Get in Shape this Summer

Looking to run a road race this fall? Preparing your son or daughter to join the cross-country team? Just want to shed a few of those hibernation pounds? Nothing like a good jog on the Lakeshore Path or a run through the Arboretum to get yourself ready for the upcoming year! Experienced runner or novice jogger can “shape up” in a matter of 6-8 weeks by following a couple of simple rules.

• Train a minimum of four days a week. If you’ve never run before, start by using a combination of walking/jogging for a couple of miles every other day. If you’re an experienced runner start at a daily mileage you feel comfortable with.

• Increase your distance by about 10% a week. (i.e., if you just ran 25 miles, move up to 28, then 31, etc.) For variety, add in a short temp run by increasing your pace to the point where it just becomes difficult to converse. Once a week, try to go “long and slow.” A good mid-preseason schedule might have two easy runs, one tempo run, one long run and one medium distance run.

• Vary the scenery and the terrain. Madison has so many wonderful places to enjoy. And don’t forget to keep yourself well-hydrated!

• Go for a family run! Baby joggers (for children up to four) and bicycles can be a great way to get everyone involved in the outing!

Dr. Ron Grant
Pediatric Hospitalist
Meriter Hospital
meriterkids.com

What is the Meriter Pediatric Center?

I am so excited! Not only is this my first opportunity to write a blog, but also the long-awaited opening of the Meriter Pediatric Center is only a day away! On Tuesday, May 18th, the hard work of so many over the past two years will finally come to life. A Pediatric Center is a new concept for many of us, so I thought I would take this opportunity to explain what you can expect of a visit to the Meriter Pediatric Center.

The Meriter Pediatric Center is an 8-bed unit, located adjacent to the Emergency Department, which is staffed by Nurses, Physician Assistants, Pediatricians, and Emergency Physicians, all of whom are trained to care for children. The Center was designed specifically with children and their families in mind, and will centralize care for the majority of children receiving emergency and inpatient services at Meriter Hospital. For children 17 years of age and younger who come to Meriter for non-life-threatening emergency visits, there are 5 exam rooms dedicated to their care, along with a pediatric-only waiting area. There are also three inpatient beds which will be reserved for children 15 years of age and younger who require hospital admission for observation, further treatment or post-surgical care.

Outside of the Pediatric Center, children will continue to be cared for across the entire hospital for a host of other services, including outpatient surgical procedures, medical imaging procedures, and therapy visits. In addition, patients with severe illness and injury will continue to be cared for in the main emergency department. Children ages 16 and 17 years who require hospitalization will be admitted to the appropriate specialty unit, but will be cared for by pediatricians, surgeons or family medicine physicians.

I hope that you and your child never need the services of the Meriter Pediatric Center. But if you do, know that your child will be in the excellent hands of caring and professional staff who are all dedicated to providing the best care possible for children.

Have a Happy and Healthy Summer!

Dr. Nicole Baumann-Blackmore
Medical Director, Pediatric Hospitalist Program
Meriter Hospital
meriterkids.com

Fears in Toddlers

I was recently asked about a toddler who was afraid of her own shadow. Fears are common in toddlers, so I have included my response on our blog.

Developmentally, toddlers are becoming much more aware of what is around them and becaue of this, parts of everyday life that they didn’t notice before can become terrifying. In addition, toddlers are starting to develop a wonderful sense of imagination. They often struggle to distinguish between what is real and make-believe and they are still learning the concept of cause and effect. As a result, fears are quite common and normal in the toddler and preschool years. They become abnormal only if they develop into persistent and irrational fears that interfere with the child's normal activities. Some common fears in toddlers include fear of being separated from their parents, the vacuum cleaner or other loud noises, the bathroom drain, the dark, and yes ... even their own shadow.

For most common toddler fears, it is gentle reassurance and basic, truthful information that most successfully assuages a toddler's anxiety. For example, if he or she is afraid of shadows, don't bend over backward to avoid going outside. Make sure you acknowledge your toddler’s fear by mirroring their emotions, e.g. “the shadow is scary for you." In the case of shadows, expose him/her slowly to what he/she fears; some contact with what shadows (in a controlled setting with you right next to him/her or holding her while providing lots of reassurance will probably help). Gradually increase his/her exposure to shadows. Talk about the shadows in simple terms. Read books about shadows. You could do puppet shows on the wall. Silliness often helps. For example, you could make your shadows do silly dances. As she starts feeling more comfortable, you could play a game of “shadow tag” trying to “tag” each others shadows.

Chances are that once you have acknowledged your toddler’s fear and once your toddler senses that you are not afraid, they will follow suit.

