Tag Archives: Children’s Hospital & Medical Center

Concussions and Young Athletes

August 16, 2013 by

Here’s a question for parents—Can you describe a concussion? It’s more than a headache or a momentary blackout. Doctors consider it a traumatic brain injury, ranging from mild to severe, caused by a blow or jolt to the head. With young athletes back on the field, Kody Moffatt, M.D., a pediatrician and sports medicine specialist at Children’s Hospital & Medical Center, wants parents, coaches, and trainers to know the signs.

“We know much more about concussions today than we did even a year or two ago. A concussion in a child or teenager is different than in an adult. The impact on the developing brain can be a real problem,” says Dr. Moffatt.

Football poses a risk, particularly when players tackle with their heads down.

“I tell parents that football, in general, is a safe sport as long as young people don’t lead with the head,” he explains. “Coaches in our area have been really good about teaching young, developing players to use the shoulder or chest as the first point of contact.”

Symptoms of a concussion are as individual as children themselves. Visible signs of a suspected concussion are:

  • Loss of consciousness
  • Slow to get up
  • Unsteady on feet, falling over, or trouble balancing
  • Dazed or blank look
  • Confused, not able to remember plays or events

Dr. Moffatt says athletes with a suspected concussion should not return to the field. They need to see a doctor. Immediate emergency care should be provided when the player is vomiting, has a seizure, experiences neck pain, is increasingly confused, or is unable to stay awake.

Nationally and across all levels of play, from professional to recreational leagues, the emphasis has been on “return to play.” This focus surrounds the safe return to the game following diagnosis and treatment. This fall, “return to learn” will receive increased attention, too.

“Before young athletes are returning to play, we need to get them back in the classroom symptom-free and able to learn like they did before the concussion,” says Dr. Moffatt. “We have to keep in mind that we’re dealing with a brain injury. This can result in learning problems that impact a student athlete’s academic performance.”

The new Sports Medicine Clinic at Children’s Hospital & Medical Center will work with student athletes, their families, and teachers to customize a “return to learn” plan. Dr. Moffatt considers it to be an important part of the recovery process.

“Return to learn is a significant step, in my mind. We’re considering cognitive function and how we help the brain heal,” he says. “We’ll work with schools to help kids get back on track in the classroom.”

The Sports Medicine Clinic at Children’s Hospital & Medical Center is open to families by appointment. No physician referral is needed. To make an appointment, call 402-955-PLAY (7529). For more information, visit ChildrensOmaha.org/SportsMedicine.

Passionate about pediatric sports medicine, Dr. Kody Moffatt is a highly regarded, well-known expert in the field. An athletic trainer turned pediatrician, he holds a Master of Science degree in orthopaedic surgery and is a Fellow in the American College of Sports Medicine. Dr. Moffatt helps shape sports medicine policy on a state and national level as an advisor to the American Academy of Pediatrics and the Nebraska High School Activities Association.

Fighting Childhood Obesity

July 22, 2013 by

Loving, affectionate, intelligent, and a bookworm—that’s how parents described their young teenage daughter. Weighing more than 200 pounds, she often hid behind her books because it helped her feel invisible, a feeling she preferred to the teasing she endured for her acne and weight.

When she first came to the Healthy Eating with Resources, Options, and Everyday Strategies (HEROES) program at Children’s Hospital & Medical Center, staff saw a shy, withdrawn, and sad young lady who stayed mostly in the background. Slowly but surely, however, she began to emerge as a leader in the group. She lost more than 30 pounds and started to incorporate fitness into her daily life. She soon discovered a love for running. After completing six months with the program, this young lady had become an intricate part of the group. She talked about the newness of having boys notice her—something that had never happened before—and she gradually began to regain her self-esteem.

The staff at HEROES says scenarios like this are quite common among obese children, and, many times, parents don’t know how to help or change the situation.

These children are often caught in a vicious cycle, notes Cristina Fernandez, M.D., pediatrician and medical director of the HEROES program. “They are bullied and made fun of, which lowers their self-esteem and makes them depressed,” she says. “This then feeds into their eating and weight problem. One of our teenage girls told us her classmates were throwing food at her like they were feeding an elephant.

Cristina Fernandez, M.D., pediatrician and medical director of HEROES

Cristina Fernandez, M.D., pediatrician and medical director of HEROES. Photo by Bill Sitzmann.

“We can turn their lives around. These children need to know they can change, they can do better, and they can do it every day. We teach them how. The quality of life for these children improves significantly once they have been in our program for a while.”

Obesity is a growing problem in this country. The American Academy of Pediatrics reports that 20 percent of children in this country are overweight or obese. The problem may be even worse in the Omaha metropolitan area. A 2012 survey conducted by Children’s Hospital and Boys Town National Research Hospital found that 30 percent of children aged 5 to 17 years old were overweight or obese.

