Late-talking toddlers: Should parents worry?

By Rebecca Reim, MD | January 16, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

We parents love to chart our children’s developmental milestones. From the first little smile,  to the first tooth, to the first steps – we look forward to these important moments
as our children grow.

First words are among the more memorable milestones, and when they’re late to arrive, parents may worry. Like everything else, language develops at different rates for different children – but, as parents, we  cannot help but compare our children to their peers or older siblings.

Here’s some good news for parents of toddlers with few words: a recent study reports that late talking does not foreshadow problems down the road.

The study looked at two-year-olds with language delays and checked in with them in elementary and high school. As toddlers, these children had more problems getting along with others and managing their behavior – which the researchers chalked up to the frustration of having few words. But, as they grew (and caught up in language development,) the late-talkers were just as well-adjusted as their peers.

This does not mean we should ignore language delays. If you are concerned about your child’s late talking, talk to your child’s doctor – either a family medicine physician or a pediatrician. It’s important to monitor  overall development to ensure that any problems are identified and addressed as early as possible.  As long as children have the vocabulary they need when kindergarten rolls around, parents can rest assured that their late talkers will do just fine.

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Yummy, yummy for tiny tummies!

By Laurie Runte, PNP | January 9, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

yummy, yummy for tiny tummiesOnce your baby moves beyond those first weeks of round-the-clock feedings, making sure your baby has the proper nutrition can get a bit more complicated. Breast milk or formula was all baby needed for the first six months of life. Over the next year to 18 months, though, expect a bit more adventure on the feeding front. Introducing solids, trying out table foods and weaning can leave many parents unsure about their little one’s nutrition. Starting good habits early helps set the stage for a lifetime of healthy eating.

Table talk
Healthy eating from the start Try some of these tips when starting solids:

  • Offer one new food at a time. Use single ingredient foods and wait a few days to watch for signs of allergy (rash, diarrhea, increased gas or fussiness) before
    trying another.
  • Start with rice cereal first and go through the grains available in your area. Veggies should be next, followed by fruits and then meats.
  • Limit juice, offer water if any other beverages are needed, such as during hot weather.
  • Use a rubber-tipped sppon to start. Don’t put cereal or food in your baby’s bottle. This can cause babies  to eat too fast, leading to overeating, and doesn’t teach them to eat solids.
  • Pay attention to cues that baby is full. Your baby may turn away from the spoon,
    lean backward or refuse to open his or her mouth. Resist trying to force
    another bite.
  • Keep trying new tastes and textures. At about 8 months, your baby’s probably ready for chunkier and coarser foods that require more chewing, such as mashed potatoes, yogurt, some dry cereals, light crackers, cottage cheese, shredded cheese, small pieces of chicken, ripe banana, well-cooked pasta and well-cooked or canned fruits and vegetables. You may also choose to fork-mash, cut up or grind whatever food the rest of the family is eating.
  • Always monitor for changes in behavior, skin and bowel patterns with dietary changes.

Making mealtimes work
During your child’s second year, his or her eating habits will evolve to be more like your own. Draw the high chair up to the table so he or she can join the rest of the family and try some of these strategies:

  • Establish a routine. Offer three meals and two to three snacks a day on a regular
    schedule so that your child learns to expect food at certain times.
  • Accept a missed meal. Toddlers may skip meals from time to time simply because they’re not hungry. Resist the temptation to keep offering something else. Don’t push food on a child who isn’t hungry.
  • Allow some control. Don’t make mealtimes a power struggle. You decide what healthy foods to offer, and your child decides which to eat, how much to eat and whether to eat at all.
  • Start the sippy cup. Offer whole milk (after age 1), breast milk, formula, water or
    juice in a trainer cup with a lid and spout. It may take several weeks before
    the cup becomes more than a new toy, but using a cup helps improve hand-to-mouth coordination and can pave the way for weaning.
  • Use whole milk. Continue to breastfeed if you wish, but if you use cow’s milk after
    age 1, opt for whole milk instead of lower-fat versions until age 2.
  • Be persistent with new foods. Children often need at least 10 exposures to a new
    food before they’ll accept it. So keep offering broccoli, peas or any other foods about which they may seem hesitant.
  • Limit sweets and empty calories. Little tummies can only hold so much, so serve foods packed with the nutrients they need.

Remember to set a good example. Your baby will develop and model many food preferences and habits after your own.

