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Children's

Wearing and Caring for Masks and Face Coverings

To help slow the spread of coronavirus (COVID-19), health experts recommend that:

  • Stay at least 6 feet away from other people who do not live with you (called social distancing or physical distancing).
  • Clean our hands well and often.
  • Wear a mask (or face covering) when leaving our homes.
  • Follow local and national health department recommendations.

How Does a Mask Help Prevent the Spread of Coronavirus?

Coronavirus can spread when people breathe, talk, cough, or sneeze. Wearing a mask keeps the virus from reaching others. It also can stop the virus from reaching you. If everyone wears a mask when they’re out in public, fewer people will get sick.

Masks do not replace social distancing. Outside your home, stay at least 6 feet away from others who do not live with you.

Should People Who Are Not Sick Wear a Mask?

People with coronavirus may not have symptoms, but they can still spread the virus. So even people without symptoms should wear a mask.

Who Should Not Wear a Mask?

  • Children under 2 years old should not wear a mask.
  • Someone who is sick and has trouble breathing should not wear a mask.
  • Anyone who can’t take a mask off without help (for example, if they’re unconscious) should not wear a mask.

What Is the Best Way to Put on a Mask?

  1. Before touching your mask or face covering, clean your hands with soap and water or an alcohol-based hand sanitizer.
  2. Pick up the mask by the strings or ear loops, if it has them. If you have a cloth face covering that does not have strings or ear loops, try to pick it up in an area that will not touch your face.
  3. Adjust the strings, ear loops, or cloth face covering so it fits snugly against your face. There should be no gaps on the side of your face.
  4. The mask should cover your nose and mouth at all times.
  5. Do not pull the mask down to talk, cough, or sneeze.

What Is the Best Way to Remove a Mask?

  1. Before taking off your mask or face covering, clean your hands with soap and water or an alcohol-based hand sanitizer.
  2. Untie the strings or remove by the ear loops, if your mask has them. If you have a cloth face covering that does not have strings or ear loops, remove the covering by touching a part of it that does not touch the face.
  3. Fold the mask together (with the part that touches the face on the inside) and place in a clean paper bag or into the washing machine.
  4. Clean your hands with soap and water or alcohol-based hand sanitizer.

How Should We Take Care of Masks and Cloth Face Coverings?

  • Wash any worn masks at least once a day, or more often if they look dirty. If the manufacturer gave any special directions, follow them. Use the warmest settings on the washer and dryer that’s safe for the material.
  • It’s OK to put your mask in the washing machine and dryer with your other laundry.
  • Don’t share masks unless they’re washed and dried first.
  • Don’t store your mask with other people’s masks. You can store each mask in its own clean paper bag or hang each one separately on a hook.

How Can I Clean My Mask Without a Washer and Dryer?

If you don’t have a washer or dryer, you can hand wash your mask in a bleach solution and let it air dry:

  1. Mix 4 tablespoons (60 cc) of household bleach in 1 quart (1 liter) of room temperature water.
  2. Soak your mask in the bleach solution for 5 minutes.
  3. Rinse well with room temperature water.
  4. Let mask air dry completely (in direct sunlight, if possible).
Children's

Nov. 18 is National Injury Prevention Day

Injuries are the leading cause of death and disability to U.S. children. According to the Injury Free Coalition for Kids, 20 children die each day as a result of preventable injuries – resulting in more deaths than all other diseases combined.

Motor vehicle crashes, choking, burns, falls, drowning and poisoning are just some of the health threats that bring nearly 200 children to the Emergency Department at Children’s of Alabama every day.

“Injuries in children are preventable,” said Kathy Monroe, M.D., medical director of the Children’s of Alabama Emergency Department and professor of pediatrics at the University of Alabama at Birmingham. “Children’s is participating in National Injury Prevention Day on Nov. 18 to bring awareness to the alarming statistics related to childhood injuries and to help parents and caregivers learn how to anticipate and prevent childhood injuries.”

