSUE WINTER 2013 | VOL26 ISSUE4

YOUNG AND HEALTHY is a quarterly publication from Cincinnati Children's Hospital Medical Center. For more health news and patient stories, subscribe to our monthly eNewsletter online at www.cincinnatichildrens.org/subscribe

© 2013 Cincinnati Children's Hospital Medical Center

3

As we approach cold and flu season, I commonly get ques-tions about the use of acetaminophen and ibuprofen to manage fever. As parents, we don't like to see our children

sick and uncomfortable. And though many people worry about fe-vers, they are a natural part of our body’s defense. While monitoring the temperature is important, as or more important is the behavior of the sick child. A child with a low fever who is breathing fast, irri-table and acting sick concerns me more than the active, playful child who has a fever of 103.

Acetominophen and ibuprofen both work to make children more comfortable, and are generally viewed as safe when you follow dos-ing guidelines. Infants under 2 months, however, require special consideration since they may not give any indication of the cause of their fever. Call your doctor if your young infant is running a fever over 100.5 or is acting sick.

As with all medications, be careful in using acetaminophen and ibu-profen. Each has a limited dose recommendation for a 24-hour period. I recommend keeping a log with the name, time and dose of medication given to prevent duplication and overdosing. If you give your child ad-ditional meds, read labels carefully, since multi-symptom cold medicines may already have acetaminophen in them. Too much acetaminophen can damage the liver. Ibuprofen may alter the blood flow to the kidneys and should not be used in dehydrated children or children with kidney disease. Due to its association with Reye’s Syndrome, we don’t recom-mend using aspirin to treat fever symptoms. n

PRODUCED BY

The Department of Marketing & CommunicationsCincinnati Children's Hospital Medical Center3333 Burnet Ave., MLC 9012, Cincinnati, OH 45229-3026Phone: 513-636-4420

Advisers: Chris Peltier, MD, and Zeina Samaan, MDEditorial Consultant: John Bruns, MDEditorial Staff: Mary Silva/managing editorPhotography: Tine Hofmann, tm photographyDesign: Christina Ullman & Alix Nothrup, Ullman Design

RESEARCHSTUDYJ O I N A

Researchers at Cincinnati Children’s conduct hundreds of studies each year to figure out why people get sick and what treatments might help them. Discoveries researchers make in the lab can lead to even better treatments and ways to prevent diseases from happening in the first place. Did you know you could be part of the process of helping our scientists solve medical mysteries? You can participate by joining a research study. Here’s what we’re recruiting volunteers for now.

2- TO 12-YEAR-OLDS WITH PSORIASIS NEEDED FOR A RESEARCH STUDY

What: We want to learn how the study drug, an ointment applied two times a day, is handled by the body in children with psoriasis.Who: Children, 2 to 12 years old, with plaque type psoriasis, may be eligible for participation.Pay: Participants may receive up to $600 for completing all of the study visits.Contact: Laurie Vanderah at laurie.vanderah@cchmc.org • 513-803-0003

If you have a question for the pediatrician, email youngandhealthy@cchmc.orgHAVE QUESTIONS?

HAVE YOU HAD OR ARE YOU AT RISK TO HAVE A PREMATURE BABY?

FETAL (Family and Environment in the Timing of Abnormal Labor) StudyWhat: This is a research study to determine if there is a pattern in some families of mothers giving birth prematurely, and if so, to explore a possible genetic link.Who: Women who have given birth to a premature baby (more than one month before their due date) or are at risk for giving birth prematurely may be eligible to participate.Pay: Participants will receive between $50 and $100 for their time.Contact: For more information, contact Dr. Louis Muglia at louis.muglia@cchmc.org • 513-803-7902.To take a survey to see if you are eligible for this study, go to www.cincinnatichildrens.org/fetalstudy.

facebook.com/cincinnatichildrensfans youtube.com/cincinnatichildrens cincinnatichildrensblog.org@cincychildrens

Children’s Motrin/Advil (Ibuprofen Suspension 100 mg/5ml)

Administer every 6-8 hours, do not exceed more than 4 doses in a 24 hour time period.

AGE WEIGHT DOSE

lbs kg 10 mg/kg

6-11 mos 13-17 6-7.9 1/2 tsp (50 mg)

12-23 mos 18-23 8-10.9 1 tsp (100 mg)

2-3 yrs 24-35 11-15.9 1 1/2 tsp (150 mg)

4-5 yrs 36-47 16-21.9 2 tsp (200 mg)

6-8 yrs 48-59 22-26.9 2 1/2 tsp (250 mg)

9-10 yrs 60-71 27-31.9 3 tsp (300 mg)

11-12 yrs 72-95 32-43.9 4 tsp (400 mg)

Adult 96-154 44-70 4 tsp (400 mg)

n u t r i t i o nFOCUS ON protect your child's health

foo d al l e rg y

If you are unsure about whether your child is allergic but he has shown some signs of a food allergy, pediatrician Charlie Cavallo, MD,

says to talk with your pediatrician and have your child tested.

