With the cold weather and snow finally here, I’m just waiting for the calls from worried parents about lice and nits. Picture it: Mittens, hats and coats jumbled in piles outside the classroom, with all the kids trying to figure out which hat is theirs. Parents call us in tears. They tell us that their son or daughter has been “kicked out of school” until all the lice and nits are gone. It’s a rough situation.

The American Academy of Pediatrics (AAP) issued a report that provides good recommendations for dealing with lice. Some of the key points of the report include:

• School-based head lice checks are not cost effective. The AAP says that your pediatrician should take a greater role to help diagnose and treat lice.
• Accurate diagnosis is important. Oftentimes, children with dandruff or other dirt and debris in their hair are mistaken for having lice or nits.
• Treatment needs to follow proper use. Over- or under-using the treatment can cause the lice to survive. The AAP recommends an over-the-counter permethrin (1 percent) treatment such as Nix®. It’s important that parents follow the instructions and remember to reapply the treatment about a week later to ensure all the lice and eggs have been killed. Wet-combing and hand-picking the lice and nits from your child’s hair is an effective but time-consuming treatment method. If your child still has issues with lice, work with his or her doctor to find an effective prescription-strength medication.
• “No-nit policies” should be discouraged. The report says that keeping kids away from school can have emotional and academic consequences. No child should have to stay home from school because of head lice. Most cases of lice are picked up in homes, not at school. Lice crawl. They don’t hop or fly so you have to get lice from direct head-to-head contact. Despite this, many school districts have no nit policies. Be sure to check on your options with your child’s school.

If your child has head lice, they have probably been there for at least a month. Treat the lice right away. Have your child avoid close, head-to-head contact with others until you know the lice are gone. Follow all treatment instructions carefully.

~ Robert Rohloff, MD, pediatrician, Southwest Pediatrics
Southwest Pediatrics is part of Children’s Medical Group, a network of primary care pediatricians throughout southeastern Wisconsin. Dr. Rohloff is a pediatrician at Southwest Pediatrics in New Berlin, Wisconsin.

Are you looking for a pediatrician? Children’s Medical Group has more than 50 pediatricians serving children at 17 clinic sites. Visit childrensmedicalgroup.org to find a pediatrician near you.

Honestly, it’s never too early to start looking for a pediatrician. Once you know you’re pregnant, go ahead and start the search. However, first be sure you understand the difference between a pediatrician and a family medicine doctor. Pediatricians have three years of specialized, child-focused medical training after completing medical school. Family medicine doctors have three years of training after medical school in the care of all family members.

Start by asking for recommendations from close friends, co-workers or neighbors with children. Specifically ask them what they like about their pediatrician. Gather a few names, then call the clinic and ask to meet with the doctor. Many clinics offer a free “meet and greet appointment” to see if you connect with the doctor on a personal level. Make sure the location is convenient, and talk to the staff at the clinic too. Happy and helpful staff will tell you a lot about the service experience you’ll receive.

When you meet with the doctor, bring a list of questions. Consider gathering information about:

• Education: What is the doctor’s training? What is his or her previous experience?
• Communication: Is the doctor a good listener? Does the doctor try to understand your concerns. Does the doctor offer educational information and care options?
• Scheduling: Does the doctor tend to overbook appointments to fit in more patients? Can he or she spend enough time with you and your child so appointments aren’t rushed?
• Emergencies: How do you reach the covering doctor during off hours?
• Reputation: What are other parents saying about their experiences with the doctors in the practice?
• Practice: Consider how the size of the practice might affect your family. You might find a large practice to be impersonal or busy, but there will always be a doctor available to see your child. Choosing a small practice might allow the doctors and staff better opportunities to get to know your family. However, it may be harder to get an appointment at a small practice depending on the doctor’s availability and the number of patients in the practice.

Many websites now rate and score a doctor’s performance. While these may be a source of information, it’s important to know that they’re not regulated and can be subjective. The best way to check into a doctor’s background is to contact the Wisconsin Department of Regulation and Licensing.

All parents want the perfect pediatrician for their child. Ultimately, it depends on how the doctor makes you and your child feel. Even though it requires some effort to find your perfect fit, the payoff is definitely worth it.

Are you looking for a pediatrician? Children’s Medical Group has more than 50 pediatricians serving children at 17 clinic sites throughout southeastern Wisconsin. Visit childrensmedicalgroup.org to find a pediatrician near you.

~ Anna Rakovshik, MD, pediatrician, North Shore Pediatrics
North Shore Pediatrics is part of Children’s Medical Group, a network of primary care pediatricians throughout southeastern Wisconsin. Dr. Rakovshik is a pediatrician at North Shore Pediatrics in Mequon, Wisconsin.