The rooftop lights at Children’s of Alabama will be lit green on Nov. 18, joining other pediatric hospitals across the country to “help light the way toward child injury prevention.” Doctors in Children’s Emergency Department and the Adolescent Medicine and Primary Care clinics as well as physicians around the state from the Alabama Chapter of the American Academy of Pediatrics will distribute safety education materials to patient families.

Injuries affect children of all ages. Dr. Monroe and the team of physicians in the Children’s of Alabama Emergency Department offer these age-based tips to protect children from the most common causes of injury.

Infants – Safe Sleep
There are about 3,500 sleep-related deaths among U.S. babies each year, which occur from accidental suffocation, co-sleeping or sudden infant death syndrome (SIDS).

Risk Factors:
• Placing infants to sleep on their stomach
• Sharing a bed with an adult
• Sleeping on a soft surface or with loose bedding
• Exposure to secondhand smoke

What You Can Do:
• Follow the ABCs of safe sleep: Alone, on his or her Back and in a Crib.
• Put your baby to sleep alone. (Never let the baby sleep in bed with you. It is okay to share a bedroom, but not the same sleeping surface until your child is at least one year old.)
• Put your baby to sleep on his or her back. (Babies should always be placed on their backs when going to sleep for both naps and bedtime.)
• Put your baby to sleep in a crib or bassinet. (This should be completely empty except for one fitted sheet. Do not use soft bedding, bumpers, blankets, pillows or soft toys in the crib or bassinet.)

Toddlers – Poisoning
Children of all ages are at risk of poisoning in the home. Young children and toddlers often put what they find in their mouths as a way of exploring their world. Safely storing household medications and products is the best way to prevent your child from accidental poisoning.

Risk Factors:
• Brightly colored or scented cleaning products
• Pills that look like candy
• Toys that have small parts can be a choking hazard

What You Can Do:
• Place cleaning products and chemicals on a high shelf, out of reach of small children.
• Store all medications in a locked place, such as a lockbox or a locked cabinet.
• Do not leave medications out on the counter where children may easily reach them.
• Follow instructions from your doctor or pharmacist to dispose of expired or unused medications.

Preschool Children – Drowning
Drowning is the leading cause of injury-related death in U.S. children ages 1 to 4 years. Drowning can be fast and silent. Children can drown in less than 1 inch of water and can occur in bathtubs and toilets, buckets of water, swimming pools and natural bodies of water.

What You Can Do:
• Use childproof doorknob covers and toilet locks to keep unsupervised young children out of the bathroom.
• Empty buckets, inflatable pools, and bathtubs immediately after using them.
• Ensure that all children wear a Coast Guard approved life jacket while boating or around natural bodies of water.
• Enroll children in swim lessons from an early age to learn water safety skills.
• If you have a pool, install a fence that is at least 4 feet tall and surrounds the pool on all four sides. Use self-closing and self-latching gates to keep young children from entering the pool area unattended.

Older Children – Firearms
Firearm-related deaths are the third leading cause of injury-related death among U.S. children. Young children are curious and cannot truly understand how dangerous guns are (even if you have talked to them about gun safety). If your child comes across a loaded gun, he or she can be accidentally hurt or killed, or may hurt or kill others. Teens can be impulsive and may act without thinking.

What You Can Do:
• Keep all guns locked, either with a gun lock or a gun safe.
• Store guns unloaded and away from ammunition.
• If anyone in the house is undergoing treatment for mental health disorders such as depression or suicidal thoughts, remove all firearms from the house for his/her safety.

Adolescents – Motor Vehicle Safety
Motor vehicle collisions are the number one killer of older children and teens. Learning to drive is an exciting time, but inexperience and distractions can put teens at risk.

What You Can Do:
• Properly restrain children in the correct car seat, booster seat or seat belt, depending on their age.
• Discuss car seat safety with your pediatrician, and make sure you learn how to properly install your car seat in your vehicle.
• Do not allow children under age 12 to sit in the front seat of the vehicle.
• Teach teenagers to obey traffic lights and street signs, drive the speed limit and wear a seat belt.
• Remind teenagers not to talk on the phone or text while driving.
• Model good behavior: always wear your own seatbelt while in a vehicle, and check to be sure that your children are wearing theirs.
• ATVs should only be used while wearing a helmet and following the safety instructions from the manufacturer. Never let a child under 16 ride an adult-sized ATV, and never allow more riders than the ATV was designed to carry.