Obesity is a multi-factorial disease, says Fernandez. While genetics may play a role, the majority of children are overweight due to their environment and an unhealthy lifestyle. Lack of exercise, extra-large portion sizes, excessive snacking, and overconsumption of fast foods, as well as excessive time spent in front of computers and video games, are all taking a toll.

Minorities like Latinos and African-Americans have a higher rate of obesity than the Caucasian population, and this appears to be in large part due to their environment, notes Fernandez.

But obesity is about more than being overweight. It is a chronic disease and serious health problem that can lead to numerous health conditions, including type 2 diabetes, coronary artery disease, high blood pressure, high cholesterol, sleep apnea, chronic headaches, venous stasis disease, urinary incontinence, liver disease, and cancer.

If the situation is not turned around, these children will begin having the types of health problems in their 20s and 30s that we normally see in people in their 60s and 70s, explains Fernandez.

Losing weight and maintaining an ideal body weight often requires a multi-faceted approach that includes medical management, nutrition counseling and education, exercise, behavior modification, and behavior therapy.

“Our goal is to help them work through their barriers,” says Martha Nepper, MS, RD, LMNT, certified diabetes educator and certified childhood and adolescent weight manager with Nebraska Methodist Health System. “It’s about getting accurate information about diet and nutrition and the proper support. For some children, that might be individual counseling, while others might benefit more from group classes and support.”

Martha Nepper, MS, RD, LMNT, Nebraska Methodist Health System

Martha Nepper, MS, RD, LMNT, Nebraska Methodist Health System. Photo by Bill Sitzmann.

Nepper works with LifeShapes, a program sponsored by Nebraska Methodist Health System that provides nutrition counseling and support for overweight and obese kids and teens.

Nepper says it’s a process that requires both the child and the parents to achieve the greatest success. “Parent involvement is extremely critical,” she says. “The parents are the gatekeepers—they control what comes into the house. The adoption of healthy habits, including diet and exercise, needs to start with them.”

Nepper adds that, oftentimes, just making small dietary changes can help decrease caloric intake enough to halt weight gain and allow children to grow into their weight. This includes steps like trading sugary beverages (like pop and Gatorade) with water, decreasing portion sizes, increasing consumption of fruits and vegetables, and having more family meals.

Some common things for parents to avoid include:

  • Pressuring children to clean their plates
  • Allowing children to have televisions in their bedrooms
  • Bringing too many energy-dense foods into the house, like cookies, chips, and toaster pastries
  • Not being a good role model by not exercising regularly or participating in activities that involve exercise with their children
  • Eating out too often and too much fast food

Using the U.S. Department of Agriculture’s (USDA) MyPlate is a great way to determine what should be on your child’s plate, says Nepper. With MyPlate, half of the plate should be fruits and vegetables with the remaining half split between proteins, whole grains, and dairy.

Even after completing an intervention program, these children do best when they come back for occasional follow-up visits. “It’s a lifelong battle,” says Fernandez. “A smoker or an alcoholic can stop using tobacco or alcohol; we can’t stop eating.”

Cranberry Breakfast Bar

Toss the sugary cereals. Here’s an on-the-go breakfast bar or healthy snack recipe that’s ready when you are. Full of sweet cranberries, oats, and almonds, these bars offer great taste in every bite.

Ingredients (yield 16 bars)

  • 3 cups old-fashioned rolled oats
  • ½ cup (about 2 oz.) chopped almonds
  • 3 cups unsweetened puffed-grain cereal, such as Kashi
  • 2 cups dried cranberries
  • ¼ cup whole wheat flour
  • ½ tsp salt
  • 12 oz. silken tofu, drained
  • 1 large egg
  • ½ cup canola oil
  • ¾ cup honey
  • 1 Tbsp vanilla extract
  • 2 Tbsp grated orange zest

Preparation

  • Preheat oven to 350°. Coat a large (15¼” x 10¼”) baking pan with nonstick cooking spray.
  • On another baking sheet with sides, spread oats and almonds. Bake until light golden, 8 to 10 minutes. Transfer to a large bowl and add puffed cereal, dried cranberries, flour, and salt; stir to combine. Set aside.
  • In a food processor or blender, purée tofu, egg, oil, honey, vanilla, and orange zest until smooth.
  • Add the tofu mixture to the puffed cereal mixture and stir gently until combined. Spread evenly in the prepared pan.
  • Bake for 35 to 40 minutes, or until firm in the center and golden brown. Let cool completely in the pan on a wire rack. With a sharp knife, cut into 16 bars.
  • To make ahead: Individually wrap each bar in plastic wrap and store at room temperature for up to 5 days or freeze for up to 1 month. Thaw at room temperature or remove plastic, wrap in a paper towel and defrost in microwave.