What’s off limits?
Remember to keep solid food items pea-sized or smaller and that not every food is suitable for young children. Avoid feeding:

  • Cow’s milk, eggs, citrus or honey before age 1
  • Peanuts, peanut butter, fish or shellfish before age 3
  • Choking hazards like whole grapes, hot dogs, hard candy, raisins, popcorn, raw carrots, nuts or large pieces of meat before age 3

If you have questions about what to feed your toddler, bring it up to your provider at your next Well Child visit. Proper nutrition is CRITICAL in these early years and can set your child up for a lifetime of good choices.

www.FortHealthCare.com/Integrated

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Healthiest community in WI? Let’s do this!

By admin | December 19, 2012 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Jefferson County and our surrounding communities can be healthier and live healthier. Our current health status, according to CountyHealthRankings.org, isn’t so good. Of the 72 counties in Wisconsin, Jefferson County ranks 33rd for overall health outcomes, 39th for morbidity (overall health, physical health, mental health and babies born with a low birth weight) and 44th for health behaviors (alcohol and tobacco use, sexual activity, diet and exercise). Walworth County has a more favorable rank of 22nd in the health behaviors category, but fares worse in two indicators: 38th for overall health outcomes and 57th for morbidity.

Our goals
Fort HealthCare’s vision is “Be the healthiest community in Wisconsin.” How do we make this a reality? As the leading healthcare provider in our region, Fort HealthCare has determined that a wide-reaching health and wellness campaign—directed to the public as well as our partners—can positively affect change. Our strategies for making significant changes in health outcomes, health behaviors and morbidity focus on health and  wellness education, awareness of critical health issues and encouraging healthful behaviors.

We believe the goal to create Wisconsin’s healthiest community is a bold, daring, challenging and incredibly important undertaking. To make this happen, we need to:

  • Educate area residents on the benefits of becoming the healthiest community in Wisconsin help each community be ready to embrace and act upon health-related messages.
  • Help area residents to see the benefits of healthy eating, health screenings and lifestyle improvements.
  • Encourage individual responsibility and accountability.

If we accomplish our goals, we’ll improve our status in the county health rankings and, ultimately, create the healthiest community in Wisconsin. Your role is quite specific. We want you to exercise regularly and follow a diet that provides you and your family with healthy, nutritious foods. Also, we’ll remind you to have regular health screenings, such as mammograms and colonoscopies, and encourage you to maintain or establish an ongoing relationship with a Fort HealthCare primary care physician.

Rather than focusing on one individual at a time, we hope to motivate all individuals to see how their health affects the overall population. Our messages will encourage everyone to work toward a shared goal. The call to action and campaign brand is: Let’s Do This! Our theme is a literal call to action. It’s positive, motivating and, hopefully, appeals to all audiences, from individuals to employers to community coalitions. You’ll see this mark
throughout all our print, outdoor and social media. And, you’ll hear this message in our radio advertisements. Are you in? Let’s Do This!

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French fries are NOT vegetables

By Heidi Jennrich, APNP | December 13, 2012 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

In this age of taco palaces, microwave meals and energy bars, some kids probably think the food pyramid is some ancient Egyptian relic. Overstated? Not necessarily, when you consider that almost 17% of kids ages 2 to 19 are obese; that diabetes, a debilitating disease strongly linked to obesity and inactivity, is rising among children and teens; and that by age 10, most overweight kids already have at least one risk factor for heart disease.

Ideas for happy meals
Nutritionists recommend these steps for getting your child on course for a lifetime of better eating habits:

  • Trim the meat. Sure, it’s protein-packed, but red meat is also a culprit in heart disease and some cancers. Better to offer it as a side dish of 3 ounces or less and make fruits and vegetables the main course.
  • Serve less. Watch portion sizes closely so kids don’t consume excess calories. Rule of thumb: Your preschooler’s portion should be two-thirds the size of a regular portion.
  • Play traffic cop. Use a traffic-light model for your kids’ diet: Serve “green-light” foods like whole grains, rice, pasta, fruits, vegetables, peanut butter and low-fat dairy often; serve “yellow-light” items like pancakes, lean meat, poultry, baked goods and jams in moderation; and serve “red-light” foods like doughnuts, bacon, French fries, butter, junk foods, sweets and soda rarely.

5-3-2-1-almost none
The pediatricians and pediatric nurse practitioners at Fort HealthCare Internal Medicine & Pediatrics recommend the “5-3-2-1-almost none” model for children’s wellness:

  • 5 or more servings of fruits and vegetables daily
  • 3 structured meals daily: Eat breakfast, less fast food and more meals prepared at home
  • 2 hours or less of television or video games daily
  • 1 hour or more of moderate to vigorous physical activity daily
  • Almost none sugar-sweetened drinks

 

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Fitting fitness into your child’s day

By Tara Zachgo, LAT | December 6, 2012 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Fitting fittness into your child's dayThere’s no denying it: American kids are getting bigger. In fact, the number of obese teens has tripled over the last three decades. If your kids aren’t getting the minimum 60 minutes of daily activity recommended for children younger than 18 by the Centers for Disease Control and Prevention, it’s time to involve them in some age-appropriate activities that encourage them to get moving.

