SPRING 2012

A PublIcAtIoN of levINe chIldReN’S hoSPItAl

carolinas kids

SIdeSteP SPoRtS INjuRIeS 5 wAyS you cAN helP PRotect youR chIld

School tIMe IS youR chIld ReAdy?

Advanced rehab services for

children

>> Parents’ pages

2 >> carolinas Kids

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You knew pregnancy

would take a toll on

your body—but maybe

you didn’t realize exactly

how having a child

would affect you

physically after

you gave birth.

Back pain is one

common complaint

of new moms,

especially as your baby

starts to gain weight. Here

are some tips for keeping

your back in good health,

courtesy of the American

Academy of Orthopaedic

Surgeons:

• With your healthcare

provider’s OK, try to begin

exercising soon after you

have your baby (women

who’ve had C-sections

usually need to wait at

least six weeks before

beginning an exercise

program). This will help

rebuild tone in your

abdominal and back

muscles, and help

you return to your

normal weight.

• When lifting

your baby,

bring him or

her close to

your chest.

Bend at your

knees, lifting

with your legs, instead of at

your waist when lifting baby

from the ground.

• Carry your child in a

front pack for longer

walks instead of on

your hip.

• When

breastfeeding,

use a chair that

offers back support.

• Kneel on the back seat

when placing your child in a

car seat.

“Five to 10 minutes of

stretching upon rising and

again before bedtime

oxygenates your muscles

and maintains flexibility,”

says Aviva Stein, MD, with

Charlotte OB/GYN. n

Kids taking in more calories from takeout

Kids are eating away

from home more often

these days—and it may

show on their waistlines. It

turns out, when kids shun

home-cooked meals and

get their calories away from

home, they tend to eat more

calories—which is cause for

concern, say researchers.

Study authors analyzed

food survey data from nearly

30,000 children. They found

that the percentage of

calories eaten outside the

home jumped from 23.4 to

33.9 percent between 1977

and 2006. The source of the

biggest increase in calories

was fast food eaten at home

and store-bought food eaten

away from home.

“In addition to avoiding

the high-calorie cost of eating

on the run, dining together at

home provides a chance for

family bonding and catching

up on the day’s events,”

says Meghan Jackson, MD,

with Pediatric Associates. n

New moms: 5 ways to prevent back pain

www.levinechildrenshospital.org << 3

how do I know if my child is ready for school?

Most schools use cutoff

dates—deadlines by

which a child must be a

certain age—to determine

eligibility for kindergarten.

However, it’s also important

to make sure that your child

is ready. Consider his or her

communication and listening

skills. Does your child play

and cooperate well with

others? Use your own intuition

as a parent and consult your

child’s healthcare provider

and preschool teacher to

learn more about your child’s

readiness for school.

“Social readiness is

important for long-term

school success,” says Michael

Bean, MD, with University

Pediatrics-Prosperity Crossing.

“It’s far better to have your

child take another year

to mature socially, than

to advance him or her to

kindergarten,” Dr. Bean says.

Try these tips to help

prepare for the upcoming

transition:

• Encourage basic skills. Work with your child to help

him or her recognize letters,

numbers and colors.

• Read, sing and play games. Start reading to your

child when he or she is an

infant. Singing and playing

how do I get my child to go to bed?

Getting your child

to sleep can be a

struggle. To help your child

sleep more easily, start

by creating a calming

nighttime routine. Repeat

the same routine each

night—like giving your child

a warm bath, brushing his

or her teeth and reading a

bedtime story. Then, make

your child feel comfortable

by tucking him or her in.

Some children feel like

they aren’t tired; others think

>> Moms want to know …

>> Milestones

more appealing if your child

slows down before bedtime.

• Remind your child you’ll be

going to bed shortly after him

or her and limit other family

members to quiet activities.

• If your child is afraid of the

dark, turn on a night light

or leave the bedroom door

open.

• If your child isn’t tired,

try fewer daytime naps or

waking up your child earlier

in the morning. You can

also put your child to bed

a few minutes earlier every

night. n

rhyming games can help

encourage language skills.

• Expose your child to learning experiences. Look

for opportunities to broaden

your child’s horizons, such as

preschool.

• Encourage socialization. Promote your child’s social

skills by encouraging him or

her to play with children of

both sexes. n

they’re missing out on fun

activities that happen after

they’re asleep or are scared

of being alone in the dark.

To address these feelings, try

these tips:

• Keep things quiet the last

hour before bedtime and

dim the lights. Sleep may be

1000 Blythe Blvd., Charlotte, NC 28203704-446-KIdS (5437)

Carolinas Kids is published as a community service of Levine Children’s Hospital, located on the campus of Carolinas Medical Center. If you are interested in receiving an e-mail when a new issue is available, visit www.levinechildrenshospital.org.

