Child Life Month

How Play is Helping UMMC’s Youngest Patients

By: Colleen Schmidt, System Communications Intern

As many parents know, the hospital can be a scary and unfamiliar place for a child. To help relax these fears, UMMC’s team of child life specialists and assistants use a variety of techniques to help children adjust to the hospital setting. Child life specialists, or CLS, aim to provide a positive and non-traumatic hospital experience for all patients at the University of Maryland Children’s Hospital.  UMMC’s Child Life team consists of six CLS and two assistants. They work in the Pediatric Progressive Care Unit (PPCU), Pediatric Intensive Care Unit (PICU) and the Pediatric ER.

Members of the Child Life Team

 

Play is one technique often used by child life team to help normalize the child’s hospital experience.  Various types of play are thoughtfully used to help children meet developmental milestones, express emotions, and understand their medical situation.  For example, during a practice called medical play, a CLS will provide their patient with a “hospital buddy” or small doll that the child can decorate. Next, with the guidance of a CLS, the child is introduced to medical equipment that they can explore and use on their new hospital buddy.  According to Aubrey Donley, a CLS at the pediatric ER, medical play is helpful in addressing misconceptions the child has about medical equipment.

“It gives them a sense of control and mastery over their hospital experience and over what they’ve been through,” she explains. Medical play empowers patients and allows them to have an active role in their hospitalization. Helping the children understand their environment lessens the chances of confusing or traumatizing them.

In addition to medical play, the child life team uses therapeutic play to help children work through a variety of issues that may accompany hospitalization. Sometimes, children who are hospitalized have experienced severe trauma. Unlike adults, children may not be able to verbalize their feelings. Play is how they express themselves and work through their experiences. For instance, one of Donley’s young patients survived a house fire and used play to understand what happened to him. “He was running around in a fireman costume pretending to put out a fire. For an onlooker, it might seem like he was just playing but we understand he is trying to make sense of the chaos and trauma that he had witnessed,” she explained. Therapeutic play can also help children who are at the hospital for long periods of time meet their physical and cognitive milestones.

With backgrounds in child development, the child life team is able to make individual plans for each child that matches their medical, physical, and emotional needs.  The team advocates for the children they support, and work with an interdisciplinary team of medical professionals to provide a comprehensive plan for that child. Child life specialists also provide educational and emotional support for families. All services provided by the child life team come at no charge to families.


For more information on our child life services please visit: http://umm.edu/programs/childrens/services/inpatient/child-life

Winter Wives’ Tale

The University of Maryland Children’s Hospital sets the record straight…

Put on your hat since you lose most of your body heat through your head.”
This is not necessarily true! Your body heat escapes from any exposed area- so if you had on snow pants and a T-shirt and you forget your hat and jacket, the most amount of heat would escape through your arms- since that would be the largest exposed part of your body. Putting on winter accessories such as hats, mittens and scarves is still a very good idea to avoid the outside dangers of frostbite and hypothermia.

You will get sick if you go outside with wet hair.”
This is another winter wives’ tale. While your kids may be cold, they won’t actually catch a cold by venturing outdoors with a wet head. Germs are spread by people, and temperature simply doesn’t play a part.

 

Setting the Table for Celiacs: Q&A with Celiac Disease Program’s Nutritionist

University of Maryland Medical Center nutritionist Pam Cureton answers questions about celiac disease and gluten-free diets.

pam-cureton-rdQ: What is gluten?

A: Gluten is a protein found in wheat, rye and barley. These grains in any form must be avoided. Foods labeled gluten free are safe to eat but if a food item is not labeled gluten free look for these six words in the ingredient list to see if it contains a gluten containing ingredient: Wheat, Rye, Barley, Malt, Brewer’s yeast and Oat (only use oats that are labeled gluten free).

Q: What exactly is wrong with gluten?

A: The problem with gluten is that it is not completely broken down into smaller amino acids that can be easily absorbed by the intestine. For the majority of people this presents no problem at all but in individuals with celiac disease, the body sees this protein as a toxin and this sets off a string of reactions leading to intestinal villous damage.

Q: What cross contamination problems should I look for in the kitchen?

A: Preventing gluten free foods from coming in contact with gluten containing foods make the difference in your guest enjoying a wonderful holiday meal or becoming ill and leaving early. Guest with celiac disease cannot simply take the croutons out of a salad or eat the meat from the wheat bread sandwich. Gluten free foods can be contaminated by using the same spoon to mix or serve foods, putting wheat products next to the gluten free dips, “double dipping” the knife into a condiment then gluten containing product then back into the condiments or using the same toaster.