For preschoolers
For children who aren’t yet school age, experts recommend “free play.” This means encouraging them to go outside and run around – with proper supervision, of course. Take them to the playground, teach them how to play tag and hide-and-seek, toss them a ball to chase, even if they’re too young to catch it. The point is to keep them moving.

Show your kids how to take advantage of the sights and sounds of the season. Organize a sledding party, build a snowman or make snow angels to enjoy the winter weather. Your little ones may even like helping parents clear off the sidewalks or driveway. This will help teach them that being active doesn’t have to be boring.

For school-age kids
Once kids reach school age, they can begin playing sports and become involved in other group activities. Younger children benefit from activities such as ballet and gymnastics or team sports like soccer and baseball. And if your children’s school offers physical activity programs, make sure your kids are making the most of them. If competitive sports don’t appeal to your children, encourage them to try activities like in-line skating or skateboarding. Just make sure they wear the proper protective gear like helmets and wrist guards. Also, this is a good time to begin thinking about ImPACT screening, just in case a concussion ever happens.

Also, this is a great time to consider participating in our Shapedown program. The program builds on the strength of the family while gently and effectively supporting families in creating an active lifestyle and a healthy diet. Parents learn skills to curb their child’s emotional overeating and sharpen limit-setting skills to prompt children toward a healthier lifestyle. Children accept more responsibility for diet and activity and feel happier and safer. Food becomes less important, activity more exciting and the child’s weight begins to normalize.

For tweens and teens
Older kids have even more opportunities to be active. Unfortunately, they have more sedentary distractions, too, like texting and video games. As your children’s independence begins to take hold, encourage them to choose activities they enjoy. They may want to get involved in school sports like track, basketball, cheerleading or football. Expose them to other activities like martial arts or aerobics. And don’t forget, fun activities like  dancing, jumping rope and playing Frisbee burn calories, too!

For other suggestions or to find out if your child is on track with growth and development, talk with your child’s pediatrician or other provider. And don’t forget, Shapedown is an excellent and cost-effective way to build a stronger child and relationship with your
child.

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Healthy Holiday: Cranberry Artichoke Stuffing

By Lisa Ashwill, RD CD | November 21, 2012 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Cranberry Artichoke StuffingIt’s almost here – Thanksgiving! It is probably the most food-focused holiday there is, so it seems appropriate that this week we talk about a favorite side dish…stuffing! Who doesn’t love stuffing? All those mushy carbs soaked in fat. Yum! OK, yes, stuffing is delicious but it can also be very unhealthy. One website published this estimate of calories consumed on Turkey Day, stuffing comes in around 500.

We can do better, right? Change it up this year, and you’re looking at eliminating 340 calories! (That’s like and extra slice of pumpkin pie, one more dinner roll AND some additional cranberry sauce.) Try it out and let me know what you think. Will it become a regular staple on your Thanksgiving buffet?

  • 8 artichokes (medium size), prepared and cooked as directed for whole (OR buy canned, quartered artichokes – NOT marinated)
  • 2 cups chopped carrots
  • 1 cup chopped onions
  • 5 cups bread crumbs
  • 2 cups cranberries, freshly chopped (for easier chopping, freeze cranberries and chop with food processor fitted with metal blade)
  • 1 Tbsp. chopped fresh thyme, or 1 tsp. crushed dried thyme
  • 1/2 tsp. ground allspice
  • 1/3 cup orange juice
  • pepper to taste

Remove outer petals from artichokes; save to enjoy as an appetizer or snack. Remove center petals and fuzzy centers of artichokes; trim out hearts. Chop hearts and place in a large bowl. Set aside. Steam carrots and onions for 8 to 10 minutes, or until carrots are nearly tender. Add steamed vegetables to artichokes; stir in bread crumbs, cranberries, thyme and allspice. Toss until well combined. Sprinkle orange juice over mixture to moisten stuffing as desired. Toss well; season with pepper. Bake in a lightly greased baking dish, covered, during the last 30 to 40 minutes of roasting.

Serves: 10.

