Concussions are brain injuries and need to be taken seriously. They don’t just happen in professional sports, they happen in every sport, at any age, to boys and girls.

Concussions are treated much differently now than they were 10 years ago. While we have learned a lot about concussion, medical professionals continue to learn how to better recognize, treat and prevent short- and long-term consequences.

A concussion is a brain injury that temporarily alters brain functions. It usually happens after a direct blow to the head, but it also can happen from a blow elsewhere on the body where the force gets transmitted up to the head. Most young people are not knocked out, and many kids have no memory loss. Even a child with a normal MRI or CT scan of the brain can have a concussion, because it’s a functional injury, not damage to the brain’s structure.

After any hit to the head, it’s important to watch your child for any symptoms or signs of a concussion. Symptoms fall into four categories:

1. Cognitive. (Confusion, disorientation, memory loss, slow to answer questions and follow commands, easily distracted.)
2. Physical. (Headaches, nausea or vomiting, dizziness, clumsiness or balance problems, blurry vision, poor coordination, sensitivity to light or noise, or loss of consciousness.)
3. Emotional. (Nervousness or anxiousness, sadness, irritability or mood swings, inappropriate behavior.)
4. Sleep problems. (Difficulty falling asleep, frequent waking at night, fatigue or tiredness during the day.)

Any athlete with a concussion should stop playing immediately. He or she should never return to any activity (even jogging or weight lifting) the same day the concussion happened. This is important even if the symptoms last for 15 minutes then seem to go away.

All athletes with a concussion should be evaluated by an appropriate health care professional before returning to activity. Athletes also shouldn’t return to a sport while they are still having concussion symptoms.

Concussions in young people can last weeks or months. In fact, adolescents with concussions heal more slowly than adults. Symptoms of concussion can interfere with school, social activities and family relationships. Athletes who have had a concussion are at least twice as likely to suffer another one. Each concussion needs to be treated individually, and athletes who suffer multiple concussions will have more problems with recovery.

Treatment for a concussion involves rest from sports and physical activity. Through Children’s Hospital’s Concussion Clinic, we educate families, athletes, coaches and teachers about concussions, and guide a safe return-to-play program. We also use ImPACT™, a computerized testing program to help guide concussion treatment.

I can’t stress enough that all concussions are brain injuries and need to be taken seriously.

–Kevin Walter, MD, program director, Pediatric and Adolescent Sports Medicine

The farmer’s market is sponsored by Children’s Hospital and Health System’s Employee Health and Wellness team. It provides employees, as well as patients, their families and other employees at the Milwaukee Regional Medical Center, with easy access to farm-fresh produce.

Stop by the Children’s Hospital farmer’s market every Tuesday from 1 p.m. to 6 p.m. through late September.

Check out this video to see more of the advantages of buying produce from local growers:

Click here to view the embedded video.

There are many different causes of hearing loss, but the increased popularity of MP3 players and iPods®, especially when used with ear buds, has been recognized as a major contributor to noise-induced hearing loss. Ear buds actually can be more damaging to your hearing because they are placed directly into the ear and can increase the sound signal by as much as six to nine decibels. That’s the difference between the sound made by a vacuum cleaner and the sound of a motorcycle engine.

Ear buds don’t block unwanted sound, so kids increase the volume to hear the music. Portable music players also have a longer battery life and a capacity to hold and play lots of music. This encourages kids to listen longer, which also increases the risk for potential hearing loss.

Noise-induced hearing loss happens when the tiny hair cells in your ears are damaged. The inner ear contains thousands of these hair cells, and sound causes them to vibrate. This sends a signal to your brain so you can understand what you hear.

Compare the hair cells in your ear to blades of grass and loud music to people stepping on the grass. If one person walks across the grass, the grass bends but quickly springs back up. If 50 people walk across the grass over and over, it doesn’t have time to recover and eventually becomes permanently damaged—just like your child’s hearing.

So how loud is too loud? If you can hear the music coming from your child’s iPod or MP3 player, the volume is too loud. To make sure your child is using these devices safely, remember the 60 percent and 60 minute rule. Hearing specialists recommend listening to portable music players with ear buds at 60 percent of their maximum volume for no more than 60 minutes a day.

-Laurie Newton RN, CPNP, pediatric nurse practitioner, Otolaryngology, Children’s Hospital of Wisconsin Clinics-New Berlin.

While this might seem like a dramatic example, this could have been a reality for many Americans. State Medicaid budgets throughout the country are struggling and without adequate funding, states are forced to make cuts to essential programs including funding for health care providers who serve kids covered by Medicaid.