“It’s important to take food allergies seriously,” Cavallo says. “Even if your child has only had a mild reaction to a certain food one time, the next reaction could be severe. Reactions can be unpredictable. The safest thing is to avoid the food altogether until you can get your child tested.”

Testing by an allergist can determine specifically what a child is allergic to, especially if he’s had a reaction after eating several foods and you’re not sure which one was the cause.

Do not try to test it yourself by giving a child small amounts of the suspected food, Cavallo says, and don’t assume that cooking or baking the food will make a difference. Skin or blood testing by an allergist is the only true way to tell. n

4

When planning for the holidays, whether for parties

outside your home, school or daycare activities, or even

going to a restaurant, here are some tips from pediatrician

Charlie Cavallo, MD:

T I P S F R O M T H E P E D I AT R I C I A N

CHARLIE CAVALLO, MD. General Pediatrician with Pediatric

Associates of Northern Kentucky

D E A L I N G WI T H foo d al l e rg i e sD U R I N G T H E H O L I D AY S

Gatherings at this time of year almost always involve food. For parents of kids with food allergies, that can mean added worry about what they’re exposed to.

n Know what your child is allergic to.

n Always carry an EpiPen®.

n Inform your child’s school or daycare

teachers about his allergy.

n If you’re visiting, let your host know in advance.

n At a restaurant, tell the waiter.

n From an early age, make sure your child

knows what she is allergic to and why not to

eat that food.

For more information go to AAAAI.org American

Academy of Allergy, Asthma and Immunology

Foodallergy.org.

online

Go to Cincinnati Children’s blog to read about

one mom’s experience with food allergies during

the holidays.

calmKEEPING HOLIDAYS

Regardless of what traditions your family celebrates, for a child with an autism spec-trum disorder, the break from routine that holidays bring is especially challenging. Here are just a few ideas to help make holidays more enjoyable for your child, and your family.

n PREPARING IS KEYA little preparation goes a long way toward keep-ing things calm, says Judy Reinhold, RN, MSN, CPNP. Reinhold works with families at the Kelly O’Leary Center for Autism Spectrum Disorders at Cincinnati Children’s.

“During the holidays, routines go out the window,” Reinhold says. “Parents know best what their child will enjoy and what will be a struggle, so they should plan accordingly.”

Reinhold says one good way to prepare a child for holiday gatherings is with “social stories” – creating a story with pictures to prepare the child for what to expect in various situations.

n DECORATIONSLights and decorations, music – even new foods and smells – can be overwhelming to a child with autism. Limiting changes in routine and introduc-ing new things gradually, whenever possible, can help your child get comfortable with them.

n GIVING AND RECEIVING GIFTSPractice giving gifts and taking turns opening gifts. Role play with your child to prepare him for receiving a gift he does not want. Keep familiar toys nearby.

n FEELING OVERWHELMEDIf you are having visitors, designate a quiet, safe place in the house where your child can go when feeling overwhelmed. If you are away from home, ask your host to identify a spot where your child can go when things get hectic.

n TIPS FOR TRAVELBring your child’s favorite foods, books or toys along. This is especially helpful if there are delays. If you are flying for the first time, you might bring your child to the airport in advance to help him see what it is like. Or use stories and pictures to re-hearse what will happen when boarding and flying.

n ENGAGE FAMILY MEMBERSDon’t shield your child from extended family. With some help from you, family members can understand the challenges you face, and can even be a source of support.

n ABOVE ALL, TRUST YOURSELFThe most important thing, says Reinhold, is to trust what you know about your child. n

children with special needsPA R E N T I N G A D V I C E F O R

JUDY REINHOLD, RN, MSN, CPNP

Kelly O' Leary Center at

Cincinnati Children’s

Go to http://support.autism-society.org

to download a PDF of holiday guidelines.

online

5

psychologyC H I L D L I F E A N D

Most people love celebrating holidays – time to be with family and friends, enjoy special foods and observe family traditions. But holidays can also bring the pressure to do more and spend more than we are willing or able.

If holidays leave you feeling stressed out, there are ways to set limits and make the time more mean-ing ful, says Lynn Sanner, a child life specialist and educator in the Department of Child Life at Cincinnati Children’s.

LYNN SANNER

Child Life Specialist and Educator,

Department of Child Life at Cincinnati Children’s

6

Decide What’s Important to You“Most of us are already leading very full lives just taking care of our work and our families,” says Sanner. “The holidays can add another layer of responsibility to what we already do.”