Per serving: 160 calories, 1 g fat, 230 mg sodium, 35 g total carbohydrates, 11 g fiber, 8 g protein

 

 

 

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4 steps you need to take right away to control your blood sugar

By RhondaPerdelwitz RN, CDE | November 14, 2012 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Are you a person with diabetes? Whether you were recently diagnosed or have been living with diabetes for years, this is a helpful reminder on the four things you must do to maintain a healthy blood sugar. Even if you are NOT DIABETIC, these tips can help keep you on track to avoid future blood sugar or insulin-related problems.

1)     Test your blood sugar. Use a portable glucose meter to test your blood sugar level as recommended by your physician. Your provider will help pinpoint your target ranges, but most people with diabetes aim for blood sugar levels between 70 and 120 mg/dL before meals and less than 160 mg/dL two hours after the first bite of food, according to the American Diabetes Association.

2)     Upgrade your diet. A healthful diet will help control your blood glucose and weight. Divide your plate into quarters:

  • 1/4 whole grains such as brown rice
  • 1/4 protein like fish or skinless poultry
  • 1/2 non-starchy vegetables like broccoli, cauliflower, tomatoes and carrots.
  • 8 oz. nonfat milk
  • Fresh fruit for dessert

Small adjustments like drinking more water, eating more fruits and vegetables and limiting prime rib dinners to just once or twice a month can make a huge difference!

3)     Get moving. Exercise is a must. It helps you control blood sugar levels, maintain a ealthy weight, lower blood pressure and improve cholesterol. Your doctor may even be able to lower your dose of insulin or other medications. Aim for 30 minutes of physical activity on most days. There’s no need to buy equipment or join a gym: dance in your living room, jog down your street or walk the dog. The possibilities are endless!

4)     See health care providers more often. At least once or twice a year, see your primary care provider for a checkup and tests to measure your glucose control, blood pressure, cholesterol and kidney function. See an eye professional and podiatrist for yearly exams and visit your dentist twice a year for a cleaning and checkup. Don’t forget to stay in contact with your diabetes educator throughout the year to address any questions or concerns right away.

Diabetes education is a Medicare-covered benefit. People with diabetes are offered 10 hours of education during their first year of diagnosis and two hours every year following.

Ask your doctor for an annual referral to a Fort HealthCare diabetes educator or registered nurse. Learn more at FortHealthCare.com/Diabetes.

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Well Woman exam important in early detection

By admin | November 7, 2012 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Well Woman exam important in early detectionThe purpose of an annual Well Woman exam is to detect and treat any new or ongoing health problems, as well as to help prevent future ones from developing. Even if you’re not due for a Pap test, it’s still important to visit your doctor yearly for a comprehensive Well Woman exam. The standard components of a Well Woman exam include assessments of:

 

  • Current health status
  • Nutrition practices
  • Physical activity
  • Sexual practices
  • Tobacco, alcohol, and drug use

Across age groups, the exam also includes height, weight, body mass index (BMI) and blood pressure. Annual breast and abdominal exams begin at age 19.

The American Congress of Obstetrics and Gynecology currently recommends Pap screenings starting at age 21, every two years for most women under age 30, and every three years for women 30 and older who have three negative prior screenings and cessation of cervical cancer screening at age 65 or 70, depending on a woman’s screening history.

Women may be worried that less frequent screening is detrimental to their overall healthcare needs, but this isn’t the case. Over-screening can lead to unnecessary
treatment and could contribute to negative outcomes, such as preterm birth or having
low-birth-weight infants in the future.

Some women may have certain high-risk factors or conditions that may require additional or more frequent tests and interventions. For instance, it is recommend that women
have their first mammogram at age 40 and yearly beginning at 50, but a woman and
her doctor may decide to have a baseline mammogram before age 40 if there is a
family history of breast cancer.

Schedule your Well Woman exam today
Well Woman exams are a routine part of a woman’s health care and are covered buy nearly every insurance provider. We offer these exams at any of our family medicine or internal medicine clinics, and the Fort HealthCare Center for Women’s Health. Visit FortHealthCare.com/FindADoctor to find a physician that’s right for you.

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Calming a crying baby – The Safe Way

By Jan Simdon, RN | October 31, 2012 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

calming a crying babyBabies cry.

It’s how they know to communicate with the world around them. But when a baby won’t stop crying, it can be frustrating. The stress of caring for a baby, especially if your baby has been sick, puts a strain on parents and caregivers. But shaking a baby, even slightly, is very dangerous and can cause a life-threatening condition called shaken-baby syndrome. This condition can lead to major brain damage and death.

 Why it’s a problem

When a baby is shaken, the brain moves back and forth inside the skull. Even a little force could cause the brain to hit the inside of the skull, which can result in bleeding and swelling inside the skull. It can lead to permanent brain damage, coma or death.