These are challenging fiscal times. Fortunately, last week federal lawmakers took action and voted to extend enhanced Medicaid matching funds (FMAP). The extension, which runs through June 2011, provides critical funding for the Medicaid budget, which is crucial for hospitals such as Children’s Hospital of Wisconsin. More than 50 percent of the children receiving care at Children’s Hospital and its clinics rely on Medicaid for health care coverage. The hospital cares for all kids in need, regardless of the family’s ability to pay. That is part of what makes us special, but it also is a challenge to maintain when Medicaid budgets are strained. Even with these enhanced dollars from the federal government, our costs for providing care are only partially paid.

Our Medicaid budget remains fragile, but there is no question that without these additional federal dollars, we would be at larger risk

Children’s Hospital and its advocates actively lobbied our federal delegation for support of this important provision. We can give a sigh of relief that they listened and helped bring critical funds back home to Wisconsin.

Do you want to learn how to be an advocate for children’s health care? Visit Children’s Advocacy Network.

-Michelle Mettner, vice president, Government Relations at Children’s Hospital of Wisconsin.

The Noel Family Healing Garden is more than just a beautiful outdoor space. In fact, studies show that being exposed to peaceful, outdoor areas such as this one can help our patients heal.

The garden also provides a temporary respite for our families and staff. It is designed for the mother who needs to sit alone with a book for a few moments of peace, the nurse who needs to gather his thoughts after a difficult day in the Emergency Department and for the father whose child has just been diagnosed with a heart defect. This is a place of peace.

No leaf went unturned in the planning of the Healing Garden. The plants, trees and shrubs won’t attract the insects that could hurt our patients. A life-sized statue of dancing children serves as the garden’s centerpiece. To help create a peaceful ambiance, we’re piping calming music into the area. And, just for weeks like this one, we have a larger-than-life canopy to help our families escape from the unforgiving Wisconsin summer sun.

Without a doubt, the Noel Family Healing Garden provides an environment of support. This place was created with the goal of providing support and soothe the hurt. It is a gift that will keep on giving, changing and growing for years to come. In essence, this is what we all do – keep moving forward in hope.

After all, where there is hope, there is healing.

-Maggie Butterfield, MS, director of Patient Amenities and Family Services at Children’s Hospital of Wisconsin.

John and Patty Noel

Having a baby is one of the most exciting times in any woman’s life. So many fun, new changes happen when we have a baby. There are so many decisions to make, especially about what to feed this new little wonder. Most people have heard that breast milk is best, but often they don’t know why.  Being a nurse and a lactation consultant, I have learned so much about breast milk and why it’s so fantastic. I have a few insights that may help you in making your decision about whether to breastfeed.

During pregnancy our bodies grow this new life, get ready to deliver and feed this new baby. Our breasts are designed to make milk. Breast milk is full of antibodies, which help fight many common diseases and illnesses, such as ear infections. Breast milk is easy for babies to digest and it is ready to go, no mixing or warming! Breast milk is free, so that’s a benefit, too. Breastfeeding also gives new moms a chance to hold their babies close, which is comforting and creates a wonderful bond.

Breastfeeding also has many benefits for us mothers. It helps us lose our pregnancy weight easier and faster and lowers our risk for breast and ovarian cancer and osteoporosis.

Breastfeeding my baby is one of my proudest memories. Watching her grow and gain weight at every doctor’s visit really made me beam with pride. It was awesome to look at her and realize she came from me. To see her grow on my breast milk was even more amazing.

With a little help and patience, most women can successfully breastfeed, as briefly or for as long as they want. Sometimes, we all need a little help with this, so don’t hesitate to call a lactation consultant who can help or answer your questions. I breastfed for two years (and needed my lactation consultants’ help in the beginning), but not every woman wants to or can do it for that long. You need to decide for yourself. Some women pump and give breast milk in a bottle, and that’s fine, too. This is the only time in your baby’s life that you can do this for him or her, and it is so rewarding. Give it a try. Who knows, you may love it as much as I did and experience the true joy of breastfeeding.

August is National Breastfeeding Awareness Month. If you would like to know more about Children’s Hospital of Wisconsin’s Lactation Management Services, including education and consultation, please visit our website.

-Posted by Linda McNamara, RN, BS, IBCLC, RLC, lactation consultant at Children’s Hospital of Wisconsin.

As children return to school in the fall, our office starts getting calls from worried parents about lice and nits (lice eggs). In some cases, parents call us in tears and tell us that their son or daughter has been kicked out of school until all the lice and nits are gone. Not only do we have to work to get rid of the lice, but we have to fight to get the child back to class.

