Browsing Category



Fever FAQs & Advice from a Pediatrician

All kids get a fever from time to time. A fever itself usually causes no harm and can actually be a good thing — it’s often a sign that the body is fighting an infection.

But when your child wakes in the middle of the night flushed, hot, and sweaty, it’s easy to be unsure of what to do next. Should you get out the thermometer? Call the doctor?

Here’s more about fevers, including advice from Children’s of Alabama pediatrician, Dr. Peily Soong.

What Is a Fever?

Fever happens when the body’s internal “thermostat” raises the body temperature above its normal level. This thermostat is found in a part of the brain called the hypothalamus. The hypothalamus knows what temperature your body should be (usually around 98.6°F/37°C) and will send messages to your body to keep it that way.

Most people’s body temperatures change a little bit during the course of the day: It’s usually a little lower in the morning and a little higher in the evening and can vary as kids run around, play, and exercise.

Sometimes, though, the hypothalamus will “reset” the body to a higher temperature in response to an infection, illness, or some other cause. Why? Researchers believe that turning up the heat is a way for the body to fight the germs that cause infections, making it a less comfortable place for them.

What Causes Fevers?

It’s important to remember that fever by itself is not an illness — it’s usually a sign or symptom of another problem.

Fevers can be caused by a few things, including:

Infection: Most fevers are caused by infection or other illness. A fever helps the body fight infections by stimulating natural defense mechanisms.

Overdressing: Infants, especially newborns, may get fevers if they’re over bundled or in a hot environment because they don’t regulate their body temperature as well as older kids. But because fevers in newborns can indicate a serious infection, even infants who are overdressed must be checked by a doctor if they have a fever.

Immunizations: Babies and kids sometimes get a low-grade fever after getting vaccinated.

Although teething may cause a slight rise in body temperature, it’s probably not the cause if a child’s temperature is higher than 100°F (37.8°C).

Is it a Fever?

A gentle kiss on the forehead or a hand placed lightly on the skin is often enough to give you a hint that your child has a fever. However, this method of taking a temperature (called tactile temperature) won’t give an accurate measurement.

Use a reliable digital thermometer to confirm a fever. It’s a fever when a child’s temperature is at or above one of these levels:

  • measured orally (in the mouth): 100°F (37.8°C)
  • measured rectally (in the bottom): 100.4°F (38°C)
  • measured in an axillary position (under the arm): 99°F (37.2°C)

But how high a fever is doesn’t tell you much about how sick your child is. A simple cold or other viral infection can sometimes cause a rather high fever (in the 102°–104°F/38.9°–40°C range), but this doesn’t usually mean there’s a serious problem. In fact, a serious infection, especially in infants, might cause no fever or even a low body temperature (below 97°F or 36.1°C).

Because fevers can rise and fall, a child might have chills as the body’s temperature begins to rise. The child may sweat to release extra heat as the temperature starts to drop.

Sometimes kids with a fever breathe faster than usual and may have a faster heart rate. Call the doctor if your child has trouble breathing, is breathing faster than normal, or is still breathing fast after the fever comes down.

Q&A with Dr. Soong, Pediatrician at Children’s of Alabama

Q: What advice do you have for parents when their child is dealing with a fever?

A: “Fevers are a natural way your body reacts when fighting off infections. For the most part, parents should not panic about a fever and can treat their child’s fever with over-the-counter fever reducers if their child is feeling bad from the fever. With normal cold infections such as the common cold or flu, fevers can commonly reach temperatures of 105F. Parents should not stress on how high a fever is, but stress on how their child is feeling or acting.”

Q: When should a parent call the doctor?

A: “Parents should contact their doctor immediately if their child is less than 2 months of age and has a temperature greater than or equal to 100.4F. Parents with older children with fever should seek immediate care if their child is lethargic, having trouble breathing, or not drinking. If at all concerned about your child having fever, go ahead and have your child seen by a doctor. Children with fevers persisting for several days should be evaluated by their doctor.”