All Ages – Fire Safety
More than 60 percent of all house fires occur in homes without working smoke detectors. It is important to install smoke detectors on each floor of your home. Test smoke detectors frequently.

What You Can Do:
• Change the batteries of your smoke detectors and check that they work every 6 months.
• Have an escape plan from the home in the event of a fire, and practice with your family.
• Place fire extinguishers in the kitchen, basement and garage.
• Keep matches and lighters out of reach of children.
• Teach children what to do in the event of fire: stop, drop, and roll.
• Make sure space heaters do not come in contact with clothing or other flammable materials. Do not keep space heaters in bedrooms.

All Ages – Motor Vehicle Safety

Motor vehicle crashes are the leading cause of unintentional injury-related death among children ages 19 and under, and more than half of car seats are not used or installed correctly.

What You Can Do:
• Properly restrain children in the correct car seat, booster seat or seat belt, depending on their age.
• Discuss car seat safety with your pediatrician, and make sure you learn how to properly install your car seat in your vehicle.

Visit http://www.childrensal.org/emergency-department for more information.

Children's

Tips for Enjoying a Safe and Healthy Halloween

Halloween is a highly anticipated day for children of all ages, but this year’s celebrations may look different due to COVID-19. Here are some tips to safely enjoy the holiday while keeping ghosts, ghouls, goblins – and germs – at a distance.

As with most activities outside the home, if you have been exposed to COVID-19 in the prior 14 days or have symptoms consistent with COVID-19, you should not participate in any in-person festivities. This includes trick or treating and handing out candy from your house. 

Dr. Gigi Youngblood, who sees patients at Pediatrics East, says that parents may need to be more involved this year to ensure that children are still following COVID-19 precautions during Halloween festivities. “Parents will need to be very hands-on this year, even with older kids who might usually go trick-or-treating on their own. We will need to supervise our kids to make sure they are being good neighbors, waiting their turn to approach the treats, hand sanitizing between houses, and keeping their masks on,” she said.

She said wiping down the candy you distribute or the treats your child receives isn’t really an effective way to control the spread of the coronavirus. “I would recommend washing hands thoroughly and wearing a mask prior to opening the sealed package that individual candies come in. Spreading out treats at the end of a driveway or edge of a yard is an effective way to prevent trick-or-treaters from clustering around a bowl or your doorway. Keep a mask on and continue to wash hands or use hand sanitizer as you replenish the treats.

And for all the trick-or-treaters who usually enjoy their candy as they move about the neighborhood, make sure they are using excellent hand hygiene. Sanitize hands between each house. “You might want to bring along a few of their favorite treats from your own home candy stash to give them when they ask to dig into their Halloween loot while still out and about,” Youngblood said. And as soon as you return home, everyone needs to wash hands thoroughly with soap and warm water for at least 20 seconds.

Costumes are always part of Halloween fun, but Youngblood said most costume masks aren’t enough to control the spread of the virus. “Halloween costume masks are often not sufficient. We need to use our typical, well-fitted, cloth masks to ensure the droplets coming from our mouths and noses are contained,” she said.

When selecting a costume, make sure it fits well to prevent trips and falls. “Reflective tape or stickers, as well as flashlights and glowsticks can help drivers spot children while they are out trick-or-treating,” said Marie Crew, director of Safe Kids Alabama at Children’s of Alabama.

“Drivers should slow down and be especially alert in residential neighborhoods,” Crew said. “Children are excited on Halloween and may move in unpredictable ways.”

Parents and caregivers should remind their trick-or-treaters to cross the street at corners, using traffic signals and crosswalks. Look left, right and left again when crossing the street and keep looking as you cross. Crew suggests using sidewalks or paths, and where those aren’t available, walk facing traffic as far to the left as possible.