Dr. Sumita Ram
Pediatrician
Meriter Pediatrics
2275 Deming Way, Suite 220
Middleton, WI 53562
608.417.8388
meriterkids.com

Planting a garden with your child

Spring has sprung, and summer is on its way. This is a great time to plant something with your child. Flowers are fun, but vegetables can help a child learn that food doesn’t just come from the refrigerator. Even veggie-avoiding kids will sometimes try things that they grew themselves.

Many of the most delicious crops require full sun, but they don’t require a garden plot. Some can be grown in a pot! Every summer I grow five big tomato plants out in my main vegetable garden, but I also grow a cherry tomato in a half barrel that’s on our deck. I plant flowers all around the tomato and use a more decorative support structure since it’s visible right out the window. Last year my main task was trying to teach my two-year old that the tomatoes taste best if you wait until they are orange. (I planted Sun Gold, a very tasty variety that I highly recommend!)

Pole beans are green beans that grow on tall vines and taste delicious. If you have a sunny piece of ground, you can put up one 6 to 8 foot pole and bring strings down from a nail at the top to tent pegs in the ground in a circle that is 4 to 6 feet in diameter. Have the strings about a foot apart on the ground, and leave one area with at least two feet in-between strings for an opening. Then plant 4 beans at the base of each string. As the summer progresses, the vines will create a playhouse of leaves—a shady place with first flowers and then beans. If you have multiple poles available you can make a teepee of poles, tied together at the top. Then you could plant 6-8 seeds for each pole since they are further apart, as in this picture. Alternatively if there’s a window of your house with a southern or western exposure, you could set up strings in front of the window. By the hottest part of the summer, the beans will provide a nice leafy sun block.

Have fun with planting and add your suggestions as comments on our Meriter Facebook page. What have you grown with your kids in the past?

Dr. Julia Mason

Pediatric Hospitalist

Meriter Hospital

meriterkids.com

Bug Off!

It’s so exciting that spring is finally here after our long Wisconsin winter! Continuing on the summer theme, I’d like to talk about protecting kids from those pesky mosquitoes. Ordinarily, the bites of mosquitoes are just a nuisance. The bite may cause itching or swelling (a lot more swelling in some people than in others — and, yes mosquitoes definitely prefer some of us more than others).

Here are some tips to avoid mosquito bites when outdoors:
- Don't use scented soaps, perfumes or hair sprays on your child.
- Avoid areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in bloom.
- Avoid times when mosquitoes bite. Generally, the peak biting periods occur just before and after sunset and again just before dawn.
- Wear appropriate clothing. Long-sleeved tops and long pants made of tightly woven materials keep mosquitoes away from the skin. Be sure, too, that your clothing is light colored. Keep trouser legs tucked into boots or socks.

You will also need to use an insect repellant. DEET-containing products are the most effective mosquito repellents available. DEET has been used for over fifty years with a very good safety profile. Other products have not necessarily been as thoroughly studied as DEET, and may not be safer for use on children. The American Academy of Pediatrics Committee on Environmental Health feels that products containing DEET up to concentrations of up to 30% are safe for use in children 2 months and above. In choosing the strength of DEET to use, keep in mind that the more DEET a product contains, the longer the repellant can protect against mosquito bites.

Products containing citronella, lavender, mineral oil and soybean oil generally do not last very long. Herbal products containing lemon eucalyptus oil as a repellant are the only ones found to have effectiveness similar to DEET containing products. Those are only recommended in children above the age of 3 years old.

When using DEET containing repellants in children, keep in mind the following safety tips:
- Select the lowest concentration effective for the amount of time spent outdoors. It is generally agreed that DEET should not be applied more than once a day.
- Apply the product to your own hands and then rub them on your child. Avoid children's eyes and mouth.
- Do not apply repellent to children's hands. (which often end up in their mouth)
- To make sure your child’s skin will not react to the repellent, apply the product to a small area of skin, arm or leg before general use.
- Use just enough repellent to cover exposed skin and/or clothing. Do not use under clothing.
- After returning indoors, wash treated skin with soap and water. Wash treated clothing before wearing again.
- Do not apply over cuts, wounds or irritated skin.
- Do not spray DEET-containing products in enclosed areas. DEET products will NOT repel stinging insects such as wasps and bees.

Questions or comments? Please post them on our Meriter Facebook Page.