Q: Can you taste the difference between gluten-free foods and their gluten counterparts?

A: Gluten free foods have come a long way in their taste and texture to be very close to their gluten containing counterpart. There are so many great tasting gluten free products on the market today that no one should be eating something they do not like.

Q: What are the symptoms of Celiac Disease:

A: Celiac disease can present itself in many different forms. Untreated, celiac disease causes multi-system complications such as diarrhea, constipation, gas, bloating, iron deficiency anemia, decreased bone density, failure to thrive, short stature, and behavior problems. If you have any concerns, please check with your primary care provider before you start a gluten free diet.

Q: I have severe reactions when I eat bread, such as stomach bloating and pain in my joints. Does this mean I could have celiac or gluten sensitivity?

A: We recommend that you see your primary care provider and ask to be tested for celiac disease. However, do not start a gluten free diet before this testing is done. The first step is a simple blood test for screening. If all the tests are complete and you do not have celiac disease, then try a gluten free diet to see if you improve as it may be non-celiac gluten sensitivity.

Q: How common is late-onset celiac disease and is there any way to know if other family members are at risk of developing it later in life?

A: It is possible to develop celiac disease at any age. You may have had celiac disease for many years before being diagnosed because symptoms may have been attributed to other conditions or you may not have had any symptoms with the active disease. We recommend that all first degree relatives be screened for celiac disease after the relative had been diagnosed and if negative at that time, repeat the screening labs every 2-3 years or if symptoms appear.

Q: Is there a cure for Celiac Disease?

A: Currently the only treatment for celiac disease is the gluten free diet. In most cases, this treatment works very well but it can be expensive, socially isolating and, at times, difficult to follow. Also, there are people that do not respond completely to the diet or take up to 2 years to heal after diagnosis. For these people, additional therapies are need to prevent additional complications of celiac disease.

 

Learn more about the Celiac Disease Program or call 410-328-6749 to make an appointment.

vegetables

 

“No Screens Under 2” Q&A with Dr. Brenda Hussey-Gardner

brenda-hussey-gardnerHi, my name is Dr. Brenda Hussey-Gardner. I am a developmental specialist who works with the Department of Pediatrics at the University of Maryland Children’s Hospital. I attended the American Academy of Pediatrics conference in San Francisco to share the results of research that I have done with colleagues here at the University of Maryland and to learn what other researchers are doing across the nation in order to bring this new knowledge back to the hospital to better serve our children and their families. At this conference, the American Academy of Pediatrics released their new guidelines regarding screen time and children.

Please see the Q&A here for more information on these guidelines.

Q: What is the “No Screens Under 2” rule and in what ways is it changing?

A: The American Academy of Pediatrics (AAP) previously recommended no screen time for children under 2 years of age. In its new guidelines, the AAP offers slightly different recommendations for children less than 18 months and those 18 to 24 months of age.

Children less than 18 months

The AAP discourages parents from using digital media with one exception: video-chatting (e.g., Skype, FaceTime). This form of interactive media can be used, with parent support, to foster social relationships with distant relatives.

Children 18 to 24 months

The AAP recommends that parents, who want to introduce their child to digital media, do the following:

  1. Only use high-quality educational content.
  2. Always watch shows or use apps with your child. Talking about what the child sees helps foster learning.
  3. Never allow your child to use media alone.
  4.  Limit media to a maximum of 1 hour per day.
  5. Avoid all screen time during meals, parent-child playtime and an hour before bedtime.

Q: Can you provide some insight into how the decision was made? What research was taken into account?

A: The AAP Council on Communications and Media reviewed research on child development, television, videos and mobile/interactive technologies to develop their current recommendations. Research shows that children under the age of 2 years need two things to develop their thinking, language, motor and social-emotional skills: (1) they need to interact with their parents and other loving caregivers, and (2) they need hands-on experiences with the real world. In fact, researchers have demonstrated that infants and toddlers don’t yet have the symbolic, memory and attention skills needed to learn from digital media. Importantly, research also shows evidence of harm (e.g., delayed thinking, language and social-emotional development; poorer executive functioning) from excessive media use with young children.

Q: Why do these new guidelines matter to parents, and should they affect the ways parents and their young children interact with technology?

