I am often called the “Safety Lady” in my neighborhood and I take great pride in that, despite my girl’s embarrassment. I am a pediatric trauma injury prevention coordinator for Children’s Hospital, and summer is the hardest time of year for me. Now that the weather is getting warmer and school is almost out, we will unfortunately begin to see a lot more kids being admitted to the hospital.

One area of concern for those in field is the use of trampolines.

Are trampolines something to have fun on or something to be feared?  According to the American Academy of Pediatrics, trampolines are simply too dangerous for children to use outside of a structured sports training program with proper supervision. Citing nearly 100,000 trampoline-related injuries in 2009, the Academy noted that installing safety nets and having adults nearby do not seem to affect the occurrence of injuries.

Parents often view trampolines simply as recreational equipment that keeps children busy, but trampolines are not toys. Injuries on trampolines can have very dangerous ramifications. Research shows that 75 percent of trampoline injuries occur when more than one person is jumping on the mat. The youngest kids are at greatest risk for significant injury, including fractures of the legs and spine.

To repeat: the AAP recommends avoiding recreational trampoline use entirely.

In spite of these warnings, kids love bouncing on them and in my neighborhood almost every other home has them. Trampoline injuries are not just freak accidents. They follow a pattern and may be prevented.

If parents choose to allow their children to jump on trampolines, the academy says that:

• Trampoline use should be restricted to a single jumper on the mat at any given time.
• Trampolines should have adequate protective padding that is in good condition and appropriately placed.
• Trampolines should be set at ground level whenever possible or on a level surface and in an area cleared of any surrounding hazards.
• Frequent inspection and appropriate replacement of protective padding, net enclosure, and any other damaged parts should occur.
• Trampolines should be discarded if replacement parts are unavailable and the product is worn or damaged.
• Children should not perform somersaults and flips in the recreational setting; these are among the most common causes of permanent and devastating cervical spine injuries.
• Children should be actively supervised at all times by adults familiar with these safety guidelines.
• Homeowners should verify that their insurance policies cover trampoline-related claims. Coverage is highly variable.

If you do decide to purchase or use a trampoline this summer, remember that it is not as harmless as it may seem.

Read the complete AAP policy.

Imagine you are 4 years old (or 8 or 12 or 16, for that matter) and you have to come to the hospital. You have to leave your regular routine to go to a place that is perhaps scary or lonely and you aren’t exactly sure what is going on. You might be feeling emotionally anxious and fearful or physically in pain or discomfort.  Now imagine that you are that child’s parent, knowing that you will do just about anything to help them cope well and feel better.  Well, in the infamous words from the movie, Ghostbusters, “Who are you gonna call?” The music therapist!

Our music therapists are board-certified and trained to meet the child where they are by using their knowledge, creativity and skills to create an individualized treatment plan for that patient.  Here are some reasons for using music therapy and examples of how it works:

Pain Management/Relaxation:  The music therapist sits at the bedside of a 4-year-old boy while she strums her guitar to the rhythm of his breathing.  She helps him to visualize what his abdominal pain might looks like in order to help guide him in imagining that this pain is getting smaller. The strum of the guitar slows the rhythm of his breath until he is able to relax enough to fall asleep.

Emotional Expression:  A 17-year-old girl relies heavily on her faith to get her through a difficult diagnosis. The music therapist encourages her to write her favorite passages from the scripture and helps set these lyrics to music, creating a song entitled, “Keeps Me Going,” which eventually serves as a legacy by which her family can remember her.

Normalization/Socialization: A group of young children sit around a table choosing and playing a variety of instruments. The music therapist names each child in the opening “Hello Song,” and invites each one to choose and sing their favorite song.  The children are a part of a music group like they might encounter in school, but can’t because they are in the hospital.  “Wheel on the Bus” and “Ants Go Marching” serve the same purpose, to bring children and music together in a fun, normal and social environment.

Distraction: A drum and a xylophone go a long way to distract a child. Using musical improvisation and/or exploration can help a child focus on the sound he is creating rather than a procedure that is going on or will happen soon. The child can play a simple melody on the xylophone as the music therapist sings a familiar song while he is getting stitches.  Or the music therapist can engage the child in a non-verbal drum “conversation” alternating back and forth in response to the other’s drum beat. Before the child knows it, time has passed and it was not spent worrying. Check out this short video of a music therapy session.

Music therapy helps the children cope with all aspects of their hospitalization.  Music is something that most children and families have experience with and thus is familiar and welcome in the healing process.

