During an EXIT procedure, a team of specialists—including a perinatologist, neonatologist and pediatric surgeon—put the mother and unborn baby to sleep with anesthesia. An incision is made in the lower belly just like in a cesarean section. The baby gets its oxygen through the umbilical cord until a safe way is found to help the baby breathe. Then, the baby is delivered through a C-section. The Fetal Concerns Center of Wisconsin is the only place in Wisconsin that performs this procedure. The center is a joint program of Children’s Hospital of Wisconsin, Froedtert Hospital and the Medical College of Wisconsin.

My work is very rewarding for several reasons. First, we use cutting-edge medicine to save a baby that otherwise may have not survived. Second, it’s gratifying to be part of a team representing three institutions that work closely together for the benefit of a patient. At the end of the day, these cases represent why I, and others on the Fetal Concerns Center of Wisconsin team, chose to practice medicine.

~ Robert Chun, MD, pediatric ear, nose and throat specialist, Children’s Hospital of Wisconsin
Dr. Chun is part of a team of specialists that provides medical consultation and treatment for pregnant women and their babies through the Fetal Concerns Center of Wisconsin.

CHD is the most common birth defect, and it is present in eight of out of every 1,000 births. Some forms of CHD cause few problems in health, growth and development. Other forms are more critical, and if not detected within the first few hours of life, can lead to death.

Luckily there is a simple, noninvasive and painless screen — pulse oximetry —that can be performed at birth to detect CHDs which measures the levels of oxygen in the blood. Low levels of oxygen or a difference in oxygen saturation between upper and lower extremities are red flags for a heart problem. Without this screening, newborns with undetected and significant CHD could be discharged and would be at risk of getting very sick.

Unfortunately this test is not required at birth. Next week, I will be traveling to Madison along with several other colleagues from Children’s Hospital of Wisconsin to join with the American Heart Association and Mended Little Hearts to educate our elected officials about CHD and the importance of the pulse oximetry screen.

I urge parents to ask their physicians about the availability of the screening because when detected early, babies with a CHD have a better prognosis. It’s important not to forget the smallest of hearts — the ones in a newborn child.

~ 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.

One day, J.C. decided he wanted a puppy to add to the organized chaos we called home. With my fingers crossed, I told him I was only allowed to potty train one living thing at a time, and until he stopped wearing diapers, we would only have a household of two-legged creatures. From that very instant, he was an official “big boy” and I was on the hunt for a puppy.

The trek for this puppy was six hours in a snowstorm—on New Year’s Day—to Minnesota (who would have thought, just to go to our pound!) to obtain the newest member of our family. All this for our foster son who called my bluff. Outsmarted by a 3-year-old, again.

It was a given that this puppy we named Riley would go with the children when they went home. Their parents loved the dog, bringing treats for the dog whenever they came to visit their children. Then their landlord had a change of heart. Like the narrator on Peanuts, I heard it echo loud and clear, “No dogs allowed.”

J.C. is still at home, and I still have his promised potty puppy. This cute little canine that came to us the size of a 12-ounce soda can, has morphed into a 6-year- old overweight dog who is blind in one eye, has a tumor on one leg and is a constant reminder of the first time I fell head over heels in love with a child that I parented that I did not birth. That it is possible to unconditionally love outside of your gene pool, to be a fiercely protective mama bear to someone who calls someone else mama. Life lesson brought by a 3-year-old boy and a dog.

So I leave you with this question. What life lessons have you learned in an unconventional way? Did an impromptu visit to a shopping mall bring about a lesson you learned? Did you finally see something for the first time through the eyes of a toddler that was there all along, but your eyes were closed to it?

Share with us. Let us learn through you!

Best to all this day,
Paulette

~ Paulette Drankiewicz, foster parent liaison, Children’s Service Society of Wisconsin

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.

I know that all pieces of free-standing furniture and TVs have the capability of tipping over. As a parent of a 10-month-old and as the Safe Kids Wisconsin coordinator, I am well aware of the potential hazard that poses for my son. After all, my son is curious and into everything just like all other toddlers and kids.

Since October, there have been three deaths in the Chicago area related to TVs falling onto children. Consumer Product Safety Commission data shows in 2006, there were 19,300 injuries associated with product instability or tip-overs involving children younger than 10. It’s not just an infant and toddler issue.

As parents, it’s important to make our children’s environment as safe as possible. My husband and I recently bought furniture straps to secure our television stand to the wall. We also bought a wall mounting bracket for our television.

Here are a few tips for securing your furniture:

• If a piece of furniture is unstable or top-heavy, secure it to a stud in the wall using brackets, braces, anchors or wall straps. Large items such as TVs, microwaves, fish tanks, bookcases, heavy furniture and appliances can topple off stands and fall on children.
• If you have a newer, flat screen TV, make sure it’s properly anchored to the wall.
• Read the manufacturer’s instructions for tips or warnings regarding placement of your TV or furniture.
• Keep heavier items on lower shelves or in lower drawers as this will help eliminate top-heavy furniture which topples over easily.
• Don’t keep remote controls, candy, toys or other items that attract children on top of furniture, as your child might be enticed to reach for these items.
• Supervise young children at all times.