Children's, Health and Safety

FAQs: 2022-2023 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 of Alabama Celebrates Hispanic Heritage Month

We’re celebrating Hispanic Heritage Month, a time to honor the histories, cultures and contributions of our employees from Central and South America, Mexico and Spain. At Children’s of Alabama, we are united in our mission and dedication in providing the finest pediatric healthcare to all children. Each of the employees featured here contribute to our core values of trust, teamwork, compassion, innovation and commitment. We thank them for sharing their stories of inspiration and impact.

Itala Milan
Language Services Manager

What led you to a career in healthcare?
I was the child who always wanted to help others. The medical field has allowed me to explore different career paths over the years. I eventually landed within an area about which I am passionate.

Who are some Latinos or Latinas that have inspired you?
I will have to say my father was a great inspiration, he was kind and made an impact on everyone who knew him. He taught me that education and knowledge of languages were two vital tools I would need in my life (He was right!).

On the famous side, Ellen Ochoa, who was the first Latina to go to space and the second female to be the director of the Johnson Space Center. She broke through many barriers and used her drive to accomplish so much. I always find inspiration from one of her quotes: ““Don’t be afraid to reach for the stars. I believe a good education can take you anywhere on Earth and beyond.”

What kind of impact do you hope to have? How do you hope to inspire others?
I hope I can have an impact on increasing awareness of the value of communication access, the use of technology available and communication going beyond the spoken word. If this eventually leads to our families at COA – to have a more positive patient experience – I will feel accomplished. I hope to inspire others by my actions: to motivate them to work hard and help build them up to have integrity, practice gratitude and stay true to who they are.

Evelyn Inestroza, RN
Emergency Department and CV Periop

What led you to a career in healthcare?
I chose to pursue healthcare/a career in nursing because of my mother and my sister. My mother is a nurse and growing up, I heard about her time as a nurse during the War in Nicaragua. I also watched how she cared for those in need in our community back in Honduras and then again when we moved to Alabama. The way she nurtured those in need with love and compassion are some of the qualities I knew came from her calling as a nurse.
I knew growing up I wanted to be in healthcare, but didn’t quite know what role I wanted to pursue. I remember choosing nursing as a career after my sister was given the devastating news that she could no longer pursue nursing due to her health issues. I chose to become a nurse to honor my sister’s dream.

Who are some Latinos or Latinas that have inspired you?
I consider my family to be my inspiration. My grandparents came from very little, yet they worked hard to give my parents an opportunity for a better life. My parents are my constant inspiration to want to do more; they are examples of hard work, loyalty, courage, determination, dedication and selflessness. Together they have managed to provide education not only for my siblings and I, but also for many others in Honduras and Nicaragua. My parents overcame many obstacles in their lives in order to provide for us and those in need, and I can say without a doubt that their efforts have paid off.

What kind of impact do you hope to have? How do you hope to inspire others?
I hope to impact the lives of those I encounter in or outside the hospital by setting an example of hard work, determination, compassion and show the endless possibilities you can accomplish as a nurse in someone’s life, including your own. I hope to remind parents that the hard work they are putting in now for the future of their children will one day also pay off as it did for me and my parents.

My hope is to inspire the younger generation to go after their dreams, to reach high and work hard, to take advantage of the opportunities they are given and use them for good. I hope to encourage our generation to use their talents, such as being bilingual to communicate effectively with those/and for those who struggle due to language barriers and help meet their health needs.

Amado Santos
Director of Patient Relations and Language services

What led you to a career in healthcare?
I chose healthcare because it gave me the opportunity to serve others. Since my early childhood in the west mountains of Honduras, I saw my mom and dad always being eager to serve others unconditionally. When I moved to the United States in 1989, my adoptive family in Alabama displayed the exact same spirit of servitude toward others. I always thought that I had to return to Honduras to be able to make a difference in my community; however, my career at Children’s has given me the opportunity to honor my parents (in both countries) by serving others as they did.

Who are some Latinos or Latinas that have inspired you?

Without a doubt my parents in Honduras. Regardless of the enormous challenges they faced due to lack of resources, they always found a way to keep food on the table for all of us (11 kids). To be humble, honest and work hard were expectations they had from me and my siblings. Most importantly they taught me to always treat others with kindness, dignity and respect.

