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Health and Safety

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.

Children's, Health and Safety

April is Child Abuse Prevention Month

One in four children experience some sort of neglect or abuse in their lives and one in seven have experienced abuse or neglect in the last year (American Academy of Pediatrics). In over 90% of abusive situations, a child is abused – sexually or physically – by someone they know. Abuse is often carried out by the child’s caregiver.

The current health and economic crisis induced by COVID-19 intensified several challenges for children. Loss of jobs and resources, health concerns, and isolation have led to high stress among families. Director of the Children’s Hospital Intervention and Prevention Services (CHIPS) Center, Debra Schneider, said, “Increased stress levels among parents is often a major predictor of physical abuse and neglect of children.” Stressed guardians may be more likely to respond to their child’s behavior in an aggressive way. The support systems that many at-risk parents rely on, such as extended family, childcare, schools, religious groups and other community organizations, were no longer available in many areas due to the stay-at-home orders. Child protection agencies also experienced strained resources with fewer workers available, making them unable to conduct home visits in areas with stay-at-home orders.

Schneider, said, “There has been more suspected physical abuse cases seen by the CHIPS Center in the last six months directly relating to the pandemic compared to before.” Kids are at home more under the supervision of their caregivers. Caregivers aren’t getting as much of a break because the kids are not in school.

Vulnerable situations and disasters such as the tornadoes that recently plagued central Alabama can also lead to misplaced and unsupervised children, which can then result in abusive situations.

Lack of understanding regarding child development can also lead to abuse. In instances of physical, sexual or emotional abuse, Schneider said the child is often left in the care of a family member or significant other. That person may not understand the process of child development and expects a child to do a task they cannot yet fulfill – such as walking, feeding themselves or being potty-trained. They may take out their anger on the child through a form of abuse if they cannot fulfill the task.

Signs to watch out for in victims of abuse and abusers:

There are many signs that may indicate a child is being abused. Children who are being abused might:

  • Have new onset fears
  • Have a vocabulary too advanced regarding sexual activity
  • Be withdrawn from friends and family
  • Have nightmares
  • Experience a drop in their grades
  • Change in appearance (wearing clothes that don’t align with the weather)
  • Not want to go home
  • Start using drugs
  • Bully others
  • Be sad or depressed
  • Have stories to explain injuries that don’t make sense or keep changing
  • Not want to be with the abuser
  • Act out at school

There are also signs to watch out for in abusers themselves. They usually walk the victim through a grooming process. Schneider said it is important to remember that the child is usually not abused 24/7. The relationship often consists of a more positive bond. The abuser knows what the child likes, is curious about and afraid of, and they use it to their advantage. Some sort of ‘relationship’ is formed, and a trust is established between them. That way, when harm enters the picture, the child is less likely to question their character and actions. Other signs include spending more time with the child than is appropriate, giving extraordinary gifts to the child more than what’s normal, using excuses to be alone with the child and implementing gaslighting techniques. Gaslighting is defined by the Centers for Disease Control and Prevention as “presenting false information to the victim with the intent of making them doubt their own memory and perception.”

Most kids think abuse comes from a stranger, but abusers are usually someone a child knows. Schneider suggests teaching kids “stranger danger;” however, build off that concept to make them aware that abusers can be someone they know.

Steps for parents to take to prevent or stop abuse:

Parents should be aware of abusive situations and know the signs to look out for in children when they are victims of abuse. The child who has endured abuse the longest typically has the longest healing process.  The quicker an abusive situation is reported, the faster a child will be removed from the situation and be provided with medical care, therapy and counseling to heal.

If an adult suspects an abusive situation, they should report it immediately. Anyone can provide an anonymous report of abuse and NOT have to prove it.

Children in an abusive situation need a trusted adult to confide in – whether that is a teacher, friend’s caregiver or guidance counselor. Schools encourage a child to tell three adults; two inside and one outside their family. That trusted adult can clearly communicate to the child, “I am here for you if anything is going on. I am not here to judge.” In some instances, the trusted adult’s child may be present for the conversation if it creates a comfortable atmosphere for the child experiencing abuse.

Adults who suspect abuse should approach the child gently. If the adult asks too many questions, the child may feel in trouble. Adults should never make promises to not tell anyone, since that is a key action to be taken when stopping abusive situations. Remind the child that abuse is NEVER their fault.

Since conversations about abuse can be very difficult to bring up, adults should consider this advice when approaching a suspected victim of abuse. Schneider suggests bringing up an incident from the news as a segue into a conversation about the abusive situation. In addition, having these conversations in the car creates a more relaxed, noninvasive environment.

The next step for adults would be to report to the local department of human resources or a child protective services agency. You can also contact the Childhelp National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453). You don’t have to give your name. If the child is in immediate danger, call 911.

 “Abuse is not the child’s whole story,” Schneider said. “There is hope when intervention occurs.”