The American Academy of Pediatrics recently 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 organization says that your pediatrician should take a greater role to help diagnose and treat lice.
• Accurate diagnosis is important. Often times, children with dandruff or other dirt and debris in their hair are mistaken for having lice or nits.
• Treatment should follow proper use. Overdoing or underdoing treatment can cause the lice to survive. The academy 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 your pediatrician 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 and 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, Children’s Medical Group-Southwest Pediatrics

Do you know the difference between sunburn and sun poisoning?

The symptoms of sunburn may include redness, swelling of the skin, pain, blisters and peeling skin days after the burn. If your child gets sunburn, give him or her a cool bath or place cool washcloths on the sunburned area. You also can give your child acetaminophen or ibuprofen. Apply a moisturizer, like aloe or hydrocortisone cream to the sunburned skin. If the skin blisters, don’t break them open, because they can get infected. It’s also a good idea to keep your child out of the sun until the burn is healed.

Sun poisoning or heat exhaustion refers to the effects of too much sun. Your child may feel sick to his or her stomach, breathe quickly, be very tired or have a headache. If your child shows signs of sun poisoning or heat exhaustion:

• Get him or her out of the heat immediately.
• Make sure he or she drinks plenty of water or a beverage with electrolytes, like Gatorade®.
• Apply cool compresses to your child’s skin.

Heat exhaustion isn’t life threatening. Most kids feel better after rest, fluids and cooling down. If your child shows signs of confusion, disorientation, or has severe nausea and vomiting, get medical help quickly.

It’s important to develop good habits early. Protect your child’s skin before exposure to the sun with sunscreen. We recommend choosing a broad-spectrum (label will say UVA/UVB), water-resistant sunscreen with a sun protection factor (SPF) of 30 or higher. Apply sunscreen 30 minutes before going outdoors and reapply often.  Stay out of the sun between 10 a.m. and 4 p.m. when the rays are the strongest. It’s a good idea to have children play in the shade and wear protective clothing and hats. Make it a part of the routine of going outside. It is never too late to protect your child from the sun.

-Valerie Lyon, MD, and Karen Monreal, RN, Dermatology Clinic at Children’s Hospital of Wisconsin.

Whether you are traveling by car, plane, train or bus, the key to an enjoyable trip with your child is to plan ahead. Advanced planning will ensure a successful, fun vacation and reduce the stress associated with traveling as a family.

Here are some things you can do to ensure you and your children have an enjoyable and memorable experience:

• Talk to your child about the trip. Tell your child where you are going, who you will see and how long you will travel. Order brochures and get visual aids to help explain the trip to your child.
• Visit the library and check out children’s music tapes, books on tape and DVDs for portable DVD players.
• Allow your child to choose the toys he or she wants to take on the trip.
• Create a travel art kit. Fill a large zip-top bag with art supplies, such as crayons, stickers, paper and coloring books.
• Pack plenty of healthy snacks for the trip. Keep in mind Transportation Security Administration (TSA) restrictions for items you plan to take on a plane. Visit the TSA website at www.tsa.gov/311.
• Make goody bags. Collect items from dollar stores or party stores such as small toys, games and snacks to surprise your child when boredom or irritability set in.
• Keep your child’s sleeping and eating routine as normal as possible. Children will behave better if they follow their regular routines.

If you’re taking a trip by car with small children, remember to allow extra time to reach your destination. Also, stop often to let your child stretch or use the bathroom. You can plan fun stops along the way such as visiting a park.

If you’ll be flying to your destination, carry a current photo of your child in case he or she wanders away from you. Plan activities during the flight in 10-minute segments. This is the approximate length of a child’s attention span. Be sure to bring enough activities to cover delays and time in the airport.

-LaKesha Knighten, Children’s Service Society of Wisconsin, Parklawn Family Resource Center supervisor.

Understanding this, it is important for the adults to watch out for kids during and after storms. Deciding to go walk across, go swimming or fishing in a river can be very risky. Others may decide to use a raft or inner tube to go whitewater rafting. My advice? Just don’t do it.

Children also tend to go in groups to check out the water. If one child gets caught in a current, another child may try to save him or her. This can result in a double tragedy. If you or your child sees someone who has fallen in the water, call 911. Do not try to save the other person.

As powerful weather continues to hit our area, be careful. Watch your children. Make sure you are present at all times.

-Marlene Melzer-Lange, MD, is the medical director of Emergency Services at Children’s Hospital of Wisconsin