What kind of impact do you hope to have? How do you hope to inspire others?

I hope to have a positive impact for those around me by staying truthful to my personal and professional core values and principles. I seek to inspire others by being a more genuine, kind, honest and compassionate human being.

Cristina Cruz, RN
Sexual Assault Nurse Examiner

What led you to a career in healthcare?
Coming from a border town and noticing the health disparities in underserved populations led me to want to help people in their most vulnerable times.

Who are some Latinos or Latinas that have inspired you?
I don’t have one or two Hispanic individuals that inspire me, I have thousands. I’m inspired by every single immigrant family out there that despite the stigma, having to learn another language and working long and odd hours to keep their family going, they wake up every morning and give it their all. Who could be more inspiring than them?

What kind of impact do you hope to have? How do you hope to inspire others?

I hope that as a nurse I can help educate the Hispanic people living in the South. It would be a dream to close the gap in health disparities in this underserved population. The fact that English is not your first language shouldn’t hinder you from being able to get the healthcare you need.

Representation is important. I hope by being on the front line, I can inspire the next generation of Hispanic healthcare workers! We need more of us that can relate to and educate our people.

Jeannette Elizondo
Certified Medical Interpreter

What led you to a career in healthcare?
I have always loved the healthcare field because you are constantly learning and will always have an opportunity to help someone in need.

Who are some Latinos or Latinas that have inspired you?
Honestly, the people that inspire me the most are my parents. They have always taught me to strive for the best, never give up, stay humble and always be kind because you never know what people are going through. They both have worked so hard for our family and I would never want to do anything to disappoint them. Both of my parents have had businesses of their own and didn’t let anyone or anything stop them. They have showed me to go for what you want and never give up.

What kind of impact do you hope to have? How do you hope to inspire others?
I hope to provide the best interpretation services to all children and parents that walk through this hospital. The best way I plan to make the most significant impact is to think of Children’s of Alabama mission, and that is to ensure I provide the finest and most accurate interpretation to all of our families. I hope to inspire others to always advocate for every child or patient that comes through our doors by making them feel welcomed, safe and educated. I love Children’s of Alabama and I think we do a great job at showing everyone that we love being here!

Carolina Chacon, RN
7 Dearth MedSurg Nurse

What led you to a career in healthcare?
I was always drawn to the healthcare field. After a few clinical rotations in high school, I decided nursing was the career for me. Nursing is a very rewarding field, you learn something new every shift. In this field, one is responsible for advocating and delivering the proper care to patients of all ethnic backgrounds and cultures.

Who are some Latinos or Latinas that have inspired you?
My parents are my biggest inspiration. They left their home country, came to the U.S., learned a different language and worked in laborious jobs just to provide their children opportunities they never had. That to me is a huge sacrifice and the most inspiring thing anyone can do.

What kind of impact do you hope to have? How do you hope to inspire others?

I hope to impact other Latinos who are seeking careers in healthcare. Representation matters. I remember growing up thinking none of these people looked like me. Latinos are everywhere, being a minority is not a barrier. We can be anything we want to be and we can achieve all the things we put our minds to. Whether it’s being a nurse at Children’s of Alabama or being an astronaut at NASA. We are all capable of doing great things.


Children’s of Alabama believes in the importance of effective communication in order to deliver the best possible family-centered pediatric care to all our patients and families. Language Services’ goal and commitment are to ensure that all language needs within our hospital are met in a timely and effective manner.

Our staff Spanish interpreters are trained medical interpreters who are cognizant of the importance of culturally-competent care. These services are provided free of charge to all our families and patients who need them.

Above are some of our Language Services team who bridge the communication gap for patients and families every day. Pictured left to right: Dahlia Smith, Irsia Quevedo, Jeanette Elizondo, Amado Sandos, Veronica Ramirez, Itala Milan, Areli Torres.


FAQs: Vaccines for Children

August is National Immunization Awareness Month. This annual observance highlights the importance of vaccination for people of all ages. With the back-to-school season in full swing, it’s important to understand the importance of vaccines for children and check your child’s immunization chart.

Q: What Do Vaccines Do?