Visit the American Academy of Pediatrics, Centers for Disease Control and Safe Kids Worldwide for additional Halloween safety tips.

Children's

FAQS: 2020-2021 FLU, RESPIRATORY ILLNESS SEASON

Q: What is influenza or flu?

A: Influenza (also known as the flu) is an infection of the respiratory tract. It is caused by a virus that spreads easily from person to person.  It spreads when people cough or sneeze out droplets that are infected with the virus and other people breathe them in. The droplets also can land on things like doorknobs or shopping carts, infecting people who touch these things.

Q: Is flu contagious?

A: The flu is very contagious. People can spread it from a day before they feel sick until their symptoms are gone. This is about one week for adults, but it can be longer for young children.

Q: How will I know if my child has flu and not just a cold?

A: The fall and winter months are cold and flu season. Both the cold and the flu can present similar symptoms, including cough, congestion and runny nose. In general, the flu hits a lot harder and quicker than a cold. When people have the flu, they usually feel worse than they do with a cold. Most people start to feel sick about two days after they come in contact with the flu virus.

Q: What are some symptoms of flu?

A: Common symptoms of the flu include:

  • Fever or feeling feverish with chills, though not all people with the flu will have a fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue
  • Vomiting and diarrhea, which are more common in children

Q: When should we get this season’s flu vaccine?

A: Flu season in the United States is from October to May. Vaccines are provided at most pediatricians’ offices. The American Academy of Pediatrics (AAP) recommends the flu shot for everyone over 6 months old.

Q: What is the treatment for flu?

A: Most children with flu get better at home. In the event a child does get sick, you can help mitigate symptoms. Make sure your child is drinking plenty of fluids. You can give appropriate doses of acetaminophen or ibuprofen to relieve fever and aches, and make sure they are getting plenty of rest.

Q: When should I seek medical treatment for my child if I suspect flu?

A: Bring your child to the doctor if you’re concerned about severe symptoms. Most of the time parents can care for their children with plenty of rest, fluids and extra comfort. Some children are more likely to have problems when they get the flu, including:

  • children up to the age of 5, especially babies
  • children and teens whose immune system is weakened from medicines or illnesses
  • children and teens with chronic (long-term) medical conditions, such as asthma or diabetes

Q: In addition to the flu vaccine, how else can we stay healthy during cold and flu season?

A:  The American Academy of Pediatrics (AAP) recommends the flu shot for everyone over 6 months old. Here are some other tips for staying healthy during cold and flu season:

  • Cover your cough and sneeze
  • Wash your hands
  • Clean living and working areas
  • Avoid crowds
  • Stay home from work or school if you are sick
  • Avoid touching your eyes, nose, and mouth

Q: How can we prevent the spread of germs in our house if my child is sick?

A: The flu virus spreads when people cough or sneeze out droplets that are infected with the virus and other people breathe them in. The droplets also can land on things like doorknobs or shopping carts, infecting people who touch these things.

Teaching children the importance of hand washing is the best way to stop germs from causing sickness. It’s especially important after coughing or nose blowing, after using the bathroom and before preparing or eating food.

There’s a right way to wash hands, too. Use warm water and plenty of soap, then rub your hands together vigorously for at least 20 seconds (away from the water). Children can sing a short song — try “Happy Birthday” — during the process to make sure they spend enough time washing. Rinse your hands and finish by drying them well on a clean towel. Hand sanitizer can be a good way for children to kill germs on their hands when soap and water aren’t available.

Cleaning household surfaces well is also important. Wipe down frequently handled objects around the house, such as toys, doorknobs, light switches, sink fixtures, and flushing handles on the toilets.

Soap and water are perfectly fine for cleaning. If you want something stronger, you can try an antibacterial cleanser. It may not kill all the germs that can lead to sickness, but it can reduce the amount of bacteria on an object.

It’s generally safe to use any cleaning agent that’s sold in stores but try to avoid using multiple cleaning agents or chemical sprays on a single object because the mix of chemicals can irritate skin and eyes.

Q: If my child has had flu, when can he return to school, child care, etc.?