The information contained in this publication is not intended as a substitute for professional medical advice. If you have medical concerns, please consult your healthcare provider.

Copyright © 2012 Carolinas HealthCare System

A PublIcAtIoN of levINe chIldReN’S hoSPItAl

carolinas kidsSPRING 2012

4 >> carolinas Kids

through a partnership with Carolinas

Rehabilitation, Levine Children’s Hospital

provides inpatient and outpatient pediatric

rehabilitation services in a unique kid-friendly

environment. Our primary goal is to help young

children and adolescents lead longer and

richer lives at the highest level of functioning

possible. Since both facilities are part of Carolinas

HealthCare System, they’re able to provide

coordinated care, making transitions seamless for

patients and families.

With Colleen Wunderlich, MD, MSc, a board-

certified pediatric physiatrist on staff, patients and

their families receive care that few hospitals in

the country can match. Only five board-certified

pediatric physiatrists practice in North Carolina

and fewer than 200 practice in the United States.

Carolinas Rehabilitation recently opened a

pediatric-dedicated outpatient therapy location in

leading-edgerehabilitativetechnologyfor children

oN the Move: olivia Alverez practices walking, while her physical therapist, jennifer dicicco, dPt, offers encouragement.

www.levinechildrenshospital.org << 5

“Before, her legs would go everywhere, except the

right way,” says Esperanza. “Now, she has better leg

control, which has helped her mimic the correct

way to walk.” n

Charlotte, which is designed to provide children

with a relaxed and comfortable environment

where they’re treated for a range of conditions

(see Comprehensive rehab services, at right) and

receive specialized treatment options.

Our expertise in pediatric rehabilitation has

been noticed. Carolinas Rehabilitation recently

received $119,750 in grant funding, which enabled

us to purchase the pediatric component for the

existing robot-assisted gait-training orthosis.

Previously, this service was only available to adult

patients.

working toward a dream One young patient who’s had great success

with the device is 11-year-old Olivia Alverez, who

has cerebral palsy and can’t walk on her own.

According to her mother, Esperanza, Olivia

suffered from a lack of oxygen to her brain when

she was born, which damaged the part of the

brain that controls physical movement.

Olivia has used a wheelchair since she was

2½ years old and is quite skilled at driving it. Even

so, her mother has high hopes for her daughter.

“My hope and dream is to see her walk one day,”

says Esperanza.

She’s made real progress toward that goal with

the help of the robot-assisted orthosis. Jennifer

DiCicco, DPT, Olivia’s primary therapist, has

worked with her for a year, training Olivia on the

device. DiCicco explains that Olivia experienced

the feeling of normal walking—something she had

never had before. “Our goal is not only to improve

the quality of Olivia’s walking, but also to work

toward walking in a gait trainer or walker with

little or no assistance.”

Rerouting brain signals“The robot-assisted orthosis reroutes signals

in the brain that are disturbed due to neurological

problems,” explains LaTanya Lofton, MD, a

physiatrist at Carolinas Rehabilitation. “This helps

patients improve their strength and increases

circulation.”

Along with her physician and therapists,

Olivia’s mom is very happy with her progress.

comprehensive rehab serviceslevine children’s hospital provides comprehensive

inpatient rehab services for children and

adolescents who have experienced a debilitating

illness or injury. our nationally recognized pediatric

program serves children of all ages. Inpatient

rehabilitative specialties include:

• brain injury rehabilitation

• cognitive education

• nursing

• occupational therapy

• physical therapy

• psychology

• recreational therapy

• rehabilitative medicine

• social work

• speech therapy

• spinal cord injury rehabilitation

carolinas Rehabilitation Pediatric outpatient

therapy program works with children who require

therapy after discharge from a hospital. the

interdisciplinary team designs custom treatment

and community integration programs for any child

who has challenges with speaking, swallowing,

mobility, self-care skills, handwriting and sensory

concerns.

Another Pediatric outpatient therapy program

is conveniently located at carolinas Rehabilitation-

university in university Medical Park.

See the action!

To watch a video showing

Olivia working with her

therapist, scan this QR code

with your smartphone or visit

www.levinechildrenshospital.org/olivia.

eNjoyING the fReSh AIR: olivia Alverez and her physical therapist, jennifer dicicco, dPt, continue therapy outside.

with middle-aged athletes, are particularly

vulnerable to sports injuries.