A: AAP guidelines matter because parents want their children to be well adjusted and smart, and they don’t want to do anything that may harm their child’s development. As such, parents should try their best to avoid screens with their children who are less than 18 months of age and realize that it is their interactions with their child that are the most important. Then, from 18 to 24 months of age, parents should strive to use only the highest quality educational technology with their child. As hard as it is, parents should try to avoid using technology as a babysitter and try to understand the negative impact that it can have on their child’s development.

Q: What is your biggest take-away from the session?

A: A parent’s lap is always better than any app!

Q: What is your opinion on the new guidelines and do you think it will affect your clinical practice? If so, how?

A: I believe that the new AAP guidelines, while a little more flexible, may still be difficult for parents to adhere to, as screen time is so pervasive in our society. However, it is very important for parents to make smart choices about digital media and screen time if they want to help their infant and toddler develop into a child who is healthy and ready for success in preschool. It is my goal to develop a pamphlet summarizing the research findings and AAP guidelines to help parents make the best choices for their child and family.

 

For more information about media, screen time, and child development, parents are encouraged to read the AAP recommendations located within the publication “Media and Young Minds,” and to read the “Early Learning and Educational Technology Brief” published by the U.S. Department of Education and the U.S. Department of Health and Human Services.

Signs of Bullying

This information is provided by University of Maryland Children’s Hospital, the Center for Infant and Child Loss and the Maryland Department of Health and Mental Hygiene.

As a parent, there are many things you need to diligently watch for in your child. One of them is to look for signs of bullying.

There are health risks related to depression for the victim, bully, and those who witness bullying, which may include:

  • Irritability or angerdoctor-consoling-patient-126648704
  • Nightmares
  • Headaches
  • Stomachaches
  • Inability to concentrate
  • Multiple joint and muscle pains
  • Weight gain or loss
  • Depression
  • Difficulties in falling and/or staying asleep
  • Self-injury (i.e., cutting)
  • Impulsivity
  • Suicide attempts
  • Homicidal thoughts

If your child is experiencing any of the above, talk with them, and contact their pediatrician or teacher. For more information call 800-808-7437.

 

 

8 Tips to Confront Bullying in School

This information is provided by University of Maryland Children’s Hospital, the Center for Infant and Child Loss and the Maryland Department of Health and Mental Hygiene.

bullyingBullying is a behavior that is both repeated and intended to hurt someone either physically, emotionally, or both. It can take many forms like teasing, name calling, making threats, physical assaults, and cyber-bullying.

If your child is being bullied and is attending one of Maryland’s public schools, you and your child have the right to report your concerns. The school also has the responsibility to investigate those concerns. Here are eight tips to stop bullying and report the problem:

  • Ask your child’s teacher, counselor, or administrator if you can speak privately about a personal problem. Talk about what is happening or making you (or your child) uncomfortable, and how long it’s been going on.
  • Ask for a Bullying, Harassment or Intimidation Reporting Form; or download at GracesLawMaryland.com. Complete the form, return one copy to the administrator, and keep a copy for yourself.
  • Feel free to call the Maryland State Department of Education if you have additional questions regarding the completion of the Bullying Form. You can reach them at 410-767-0031.
  • If an incident occurs in an unstructured area, ask what the school will do to make you (or your child) feel safe.
  • Ask the administrator to investigate allegations, develop a plan of support and schedule a meeting.
  • If your child is being bullied on a social media site, take a screen shot and save the content to share with parents, police, and the school administration. Fill out a report as often as you need to.
  • Change your password, use privacy settings, and block people on social media who send negative messages, texts, tweets or photos.
  • Ask friends not to share negative social media or pass along to others.

For more information call 800-808-7437.

Pediatric Residents at Univeristy of Maryland Reach Out and Read

A string of rainy days in Baltimore made Friday the perfect day to stay inside and read a good book. And thanks to the efforts of some hard-working Pediatric Residents at the University of Maryland School of Medicine, more than 200 students in Baltimore City had a new story to read!

Throughout the morning, the pediatricians-to-be visited several schools in the University of Maryland Children’s Hospital community, including James McHenry Elementary-Middle School and Franklin Square Elementary in West Baltimore. They spent time interacting with the students, with the hopes of promoting a healthy attitude toward development and literacy at a young age.

James McHenry students had a special visitor: Baltimore City Council President Jack Young handed out books and spent time reading to four classrooms of Pre-K and Kindergarten students.

