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Be Well for Parents - March 2012 Issue


Feature: Ban the Bumpers from Your Baby’s Crib

Feature: Ban the Bumpers from Your Baby’s Crib

Deaths from sudden infant death syndrome – unexplained infant deaths – have declined since 1992. That’s when the American Academy of Pediatrics (AAP) first recommended that babies be placed on their backs to sleep.

But today, deaths from accidental suffocation are on the rise. And crib bumpers are partly responsible.

Pediatricians say crib bumpers – decorative pads that coordinate with crib décor and prevent tiny arms and legs from getting stuck between the slats – aren’t needed. In fact, new AAP guidelines urge parents to avoid them.

Too close for comfort

“After about 2 months of age – even before they can roll – some babies are able to scoot themselves over to the side of the crib. There is a danger that they will squash their faces against the bumper or wedge themselves between the bumper and the crib. Those who are not strong enough to turn away – or who can roll only in one direction – can suffocate,” says Emma Raizman, MD, Cleveland Clinic Children’s Hospital pediatrician.

Hands and feet caught between slats don’t typically result in injuries, she says. But if the prospect worries you, it’s best to buy a new crib. Consumer studies find that in newer cribs — designed with the slats closer together — bumpers don’t offer any extra protection.

Sleeping lean

Crib bumpers aren’t the only cause of accidental suffocation in cribs — any soft material can be dangerous. For that reason, Dr. Raizman urges parents to follow these AAP tips for safe sleep:

  • Place babies on their backs, in the center of a crib or firm sleep surface.
  • Remove all soft objects and loose bedding from the crib. This includes stuffed animals; set them on the floor or on a dresser or window seat.
  • Keep the room warm enough so that your baby is comfortable in a Onesie® or swaddled.
  • Don’t cover your baby’s head; it’s important that babies not become overheated.
  • Do not use pillows, wedges or positioners.
Safe bonding tips

Many parents enjoy bringing baby into their bed — partly for convenience when breastfeeding and partly to encourage bonding. But just like crib bumpers, bed-sharing is an all-too-common cause of accidental suffocation.

“It is very easy for an exhausted parent to fall sound asleep, roll over and suffocate a baby. It’s far more common and more dangerous than the baby getting a hand or foot caught in the slats of a crib,” says Dr. Raizman.

Share your room, not your bed

Although sharing the bed with your baby is discouraged, sharing a room is recommended.

“When your baby awakens, you can sing, and massage him for a few minutes. Then as soon as he falls asleep, go back to your bed. This will enhance the bonding experience, but in a safe way,” says Dr. Raizman.

And should your baby’s hand get caught between the slats of the crib, his or her cries will awaken you.

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Tip: Caring for Kids’ Coughs

Tip: Caring for Kids’ Coughs

If your child has a runny nose, you can expect a cough for seven to 10 days after it stops. Use a humidifier to moisten dry air, and give your child lots to drink. But skip the cough medicine for children under age 6. Cough medicine doesn’t work and has problematic side effects in young children.


Parents Be Well – March 2012 Issue
Feature: Gallstones – From Mummies to Mommies

Feature: Gallstones – From Mummies to Mommies

Gallstones were first found in a mummified Egyptian priestess. Today they are found in people all over the world.

Gallstones affect adults at different ages and stages, from young expectant mothers to middle-aged couch potatoes. The risk factors include:

  • Being over 40
  • Having high cholesterol
  • Being overweight
  • Leading a sedentary life
  • Being pregnant
  • Taking estrogen or oral contraceptives
  • Experiencing recent weight loss
  • Fasting extensively
Why gallstones form

The gallbladder, a pear-shaped organ located just beneath the liver, plays a role in digestion. Its job is to store and release bile, a substance made in the liver. When you eat, your gallbladder sends bile through a duct into the small intestine to help digest fats.

Bile is made mostly of cholesterol and a substance called bilirubin. Gallstones can form when there is too much of either substance. They are usually discovered by accident when abdominal scans are performed for a different problem.

“Gallstones in the gallbladder are mostly harmless and don’t cause symptoms, even when they are big,” explains Cleveland Clinic gastroenterologist Mansour Parsi, MD. “It’s the smaller stones that migrate into the bile ducts that we worry about. We go after them because complications can happen.”