A: Children with the flu should stay home from school and childcare until they feel better. They should only go back when they have been fever-free for at least 24 hours without using a fever-reducing medicine. Some children need to stay home longer. Ask the doctor what’s best for your child.

Q: How do I know if my child’s symptoms are flu or COVID-19?

A: The symptoms between these two viral illnesses can be similar, making it difficult to distinguish between the two based on symptoms alone. Diagnostic testing can help determine if you are sick with the flu or COVID-19. A phone call to the child’s pediatrician or primary care provider will help determine next steps regarding testing for flu and/or COVID-19.

Q: Do COVID-19 symptoms develop like flu symptoms?

A: If a person has COVID-19, it could take them longer to develop symptoms than if they had flu. According to the CDC, symptoms may appear two to 14 days after exposure to the virus. People with these symptoms may have COVID-19:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea
Children's

Stopping the Spread of Germs During Respiratory Illness Season

Fall typically marks the start of ‘respiratory illness season,’ so in addition to protecting yourself from COVID-19, it’s also time to get your annual flu vaccine.

Getting a flu vaccine — combined with the additional protection of masks, hand washing and social distancing — is the best way to reduce the likelihood of getting sick. The American Academy of Pediatrics recommends an annual flu vaccine for everyone 6 months and older.

Delphene Hobby-Noland, manager of infection prevention and control at Children’s of Alabama, said hand washing is the best way to stop the spread of germs.

“Our hands are the primary way that we transmit germs,” Hobby-Noland said. She suggests washing hands with soap for about 20 seconds (hint: sing ‘Happy Birthday’ twice). Alcohol-based hand sanitizers are a good alternative when soap and water are unavailable.

Hobby-Noland said that those most susceptible to the flu are children and the elderly because their immune systems tend to be weaker. Children under the age of 5, especially those younger than 2 years old, are particularly more likely to suffer from flu-related complications. These complications include pneumonia, dehydration, worsening of long-term medical problems like heart disease or asthma, swelling in the brain, sinus problems and ear infections. Children younger than 6 months cannot receive the flu shot, meaning that it is important for everyone who is of age to be immunized, especially caregivers and parents of young children. While the shot does not cover all strains of the flu, it can shorten or cause the case to be less severe even if someone does get the illness.

Other preventative measures involve disinfecting commonly used surfaces, as well as encouraging children to cover their mouths with a tissue when coughing or sneezing and to avoid touching their faces.

If your child is experiencing milder flu-like symptoms, contact your pediatrician or primary care provider before going to the hospital. This helps to prevent further overcrowding, risking exposure to more serious illnesses and spreading the flu to children with underlying conditions who can’t fight infection as well as others.

Common symptoms of the flu include:

  • Fever or feeling feverish with chills, though not all people with the flu will have a fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue
  • Vomiting and diarrhea, which are more common in children

For more flu and respiratory illness resources, visit https://www.childrensal.org/cold-and-flu-updates-and-resources

Children's

Is It the Flu or COVID-19?

These past several months have brought a lot of uncertainty during a global pandemic with fears of COVID-19. Now, as we enter cold and flu season, medical professionals are even more concerned. Delphene Noland is the manager of Infection Prevention and Control at Children’s of Alabama. She’s concerned that families, already fatigued from the pandemic, may let their guard down this flu season. “I think my biggest concern is that people become lax and forget that the flu is a real threat to our community,” she said.

There’s hope that the measures already being taken to respond to COVID-19 may help mitigate the flu. Masks, social distancing and hand washing are all helpful in limiting the spread of both coronavirus and the flu. But the increase in positive COVID-19 cases statewide shows those efforts are not enough to stop transmission entirely. That’s why Noland says it’s critical to get the flu shot this year. “It is of the utmost importance to get your flu shot,” she said. “They are available now. Make it a family event and get everyone vaccinated for the flu.”

How can parents recognize the difference between the flu and coronavirus? What complicates matters is that their symptoms are so similar. “Loss of taste and smell is hallmark COVID-19,” Noland says. “Shortness of breath, is usually seen later in the flu process if the patient gets pneumonia as a complication. But shortness of breath can be seen early on in patients with COVID-19.”