The Maryland Book Bank and the Maryland Chapter of the American Academy of Pediatrics donated the 200 books that went home with students.

The day of reading was a part of a nationwide “ROAR: Reach Out and Read” effort, which is a non-profit that works to incorporate books and literacy into pediatric care.

Friday was also designated as a “Call to Action” Day by the American Academy of Pediatrics to F.A.C.E Poverty: promote Food Security, Access to Health Care, Community, and Education.

Brushing Twice a Day Keeps Decay Away – National Children’s Dental Health Month

By Zuryna Smith, System Communications Intern

Little boy teethNational Children’s Dental Health Month was introduced by the American Dental Association as a way to provide crucial information regarding oral health in children.

It started as a one-day event in Cleveland. As the importance of the issue of oral health became more prevalent, the one-day event spanned across a week and eventually became a month-long event that garnered global attention.

The ADA provides health fairs, free dental screenings, and other activities that promote the adoption of healthy oral health techniques.  This year’s campaign slogan is entitled “Sugar Wars,” a spin on the sci-fiction film Star Wars.

Tooth decay and loss is one of the main oral health issues that affect children. Preventative care is the only way to deter the loss of teeth. The rule of thumb is to brush two times a day for two minutes each time. In addition to proper brushing techniques, parents should be vigilant in their efforts to keep their children’s teeth shiny and healthy.

Here are a few tips that will encourage healthy dental habits:

  • Emphasize the importance of fluoride. Fluoride is a natural chemical that prevents decay and strengthens the enamel of teeth. It can be found in tap water and is also available as a supplement.
  • A healthy and balanced diet is a necessity in order to prevent tooth decay. While starches and fruits are essential to a child’s diet, certain foods need to be given in moderation. Starchy and sticky foods tend to stay on the child’s teeth and cause cavities as well as decay.
  • Daily cleaning should take place as soon as the child develops their first tooth. A small piece of gauze or a damp cloth can be used to clean the tooth. As the child gets older a toothbrush with a small amount of fluoride toothpaste should be used.

Dental sealants are another method of prevention for young children. Dental sealants are small, plastic coatings that cover the chewing surfaces of the back teeth. It helps to prevent excess food and germs from getting caught in the crevices of the teeth.

Childrens teeth

University of Maryland School of Dentistry students participated in an outreach program where they provided free sealant treatments to children in need at the Perryville Clinic. The overall purpose of the event was to provide assistance and education to those who would not normally have access to proper dental care providers.

For more information about an upcoming Sealant Saturday event please contact the Perryville Clinic at 410-706-4900.

Pediatric Dental Appointments are available at the University of Maryland Pediatric Dental Clinic by calling 410-706-4213. You can also search for a Dental Health provider by using our website.

Governor Larry Hogan Visits the Neonatal Intensive Care Unit

“Heading to my fifth round of five-day, 24-hour chemo this morning at the University of Maryland Medical System in Baltimore. As always thank you to everyone for your prayers and support during this journey!

Before my treatment I took some time to visit the brand-new, world-class Drs. Rouben and Violet Jiji Neonatal Intensive Care Unit at UMMS which officially opened on Tuesday. There I met families with children being treated at the NICU and listened to the stories of Baby Rebecca, Baby Ilyanna, and Baby Javion who are on the road to recovery following bouts with a range of health challenges such as infections, cardiac abnormalities, and abdominal complications. They are carefully cared for, with a balance of compassion and unparalleled clinical excellence!

The work these incredible doctors and nurses at the NICU do is amazing and they are saving lives every day! Please keep these families in your thoughts and prayers!”

-Governor Larry Hogan

Gov. Hogan NICU 1Gov. Hogan NICU 2Gov. Hogan NICU 3Gov. Hogan NICU 5Gov. Hogan NICU 6

 

Public Health Leaders Urge Vaccination Against Measles

Physician-in-Chief, University of Maryland Children’s Hospital

It is impossible today to turn on the TV or read the news without hearing about the current debate surrounding childhood vaccinations and the measles outbreaks in the United States.

As chair of the Department of Pediatrics at the University of Maryland School of Medicine, I took the opportunity to encourage parents to get their children vaccinated by participating in a joint statement with other pediatric and public health leaders from around Baltimore. Please consider the public health benefits of vaccinating your children, and talk to your pediatrician to get the answers you need to feel comfortable with this lifesaving decision.