A symphony rainbow, a chorus so bright
Music is healing us all through the night

Editor’s note: Learn the story behind the CD Everybody Has a Story, which is a compilation of songs written by children in music therapy sessions and sung by some of the industry’s top singers: Kix Brooks, Melinda Doolittle, Fisk Jubilee Singers, Vince Gill, Amy Grant, Faith Hill, Alison Krauss, Maura O’Connell, Johnny Reid, SHEL and Phil Vassar.

A decade ago, just before I married, two of our closest friends lost their youngest daughter in a drowning accident. She was 3 years old and had managed to sneak away from a group of children and slip into a pool without her mother’s knowledge. She had spent lots of time in pools that summer, always wearing water wings, and she probably thought she could swim in that pool without them.

She was wrong.

I’m a writer, but I could never capture in words the horror and grief of the months that followed her death. The agony her parents suffered was excruciating to watch, and frankly, I still don’t know they got through it. My husband and I will never forget that time. It has made us far more cautious with our children than we might have been otherwise.

In particular, it has made me ridiculously paranoid about swimming.

You would probably laugh if you had seen my husband and me over the years when our kids were in the water. I still remember a day when my son was around 2 and we were playing with him in a kiddie pool. He was wearing a life jacket, but somehow he toppled and went face first in the water. Because of the life jacket, he couldn’t regain his footing, and he floated for a helpless second or two, face down. My husband was right beside him and quickly set him upright. Still, we both shouted as if my son had fallen into the deep end of the pool, and we were on the other side. Later, I realized that the other parents around us must have thought we were nuts.

Our paranoia may have rubbed off on our kids. They are now 9 and 6 and we are still struggling to get them to swim on their own. We’ve spent hundreds and hundreds of dollars over the last five years on swimming lessons. At this point I’m (FINALLY) confident that the kids could at least swim to the side of a pool if they fell in, but they are by no means strong swimmers. My daughter honestly hates it.

At her latest lesson last week, she panicked when her instructor wanted her to practice going under water, something that terrifies her. She climbed out of the pool, sodden and crying, so that I could have a serious talk with her.

“Punky, you’re 9 years old,” I told her. “It’s time to suck it up and do this. You have got to learn to swim. There’s no other option.”

“But why do I have to learn to swim?” she sobbed. “Why? Why can’t I just stay away from water?”

“Because it’s something every child has to be able to do,” I told her. “I know you can’t understand it now, but sometimes I have to do things that I know are best for you. Even if I know you’re scared and it’s going to be hard, and you don’t want to do it. You’ve just got to know how to swim.”

And I know that’s true, although I hate to see her suffer. My husband  and I both have older relatives who can’t swim. For their entire lives,  they have avoided boats. And swimming pools. And the lake. And the beach. Not being able to swim means missing out on so many wonderful life experiences. It means being fearful in situations that should be enjoyable. It means that if my children for some reason find themselves in deep water, they may not be able to make it out. The thought of that is unacceptable.

So we will continue working to make our kids strong swimmers, no matter how long it takes and how many trips to the pool we have to make and how much it ends up costing us. (Trust me, I don’t like to even THINK about how much it’s costing us!) We owe it to them. And I hope every parent who reads this post feels exactly same way.

I also want you to know that if you’re a parent with children who seem to be taking FOREVER to learn to swim, you’re not alone. Don’t give up.

I promise that I won’t, either.

The young girl was coming in to the emergency department for stitches. One look in her eyes told me she was scared.

As I watched, the child life specialist quickly established rapport, and I could see the little girl start to relax. As they played together on an iPad, the child life specialist explained that her job is to help kids understand a little more about the hospital – and sometimes find some fun things to do too. 

The little girl smiled.

 “First the doctor is going to clean your owie with this bottle,” the specialist said. “What does it look like to you?”

“Water.”

The child life specialist then described the “special water” and let the girl squirt it. Together, along with the child’s parents, they talked about the process of getting a cut stitched up: how instruments feel, what they sound like and what they are for. The child even practiced on a medical play doll she could later take home. They came up with a plan for being still when the doctor did the stitches using the “special string holders” and paper towels to keep the area clean. The little girl did an incredible job holding still while watching a movie on the iPad. When it was over, she was no longer scared but proud.

I recently observed this scene in our emergency department but similar situations occur throughout our hospital every day as these trained professionals help children and families cope with illness, injury and hospitalization through play, preparation, education and normalization of the hospital environment.