A: Vaccines work by preparing the body to fight illness. Each vaccine contains either a dead or a weakened germ (or parts of it) that causes a particular disease.

The body practices fighting the disease by making antibodies that recognize specific parts of that germ. This permanent or long-lasting response means that if someone is exposed to the actual disease, the antibodies are in place and the body knows how to fight the disease, so the person doesn’t get sick. This is called immunity. The process by which vaccines create immunity is known as immunization.

Q: Will the Immune System Be Weaker by Relying on a Vaccine?

A: No, the immune system makes antibodies against a germ, like the chickenpox virus, whether it encounters it naturally or through a vaccine. Being vaccinated against one disease does not weaken the immune response to another disease.

Q: Can a Vaccine Give Someone the Disease It’s Supposed to Prevent?

A: It’s impossible to get the disease from any vaccine made with dead (killed) bacteria or viruses or just part of the bacteria or virus.

Only those vaccines made from weakened (also called attenuated) live viruses — like the chickenpox (varicella) and measles-mumps-rubella (MMR) vaccines — could possibly make a child develop a mild form of the disease. But it’s almost always much less severe than if a child became infected with the disease-causing virus itself. However, for kids with weak immune systems, such as those being treated for cancer, these vaccines may cause problems.

Q: Can Getting So Many Vaccines at One Time Harm My Baby?

A: Babies have stronger immune systems than you might think, and they can handle far more germs than what they receive from vaccines. In fact, the number of germs in vaccines is just a small percentage of the germs babies’ immune systems deal with every day.

A lot of consideration and research went into creating the immunization schedule most doctors use, and it has been proven safe time and time again. Still, some parents choose to use alternative schedules (spreading or “spacing out” vaccines) because they’re concerned about the number of shots their babies get at each checkup. This is actually more likely to make a baby sick. Studies show that many babies on alternative immunization schedules never get all the vaccines they need.

Q: Why Should My Child Get a Painful Shot if Vaccines Aren’t 100% Effective?

A: Few things in medicine work 100% of the time. But vaccines are one of the most effective weapons we have against disease — they work in 85% to 99% of cases. They greatly reduce your child’s risk of serious illness (particularly when more and more people are vaccinated) and give diseases fewer chances to take hold in a population.

Q: Why Do Healthy Kids Need to Be Immunized?

A: Vaccinations are intended to help keep healthy kids healthy. Because vaccines work by protecting the body before disease strikes, if you wait until your child gets sick, it will be too late for the vaccine to work. The best time to immunize kids is when they’re healthy.

Q: Can Vaccines Cause a Bad Reaction in My Child?

A: The most common reactions to vaccines are minor and include:

  • Redness and swelling where the shot was given
  • Fever
  • Soreness at the site where the shot was given

In rare cases, vaccines can trigger more serious problems, such as seizures or severe allergic reactions. If your child has a history of allergies to food or medicine, or has had a problem with a vaccine before, let the doctor know before any vaccines are given. Every year, millions of kids are safely vaccinated and very few experience serious side effects.

Q: Should Children Get a COVID-19 Vaccine?

A: Yes, safe and effective COVID-19 vaccines are recommended for adults and all children ages 6 months and older. Booster shots are recommended for everyone ages 5 and older. Everyone who is eligible should get the COVID-19 vaccine and booster shot as soon as possible.

Participating Pediatric Practices are now offering the COVID-19 vaccine to patients 6 months and older. The vaccine is:

  • Available for patients 6 months to less than 5 years in a 2 or 3-dose series
  • Available for patients ages 5-11 years as a 2-dose series with a booster after 5 months
  • Available for children ages 12 and older as a 2-dose series with a booster after 5 months

To find a practice near you, visit


You may be thinking, “My child hates shots and pitches a fit even at the word.” There are techniques to make shots easier, such as encouraging your child to take calming breaths or even coughing as the needle goes in. Regardless of the fear, remind them that the shot itself lasts only for a second, but the protection lasts a long, long time after that.

Get your child up-to-date with their vaccines today. Click here to read the recommended immunization schedule.