Talk with your family about what is most meaningful and beneficial about your holiday observance, she suggests. “Choose two or three things about the holiday that your family cares about most, and limit your activities to those things.”

Take Time for Your HealthSanner says it’s especially important to take time for healthy activity during the holiday season. “Eating well, exercising, getting enough sleep – all of those things are threatened if we overdo it during the holidays,” Sanner says.

And make sure kids stick to predictable routines and regular schedules, especially while school is in session. “School holiday concerts and parties can be great fun, but they can also be disruptive to homework and home routines.”

Rethink Your GivingEveryone enjoys giving gifts to those they care about. Gifts can take many forms, says Sanner. “The most valuable gifts come from creativity – things

we’ve made or words we give to people,” she says. A handmade note to a teacher from your child about something he really enjoyed doing in school, or doing something thoughtful for a neighbor or friend, can be precious gifts.

VolunteeringGiving back to the community is a great idea. “But agencies get a lot of offers of help at holiday time, and what they need is help in August,” she says. “For a young child, it is probably most effective to provide service specifically at holiday time. Older children may be happy to consider what they can do later in the year.”

Give Kids an 'Out'To help children set limits during the holidays, a little creative license may be in order, says Sanner. You may help your child decline invitations to become too busy, perhaps by using a response such as “My mom says I’m not allowed to.” “This phrase provides a really good shelter for kids,” Sanner says.

It Doesn't Last ForeverMost important, she says, “Know that whatever you do for your family’s holiday is enough. Enjoy the parts of your holiday that you care about the most and let go of the things that don’t really matter.” n

Putting more meaning into your

HOLIDAYS

7

psychology Seeing holidays through the eyes of a child is one of life’s great joys. Help keep your holidays joyful by taking a few precautions.

“It’s difficult to imagine that some of the fun and festive things we do could pose risks to young children, but they can,” says Melissa Klein, MD, a pediatrician in the Division of General and Community Pediatrics at Cincinnati Children’s.

Klein offers a few tips to help keep children safe and holidays happy.

hazardsT O Y

Pay attention to age-appropriate

labels on toys, and keep a special

lookout for tiny parts from older sib-

lings’ toys that babies might swallow.

See the article about button batteries

and magnets on page 1.

safetyT R E E

If your holiday traditions include a

tree, be sure to secure it from tip-

ping over. If you have an active tod-

dler, you might want to think about

blocking the tree from little hands

with a safety gate. Don’t place

ornaments or lights on the bottom

portion of the tree, where toddlers

(and pets) can reach them.

decorationsH O L I D A Y

Poinsettias are not poisonous, as is commonly

believed, but mistletoe berries are. It’s a good

idea to keep all flowers and greenery out of reach

of children. Wrapping paper, ribbons, and bows

can be choking and suffocation hazards. And

watch out for foam peanuts and other plastic

items used in packaging.

hotlinePOISON CONTROL

If you’d rather be safe than sorry, keep the poison

control phone number handy. The Drug and Poison

Information Center at Cincinnati Children’s has a

24-hour hotline, 1-800-222-1222.

safetyK I T C H E N

Busy, crowded kitchens are part

of most holiday households.

“Burns and scalds are a major

holiday hazard,” says Klein, so be

extra cautious when cooking and

carrying hot foods or liquids from

one room to another – especially if

there are little ones in the house.

candlesL I G H T I N G

If your holiday traditions involve light-

ing candles, keep the lit candles out

of reach of children. Avoid placing

lit candles on tablecloths that can be

pulled down. In fact, pass on table-

cloths altogether – crawling toddlers

can tug at them, sending dishes, hot

food, and candles flying.

MELISSA KLEIN, MD. General Pediatrician, Division of General

and Community Pediatrics at Cincinnati

Children’s Hospital Medical Center

T I P S F O R A S A F Eholiday

S A F E AT H O M ETips on keeping your child

safe during the holidays.

insideTHIS ISSUE A L L I S C A L M

Helping children with autism

enjoy the holidays.

3333 Burnet Avenue, MLC 9012Cincinnati, Ohio 45229-3026

Our newly-opened Seacrest Studio will make it possible for Cincinnati Children’s patients to enjoy kid-friendly music, game shows, celebrity interviews and more, right from their hospital rooms. The closed-circuit television and radio station WKID 33 operates from the multimedia broadcast facility on our Burnet campus, developed in partnership with the Ryan Seacrest Foundation.

W I N T E R 2 0 1 3

VOL26 ISSUE4

How to make the most of seasonal celebrations with your child.making holidaysmeaningful

A guide to your child’s good health

healthyyoungand

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