Last, get down on your knees and look around the room to see the dangers at your child’s level. I also encourage you to visit safekidswi.org for additional resources.

Parents, post a comment and share your tips for keeping children safe at home.

~ Libbe Slavin, coordinator, Safe Kids Wisconsin Coalition

We are often asked, “Does hearing from me really make a difference when you are voting on policy issues?” The answer is YES! We benefit from and rely on hearing from our constituents about issues that are important to them.

Rep. Jason Fields

Even one phone call, one email or one letter can make a difference. This is especially true when we are talking about issues that impact kids.

If not you, then who will speak up for the children in your community?

While facts and data are important when talking about certain issues, it is also important for us to hear about your personal experiences and why you feel so strongly about an issue. Building a relationship with our constituents is a priority for us and we are better at our jobs if we know where our constituents stand on policy issues.

So…don’t be afraid to pick up the phone or drop an email to your legislator. Remember, we want and need to hear from you!

Sen. Leah Vukmir

We encourage you to consider joining Children’s Advocacy Network (C.A.N.), a wonderful advocacy network operated by Children’s Hospital of Wisconsin that helps improve the health and well-being of children and their families.

By joining C.A.N., you’ll learn about opportunities to contact your legislator, receive updates on child advocacy activities and be asked to participate in community events.

Visit chw.org/CAN to learn more, sign up and start advocating on behalf of children.

~ Representative Jason Fields, 11th Assembly District, and Senator Leah Vukmir, 5th Senate District.

So what does this really mean for the children and families who come through our doors?

• Children treated here benefit from cutting-edge therapies when traditional treatments have been exhausted.
• Children and their families can stay right here in Milwaukee with their trusted doctors and nurses to participate in a clinical study. Previously children and their families would have to relocate to participate in these studies.
• Information gathered by the consortium contributes to the development of new therapies and adds to the understanding of childhood cancer around the world.

A heartfelt thank you to the MACC Fund for their support in developing the infrastructure needed to run these early clinical trials. It’s a great thing when we know we are offering our children the best possible treatment options.

~ Michael Kelly, MD, PhD, Children’s Hospital of Wisconsin
Dr. Kelly is part of the multidisciplinary oncology team at Children’s Hospital of Wisconsin that diagnoses and treats childhood cancers. Founded in 1974, our Oncology Program is an active member of Children’s Oncology Group, an organization dedicated to studying childhood cancers.

Sitting at a meeting one hot August night, I found myself accosted by a 2-year-old boy with an angelic face who promptly jumped into my lap, buried his sweaty little head in my chest and sat there for the entire two-hour meeting. When the meeting ended, I looked at his presumed parents and playfully asked, “Can I have him?”

Unbeknownst to me, my life was about to look vastly different in the months ahead. You see, this beauty of a boy was being fostered by his aunt and uncle – “kinship care” in foster speak – and that very afternoon, they had called the social worker and given their 30-day notice. They were unable to continue providing care for this little guy and his 3-year-old sister.

After discussing this with my husband and birth children, we decided as a family to enter the world of fostering. Our lives have never been the same.

So I ask each of you the question I opened with. Why did you choose fostering? More importantly, for those of you who have yet to embark on the fostering road, why have you NOT chosen to foster?

With your involvement, I look forward to continuing to blog about all things related to fostering. My goal is to start a conversation not just for foster parents, but for all who want to make a difference in the life of a foster child. When you get involved, your life will never be the same.

I encourage you to visit cssw.org or call 414-KID-HERO (414-543-4376) for more information about foster care.

~ Paulette Drankiewicz, foster parent liaison, Children’s Service Society of Wisconsin

“Children are made readers on the laps of their parents.”
~ Emilie Buchwald, award-winning children’s novelist

So what’s a busy family to do when the lap time gets crowded out? Is it possible to nurture your child’s love of reading and maintain the pace of modern family life? How does your family find time for literacy in a Blackberry-paced world?

Here are some literacy tips for early readers:

• Point out print in the child’s environment – on cereal boxes, food labels, toys, restaurants and traffic signs. Sing songs, say short poems or nursery rhymes and play rhyming word games with your child.
• Read a short passage several times to your child until he or she can read it with you. Then encourage your child to read the passage to you.
• Encourage older children to read with younger children.
• Encourage your child to read (or pretend read) to you. Make this reading enjoyable. Don’t worry if your child does not read all of the words correctly but, rather, applaud your child’s efforts to read.
• Have books, magazines and newspapers around the house. Let your child see you reading.
• Encourage your child to write messages such as grocery lists, to-do lists, post cards, etc. He or she also could write short messages to family members or friends. Don’t worry about conventional spelling at this point but, rather, encourage your child’s first efforts at authorship.

Parents, what do you think? Post a comment and share your early reader successes!

~ Aaron Heffernan, therapist, Children’s Service Society of Wisconsin
Literacy tips above adapted from Mraz, Padak and Baycich (2002). Visit chw.org/cssw to learn more about Children’s Service Society of Wisconsin.

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.