Marilyn Prier – Daisy Lifetime Achievement Award Recipient

Marilyn Prier, MPH, BSN, RN graduated from the University of Alabama Birmingham School of Nursing in 1986.  She immediately began her career at Children’s of Alabama where she worked for 37 years.  Marilyn’s life has been committed to ensuring that children have a healthy and happy life, whether at her job as a registered nurse at Children’s of Alabama or at home raising her four sons and enjoying her fifteen grandchildren. 

Upon graduation, Marilyn’s first position as a registered nurse was in the Pediatric Intensive Care Unit where she worked for two years.  She left Children’s for two years to work in home healthcare.  After receiving a call from a friend, she returned to Children’s and became the discharge planner for the inpatient units.  The CNO, Supora Thomas, had a vision for two big initiatives and she charged Marilyn with this task.  There were families whose children were discharged with a risk to suddenly stop breathing.  Marilyn put together a program to ensure that staff on the inpatient units could conduct CPR teaching for these families so they could intervene in these crucial moments.  She worked with a team reaching out to community partners and donors to supply CPR teaching kits over the years and this program remains in place today.

Another very important initiative was child passenger safety.  It was often discovered that parents did not have a car seat to safely get their child home upon discharge from the hospital.  Marilyn and her colleagues developed a program to identify these families and provide them with an appropriate child passenger safety seat.  Over the years Marilyn and her teammates became certified Child Passenger Safety Technicians, installing car seats and ensuring that families knew how to safety install their own seat.  The program has grown over many years and at the present time Children’s has a donor who supplies seats free of charge for families who are discharged from the hospital and in need of a car seat.  Another group of patients in need of car seats were patients with spica (body) casts or other physical or structural limitations.  These patients required a specialized car seat and again Marilyn and her team worked to ensure that a safe seat was acquired.  Since specialty car seats are very expensive and not needed for much longer than a few months, a loaner program was developed so that families could transport their child safely without the worry of additional expenses.

After a few years in the discharge planner role, Marilyn’s commitment to patient education prompted her transfer to the CHECK Center (Comprehensive Health Education Center for Kids) where she worked on developing printed patient health and education material for the hospital.   In partnership with BlueCross and BlueShield of Alabama, Marilyn was instrumental in creating the curriculum and design for an interactive mobile unit called Body Trek. Thousands of school age children have been given the opportunity to visit Body Trek. In the unit they learned how the human body works and important safety practices such as always wearing a seat belt and always wearing a helmet while riding a bicycle. Marilyn partnered with local schools of nursing to provide nursing students the opportunity to serve as volunteers with Body Trek while teaching the them the importance of teaching safety in the community.

In 2002, Marilyn returned to school and obtained a Master of Public Health degree.  This enabled Marilyn to grow and develop as a leader at Children’s of Alabama.  In 2006 Marilyn accepted the position as the Department Director for the CHECK Center.  The center later changed names to Patient Health and Safety Information.  She continued working on many initiatives including developing a strong liaison program between Children’s of Alabama and the Alabama Association of School Nurses and the Alabama State Department of Education’s School Nurse Administrator.  Children’s began providing annual educational sessions during the summer months so school nurses could obtain continuing education credits and stay on top of the many changing trends and treatment with school aged children. 

Marilyn is a strong advocate for child health and safety.  She was instrumental in developing partnerships that helped bring many programs into the schools and communities.   She also facilitated many new programs supporting staff inside the hospital.  Some of the programs she worked with are:

  • Kids on the Block – a national program which used puppets to educate students about peers with different abilities, disabilities and diseases. The focus was on tolerance and diversity amongst their groups.
  • Smoke House – a mobile unit funded by the Junior League of Birmingham that taught students about fire safety and how to escape from a burning house
  • Scoliosis Screening – this program was a national mandate to assess adolescents for scoliosis. Marilyn and her team worked with local schools of nursing to provide scoliosis screenings in the middle schools around Birmingham
  • Safe Sitter Inc. – this national program prepares school age children how to be safe at home alone or while babysitting.  Marilyn and her department staff taught this program at the hospital campus.
  • Hand in Hand for Fitness – a program whereby Marilyn and her team worked with donors to provide fitness equipment to elementary schools
  • Community CPR classes
  • Get Well Network – an interactive program available on smart TVs throughout the new inpatient bed tower. This program has information for families on way finding, new diagnosis teaching and videos, as well as movies for the patients to watch.
  • Daisy – this program is a recognition program specifically for nurses
  • Safety store – opened in the patient health and safety department where child and home safety items were sold. 