Some vaccines like chicken pox, influenza (flu), measles and whooping cough are just not effective in young infants. The whooping cough vaccine must be given several times before it triggers the body’s defense. The best way to protect infants is to make sure family members and caregivers are vaccinated. If the infants are not exposed to the germs, they will not get sick.

If you or your children are not up to date, call your health care provider to schedule your vaccinations. It will help protect everyone – even babies who are too young to be immunized.

~ Marylyn Ranta, MD, director of physician affairs, Children’s Hospital of Wisconsin

Dr. Rohloff was recognized for his work instituting a more family-centered way of caring for kids that led to a change in the clinic’s approach to health care. This medical home model is being implemented more widely across the country, and thanks to Dr. Rohloff, Southwest Pediatrics is a recognized leader of this effort in our community.

Robert Rohloff, MD, was recognized as a health care hero.

I’ve known Bob Rohloff for 25 years and his tireless efforts to research and institute this approach and engage an outstanding health care team to sustain this model of care are truly amazing. He volunteers his own time to further the success of the programs he’s helped develop.

I can’t begin to describe how proud I am of Bob’s work as well as all of our Children’s Medical Group pediatricians. For all of them, it’s about caring for kids in the best way possible. Every day, they look for ways to improve patient care.

Making a difference in the lives of kids and families every day. Now that’s heroic.

Are you looking for a pediatrician? I encourage you to consider Children’s Medical Group with 16 clinics throughout southeastern Wisconsin. Visit www.childrensmedicalgroup.org to find a pediatrician near you.

~ Michael Gutzeit, MD, pediatrician and chief medical officer, Children’s Hospital of Wisconsin

Whooping cough is a highly contagious respiratory infection. Although it first seems like a regular cold, whooping cough can turn more serious. It causes coughing so bad that it’s hard for kids to eat, drink or breathe. The coughing can last for weeks. In some cases, kids also develop pneumonia, seizures, and in severe cases, brain damage and death.
It’s easy to spread whooping cough and there is no treatment. Fortunately, it’s also very easy to prevent it.

The DTaP vaccine works very well, but the key is to get all five doses and a booster. Children should get one dose at each of the following ages:

• 2 months.
• 4 months.
• 6 months.
• 15 to 18 months.
• 4 to 6 years.

Older children, adolescents and adults still need protection from whooping cough. A booster shot called Tdap is recommended when kids are 11 to 12 years of age and then every 10 years. It also is recommended for adults who care for infants. The vaccine is safe and does not cause autism.

Children’s Hospital of Wisconsin and Children’s Medical Group track patient immunization data. A recent review shows that for children younger than 25 months, 22 percent of those seen in our specialty clinics and 18 percent of those seen in our primary care practices were not completely immunized for whooping cough. We’re working to improve these numbers.

Be sure to check vaccine records for you and your children. If you’re not sure whether you or your children are fully protected, contact your physician. If you or your kids haven’t been immunized, your doctor or local health department can help.

Looking for a pediatrician? Children’s Medical Group has 16 clinics throughout southeastern Wisconsin. Find a doctor near you.

~ Smriti Khare, MD, president, Children’s Medical Group

Years ago, some parents would deliberately expose their children to other kids who had an active case of chickenpox, hoping that their own child would build immunity. Today, news outlets are reporting another dangerous trend. Some parents reportedly are paying strangers they meet through Facebook to mail them candy that has been licked by a sick child or other infected items in an effort to expose their own child to chickenpox.

Deliberately exposing your children to germs, either through direct contact with a child who is ill or by exposing them to items that may contain live germs, is dangerous. Germs do not exist alone, and infection with some other germs could be much more dangerous than chickenpox. There is no way to know what else is in that spit.

Since the chickenpox vaccine became available, an 88 percent decline in varicella-related deaths has been reported. Deadly complications include pneumonia, encephalitis and infections that arise in chickenpox blisters. Studies also show a 97 percent drop in the number of varicella-related deaths in children younger than 6 since the vaccine became widely used.

Be safe – vaccinate. For more information, visit our website at chw.org/immunize.

~ Marylyn Ranta, MD, director of physician affairs, Children’s Hospital of Wisconsin

This story made me immediately think of the blog post I published back in the spring about the importance of acting under pressure. I applaud the teachers who were properly trained to act and who in the heat of the moment acted appropriately. They called 911, started CPR and applied the AED. This young girl is alive today because of their quick actions. This is a heart-warming story and reminds us why we do what we do.