Children's, Health and Safety

Poisonings: Prepare, Prevent, Protect

Your home should be a safe place for your family, but there are actually many hidden dangers. Our homes are filled with poisonous substances. Knowing the dangers and how to prevent them can keep kids safe.
Ann Slattery is the director of the Alabama Poison Information Center at Children’s of Alabama. She says parents and grandparents should do their part to “Prepare, Prevent, and Protect” kids against accidental poisoning.

PREPARE
Prepare now for the possible event of poisoning. Slattery recommends saving the toll free number for the Alabama Poison Information Center in your phone to keep it close at hand at all times. The number is 1-800-222-1222. Also, she recommends every home have a carbon monoxide detector, and that adults should prepare a list of all medications. “For adults we say have a list of your everyday medications available in case you have to call the poison center,” she said.

PREVENT
Act now to prevent the risk of poisoning. Store all cleaning products up and out of reach of children. Slattery also recommends storing prescription medicine in lock boxes. “Make sure you have child resistant closures on your medications,” she said. “Remember there is no such thing as child proof.” Slattery advises to remember this risk when visitors are in the home. You never know what guests may have in their bags, so store purses and suitcases out of reach or behind locked doors and away from children.

PROTECT
In the unfortunate event that an exposure does occur, call the Alabama Poison Information Center immediately at 1-800-222-1222. Slattery advises that if the individual is unconscious, having trouble breathing or experiencing a seizure to instead call 911 immediately.

By taking the proper precautions now, you can help keep children safe from the risk of poisoning. But if an accident does happen, be prepared to act quickly in the event of an emergency.

Health and Safety

Protecting Your Teen from Dating Violence

One in 10 teenagers will experience some sort of abuse by a dating partner, according to the Children’s Safety Network. Negative short-term or long-term health issues can result from abusive relationships. Parents should be cognizant of potential warning signs in their teenage kids’ relationships to help prevent abuse.

Dating violence manifests in many different forms, including emotional, physical and sexual abuse. Emotional abuse can be hard to recognize because it typically progresses gradually throughout the relationship. Emotional abuse can include intimidation, manipulation, intense jealousy, threats, controlling behavior, verbal assault and gaslighting. Gaslighting is defined by the Centers for Disease Control and Prevention as “presenting false information to the victim with the intent of making them doubt their own memory and perception.” Physical abuse is any means of physical harm, including hitting, kicking or punching. Sexual abuse involves forcing a partner to engage in any type of sexual experience without consent.

The director of the Children’s Hospital Intervention and Prevention Services (CHIPS Center) at Children’s of Alabama, Debra Schneider, is an expert on teen dating violence (TDV). “If the perpetrator is more interested in controlling you,” Schneider said, “then that is a big red flag.”

The victim in an abusive relationship is likely to experience adverse health issues during the relationship or develop health issues later on from the traumatic experience. If the relationship is physically violent, long-term injuries or even death could result. Teens in an abusive relationship have an increased risk of depression, anxiety, post-traumatic stress disorder, substance abuse, antisocial behaviors, eating disorders, negative body image, sexually transmitted diseases, trust issues, emotional triggers, lying, stealing, cheating and lack of discernment when picking appropriate partners in adulthood. 

In order to protect their children from teen dating violence, parents should know what to be aware of when their child is in a relationship.

Warning signs parents should be mindful of:

  • Secrecy or withdrawal from friends and family
  • Onset of anxiety and/or depression
  • Physical findings (bruises, cuts, headaches, back pain)
  • Only spending time with partner
  • Feeling excessive guilt or shame
  • Avoidance of school or social events with excuses that don’t seem to make any sense

Schneider wants parents to know how they can reduce the occurrence of TDV and protect their teens.

“Open dialogue about physical and emotional boundaries in relationships should begin when children are young,” Schneider said. “Boundaries and respect are vital to pave the way toward healthy relationships in their teenage years. If parents are modeling a healthy relationship, that’s going to be what teens are used to and what they expect in their own relationships.”

If you observe any warning signs of an unhealthy or abusive relationship in your teen, talk to them about it. It is important to start a conversation with your child/teen and listen to them. Try to understand and validate their feelings in this situation. Your show of support will increase their trust and your teen will be more comfortable sharing information with you. This open conversation will be crucial in educating your teen about what should be expected in a healthy and safe relationship.  A teen who is being abused needs someone to hear and believe them and be reminded that abuse is never deserved.

Resources you or your teen can call if they are in an abusive relationship:

  • National Dating Abuse Helpline – call 1-866-331-9474 or log on to interactive website loveisrespect.org to receive immediate, confidential assistance
  • Birmingham Crisis Center – call 205-323-7777
  • Birmingham Rape Response – call 205-323-7273
  • CHIPS Center (Children’s Hospital Intervention and Prevention Services) – call 205-638-2751
  • RAINN (Rape Abuse and Incest National Network) – call 1-800-656-4673
  • If your teen is in immediate danger, call 911
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.