Marilyn retired in April of 2021 from a lifetime career of advocating for child safety. She has been an instrumental force in nursing leadership at Children’s of Alabama.


Tips for Packing School Lunches

Back to school season is stressful for children and parents alike, and parents are concerned about ensuring that their child eats a nourishing lunch to power through the school day. The situation can prove to be frustrating when the lunches come back home uneaten. Rainie Carter, director of Clinical Nutrition at Children’s of Alabama, offers tips for packing a lunch that will please both kids and parents.

Cover the Nutritional Bases

  • Include protein to help keep them full through the afternoon with items like string cheese, yogurt, meat, or nuts (if the school guidelines allow them). Carter’s favorite tips are to use a whole wheat tortilla to make pinwheels with lunch meat or freezing yogurt the night before for a creamy treat.
  • Fruits and vegetables are important for your child’s fiber intake. “Kids love to dip and scoop so you can pack a little bit of ranch dressing or hummus with vegetables,” Carter advises. For produce that turns brown when cut, like apples, Carter suggests squeezing a little bit of lemon juice over the chunks to placate picky kids.
  • Stick with whole grain for items like bread or crackers, and stay away from concentrated sweets like candy or gummy snacks as these can lead to an energy crash later in the day. “Also, avoid sugary drinks like soda or juice. Make sure that they have plenty of water, and a frozen water bottle will work as an ice pack too.”

Involve Them in the Process

  • Plan as a family for the week’s lunches. “Spend a little time pre-chopping veggies and fruit, and let your child put portions into bags or containers. If they’re old enough, let them do the cutting too. They are more likely to eat something if they remember helping with it,” Carter said.
  • Giving your child options can be a great way to gain their interest. “Let them pick within your constraints,” Carter suggests. “For instance, show them two choices for a fruit and say, ‘Do you want apples or grapes today?” Parents can also do this in the store to make sure they buy what the child wants to eat. She says to stick to the outskirts of the store for fresh produce and whole grains, avoiding the packaged foods in the aisles.

Have a Little Fun

  • Pack a variety of snacks to keep them interested and sneak in more nutrient-rich foods. “Lunch does not have to be a sandwich and a piece of fruit. Kids enjoy finger foods so bento boxes are popular to portion out a few snacks instead of one big lunch item,” Carter said.
  • Get creative if your child tires of the same lunch items. “Some parents will use a cookie cutter to remove the sandwich crust and make a fun shape. If the school allows it, try putting things on sticks like a fruit kabob. Kids love colorful lunches too, so find ways to incorporate that,” Carter recommends.
  • Try making trail mix with your child, letting them fill their own bags. Carter’s suggested ingredients are dried fruit, granola, nuts or chocolate chips.
Children's, Health and Safety

Lawn Mower Safety

As you begin assigning chores to your children this summer, there are few things to consider about yard work and lawn mower safety.

“We see quite a few patients in our emergency room during the summer because of lawn mower injuries,” said Lisa Maloney, pediatric emergency medicine. “Most typical are skin lacerations and injuries to extremities, such as their hands and feet. We also see some eye injuries when items like rocks or sticks are picked up and thrown by a lawn mower.”

In general, children should be at least:

  • 12 years old to safely operate a walk-behind power or hand lawn mower
  • 16 years old to safely operate a riding lawn mower

When you decide your child is ready to use a lawn mower, spend some time with them reviewing the equipment’s owner manual in advance and talking about how to do the job safely. The most important thing, said Maloney, is parental supervision.

“Lawn mower injuries can be severe. These types of injuries require many surgeries involving many specialists, especially when the goal involves saving a limb,” Maloney said.

Before mowing:

  • Inspect the area to be cut, and remove any items that could be picked up and thrown by the lawn mower.
  • Ensure your lawn equipment is in good working condition.