Using play, we help children learn and understand their world. Children who are prepared for medical procedures often experience less distress and cope better in the long run. Our job is to individualize for each child and family what is happening and offer age- and developmentally appropriate explanations to promote understanding. Child life specialists also help patients and siblings with support and positive coping in the face of a new diagnosis or injury.

If you ask a child what we do, they will likely tell you we help them understand, be less afraid and have more fun while they are here.  I believe our role is to meet children and families wherever they are in their journeys and provide an individualized, family-centered care approach to coping with what for many is the worst time in their lives.

The field of child life continues to grow with more than 4,000 certified child life specialists in North America and beyond.  These specialists have a bachelor’s or master’s degree in child life or a related field, complete a clinical internship and pass an examination.  I am proud to have been one of them since I lucked into being hired during college to work in a hospital playroom. I don’t know if I discovered child life or it discovered me, but 20 years later, I am grateful.

Jodi Bauers, MM, CCLS is the Manager of Child Life Services at Monroe Carell Jr. Children’s Hospital at Vanderbilt.  She “accidently” discovered the field of Child Life years ago in college at the University of Iowa, when her former volunteer services supervisor offered to hire her to work in the playroom one summer as an activity therapy assistant.  She shares, “I am not sure if I discovered Child Life or it discovered me, but as a Certified Child life Specialist now more than twenty years later, I am grateful.”

When we think of distracted driving, it is easy to think first of young and inexperienced drivers. The character in the video is a teen-aged girl. At the premiere on Monday, McGraw noted that his daughter had gotten her driver’s license that very day so this is a topic that is top of mind for him. About 16 percent of distracted driving crashes involve drivers under age 20, according to the federal government’s website about distracted driving (Distraction.gov), but they aren’t the only ones taking risks. At any one time, an estimated 800,000 vehicles in this country are being operated by a driver using a hand-held cell phone. Are you sometimes one of them?

In observance of National Trauma Awareness Month, our trauma nurses are joining with others across the country in encouraging you to keep yourself, your family and those with whom you share the road safe by pledging to avoid being distracted while driving. That includes all distractions: from your cell phone, changing the radio station, putting on make-up, fussing at your children in the back seat — anything that takes your hands off the wheels, your eyes off the road and your mind off driving.

Will you and the other drivers in your family take the pledge?

On Sundays, the 9-year-old and I put on our aprons to make and bake snacks she will take to school.

Too much work, you say? Not at all! Get ready to be inspired to stay out of the boxed and bagged snack aisle – even if you think you can’t bake.

We spend about an hour on Sundays whirring nuts, dates, chocolate chips and dried fruit and rolling them into sticky power balls. We measure whole wheat flour, wheat germ and berries with pantry baking staples and produce muffins that bring forth lunch room envy. We use the pizza cutter to slice an easy combination of rolled-out cheddar cheese, flour and salt into crispy crackers, saying an easy goodbye the kind filled with preservatives and food coloring.

We also roll our own flour tortillas or press corn tortillas, which require nothing more than mixing water and corn masa you can buy at any local grocery. And truly, nothing is better than warm, homemade, preservative-free tortillas.

A quick how-to:

• Keep an online inspiration board and then print out the tried-and-true ones.
• Search “homemade fruit bars” online or search by the brand name of the store-bought bars you best like and add “homemade” to the search keywords. There is a homemade version for practically everything in the store.
• Search “easy homemade crackers” and add terms like “whole wheat” or “cheddar cheese” or even “gluten-free” — whatever you like.
• Don’t complicate your life. Look for quick and simple recipes that include things you normally have in your pantry and use regularly.
• Freeze extras. Muffins can defrost overnight or after just a few seconds in the microwave.
• Watch online videos on making tortillas, which also freeze really well. You can buy a cast iron tortilla griddle, a “comal,” or use your own pan.

Would I rather take a Sunday nap instead of making things I could buy cheap? Yes, sometimes. But I love that I am buying less packaged food and sending less to the recycling bin. I am especially gratified the 9-year-old in the apron is getting mom time and life lessons at the kitchen counter. Among them:

• She can feed herself well.
• She can feed others with love and thoughtfulness.
• She can make healthy choices for herself and the grandchildren I hope she one day produces for me.

And that’s worth getting the hands sticky for.

Spring is a welcome break for most after the gray and colder days of winter. Even those who have spring allergies can enjoy the warmer weather and outdoor activities, if they are prepared for the allergic symptoms that the season can bring.

