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Children's, Health and Safety, News

April is Child Abuse Prevention Month

More than 11,600 children in Alabama were victims of abuse in 2020, according to the National Child Abuse and Neglect Data System. However, the actual number may be higher because many instances of abuse go unreported. The support systems on which many families rely, such as extended family, childcare, schools, religious groups and other community organizations, were limited because of the COVID-19 pandemic.

As families continue to face health and economic strains connected to the pandemic, stressed guardians may be more likely to respond to their child’s behavior in an aggressive way. “Increased stress levels among parents is often a major predictor of physical abuse and neglect of children,” said Debra Schneider, director of the Children’s Hospital Intervention and Prevention Services (CHIPS) Center at Children’s of Alabama.

April is Child Abuse Prevention Month, but CHIPS staff works year-round to facilitate healing from physical, mental and emotional abuse and to provide prevention education.

Parents and caregivers should look for signs of abusive situations. 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 can be provided with medical care, therapy and counseling to heal. “Abuse is not the child’s whole story,” Schneider said. “There is hope when intervention occurs.”

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• Be withdrawn from friends and family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.

Most children think abuse comes from a stranger, but abusers are usually someone a child knows. Schneider suggests teaching about “stranger danger;” however, build off that concept to make them aware that abusers can be someone they know. Schneider states most children are taught about stranger danger, but children need to be taught that most sexual abuse happens with someone a child knows.

Children in an abusive situation need a trusted adult to confide in – parents, grandparents, a teacher, friend’s parent/caregiver or guidance counselor. School prevention education programs 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.”

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, 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.

If you suspect an abusive situation, report it immediately. Anyone can provide a report of suspected abuse to report to the local department of human resources or a child protective services agency. All it takes is a suspicion of abuse; the caller doesn’t have to have specific evidence. 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.

CHIPS staff is a team of specially trained counselors, doctors, social workers and pediatric sexual assault nurse examiners (PSANE). The staff works with law enforcement, the Department of Human Resources and child advocacy center representatives to provide the best possible care for children and families affected by child maltreatment. Services provided include forensic medical evaluations, social work assessments, play therapy, counseling, care coordination, prevention education, court support, expert court testimony and specialized support for victims of human trafficking. For more information, call 205-638-2751 or visit childrensal.org/CHIPS.

Children's

Fever

Parents can understandably be concerned when their child doesn’t feel well and has a fever. But how high is too high? When should a parent treat a fever at home and when should they seek medical help?

Dr. Mark Baker is an Associate Professor of Pediatrics at Children’s of Alabama and works in the Emergency Department. He says a fever is anything higher than 100.4 degrees Fahrenheit. “Fever is the body’s response to an infection,” he says. “Fevers are generally well tolerated in healthy children, especially if they are up to date with recommended childhood vaccines.” 

Dr. Baker says there are instances when a parent should take a fever seriously and seek medical attention. These include when a child has a temperature higher than 100.4 AND:

  • Is 3 months of age or younger
  • Has serious underlying medical problems
  • Experiences pain or other concerns

If any of these conditions exist, parents are encouraged to take their child to the Emergency Department. If a parent is unsure how serious the situation may be, their child’s pediatrician is available to help. Even after hours, a pediatrician’s office has a 24/7 on call line.

Dr. Baker says in an otherwise healthy child, a fever can usually be treated at home with either ibuprofen or acetaminophen, (Motrin or Tylenol). He says it is best to stick with one form of treatment and follow the dosage instructions. If the over the counter medicine isn’t helping, Dr. Baker advises parents to call their child’s pediatrician or go to the Emergency Department.

Parents can also make sure their child is more comfortable by dressing them in lightweight clothing and covering them with a light sheet or blanket. It’s very important that the child gets plenty of fluids to stay hydrated. A sponge bath or wet cloth may help lower their temperature and make them feel more comfortable. All kids get fevers, and in most cases recover completely within a few days. But if you ever have concerns about your child’s well-being, it’s best to contact their doctor for guidance.

Children's

Is This an Emergency?

Your child doesn’t feel well, but should you take him to the emergency department? Sometimes it’s hard to tell when a child requires urgent medical treatment or if the concern can wait.

Dr. Eric Jorge is a pediatric emergency medicine fellow at Children’s of Alabama. He’s seen children come to the emergency department who could have been treated at home. “It’s always a good place to start if your child is sick or has a fever, to call your on-call pediatrician or nurse,” Dr. Jorge said. “They can help guide you as to whether it’s appropriate to seek care in the emergency department or not.”

You should always take your child to the emergency department in a true emergency. These signs include:

Go to Emergency Department for:
• serious injury
• persistent vomiting
• trouble breathing
• not drinking enough, not urinating enough
• unusual sleepiness or confusion
• a head injury with vomiting
• eye injury
• serious burns
• ingested poison or unknown substance

Call 911 if your child:
• isn’t breathing or is turning blue
• is unconscious after a fall
• is having a seizure
• has a serious allergic reaction
• has broken a bone that sticks out through the skin
• is choking
• has a large cut that is bleeding uncontrollably

A high fever can be scary for a parent to see, however, Dr. Jorge said it’s the body’s natural defense mechanism against infection. “Fever is not actually dangerous to children,” he said. “A fever can make you feel pretty bad, but even a fever up to 104 or 105 degrees Fahrenheit can be handled at home.” He recommends giving a child ibuprofen or acetaminophen to see if that brings the fever down. Dr. Jorge also said that most children who are diagnosed with COVID-19 do not require emergency care and can be treated at home.

Babies are the exception to these guidelines, Dr. Jorge said. “Fever in a baby under 2 months old is considered an emergency. If your newborn has a fever over 100.4 degrees Fahrenheit, please seek care immediately.”
Dr. Jorge stresses the importance of every child having a pediatrician. Through an established relationship with a pediatrician, a child can receive better long-term care, and there is always someone on call 24-7 to help determine the best treatment for your child when you’re not sure if you need to take them to the emergency department.
Children's

Stopping the Spread of Germs During Respiratory Illness Season

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

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

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

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

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

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

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

Common symptoms of the flu include:

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

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