While mowing:

  • Use sunscreen, safety glasses or goggles, closed-toe shoes and hearing protection.
  • Small children should be a safe distance away while the lawn mower is in use.
  • Never allow children to ride as passengers on a riding lawn mower.
  • Avoid mowing in reverse.
  • Push or drive your mower up and down slopes, not across, to prevent mower rollover.

After mowing:

  • When you turn your mower off, make sure the blades are completely stopped.
  • Only refuel the mower once the engine has cooled.

A lawn mower is a very powerful tool. It can cause serious injuries, but many of these injuries are preventable. Keep your children safe around lawn mowers this summer. Following these guidelines can help prevent lawn mower injuries.

Children's, Health and Safety

Talking to Your Children About the News

Children hear about what’s going on in the world through social media, friends, or adults’ conversations. Sometimes the news is uplifting — like kids their age taking a stand on social or environmental issues. Other times, children may worry about current events like the recent school shooting in Texas and need an adult to help make sense of what’s happening.

Help your child understand the news and feel more in control by taking these steps: 

Find Out What Your Child Already Knows

  • Ask your kids questions to see if they know about a current event. For school-age kids and teens, you can ask what they have heard at school or on social media. 
  • Consider your child’s age and development. Younger kids may not grasp the difference between fact and fantasy. Most kids realize the news is real by the time they are 7 or 8 years old.
  • Follow your child’s lead. If your child doesn’t seem interested in an event or doesn’t want to talk about it at the moment, don’t push. 

Answer Questions Honestly and Briefly

  • Tell the truth, but share only as much as your child needs to know. Try to calm any fears and help kids feel safe. Don’t offer more details than your child is interested in.
  • Listen carefully. When kids hear about an upsetting event like a school shooting, they may worry, “Could I be next? Could that happen to me?” Older kids may have lots of questions. Focus on what your kids ask so you can help them cope with their fears. An adult’s willingness to listen sends a powerful message.
  • It’s OK to say you don’t know the answer. If your child asks a question that stumps you, say you’ll find out. Or use age-appropriate websites to spend time together looking for an answer.
  • Limit how much kids watch online, on TV, and social media about the events. The strong images may be upsetting for kids and teens. 

Help Kids Feel in Control

  • Encourage your child to talk. If your child is afraid about what’s going on, ask about it. Even when kids can’t control an event — like a school shooting or natural disaster — it can help them to share their fears with you.
  • Urge teens to look beyond a news story. Ask why they think an outlet featured a frightening or disturbing story. Was it to boost ratings and clicks or because the story was truly newsworthy? In this way, a scary story can be turned into a discussion about the role and mission of the news.
  • Teach your children to be prepared, not panicked. For example, if the news is about a school shooting, talk about the ways schools are keeping kids safe. If it’s about a natural disaster, make a family plan for what you might do. If an illness is spreading, talk about ways to protect yourself and others.
  • Talk about what you can do to help. After a tragic event, finding ways to help can give kids a sense of control. Look for news stories that highlight what other people are doing. Articles such as School Violence: What Students Can Do may be helpful for older kids and teens. 
  • Put news stories in context. Broaden the discussion from a specific news item about a difficult event to a larger conversation. Use it as a way to talk about helping, cooperation, and the ways that people cope with hardship.

Limit Exposure to the News

  • Decide what and how much news is appropriate for your child. Think about how old your kids are and how mature they are. Encourage them to take breaks from following the news, especially when the topics are difficult.
  • Keep tabs on the amount of difficult news your child hears. Notice how often you discuss the news in front of your kids. Turn off the TV so the news is not playing in the background all day.
  • Set limits. It’s OK to tell your kids that you don’t want them to have constant exposure and to set ground rules on device and social media use. 
  • Watch the news with your child and talk about it. Turn off a story if you think it’s not appropriate for your child. 

Keep the Conversation Going

  • Talk about current events with your child often. Help kids think through stories they hear – good and bad. Ask questions like: “What do you think about these events?” or “How do you think these things happen?” With these types of questions, you can encourage conversation about non-news topics.
  • Watch for stress. If your child shows changes in behavior (such as not sleeping or eating, not wanting to be around people, or worrying all the time), call your child’s doctor or a behavioral health care provider. They can help your child manage anxiety and feel better able to cope.