Symptoms Unique to COVID-19:

–             Loss of taste and smell

–             Shortness of breath in early stages

 Symptoms of Both COVID-19 and the Flu:

–             Cough

–             Runny nose

–             Sore throat

–             Fatigue

–             Fever

–             Nausea, Vomiting

And if your child is sick, seek guidance from your pediatrician or primary care provider. “Your pediatrician is your source of truth,” Noland said. 

Children's, News

How Genetics Is Helping Patients with Rare Diseases

Recent advances in genetics research are providing doctors with promising avenues for diagnosing and treating genetically based illnesses. “As genetic testing has become more and more advanced, we can really focus on smaller pieces of DNA, and even read individual letters of DNA, to look for answers to health conditions,” states Anna Hurst, Pediatrician and Assistant Professor of Medical Genetics at the University of Alabama–Birmingham.

The “Diagnostic Odyssey”

Although geneticists can be critical contributors to diagnosis, they are rarely the first health professionals patients visit when searching for answers to medical conditions.  “Usually another doctor, whether that’s a primary care physician or a subspecialist, has noticed there is something different about that individual’s health or development that might make a genetic condition more likely,” explains Dr. Hurst.

When the patient meets with a geneticist, tests are done to try to diagnose the condition. By “putting a name to it,” patients and their families can not only find guidance toward possible treatment, but also feel empowered to seek advice and comfort from national foundations and other support groups.

“I tell my families that those parent organizations can be so important, because other parents know things they don’t teach us in medical school. I always tell my families, if you hear anything in those support groups you think might help your child’s journey, let us know,” advises Dr. Hurst.

Recent Medical Advances

Great strides have been made in recent years to pinpoint location of genetic disorders, thereby leading to greater success in diagnosis and treatment. Among the most important advances has been exome and genome sequencing.

“Ten or 15 years ago, we would look gene by gene and read maybe a few genes at a time. But now, with exome and genome sequencing, we can simultaneously look at almost every gene in the body at once, to be able to take a more comprehensive approach,” says Dr. Hurst. 

There are approximately 6,000 rare diseases, with perhaps 70% of genetic origin. And, with estimates of as many as one in ten people having a rare disease (defined as an illness affecting fewer than 200,000 people), genetic research provides potentially enormous benefits for diagnosing and treating illness. 

Pilot Project and Public Information

Among the most important elements of advancing genetic diagnosis of illness are facilitating patient participation in, and promoting understanding of, the testing process. Because some types of genetic testing may not be covered by insurance, the cost can be prohibitive.

“Children’s Hospital of Birmingham has committed funding for at least 200 children to have whole genome sequencing. To date, we have enrolled about 75, and of those patients, we have a diagnosis of about 30%,” notes Dr. Hurst.

Unlike patient administered home testing, which can be helpful but often does not provide full genetic sequencing, professional medical testing combines completeness in testing with follow-up consultation. “The genome testing really makes things more personalized, and truly individualizes health care plans,” adds Dr. Hurst. 

Public information efforts are another important element of advancing genetic diagnosis and treatment. Among the programs designed to promote public awareness are Rare Disease Day, an international event held on the last day of February, and the Rare Disease Genetics Symposium, an annual two-day seminar hosted by the UAB Department of Genetics, Children’s of Alabama and Alabama Rare, an advocacy group.

“The first day of the symposium has a physician-scientist focus, and on the second, we have a parent and caregiver focus. The theme this year was using technology and collaboration to navigate the rare disease journey,” shares Dr. Hurst. Further information can be found on the National Institutes of Health website (GHR.NLM.NIH.gov), rarediseaseday.org, and Alabamarare.org.

Offering Hope and Direction

Genetic research and testing will continue to be powerful tools to combat illness, and with further medical advances will come greater empowerment for families seeking answers.

As Dr. Hurst says, “We try to help the family where they are in their journey, and how that information is affecting them. Oftentimes, when they are able to see the benefit, it becomes a very empowering experience. They might feel validated that they have an answer, and then go forward with planning medical care tailored to their specific needs.”   