Nutrition Facts
Serving Size: 1 bar
Calories: 321
Fat: 11g
Saturated Fat: 1g
Cholesterol: 12mg
Sodium: 81mg
Carbohydrates: 50g
Fiber: 5g
Protein: 8g

* Nutritional information is based on ingredients listed and serving size; any additions or substitutions to ingredients may alter the recipe’s nutritional content.

For more healthy recipes, visit HealthyKohlsKids.com. The Healthy Kohl’s Kids program is a partnership between Children’s Hospital & Medical Center and Kohl’s Department Stores to educate children and parents about healthy nutrition and fitness.

Light and Easy Chicken Salad

June 20, 2013 by
Photography by Children's Hospital & Medical Center

When the summer heat is on, light and easy tend to guide the menu. This healthy salad recipe is lower in fat and calories than traditional chicken salad. Crunchy walnuts and sweet red grapes enhance the taste and deliver a nutrient boost.

Ingredients (yield 6 servings)

  • 1 lb boneless, skinless chicken breasts
  • ⅓ cup reduced-fat mayonnaise
  • 2 Tbsp fat-free sour cream
  • ½ cup quartered, seedless red grapes
  • ¼ cup walnuts, chopped
  • 2 green onions, chopped
  • 2 tsp lemon juice
  • 1 Tbsp chopped cloves
  • 2 tsp tarragon
  • black pepper to taste
  • red leaf lettuce leaves for serving

Preparation

  • Preheat grill to medium-high. Grill chicken for about 5 minutes on each side, or until cooked through. Let cool.
  • Chop chicken into 1/2-inch pieces and transfer to a medium bowl.
  • Add remaining ingredients except lettuce leaves and toss to combine well. Serve on lettuce leaves.

Nutrition Facts
Serving Size: about 1/2 cup
Calories: 180
Fat: 10g
Saturated Fat: 1g
Cholesterol: 50mg
Sodium: 166mg
Carbohydrates: 5g
Fiber: 0
Protein: 19g

* Nutritional information is based on ingredients listed and serving size; any additions or substitutions to ingredients may alter the recipe’s nutritional content.

For more healthy recipes, visit HealthyKohlsKids.com. The Healthy Kohl’s Kids program is a partnership between Children’s Hospital & Medical Center and Kohl’s Department Stores to educate children and parents about healthy nutrition and fitness.

Say “Yes” 
to More Veggies

June 1, 2013 by

When it’s time to eat vegetables, does your child do the Brussels sprout pout? Don’t give up. It can take eight to 10 tries before children accept a new food.

Children are born with a natural preference for sweet foods and develop a liking for salty foods at around four months. That’s combined with an innate suspicion of foods unknown to them. But if a child rejects a food at first, it doesn’t mean they’ll always dislike it.

Healthy Kohl’s Kids, a partnership between Children’s Hospital & Medical Center and Kohl’s Department Stores, offers these tips to encourage your child to try the green stuff:

  • Don’t overcook. Steam vegetables lightly so they taste better.
  • Teach by example. Eat vegetables with your child.
  • Rather than telling your child to “eat your vegetables,” offer him or her a choice of two and ask, “Which one of these do you want to eat?”
  • Shop with your children. Let them pick a vegetable they like.
  • Add color. Use red bell peppers, bright carrot strips, and different types and colors of lettuce. Bake shoestring “fries” out of deep orange sweet potatoes.
  • Incorporate vegetables into the main dish rather than serving them on the side.

Here’s a great recipe that combines spinach with a family favorite—pizza! For more healthy recipes (with and without veggies), visit HealthyKohlsKids.com.

Spinach Pizza

Ingredients (Yield: 2 servings)

  • 1 store-bought whole wheat pizza crust (7-inch diameter)
  • 2 tsp olive oil
  • 2 garlic cloves, minced
  • 2 oz part-skim fontina or mozzarella cheese, shredded
  • ¼ cup cannellini beans, rinsed and drained
  • 2 tsp grated Parmesan cheese
  • 1 cup fresh baby spinach, chopped
  • Black pepper to taste

Preparation

  • Preheat oven to 450°.
  • Place pizza crust on a baking sheet. Brush pizza crust with 1 teaspoon of the olive oil. Evenly spread garlic, fontina or mozzarella cheese, and beans over pizza crust. Sprinkle with the Parmesan cheese.
  • In a large bowl, toss the spinach with remaining 1 teaspoon olive oil and black pepper to taste.
  • Spread the spinach leaves in the center of the pizza, leaving a border around the rim.
  • Bake the pizza for 8 minutes, or until the cheese is melted and the spinach is wilted.

Nutrition Facts
Calories: 323
Fat: 11g
Saturated Fat: 4g
Cholesterol: 18mg
Sodium: 488mg
Carbohydrates: 37g
Fiber: 7g
Protein: 12g

* Nutritional information is based on ingredients listed and serving size; any additions or substitutions to ingredients may alter the recipe’s nutritional content.