More Resources from Our Partners

Children's, Development, Health and Safety

Communication Begins at Birth: 12 – 24 Months

This year-long period is when language development truly takes off. Your child’s understanding of the world around them, especially for language and sounds, is much more developed than before. Most kids typically say their first words around their first birthday, but a toddler who is actively learning to walk will commonly postpone their speech development. By two years old, most toddlers will say 50-100 words or moreand be able to put together two-word phrases.

Listed below are some typical milestones, enhancement activities, and red flags for your baby’s hearing and speech development at this age. Note that every child is different, and some reach these milestones sooner or later than others. If your child is not developing in accordance with these guidelines, consider contacting your pediatrician or family health physician. 

Typical Development: 

  • Uses several words with a variety of speech sounds, slowly developing into 20-50 words
  • Enjoys simple songs and rhymes
  • Understands two step directions (ex: “Get your shoes and come here”)
  • Can make simple needs known through speech
  • Asks simple questions
  • Knows and points to body parts


  • Praise and encourage efforts in all areas: moving, playing, talking, singing
  • Avoid over-correcting your child’s efforts to speak
  • Always fully listen when your child speaks to you
  • Ask your child questions that stimulate thought and check understanding

Red Flags: 

  • Uses only vowel sounds to speak
  • Cannot follow simple commands
  • Does not respond to sounds or responds only to loud sounds
  • Points or grunts to make needs known

Your little one is listening to everything you say and storing it away at an incredible rate. Instead of using “baby” words, start using the correct names for people, places, and things. Speak slowly and clearly, and keep it simple. Your child’s vocabulary will grow quickly, but pronunciation isn’t likely to keep pace. By 2 years of age, most kids are understandable only about half the time, so emphasize the correct pronunciations in your responses.

Gestures are an important part of language development. Make the connection between the gestures your child makes and language by using a running commentary such as, “Do you want a drink?” (when your child points to the refrigerator), then wait for a response. Then say, “What do you want? Milk? OK, let’s get some milk.” Such behavior encourages kids to respond and participate in conversations

Children’s of Alabama Hearing and Speech Center: 


Communication Begins at Birth: 9 – 12 Months

These months can be a cornerstone period for your baby’s communication development. During this period, your baby might say “mama” or “dada” for the first time, and will mostly communicate using body language, like pointing and shaking his or her head. Your baby will pay even more attention to words and gestures and will try to imitate you and various sounds from his or her environment.

Listed below are some typical milestones, enhancement activities, and red flags for your baby’s hearing and speech development at this age. Note that every child is different, and some reach these milestones sooner or later than others. If your child is not developing in accordance with these guidelines, consider contacting your pediatrician or family health physician. 

Typical Development:

  • Continues to point his/her finger to communicate desires
  • Uses jargon that sounds like speech
  • Can clearly say 1-2 words (ex: mama, dada, uh oh, bye)
  • Imitates sounds such as animals, cars, and trains
  • Looks at or points to familiar objects or pictures when they are named 
  • Responds to his/her own name, phone ringing or someone’s voice, even when not loud


  • Point to pictures to identify people, objects and toys
  • Talk to your baby throughout the day. Mix in adult tones of speech, not just baby talk
  • Identify and imitate environmental sounds such as birds and planes

Red Flags:

  • Uses few or no speech sounds 
  • Does not use gestures to communicate: waving, high fives
  • Does not show understanding of any words

There are many activities that parents can do to ensure that their baby is getting the information he or she needs for proper development of speech and hearing. Though your baby may only be saying a few words, naming familiar objects will help your baby learn what they are called and store this information before they can use words.  Labeling objects during the course of the day reinforces the message that everything has its own name. Make learning a whole-body experience: Touch your baby’s toe when you say the word “toe.” Or point out your own ear and say, “Mommy’s ear.” Face your baby when you speak to let him or her see your facial expression and lip movements. Children’s of Alabama Hearing and Speech Center: