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Children's, Health and Safety

Safe Sleep

Statistics reveal 3,500 sleep-related deaths occur each year among infants under 12 months. Alabama has the highest rate of sleep-related deaths across the nation — approximately one hundred or more babies die each year due to unsafe sleep environments.

Dr. Erinn Schmit, a pediatric hospitalist at Children’s of Alabama and assistant professor at the University of Alabama at Birmingham (UAB), says soft bedding and babies co-sleeping with a parent or sibling are two of the most common causes of sleep-related deaths. The highest risk for sleep-related deaths in infants is between 1 and 4 months old, but Dr. Schmit recommends parents keep exercising safe sleep practices up to 12 months.

Dr. Erinn Schmit

ABCs for Safe Sleep Practices

Dr. Schmit suggests using the “ABCs” of safe sleep to remember these practices. This stands for: Alone, Back and Crib.

Alone: Babies should be in their own sleep environment every single time. This means using an approved consumer product safety-rated device, like a crib, Pack ‘n Play or bassinet.

Back: Babies should be on their backs every single time.

Crib: The crib should be empty except for a crib mattress rated for infants (a firm mattress with just a fitted sheet). There should be no loose blankets, stuffed animals, pillows or bumpers –they pose a suffocation risk.

Safe Sleep Environments

“We know that co-sleeping greatly increases their risk for suffocation. We also see some deaths from suffocation due to soft bedding, such as pillows, blankets, sleeping on an adult mattress, or sleeping in a chair or couch. These environments are not meant for babies to sleep in,” Schmit said. “Babies should be sleeping on a firm sleep surface that doesn’t allow for any air pockets where their faces can get stuck.”

For every sleep session, babies should be placed on their back until they can roll over by themselves. Swaddling is helpful for newborns who have a startle reflex that wakes them up; however, parents should swaddle their baby only until they are about 3 to 4 months old, when they begin showing signs of rolling over.

“When they’re showing signs of rolling over, you could either go cold turkey — stop swaddling them altogether—or swaddle just one arm in at a time. But we do know that swaddling while babies are trying to roll can actually increase that risk of suffocation,” adds Dr. Schmit.

Dr. Schmit also cautions against nearby cords from a baby monitor or windows with blinds near the crib. Ensure the crib or Pack n’ Play is away from the window so babies can’t pull on strings connected to the blinds. In addition, make sure baby monitors are mounted on a wall or placed on a bookcase nearby, but not directly by the edge of a crib. “Unfortunately, every year we see strangulation deaths when babies get strings stuck around their necks,” Schmit said.

Sleep sacks are well known among parents with babies and are recommended.  These wearable blankets have a hole for the neck and arms, and either zip or snap in place. Due to the design, sleep sacks don’t have loose material that can get in a baby’s face. 

Sleep sacks for younger babies swaddle with Velcro and sleep sacks for older babies have arm holes and no swaddle. Around three to four months, parents should stop swaddling and switch to a sleep sack without a swaddle.

The American Academy of Pediatrics (AAP) recommends parents share a room, not a bed, with their baby for up to 12 months. Sharing a room can help parents hear noises and be alert to their baby’s needs which can reduce Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths.

Tummy Time and Acid Reflux in Babies

Tummy time is when babies lay on their stomachs for a brief time period while they are awake and supervised. The AAP recommends supervised tummy time for babies each day to help with head and neck strength which further improves motor development. For more information on how long babies of different ages should practice tummy time, refer to this resource from KidsHealth. While babies should practice tummy time, they should not while they are sleeping. Once they can roll themselves onto their tummy, it’s okay to let them roll into that position. Nevertheless, parents should still put them to sleep on their back.

One misconception is that placing babies on their backs may aggravate acid reflux or interfere with proper digestion. This has been scientifically disproven – when babies are laying on their tummies, the food pipe is above the windpipe.

According to the AAP and the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN), sleeping on the back is safest for all babies, even those with reflux. The only situations when babies should sleep on their tummy are if they have an unrepaired surgical airway or some other serious issues—in which the doctor may recommend otherwise.

Safe Baby Devices

Parents may try to calm their fussy baby by driving around the neighborhood. Dr. Schmit said this practice is fine, but once the baby is back in the home they should be placed in the crib—not left in the car seat to continue sleeping. Dr. Schmit also urged any parent using a device such as the “Rock ‘n Play” to stop doing so immediately.

“The Rock ‘n Plays—an inclined sleeper that rocks—were recalled a couple of years ago due to being linked to multiple infant deaths around the country. Primarily, this was in situations where babies were strapped in and then rolling over and suffocating. It led to us recommending against all inclined sleepers because of that risk.”

For a list of approved baby devices, Dr. Schmit recommends parents discuss options with their pediatrician or visit websites such as healthykids.org or safetosleep.nichd.nih.gov.

Health and Safety

Is My Child Too Sick to Go to School?

Being sure that a child is well enough to go to school can be tough for any parent. It often comes down to whether the child can still participate at school. Having a sore throat, cough, or mild congestion doesn’t always mean kids can’t handle class and other activities.

As the COVID-19 pandemic continues, though, health experts ask that families keep sick kids home. Even mild symptoms like sore throat, cough, or a headache can be signs of a COVID-19 infection that can spread to teachers or other kids. During the pandemic and after it’s over, kids should stay home when they have symptoms like a fever over 100.4°F, diarrheavomiting, or trouble breathing.

When in doubt, check with the school. Schools have guidelines about what families should do during the pandemic if their kids get sick. It’s also important to report that your child is sick, so the school staff can check to see if others might have been exposed to your child.

As for other types of infections, chickenpox sores should be dry and crusted over before kids go back to school (usually this takes about 6 days). Kids with strep throat need a dose or two of antibiotics first, which can mean staying home the day after diagnosis (or possibly longer). Other contagious infections — like rubellawhooping coughmumpsmeasles, and hepatitis A — have specific guidelines for returning to school. Your doctor can help you figure this out.

Licescabies, and ringworm shouldn’t keep kids out of school. If the problem is found by the teacher or school nurse, the child should stay in school until the end of the day. Kids who get their first treatment after school should be able to return to the classroom the next morning.

You know your kids best. A child who has the sniffles but hasn’t slowed down at home is likely well enough for the classroom. But one who coughed all night and had a hard time getting up in the morning might need to take it easy at home.

Children's, Health and Safety, News

Answers for Parents about the COVID Vaccine for Children Ages 5-11

The recent news approving Pfizer’s vaccine for emergency use authorization for children ages 5-11 by the Centers of Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) may leave you with a lot of questions about what is best for your child.

Children’s of Alabama pediatricians Dr. Peily Soong and Dr. Gigi Youngblood have provided information that may help.  We asked the questions, and they provided these answers.

Why do we need to vaccinate children ages 5-11, and why is it so important to make sure they are vaccinated?

Dr. Youngblood: It’s definitely important to vaccinate children in this young age group. First and foremost, receiving vaccines are how we end this pandemic. They’re crucially important for everyone affected by the pandemic. We’re losing kids. There’s a significant portion of pediatric COVID deaths that were in the 5-11 age group. We’re also seeing long term issues with these young children, including multisystem inflammatory syndrome (MIS-C), which is a really potentially dangerous inflammatory condition that happens after someone has had COVID. Different body parts can become inflamed, and it often includes inflammation of the heart muscle or myocarditis. We feel children deserve protection from these things just as much as everyone else.

How is this vaccine different from the vaccine that may be offered to people 12 years of age and older?

Dr. Soong: It is different because it is a smaller vaccine dose, about a 1/3 of the dose given to the 12-year-old to adult group. The 12-year-old to adult dosage is 30-microgram. The smaller dose for children 5-11 years old is 10-microgram. Although it is a smaller dose, it has been shown to be just as effective in terms of antibody titers, which measures the antibodies in the blood. They compared the studies for the children in this younger age group to the older group, and the antibody levels were about the same in each. Researchers felt the dose should be just as effective at preventing COVID, and a very effective vaccine for all involved.

What are the potential side effects of the vaccine, and what should we know about them?

Dr. Youngblood: Clinical trials show that the vaccine is well tolerated in children. The potential side effects for younger children were fever, fatigue, headaches, and pain at the site of the injection as well as redness and swelling. These side effects are very similar to what we are seeing in adults, but probably even better tolerated in this young age group. We have also seen that the lower the vaccine dose, the lower the side effects, and about half as many children were getting side effects to the vaccine. It seems parents are most concerned about the side effect of getting myocarditis, which keeps making the news. Keep in mind that the only vaccine that’s going to be available for children 5-11 years old is the Pfizer BioNtech vaccine, and there has not really been an increased risk with that particular vaccine. The main thing to remember about any age group and post vaccination is even though people seem to be concerned about such things as clotting risk and myocarditis, people are at a significantly lower risk of these conditions than if they were to get the virus itself. Your child may feel a little under the weather for a day or two after the vaccine, but in terms of scary things, the vaccine there is less of a risk of developing long term side effects than taking a chance with getting COVID itself.

What is some good information for parents when making the decision to vaccinate their children, and staying healthy as we approach the holiday season?

Dr. Soong: We’re anticipating that there could be another surge of the Coronavirus as a result of holiday gatherings. Last year after holiday gatherings and through the winter months, we started seeing peaks in the spread of the virus. Children can easily spread COVID, and so it’s important to get them vaccinated to help protect, not only themselves, but others with weak immune system, the elderly, and those who are not vaccinated.

Getting the vaccine is of course a very important way of protecting your child against COVID-19, but as you’re going through the process of getting vaccinated, do parents need to take other measures, at least to a certain point in time?

Dr. Youngblood: Absolutely. When your child receives the vaccine, there are two doses of 10 micrograms given 21 days apart. It is obvious that those vaccinated do not have magical protection as soon as they receive the shots. You’re not going to reach the most effectiveness until you are fully vaccinated. The body has to build protection against the virus somewhere between one to two weeks after your child receives the second dose. This is why it’s so important that children begin the series as soon as possible before the holidays to prevent another pandemic peak. Until your child has reached that maximum effectiveness, they should continue to use a mask in social settings, and wash their hands constantly. We hope that all of us have developed the habit of washing hands as a result of this pandemic and that frequent hand washing will stay with us anyway. Also, if you or your child is not feeling well or family members are not feeling well, make sure you give full disclosure to those you love, and stay away from others until you know more about what’s going on with your child or with that loved one.

Where can people go for vaccinations?  As it becomes known that Children’s of Alabama and UAB are offering the vaccine to the 5-11 age group, are there also other places you would recommend for parents to take their children to receive the vaccine?

Dr. Soong: We are always the ones that you can trust, and we take care of your children. We are very knowledgeable and a viable resource to what has been going on through this whole pandemic. Keep in mind that a good choice is also your family pediatrician. Your pediatrician sees your child on a regular basis and offers other vaccinations as well, so it is always good to ask their opinion. They may also refer you to one of the nationwide pharmacies that will be offering it to children as well.

For the more information about COVID-19, visit childrensal.org.

Children's, Health and Safety

Is it the Flu or COVID-19?

The past year and a half has 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, Health and Safety

FAQS: 2021-2022 FLU, RESPIRATORY ILLNESS SEASON

Flu

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
Health and Safety

Ticks and Lyme Disease

Lyme disease is an infection caused by a tick bite. If left untreated it can lead to problems with the skin, heart, brain and joints. Tori Gennaro, a pediatric nurse practitioner at Children’s of Alabama, says it’s important for parents to be on the lookout for ticks and the symptoms of Lyme disease in their child.

The good news is, not all tick bites cause Lyme disease, and it’s more common in the Northeastern part of the United States. It’s spread from the deer or black legged tick, usually in the summer months.

Fortunately, in most cases, Lyme disease is easily treatable. “It’s usually treated with a 10–21-day course of antibiotics,” Gennaro say. “Once they’re treated with antibiotics the recovery is fairly quick and complete. It can take a few weeks or longer.”

Usually, because ticks are so small, a parent or child may not even see one or know the child was bitten until there are symptoms.

Symptoms of Lyme disease include:

  • Red, circular rash that looks like a bullseye
  • Flu like symptoms
  • Fever
  • Headaches
  • Muscle aches
  • Joint pain

“Prevention is key,” Gennaro says. “We recommend using a good insect repellent that has DEET.” She also advises to wear long sleeves and pants when walking in the woods, stay on trails and avoid tall brush, shower immediately after being in the woods and check daily for ticks. “Make sure you’re checking armpits, in your hair and groin as those are the areas where ticks tend to hide,” Gennaro says. If you believe your child has suffered a tick bite and is demonstrating the symptoms of Lyme disease, contact your pediatrician.

Children's, Health and Safety

Fireworks Displays Can Be Dangerous When Not Left to Professionals

Fireworks are synonymous with the 4th of July holiday. With some communities across the country canceling their professional displays this year because of social distancing concerns, there could be an increase in the personal use of fireworks, along with a potential for increased injuries.

The American Academy of Pediatrics (AAP) continues to urge families not to buy fireworks for their own or their children’s use, as thousands of people, most often children and teens, are injured each year while using consumer fireworks.

Sue Rowe, a charge nurse in the Burn Center at Children’s of Alabama, has advice for those who choose to use their own fireworks this 4th of July.

Her number one fireworks safety rule? “Never leave children unattended around fireworks.”

If you are using fireworks on your own, only use them with adult supervision. Keep children at a safe distance from lit fireworks. She also suggests keeping a bucket of water nearby. Store fireworks in a safe place, outside the main living area, such as in a garage or storage area, out of a child’s sight and reach.

And while sparklers may seem like a safe alternative to large, showy displays, they can be just as dangerous. “The tip of a sparkler produces a significant amount of intense heat,” Rowe said. The AAP reports that sparklers can reach above 1,800 degrees Fahrenheit – hot enough to melt some metals.

However, accidents do happen, and Rowe offers tips if your child is burned with a firework. “The first thing is to immediately apply cool water to the burn site.” She cautions against ice packs, though. For home care, “apply a topical antibiotic ointment to the affected area.” If the burn is significant, a trip to the closest emergency department is advised.

Each year, more than 300 children are admitted to the Burn Center at Children’s of Alabama, the only designated pediatric burn center in the state and one of the largest in the southeast. A specially trained team of pediatric surgeons, registered nurses, physical and occupational therapists, social workers, child life therapists, teachers, pastoral care staff, nutritionists and burn technicians work together to form a cohesive team of professionals dedicated to treating children with burn injuries. The Children’s of Alabama Burn Center is a six-bed specialty unit designed to care for the needs of burn patients ages birth to teenagers. On an outpatient basis, the Burn Clinic treats more than 900 patients every year. For more information, visit www.childrensal.org/BurnCenter.

Children's, Health and Safety

Vaping

Vaping is on the rise among American teens. A recent study by “The Truth Initiative” found that 27.5% of American high school students use vape products. Susan Walley is a pediatrician at Children’s of Alabama. She says it’s very important for parents to understand the dangers of vaping and to be able to recognize e-cigarettes. E-cigarettes are battery-powered smoking devices that have cartridges filled with a liquid that contains nicotine, chemicals and flavoring.

Walley says oftentimes teachers and parents do not even recognize the cartridges when they see them. “Juul is one of the most common e-cigarettes,” Walley says. “The device is very small and can be hidden in backpacks and pockets. It looks like a USB charger, so oftentimes when we show teachers and parents the products they say, I saw those but didn’t recognize them!” Walley adds that the nicotine in those small, liquid cartridges can be the equivalent of two packs of cigarettes.

Health experts are reporting serious lung damage in people who vape, including some deaths. Walley warns, “The facts are e-cigarettes are dangerous, particularly for youth. Thousands of people have been hospitalized with e-cigarette or vaping associated lung injury, also known as EVALI. These products have toxins in them that are very dangerous,” she adds.

In addition to the lung damage, nicotine is highly addictive and can slow brain development in kids and teens and affects areas like memory, concentration, self-control, and mood. It also increases the risk of other types of addiction. Many e-cigarette products appeal directly to young children through the use of fruit flavors, and even branding that can appear cartoon-like. Walley warns parents to be on the lookout beginning at an early age for signs of e-cigarette use. It is recommended that parents talk with their children and teens about the dangers of vaping. And if you believe your child has already started, look for programs to help them quit. It is important for parents to be engaged and tune into what their children are doing to help them stay safe.

Health and Safety

Bicycle Safety

Biking is a beneficial summer activity for children because it provides an opportunity to exercise, get outside, play and interact with other children. However, parents should consider these tips as their child engages in bike riding this summer. Children should be efficient in their bike-riding skills and proficient in the rules of the road before embarking on their own biking adventures. Parents should ride alongside their child until they are confident that they can ride on their own.

When riding a bike, always remember to do the following:

  • Wear a securely-fitted helmet and fasten the chin strap
  • Follow traffic signs and signals
  • Ride in the same direction as traffic
  • Stay in the bike lane whenever possible
  • Look left, right and left again before entering street or crossing intersection
  • Use the sidewalk appropriately and be alert of other pedestrians
  • Never use electronics while riding
  • Use hand signals when changing directions
  • Make sure you ride in a straight line and do not swerve around cars – be predictable as you ride
  • Use lights on your bike and wear bright-colored clothing

State Chapter Director of Division of SAFE Kids Alabama, Julie Farmer, said, “Parents should model good behavior and always wear a helmet when riding a bike.” Parents should teach their child how to ride a bike in a safe area, such as an unused parking lot or empty athletic track. Children need to be taught the rules of the road and safety hand signals. A good resource to teach hand signals  is provided by the National Highway Traffic Safety Administration at  www.nhtsa.gov/sites/nhtsa.gov/files/8009-handsignals.pdf

According to the Consumer Product Safety Commission (CPSC), “A majority of the 80,000 cycling-related head injuries treated in emergency rooms each year are brain injuries.”

According to Safe Kids, “Properly-fitted helmets can reduce the risk of head injuries by at least 45% – yet less than half of children 14 and under usually wear a bike helmet.” The Alabama law for bike helmets states that children under the age of 16 must wear a helmet when riding a bicycle. In cases of violation, the child’s parent or guardian may receive up to a $50 citation.

Parents should always make sure their child has the right size helmet. Your child’s helmet should align with the U.S. Consumer Product Safety Commission’s standards and have a certification stamp on the side – either Ansi or Snell. The fit and certification of a helmet is more important than the cost of the helmet itself. In addition, parents should make sure their child knows how to correctly put on the helmet to ensure their head is protected.

“A helmet should sit on top of the head in a level position, and should not rock forward, backward or side to side. The helmet straps must always be buckled, but not too tightly,” said Farmer.

In addition to helmet fit, proper bike fit is extremely important to ensure a safe ride. If possible, parents should bring their child along with them to the store when shopping for a bike. Be sure your child’s feet can touch the ground when they sit on the bike.

Before your child leaves on a bike ride, make sure:

  • The reflectors are stable
  • Brakes work efficiently
  • Gears shift easily
  • Tires are properly secured and inflated
  • Helmet is secured
  • Your child is not wearing long, loose clothing, flip-flops or sandals

Children should be at least 10 years old before riding a bike without a parent present. There are many factors that contribute to the decision, such as traffic, sidewalks available or where someone lives, but 10 years old is a good choice. At this age, children have the cognitive ability to determine how close the sound or sight of cars are in relation to their current location. To learn more about this or other safety topics, visit our website at childrensal.org.

Children's, Health and Safety, News

Patient Noah Stewart Remembers the 2011 Tornado Outbreak and His Care Team at Children’s

Ten years ago, on April 27, 2011, Noah Stewart – then an 8-year-old living in Pleasant Grove – was one of more than 60 children treated in our Emergency Department as part of a widespread outbreak of tornadoes throughout Alabama.

Noah Stewart shelters in the closet just 15 minutes before an April 2011 tornado demolished his house. Wearing the helmet may have saved his life, one doctor says.

Now 18, Noah is a freshman at Troy University and is a member of the Sound of the South marching band drumline. We caught up with Noah about his experience that day. Experts said one of the reasons he survived a tornado striking his home was because he was wearing a baseball helmet. At the time, that was a novel concept. Today it’s a standard part of severe weather preparation.

“The first thing I remember about April 27, 2011, is there being a tornado warning and my mom telling me to put on my baseball helmet,” he remembered. “At that point, I got a little worried, grabbed the stuffed animal my girlfriend had given me and went to our designated safe place, my parents’ walk-in closet. My dad got home from work and we, my parents, my sister Haley and I, all took shelter literally minutes before the tornado hit.

“I remember losing power, the whistle of the wind and then a very, very low rumble. It sounded like a train, getting louder and louder the closer it came. In an instant, the house exploded, and we were all sucked out by the tornado. The experience was like being swallowed by a huge wave in the ocean; I couldn’t tell up from down or right from left – I was lost. It was over as quickly as it began except that I was about 50 yards from where I was only seconds before, now laying in a field of debris against the twisted remains of a tree stump.  My parents and sister landed in different locations, but they all crawled to me. There was an immediate calm after the storm, but we soon noticed everything we owned was gone. In that moment it didn’t matter because we all survived and so did our dogs, Jack and Cody. My mom and Haley were taken by ambulance directly to the hospital. I was placed on the remains of a broken door. My dad and I were carried in the back of a pickup truck to a triage location several blocks away. Dad and I were separated when he was transported by ambulance. Several hours later, I was sent to Children’s. I was wet, cold and alone without my family but the doctors, nurses and staff were amazing. They made me feel safe and comforted me as they stitched and bandaged my cuts and bruises.”

Noah was treated that night by Drs. Mark Baker and Michele Nichols and a host of other staff.

“I wish I knew the names of each person that helped me that night,” he said. “Children’s befriended me and allowed me to be a part of several events like the Regions Classic and the dedication of the Benjamin Russell Hospital for Children. This gave me an opportunity to tell my story and about the importance of protecting your head by wearing a helmet during a storm. I had a reunion with the ER doctors, nurses and staff on the one-year anniversary of the tornado. I am unable to visit on this anniversary as I will be in Troy but my admiration and appreciation for the doctors, nurses and staff of Children’s is as strong today as it was on April 27, 2011.

“Thank you all so much for what you did for me that night and what you continue to do for the children of Alabama and throughout the world. Just as I told you on the one-year anniversary visit, you guys are my angels and I will always appreciate the care and support you gave me. You are truly heroes! Because of Dr. Bakers’ research on the use of helmets as protection during tornadoes, many lives have been saved and the use of helmets during emergency weather events is widely practiced and encouraged by life safety professionals throughout the United States.”

Noah Stewart currently attends Troy University

Is your family prepared for severe weather? The 2021 tornado season is off to a deadly start. Already this year, twisters are blamed for the deaths of more than 200 people in the US.

“Children are at risk during tornadoes because of their relatively large heads,” Dr. Baker said. “Noah’s helmet helped protect him after he was thrown high in the air. We also found two more children who were protected by infant carriers when the tornado hit their homes. Helmet use and getting in a safe place can make a big difference when violent weather strikes.”

Have your safe place planned as part of a disaster plan. During a tornado, the best bet is to lay low. The basement is the best tornado safety shelter if available; if not, have an alternate place to seek shelter quickly when necessary. If you’re outside when a tornado hits, seek cover in a safe building or in a ditch, using your hands to protect your head and neck. Families who live in a mobile home should talk to neighbors or the park owner about tornado safety options.

  • Have a portable radio (with new batteries) on hand as part of your tornado safety plan. In the event of an emergency, someone needs to listen and be aware of the two types of reports given when weather conditions are right for a tornado: A “tornado watch” means that a tornado is possible. A “tornado warning” means that a tornado has been sighted; people who are in its path should go to their tornado safety shelter immediately. A local or state map will help you visually follow the path of the tornado when listening to radio reports.
  • Have a helmet designated for each member of your family in your safe place. The most common injury related to tornados is head injury, and doctors believe helmets can prevent the majority of head trauma during severe weather. Baseball, bicycle and football helmets are all good examples of protective head gear and should have a well-fitted chin strap to keep the helmet secure.
  • Put together an emergency supplies kit. The emergency kit should include everything that might be needed during or in the aftermath of a tornado, especially if power is lost or water sources are affected. Bottled water, flashlights, batteries, prescription medicine, a first aid kit, and snacks or non-perishable food for the family are essential components of the supplies kit. Make sure the kit is easily accessible in the event it’s needed. Include notepad and pen in your kit if you are worried that your child might be anxious or frightened while executing your disaster plan. Having him or her write a journal entry on the experience of preparing for a tornado or inclement weather helps your child overcome feelings of helplessness and will also provide an interesting record of events for the future. Also, based on your child’s age, you may be able to assign him a task or two to help him or her feel more in charge of the situation. Something that doesn’t require much supervision is ideal; tasks such as testing all the flashlights and replacing batteries as needed, putting together snack bags for family members, or even occupying younger children while you are working on preparations. Giving your child some responsibility will make them feel more secure and help reduce their anxiety about the chaotic nature of the storm.
  • Moving lawn furniture and trash cans out of the storm’s path and removing dead limbs from trees in the yard can be a life-saving tornado safety precaution. Even small items can become dangerous when propelled by high winds. Make sure to move these items several hours before the storm arrives.
  • Set up a disaster plan with extended members of your family. Tornados typically strike during late afternoon and early evening, but they have been known to touch down in the middle of the night. Families should decide ahead of time which family members are responsible for calling the rest of the family to warn them and to provide them with updates as part of the tornado safety checklist.
  • If tornado sirens are sounded, it usually indicates that a tornado warning has been issued by the National Weather Service and you need to get to your “safe place.” If you happen to be outside and the sirens go off, do not panic. Find a culvert pipe, a ditch, or a low-lying area. Lie flat, cover your head and get to safety as soon as the storm has passed. In the event of severe weather, the sirens will sound when there has been damage equal to that is similar to that of a small tornado. This damage may include downed trees, power lines and property damage.

For more information on this and other children’s health and safety issues, please visit childrensal.org.