**To listen to an interview on this topic with Anna Hurst, Pediatrician and Assistant Professor of Medical Genetics at the University of Alabama—Birmingham, follow this link: https://radiomd.com/childrensalabama/item/41786

Children's, Health and Safety

Heart Transplants in Children: Providing Kids Their Best Quality of Life

Heart transplantation surgery has advanced significantly since the first successful transplant in 1967. However, it is still considered a “last resort” when treating heart conditions.

“Our goal is to keep patients alive and healthy with their own heart, with the use of medications, or other assist devices. Transplantation really is the last option. And, transplantation is not a perfect treatment. A transplanted organ does not last forever,” states Dr. Wally Carlo, Associate Professor at the University of Alabama at Birmingham and Medical Director of the Pediatric Advanced Heart Failure and Transplant Program at Children’s of Alabama.

Instances where transplantation is appropriate include:

  • Patients who are born with congenital heart conditions and have undergone multiple operations, but their heart is giving out and there is no further surgery available to them.
  • Patients who have previously been healthy children and teenagers and suddenly present with the first symptoms of a weakened heart or cardiomyopathy they may have had for years—but had not demonstrated any symptoms until that time.
  • Patients who have acquired a new infection of the heart.
  • Babies born with very rare conditions that are not amenable to surgery or conditions wherein the heart muscle is very weak.

Surprisingly, infants tend to have a very forgiving immune system. “An infant transplanted successfully in the current era should be expected to have at least a 25-year graft survival, meaning we would expect them to be benefitting from that transplanted organ for two or three decades. Then, at that point, 25 years from now, we may have new options to treat them,” explains Dr. Carlo.

Risks of Post-Transplantation

Post-transplant is a precarious time for heart recipients. Transplant patients require immunosuppressive medications to help the body not reject the organ. Unfortunately, at the same time, those medications set patients up to potentially develop infections their body cannot fight off, cancers, or other complications.

It’s important for patients and family members to understand the potential risks. Dr. Carlo assures this information is presented in a way that does not put extra strain on the family—it’s all about education.

“We really want families to enter transplantation being fully informed of the risks that come along with this treatment strategy. It’s a really involved process that requires a thorough evaluation of the patient and the family. We get to know them; they get to know us. And they get to really learn all about transplantation and what it entails, because it is a life changing therapy.”

Heart Transplant Innovations

The transplant team at Children’s is currently studying different immune system therapies done at the time of transplantation to try to better understand patient outcomes in the first year after transplant. Additional research takes a look back at transplant outcomes to learn who is benefitting the most from various immunosuppressive strategies after transplantation.

Children’s is also participating in a multicenter trial involving a group of approximately 10 institutions. The trial is studying muscle injections of stem cells into the right ventricle. The goal is that the stem cells will stimulate the right ventricle to become stronger, or to remain stronger, for a longer period of time in patients who suffer from hypoplastic left heart syndrome (HLHS).

“Hypoplastic left heart syndrome patients make up an important number of our transplant candidates, and we would love to have a way to reduce the number of those patients coming to us throughout their life. If we could help keep the function of their right ventricle better for a longer period of time, those patients will have a better quality of life and duration of life,” notes Dr. Carlo.

To learn more about the stem cell study, individuals can email hlhs@mayo.edu. And, to learn more about the transplant program at Children’s, visit http://www.childrensal.org/heart.

“We have a fantastic team. We average about nine to ten transplants per year. We would love for children to be healthy and not need any transplants. But, we are there for them and their families, and I think we provide a really tremendous service,” shares Dr. Carlo. “We also have events throughout the year where we support organ donation and try to get the word out about the importance of increasing the organ pool, so that our patients have a better chance at getting the therapy they need.”

