Monthly Archives

March 2018


Spring Break and Summer Safety


As the weather warms and wool socks are traded in for flip flops, here are a few seasonal safety tips that will ensure that your family-fun outing stays just that.

Sun Exposure

Whether it’s an afternoon at the beach, out on the river or a picnic in the park, protecting your child’s skin from the sun’s harmful UV rays is always important. Severe sunburns can increase a child’s risk for future skin cancer. Follow these guidelines from the Center for Disease Control and Prevention to prevent dangerous sun exposure:

  • Apply sunscreen that provides at least SPF 15 and UVA and UVB (broad spectrum) protection 30 minutes before you plan on being outdoors. Follow the directions for reapplying on the sunscreen bottle. Be sure to check the expiration date on your sunscreen.
  • Protect exposed skin by wearing long pants or shirts if possible. Dry and dark colored clothing offer the most protection from harmful rays.
  • Hats can offer protection for sensitive areas like the neck, ears, scalp and face. Baseball caps provide limited shade, so be sure to apply sunscreen to exposed areas.
  • It is also important to protect your child’s eyes to prevent future issues. Select sunglasses that provide as much UVA and UVB protection as possible.
  • Seek shade or go indoors at midday when harmful rays are more direct to the earth.



Lightening strikes occur most often during summer months. According to the National Weather Service, over 60 lightning-related deaths occur each year in the United States. This is why the organization stands by the the motto: “If thunder roars, go indoors.”

  • At the first roll of thunder, seek shelter. The safest place to be during a thunderstorm is in a completely enclosed building, not in a pavillion or patio.
  • If shelter is not available, the second safest place to be during a thunderstorm is in an enclosed, hard-topped, metal car.
  • There is nothing worse than having a family pool day ruined by an unexpected storm, but if you can hear thunder, you are within lightning range. Never allow your children to remain in or near a body of water during a thunderstorm. Seek shelter immediately.
  • Stay away from tall, isolated objects like trees and cell phone towers.
  • Lying flat on the ground does not actually protect you from being struck. In fact, it can put you at a greater risk. Continue to seek shelter.
  • Avoid metal objects and surfaces.


Water Safety


Swimming is among the most popular of summer activities, but without taking the proper safety precautions, it can also be one of the most dangerous. The American Red Cross recommends the following to keep your family safe while out on the water:

  • Enroll your child in age-appropriate swim lessons. It is important that every one in your family knows how to swim well and know how to respond to potential water-related emergencies.
  • Enforce the buddy-system when it comes to swimming, even if there is a lifeguard on duty. Regardless of how skilled of a swimmer thinks he or she is, no child should ever swim alone or unsupervised. Never leave your child under the supervision of another child.
  • Have young children or inexperienced swimmers wear U.S. Coast Guard-approved life jackets around water.
  • Do not allow your child to play around drains in pools or spas.
  • Install proper barriers to prevent unsupervised access to home pools.
  • Teach your child to follow instructions from lifeguards.
  • Do not dive or jump into water without knowing how deep it is or what current water conditions are like.
  • Follow posted rules, regulations and warnings at pools, water parks and beaches.
  • Pay attention to the color-coded warning flags on the beach and instruct your children to follow the warnings. (Refer to “Beach Warning Flags.”)
  • Stay at least 100 feet away from structures like jetties and piers where rip currents are more likely to develop.
  • Ensure that members of your family are aware of how to respond if they or someone else were to get caught in a rip current. (Refer to the “Rip Currents: Break the Grip of the Rip!”)


Beach Warning FlagsRip Currents



Tics and Tourette Syndrome

Tics and Tourette syndrome are neurobehavioral disorders that may begin in childhood or adolescence. A tic disorder affects a person’s central nervous system and causes uncontrollable, repetitive movements or sounds. It can be like an itch you don’t want to scratch, but can’t help it.

New Research for Tics and Tourette Syndrome

Previously, psychologists and psychiatrists primarily treated tics and Tourette syndrome through pharmaceuticals. However, new research has shown that through the work of occupational therapists and neurologists, behavioral modification and habit reversal therapies are highly effective in treating tics.

Jan Rowe leads the Comprehensive Behavioral Intervention for Treating Tics and Tourette Syndrome program at Children’s of Alabama, also known as CBIT. It’s one of 10 locations in the country designated as a Center of Excellence for treating tics and Tourette syndrome. This non-pharmaceutical, behavioral program usually consists of eight sessions.