Dealing with problem stones

Asymptomatic stones in the gallbladder usually aren’t treated. But stones that lodge in the bile duct can prevent bile from draining. Stones that block the duct leading to the pancreas can cause pancreatitis. Symptoms of blockage include:

  • Steady, severe pain in the upper-right abdomen. Pain can last several hours. Jaundice (a yellowing of the skin and eyes) may or may not occur. For either symptom, call your doctor. You’ll need blood work and an imaging test such as an ultrasound to confirm the presence and location of gallstones.
  • Fever and chills. If fever and chills accompany pain in the upper-right abdomen, infection is likely. Infection of the gallbladder or bile ducts is an emergency. Seek medical help promptly.

If you develop a blockage, you may need to undergo endoscopic retrograde cholangiopancreatography (ERCP for short). This minimally invasive procedure is used to unblock the duct, remove the stone and often place a stent to keep the duct open. “Sometimes without a stent, the problem will not resolve,” says Dr. Parsi.

But the vast majority of painful stones are treated by removing the gallbladder. This is usually a minimally invasive procedure, but some patients require traditional surgery. Gallstones may still form in the bile ducts after the gallbladder is removed. These can be removed with ERCP.

The good news is that you won’t miss your gallbladder; it isn’t needed to digest food. Instead, the liver can squeeze bile through the ducts directly into the small intestine.

If you can’t safely undergo surgery and your stones are made of cholesterol, you can get medication to dissolve them. However, the medication takes a long time to work, and stones are likely to return.

How to lower your risk

The vast majority of gallstones – 80 to 90 percent – are made of cholesterol. So it makes sense that physical activity and a low-cholesterol diet will lower your risk. Some studies have shown cholesterol-lowering statins to be helpful too.

Gallstones have also been linked to infection, so staying healthy is important. Vitamin C and coffee may help to protect against gallstones.

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Parents Be Well – March 2012 Issue

Free Guide: Solutions to Thyroid Problems

Free Guide: Solutions to Thyroid Problems

This important gland can be the source of symptoms ranging from depression to racing of the heart. Learn more about thyroid problems, and how our experts diagnose and treat them.


Recipe: Meatless Chili

Recipe: Meatless Italian Meatballs

For a twist on the traditional, try this recipe the next time you crave Italian. You’ll eat fewer calories, less fat and less cholesterol. And as a bonus, the tofu is a good source of calcium.

Ingredients

1 pound firm tofu
2 tablespoons onion flakes
¼ teaspoon oregano
¼ teaspoon salt
Pepper
Dash of garlic powder
½ cup corn squares cereal, crushed
½ cup rice squares cereal, crushed
1 egg
1 tablespoon dried parsley flakes

Sauce

1 eight-ounce can tomato sauce
¼ teaspoon oregano
¼ teaspoon dried basil
Pinch of garlic powder
1 tablespoon parmesan cheese

Preparation
  1. Preheat oven to 350 degrees.
  2. Drain tofu well and slice it.
  3. In a large bowl, combine tofu, onion flakes, oregano, salt, pepper, garlic powder, cereal, egg and parsley. Mix well with a fork. Mash to blend ingredients.
  4. Shape mixture into 24 balls, squeezing tightly.
  5. Place a single layer of meatballs on a lightly oiled, shallow baking pan.
  6. In a small bowl, combine sauce ingredients. Spoon over meatballs.
  7. Bake uncovered for 20 minutes.
  8. Sprinkle with parmesan cheese prior to serving.

Yield: 6 servings (4 meatballs/serving)

Nutrition

Calories: 102
Protein: 8.6 g
Fat: 3.95 gms
Saturated fat: 1.1 gms
Unsaturated fat: 2.84 gms
Carbohydrate: 9.1 g
Dietary fiber: 1.6 g
Calcium: 194 mg
Iron: 3.4 mg
Cholesterol: 36 mg
Sodium: 374 mg

Recipe from our Children's Hospital Pediatric Nutrition Support Team

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Parents Be Well – March 2012 Issue

Let's Move It! Free Mobile App – New & Improved

Let Cleveland Clinic and your mobile phone keep you motivated while tracking your progress on a new, built-in pedometer for the iPhone (Android update coming soon). You can also access Cleveland Clinic exercise videos, a calorie converter and weekly wellness tips.