As a refresher course and in recognition that October is sudden cardiac awareness month, let’s review the proper steps again. When someone goes into cardiac arrest, what appears to be a seizure can be the result of lack of blood flow and oxygen to the brain. During this time, it always is better to do something than nothing. In this setting, tell someone to call 911 immediately, start CPR and apply an AED. The AED will determine if a shockable rhythm is present. It will not shock someone who does not need to be shocked.

Learn more about how Project ADAM can help your child’s school get the CPR training and AEDs it needs. You could help save a life.

~ Stuart Berger, MD, medical director, Cardiology, Children’s Hospital of Wisconsin
Dr. Berger is the medical director of the Herma Heart Center at Children’s Hospital of Wisconsin, one of the nation’s top programs for medical and surgical treatment of congenital heart defects and heart disease in children.

Jenni was born with ostium primum atrial defect (a hole in the heart) and her daughter Cassie also was born with a heart defect.

A few years ago, I had problems with very high blood pressure. My family urged me to see my primary care doctor, who suggested I start by seeing a cardiologist. I immediately called Children’s Hospital of Wisconsin.

After an appointment with Michael Earing, MD, in the Adult Congenital Heart Disease Program, I learned I had hypertension as well as coarctation of the aorta, a narrowing of the largest artery in the body. Without treatment, this could have shortened my life. At 37, I had surgery again at Children’s Hospital of Wisconsin.

Since then, I have learned to listen to my body and pay attention to things that don’t seem quite right. Now, my daughter and I go to Children’s Hospital of Wisconsin every year for checkups.

If you were born with a heart defect, take my advice. See your doctor on a regular basis.

~ Jenni Sego, Adult Congenital Heart Disease Program patient, Children’s Hospital of Wisconsin

Why are we worried about childhood obesity? Because we know that if a child’s BMI is greater than 95 percent for age and gender, it increases the risk of certain complications. Those complications may include high cholesterol, high insulin levels, bone and joint problems and more. Long-term effects of these problems can lead to heart disease, type 2 diabetes and other chronic health issues.

Are you worried yet?

So, what can you do? Talk to your child’s pediatrician if you have concerns about your child’s growth. Children’s Health Education Center provides good habits to support a healthy BMI through a program called 3 2 1 0 Blast Off to a Healthier Family. Every child, regardless of weight, can benefit from this program. It includes:

• Three meals a day. Regular, well-balanced meals helps the body use energy more efficiently.
• Two hours or less of sedentary (sitting in front of a screen) activity. Sitting more makes you burn fewer calories. What do you do in front of a TV? Eat, of course.
• One hour of physical activity a day. Getting your heart rate up helps to burn calories and build good muscles.
• Zero sweetened beverages. Lots of extra sugar and calories are hidden in flavored milks, juices and other drinks. It is nutritionally better to eat the fruit than drink the juice.
• Family – Sit down to a table or a counter to eat with the TV off. This will help you enjoy and remember what you are eating. Plus, family time helps you keep up with what your kids are doing.

As parents, we can be great role models for our children. I encourage you to do all of these things with them.

For your child’s BMI and more information on BMI, ask your pediatric primary care provider. Also visit:

• Centers for Disease Control and Prevention
• USDA’s MyPlate
• American Dietetic Association

Parents, I invite you to post a comment and share how you support good habits with your children.

~ Denise M. Kilway, MSN, RN, CPNP, certified pediatric nurse practitioner, Children’s Hospital of Wisconsin

Pediatric critical care units are the backstop for all that goes on in a children’s hospital. When complications arise, the critical care team is there to support children and help them heal. While providing lifesaving care, we learn a great deal about why children come to us in the first place and the factors in the community that contribute to their health status.

Accidental injuries like falls, drowning, car crashes, fires and burns are the leading causes of death for kids. As clinicians caring for critically ill children, we get excited about new therapies that help us heal our patients. We also get excited about educating parents and other caregivers on how to keep kids from getting hurt in the first place.

Did you know wearing a seat belt in the car reduces a teen’s risk of death or serious injury by at least 50 percent?

Not only is it the law, but strapping infants and toddlers in car seats correctly reduces the risk of injury or death by 75 percent, and a properly installed booster seat reduces the risk by more than 60 percent. Wearing a properly fitted bike helmet is nearly 90 percent effective at reducing the risk of head injury after a bicycle crash. Research, advocacy and community programs at Children’s Hospital of Wisconsin focus on educating children and families on these safety devices.

We have the unique opportunity to care for children when they need us most. We learn from these unfortunate occurrences and help shape our community by educating children and families in hopes of reducing the number of illnesses or injuries.

I like to say we are a safety net and protector of health.

~ Timothy E. Corden, MD, critical care physician, Children’s Hospital of Wisconsin