To listen to an interview on this topic with Dr. Wally Carlo, Associate Professor at the University of Alabama at Birmingham and Medical Director of the Pediatric Advanced Heart Failure and Transplant Program at Children’s of Alabama, follow this link: https://radiomd.com/childrensalabama/item/41779

Children's, Health and Safety

Pharmacist Shares Her Tips for Giving Oral Medication to Children

Giving a child prescribed or over the counter oral medications can be a stressful experience for both the child and the parent or caregiver. Emily Kirby, a pharmacist from Children’s of Alabama, shares her tried and true tips for improving this necessary, but sometimes challenging, task.

  • Use the “chocolate syrup sandwich” method. Coat the tongue with chocolate syrup (or peanut butter), then give the medication, then give chocolate syrup (or peanut butter) again.
  • Have the child suck on ice or a popsicle prior to giving the medication.
  • Allow the child to drink the medication through a straw, or aim an oral syringe toward the cheek, away from the tongue to avoid taste buds.
  • Confirm with your pharmacist or physician that the tablet is safe to crush. If it is safe, crush the tablet and mix medication with applesauce, pudding or other room temperature soft food. Only mix with one to two bites of food (not an entire serving) to make sure that all the medication is taken.
  • Request a flavoring for the medication. Many pharmacies can add flavoring agents to liquid medications to improve palatability.
  • Liquid medications should only be measured with a syringe, dosing cup or medication spoon. Spoons used for eating and serving food are not accurate for measuring medication doses.

It’s important to take all doses of your child’s medication(s), so keep these tips in mind for your child’s next dose.

If your child accidentally takes more than the prescribed amount of oral medication, call the Alabama Poison Information Center for assistance at 1-800-222-1222. The poison specialist can determine if further treatment is needed.

Children's, Health and Safety

Kids and Hot Cars: Preventing Heatstroke Deaths

Heatstroke is the leading cause of non-crash vehicle related death in the United States. Since 1998, when data first began to be tracked, at least 849 children have died of heatstroke in cars —all preventable.

Marie Crew, director of Safe Kids Alabama at Children’s of Alabama, has tips for parents and caregivers to help prevent any additional tragic deaths related to heatstroke and cars.

Key Facts:

  • The average annual death toll had been 37, but in 2018 and 2019 the death tolls were the highest, 53 and 52 respectively.
  • It doesn’t need be an extreme heat day for heatstroke to happen. The inside of a car can heat up to 109 degrees in just 20 minutes on an 80 degree day.
  • A child’s body temperature increases three to five times faster than that of an adult.
  • When a child’s core body temperature hits 107 degrees, his internal organs begin to shut down.
  • More than half — 54 percent — of child heatstroke deaths occur because a caregiver has forgotten the child in the car.

Help protect kids from heatstroke by remembering to ACT:

  • AVOID heatstroke.
    • CREATE reminders.
    • TAKE action. Call 911, if you see a child in a vehicle alone.

During COVID-19, be especially careful to avoid stress-related tragedies. We know these are challenging times. That’s why it’s more important than ever to remember the proven solutions that prevent injuries and save lives.

“Leave something in the backseat you need at your destination so you’ll remember to check that backseat before you leave your vehicle. It could be your cell phone, wallet, purse or briefcase,” Crew said. 

Never leave your child alone in a car, not even during a quick trip to the store. While leaving your child in the car alone might seem like a good idea during these challenging times, it is not worth the risk. Cars can heat up to dangerous levels in just a short amount of time, even on mild, sunny days – and cracking a window doesn’t help. It’s easy to get distracted or delayed in the store, one of the scenarios that has led to too many unintentional tragedies. This is a time to consider all your options and to find other ways to get your shopping done. Many stores are delivering or offering curbside pickup, neighbors are helping each other by combining trips and leaving the kids home with a sitter may be the best choice.

Keep car doors and trunks locked and keep key fobs out of reach. With many families home and dealing with a new environment and responsibilities, supervision can be more difficult. Kids as young as 1 or 2 years old are known to climb into unlocked cars and trunks to play, but they can’t always get out. Locking your car doors and reminding your neighbors (even those without kids) to do the same provides an important level of protection. It is one less thing to worry about. If, for some reason, you cannot find a child you thought was just outside playing, check cars, trunks and pools first.