“We basically teach the children strategies to use when they feel the tic coming on or when they’re ticking,” Rowe said. “We call it ‘competing response,’ and when they use that competing response, it makes the tic impossible to happen. That interrupts the tic’s cycle, the tic stops and then they no longer have to use that strategy.”

CBIT at Children’s of Alabama treats children from across the nation for tics and Tourette syndrome with a 90 percent success rate.

Diagnosing Tourette Syndrome and Tic Disorders

Rowe says Tourette syndrome is a type of tic disorder. It’s diagnosed when a child has at least one vocal tic and two motor tics that have lasted longer than a year. If a child is younger than 18 years old and has only one tic, whether it’s motor or vocal, then the diagnosis is a tic disorder.

Tourette Syndrome

  • At least one vocal tic
  • Two or more motor tics
  • Lasting one year or longer

Tic Disorder

  • One motor or vocal tic
  • Under the age of 18 years old

Rowe said while tics and Tourette syndrome are neurologically based, stress is a significant contributing factor.

“Stress is a huge trigger for tics,” Rowe said. “That’s good stress or bad stress. It could be caused by a child looking forward to Christmas or spring break, or it can be seen in a child who is worrying about a math test.”

Rowe advises parents that if their child becomes aware and bothered by signs of a tic disorder or Tourette syndrome to contact CBIT at Children’s of Alabama at 205-638-6820. For more information, visit


AAP Provides New Guidelines for Fruit Juice Portions

Recently, the American Academy of Pediatrics (AAP) released their new recommendations for children’s fruit juice consumption. The AAP warns that fruit juice can become a problem because it is easily over-consumed by young children who enjoy the taste, and parents usually do not set limits because juice is often viewed as nutritious. Rainie Carter, a clinical nutritionist at Children’s of Alabama, says, “For years, families viewed juice as a healthy way to provide their child with more vitamins and minerals. The reality is that, when the fiber is stripped from the fruit to create juice, we are left with a product that similar to a sugary soda. The body’s blood sugar response mimics that of a soda, and there can be consequences if the product is consumed too often.” Recent research associates excessive juice consumption with intestinal gas, tooth decay, and unhealthy weight gain. “In clinical practice, I have seen both ends of the spectrum — excessive weight gain and inadequate weight gain. When children over consume juice, they gain from the unneeded calories or they have very little appetite for solid, nutritious foods,” Carter states.

The first update since 2001, these guidelines encourage parents to limit the juice servings for children over 1 year of age and to avoid giving juice to infants under 1 year of age.

Infants (under 1 year of age) 

The new guidelines indicate that fruit juice should not be given to children under 1 year of age (unless recommended by the child’s pediatrician) as “no additional nutrients are needed” to supplement human milk or prepared infant formula. The AAP advises against giving juice before introducing solid foods to the child’s diet to ensure that the child receives all necessary nutrients from milk or formula that cannot be replaced by juice.

Children (over 1 year of age)

The AAP also advises parents to reduce amount of 100% fruit juice given to older children. The portion sizes should be restricted to 4 ounces for children ages 1-3 years, 4-6 ounces for children ages 4-6 years and 8 ounces for those 7 and older. It is also important to avoid giving juice in a bottle or portable covered cup, opting instead for an open cup to reduce the amount of time teeth are exposed to the carbohydrate in juice products, which can lead to dental decay.

The importance of providing fresh, whole fruit to children is also emphasized, reminding parents that it is recommended to provide 2 to 2 ½ cups of fruit servings per day. Of this, no more than 1 cup should be replaced by 100% fruit juice. The AAP also warns that replacing the recommended fruit intake with juice does not promote the establishment of healthy eating behaviors. “Establishing healthier eating behaviors early on in life means healthier eating later in life as well. If children are given a variety of foods on a consistent basis, they will typically become less prone to picky eating,” Carter adds.

Infants can consume mashed or pureed fruit such as applesauce or fruit-based baby foods. Older children need the protein and fiber contained in whole fruits to maintain good colon health. Parents should encourage children to consume whole fruit and depend on water as the primary source of hydration. “Fiber helps to slow digestion and keep a person feeling fuller longer so whole fruit is a better choice than juice in many ways. Updating the consumption guidelines to include more fiber-rich fruits and less juice will help consumers make more well-informed decisions about their health,” Carter notes.