Enjoy your time outdoors,

Dr. Sumita Ram
Pediatrician
Meriter Pediatrics
2275 Deming Way, Suite 220
Middleton, WI 53562
608.417.8388
meriterkids.com

Keeping Summer Fun

Whoever thought that age four would be the time to start worrying about extracurricular activities? The arrival of the YMCA and MSCR summer guides began my internal debate.

Perusing through the pages of both guides peaked my interest in many activities. I haven’t played tennis is over five years, and the adult tennis class sounds like fun. If only I was ten again, I could go to summer camp. . . Okay, back to my four-year-old. Up until this year, he was too young for many activities. Promoting a healthy lifestyle (including physical activity) at this age is very important for life-long health, but do I sign him up for karate or swimming or gymnastics or yoga or outdoor soccer or a soccer camp or a multi-sport camp or . . . The list goes on and on, and it will only get longer as he gets older.

As with all families, our time is limited, and I want to make the most of the time we are together. I also look forward to having trips to the library, zoo, park and many of the other amenities offered by living in Madison. We also want to take short weekend trips to explore new places and if I fill the summer with scheduled activities, when will we go exploring? My son has taught me that spontaneity can be the most fun. Children benefit from structure in some activities, but also need time to explore the world on their own and create their own adventures. My husband and I thought it was a great idea to go see the St. Patrick’s Day parade. My son enjoyed the parade, but had just as much fun running around the Capital lawn playing hide-and-go-seek. I don’t want to limit these opportunities to create his own fun (and mine, for that fact) by scheduling away all our free time.

The American Academy of Pediatrics has a good article to help guide parents: http://www.healthychildren.org/English/healthy-living/fitness/Pages/Physical-Activity-Make-the-Right-Choice-for-Your-Child.aspx.

So, I continue to have the internal debate, but for the time being, my son is only scheduled in 1-2 activities per week. I am planning to keep all weekends free in the summer for exploring and discovering what fun we can have on our own. The most important thing is for us to figure out what works for our family, stay active and have fun.

Dr. Dana Johnson
Pediatrician
Meriter Pediatrics
2275 Deming Way, Suite 220
Middleton, WI 53562
608.417.8388
meriter.com/pediatrics

When April showers bring more than May flowers

Yes, spring is finally here … I always look forward to this season. You can see the grass turn green, flowers starting to bloom. Ah, fresh air. But for some people it may be a season that brings misery. Seasonal allergies are common at this time of the year. According to the Asthma and Allergy Foundation of America, more than 40 million Americans suffer from indoor/outdoor allergies. Unfortunately, kids can suffer from seasonal allergies as well. In fact, if a parent has allergies, the risk is higher for the child to develop them. I guess my kids can blame my wife and me for theirs.

What are the symptoms? Sneezing, clear nasal discharge and itchy eyes, are typical complaints. Sometimes a pattern of chronic colds may occur at the same time of the year as well. Other complaints may include throat clearing, stuffy nose, itchy nose and throat. In some individuals, a cough may be present. Children with allergies may have dark circles under their eyes, called "allergic shiners." And everyone has seen the classic "allergic salute." My son can demonstrate this very well. (It’s the process of itching or rubbing the nose upward with their palm.) Untreated allergies may also affect a child’s sleep patterns as well, which in turn, may affect their school or sports performance.

Sometimes the symptoms of a cold may be mistaken for allergies and vice versa. But, duration, fevers, color of discharge, as well as other symptoms can be used to differentiate between the two. For example, a fever may accompany a cold, but you would not expect that with seasonal allergies. If you are not certain, my advice would be to discuss this with your child’s doctor.

Treatment:
· Limit the time spent outside or during the peak times of pollen count
· Change clothes and wash your child’s hair after they play outside
· Keep the windows closed, or turn the air conditioner on (assuming it’s warm outside)
· Tree pollen counts may be high early in the morning during spring. During the summer, try to avoid the afternoons or early evening, to avoid grass pollen. Ragweed allergy is prevalent in the fall season and high during midday.

Medications: There are many medications to treat allergies, ranging from over the counter anti-histamines to prescription nasal sprays and medications. I’m certain you have seen the commercials. The variety of medications in the pharmacy can be quite overwhelming. My advice would be to talk to your child's doctor. You want to make certain the symptoms are consistent with seasonal allergies and not any other condition, and you also want to make sure they are age-appropriate. Allergy medications and homeopathic remedies may also have side-effects that can cause drug interaction, serious and dangerous side-effects and cause injury.

I hope that you and your family are able to enjoy this vibrant time of year.

Viren Bavishi, D.O.

Pediatrician

Meriter Pediatrics

2275 Deming Way, Suite 220

Middleton, WI 53562

608.417.8388

meriter.com/pediatrics