Kids will be kidsMany sports injuries in children are minor,

but some are more serious and can even have

lifelong effects. As a parent, remember that your

little athlete isn’t a small adult. No matter how

well your children perform on the basketball

court, they’re still masses of growing muscles,

bones, ligaments and tendons, and their bodies

are weaker than those of adults. For example,

traumas that might lead to a muscle tear or bruise

in an adult could lead to a broken bone or serious

growth-plate injury in a child. Contact sports are

especially known for putting young athletes at

risk for severe injury; despite proper training and

use of safety equipment, the dangerous nature of

contact sports puts your child at risk for serious

head, neck, spinal cord and growth-plate injuries.

Yet, the fear of sports injury is no reason to

keep your little one on the sidelines, and you can

do plenty to help keep your little athlete injury

free. “Staying active with regular, age-appropriate

exercise that incorporates safety and fun

improves lifelong health and mood,” says Colleen

Wunderlich, MD, MSc, a board-certified pediatric

physiatrist at Levine Children’s Hospital. “It’s been

shown to aid concentration, memory and thinking

in children as well as adults.”

1 Don’t push your child too hard. It’s natural

to push your child to do his or her best.

However, trying to perform beyond their ability

puts children at risk for injury. Instead, emphasize

having fun and building confidence rather than

winning or competing at a certain level.

2 Do support proper training. Little bodies

can’t endure the type of intense conditioning

Keep your little athlete injury free

g etting your child involved in

community or school athletic

programs can help him or her

establish lifelong healthy habits,

which is especially important as America’s

obesity epidemic continues to expand. Playing

sports can also help children improve their

coordination, self-esteem and self-discipline.

Team sports in particular can teach your children

valuable lessons about cooperation and working

with others. However, although sports offer many

benefits, they also involve some risks, especially

for young children. According to the National

Institute of Arthritis and Musculoskeletal and

Skin Diseases, children and adolescents, along

>> 5 safety tips

6 >> carolinas Kids

that teens and adults can; however, it’s never

too early to encourage your little athlete to train

properly. A program that includes sport-specific

exercises is one way to prevent injury. Ensuring

that your child understands the rules of his or

her chosen sport can also help. Coaches are often

good resources for developing training programs,

as are sports medicine centers in children’s

hospitals.

3 Do invest in the appropriate protective gear.

Protective gear is vital for preventing injury,

especially when dealing with contact sports. Make

sure your child knows how to use safety equipment

and always wears his or her protective gear.

4 Don’t forget about the eyes. Most discussion

of sports injuries in children revolves around

broken bones and muscle strains; however,

eye injury should also be on your concern list.

According to the National Eye Institute, the

majority of eye injuries in school-age children in

the United States are sports related. As a parent,

you can help make sure your young athlete’s eyes

are properly protected and encourage your school

to adopt an eyewear policy.

5 Do take injury seriously. Don’t allow your

little athlete to play when he or she is overly

Should my child take a multivitamin?Q

House calls nutrients. And because children

don’t need large amounts of

vitamins and minerals, they may

be getting more than you think.

Ask your physician for advice

if you suspect your child isn’t

getting enough nutrients.

If you choose to add a

multivitamin to your child’s daily

routine, follow these precautions:

• choose a multivitamin that’s

designed for your child’s age

group.

• opt for multivitamins that

provide 100 percent of the daily

value for all

vitamins and

minerals.

• Store

multivitamins

out of your

child’s reach

and make it

clear that they

aren’t candy.

Keep in mind that a multivitamin

isn’t a replacement for proper

nutrition. continue to provide

your child with healthy meals and

snacks. n

Maybe. every child is

different, and experts

disagree about whether

multivitamins are necessary.

Many children are picky eaters

and refuse to eat the nutritious

foods that should be a part of

their diet. but popular foods,

like breakfast cereals, milk and

orange juice, are fortified with

A Karen E. Breach, MD, FAAP

University Pediatrics, Mint Hill Medical Plaza

704-863-9550

tired or in pain. If your child experiences pain, he or

she may already have a minor injury that could be

made worse by continuing to play. If pain continues

after a few days of rest, schedule an appointment

with your child's physician. n

www.levinechildrenshospital.org << 7

be healthy, have fun!

In partnership with Levine Children’s Hospital,

Kohl’s Healthy Kids campaign created Box

Jocks, a creative, kid-friendly way for children

and families to learn about safety and injury

prevention. For more information and to create

your own Box Jock, visit www.boxjocks.com.

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Go to www.levinechildrenshospital.org/extraordinary and read Murphy’s extraordinary story about his very complex heart condition and how the experts at Levine Children’s Hospital are reconstructing his heart and leading the way to outcomes for these types of complicated heart problems. There are children’s hospitals and then there is Levine Children’s Hospital – which makes your choice extraordinarily simple.

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