If you feel yourself reaching your breaking point, here’s how to cope:

  • Put the baby down in a safe place, even if he or she is crying.
  • Take a deep breath. Walk away. Count to 10. Do whatever you need to do to calm down.
  • Let others help you take care of the baby. Trade off with your partner, the baby’s grandparents or other family members.
  • Talk to your baby’s doctor about what’s causing the crying. There could be a health problem or other issue that’s making the baby cry more than normal. The doctor can also give you ideas for how to console your baby.
  • If you’re feeling overwhelmed, talk to your baby’s doctor about childcare options, counseling or other resources that can help.
  • Call the Child help USA hotline at (800) 422-4453. The trained operator can help you deal with your frustration.
  • Talk to your doctor or one of our lactation consultants. You may be experiencing postpartum depression, a very serious—but treatable—condition.
  • Take the “Happiest Baby on the Block” class along with anyone who regularly cares for your baby. You will learn step-by step how to help their babies sleep better and soothe even the fussiest baby in minutes.

In alignment with our mission and vision to improve the health and well-being of its communities, and be the healthiest community in Wisconsin, Fort HealthCare developed the “Circle of Success: Shaken-Baby Education Program” to improve health outcomes for newborns. With support from grants, our program strives to improve health outcomes for newborns and families in the region, with an ultimate goal of helping other rural hospitals implement a similar program in their respective service areas.

A major focus for the Circle of Success is the “Having Healthy Babies” class. This affordable ($5) class offers a safe place and access to obstetrics RNs so parents-to-be and support people can learn and discuss topics like nutrition and exercise, caregiver selection, safe pregnancy medications, CPR, breastfeeding, shaken baby syndrome, safe sleeping
arrangements for your newborn.

If you or someone you know is expecting a child, especially this is a first child or it’s been a while since the last baby, please encourage them to participate in one of our MANY childbirth and newborn classes. It is so important.

For more information on how Fort HealthCare is improving the health and well-being of our tiniest residents, visit us at FortHealthCare.com/Baby.

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School and sniffles: What’s a parent to do?

By admin | October 17, 2012 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

School and sniffles: What's a parent to do?The leaves are falling and the crisp, fall breezes are upon us. While this time of year brings us relief from a hot summer, it also signals the return of “sniffle season.” Keeping kids well calls for more than good luck, and you can take steps to bolster your child’s resistance. Are you prepared?

Has your child had a physical? An annual well-child exam gives your pediatrician the chance to thoroughly assess your child’s health and development. The doctor will review your child’s medical history, perform a complete physical exam, take weight and height measurements and check blood pressure. Other tests may include a scoliosis screening, blood and urine tests and vision and hearing screenings. If the doctor prescribes treatment changes, be sure to inform the school nurse and give her a supply of your child’s medication. If your child plays sports, don’t forget to bring any appropriate forms for the doctor to sign.

Are you up to date on shots? Children need as many as 27 shots by the time they reach 18 months of age—are you sure your child received them all? Ask the doctor to check your
child’s immunization record and administer any missing doses.

Has your child seen the dentist? Even if your child seems healthy, tooth decay is a bacterial disease that can affect overall  health and lead to problems eating, speaking and paying attention in class. American children miss 750,000 school days each year because of dental problems. Children should see a dentist twice a year starting at age 1 or within six months of the first tooth’s appearance.

Does your child eat breakfast? Studies show that children who eat a nutritious breakfast do better academically and socially and  are less likely to overeat later. Good choices include high-fiber cereals with milk; pancakes or waffles topped with yogurt or fruit; and eggs and whole-grain toast.

Have you taught your child well? The more you enforce good hygiene habits at
home, the more likely your child will continue the practice. Insist on hand washing before every meal and snack and after visiting the bathroom or touching the class pet. Teach your child to lather for 15 to 20 seconds—or for as long as it takes to sing “Happy Birthday” twice. Show how to cover a cough or a sneeze with a tissue, the crook of an elbow or, as a last resort, the hands and then wash up. Remind your child not to share hats, combs, brushes or makeup.

Does your child get enough sleep? Sleep is as important to health as are nutrition and exercise. School-age children generally need 10 to 12 hours of sleep a night, with younger ones needing the most.

If it’s been a while since you’ve come in for a well-child exam or you are seeing symptoms of something brewing, make an appointment today. The Fort HealthCare Integrated Family Care clinic is open in its temporary location (426 McMillen St., Fort Atkinson) and our providers are excited to treat your entire family with a comprehensive wellness approach.

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