Most early spring allergies are due to allergy to tree pollen. Trees begin their blooming early, sometimes even before any spring flowers can be seen. Many who have allergy to tree pollen believe that they may be allergic to the spring flowers, when in fact, those plants that have pretty flowers or smell good are likely to be pollinated by bees and do not have the type of pollen that travels well in the wind.  Wind-borne pollen is the culprit in most cases, and these include most of the larger deciduous trees whose leaves have not yet started to form. Later spring allergy symptoms (May and beyond) are likely due to allergy to grass pollen.

If a previous spring season caused symptoms of itchy nose or eyes, runny nose, nasal congestion/sneezing, red or watery eyes, or swollen eyelids, it is wise to begin treating for these allergy symptoms even before they begin. Think about this once the start of the season has arrived.  Usually a daily antihistamine that lasts 12-24 hours will help to control symptoms. If this alone doesn’t help, and the child is over the age of 2 or 3 years, a physician may also prescribe a daily nasal steroid spray to reduce nasal inflammation, and possibly a daily or twice daily antihistamine eye drop to reduce eye inflammation. It is always wise to consult a physician when available over-the-counter antihistamines taken for symptoms do not seem to be effective, as there are other medications that may help.

Other suggestions to avoid allergy symptoms in the spring include:

• Play outdoors later in the day since pollen counts tend to be highest in the morning hours.
• Keep windows closed to avoid having pollen enter the home or car.
• Use a clothes dryer rather than putting wash out to dry, as they may pick up outdoor pollen.
• Change clothing after playing outdoors to reduce having pollen spread around in the home.
• Take time to brush off pets outdoors before they enter the home to keep them from bringing pollen in on their fur.

If you or your child has eczema that flares during the pollen season, be sure to have a protective layer of lotion or cream on the skin to keep the pollen from directly contacting the skin. Wash this off when entering and staying indoors and then reapply.

Does your child suffer from allergies? How do you beat them?

Donna S. Hummell, M.D. is an Associate Professor of Pediatrics with specialties in Pediatric Rheumatology, Immunology, and Allergy. Having graduated, interned and held residency and fellowships at John Hopkins University and also a fellowship at Vanderbilt, she has a patient care emphasis in allergic disorder, host defense and immunodeficiency states.

As a car seat technician, I educate caregivers about the proper installation and use of child restraints.  Car seat technicians also have the opportunity to educate families on a number of other safety concerns in and around vehicles, from the dangers of leaving children alone in a vehicle to the importance of checking around a vehicle for any children, toys or pets before backing up. One common topic of education during car seat checks is the danger of projectiles in vehicles.

You might be wondering what we mean by projectiles.  Essentially, this is anything that might have the ability to come loose or move freely in the car in the event of a crash.

So what types of items are we talking about?  Mirrors placed on the seat back in front of a rear-facing child. Pull down window shades. DVD players. Tissue boxes. Bags. Sporting equipment. Toys. Booster seats. You get the picture.

Any of these items are a concern because, in a crash, they may strike the driver or other vehicle passengers, causing injury. (Check out this blog post about a child who had to receive more than 400 stitches because of a soft-spouted sippy cup that went flying in an accident.)

Car seat technicians use a simple formula to help explain crash forces: weight x speed = force.

As an example, if you have an older child that uses a booster seat, chances are you don’t think about fastening the booster seat into the vehicle with the seat belt when the child is not using it.  Let’s say that booster seat weighs about 5 pounds.  Even in a low-speed crash – 30 miles per hour – using the formula above as a guide, during that crash the unrestrained booster seat will now move towards the point of impact with approximately 150 pounds of force.

To help limit the threat of projectiles in your car consider doing the following:

• Buckle up unused booster seats;
• Store items (like bags and purses) on the floorboard of the vehicle;
• Use cargo nets or shields in the back of SUVs;
• Choose window-cling sunshades rather than the shades with suction cups and metal bars; and
• Entertain a small child with soft options, such as stuffed animals or soft covered books.

And remember, it is important for ALL passengers in the vehicle to buckle up on every ride.

Click here for more information about child passenger safety and the car seat services offered at Children’s Hospital.

I remember the biggest fear of adopting Losiah. It was quite simple.  What would it do to the dynamic of our already “prefect family”?

Notice the quotes on “perfect” because we all know you have the perfect family… But it was a legitimate thought.

I was fearful of the unexpected, of how the kids would mesh, of how we would all get along.

Of course those fears were gone the second we got home because where there is love, I always believe there is strength.

And although there were days where my wife and I thought, “We are going to fall apart!”, those days were few and far between.

Here are some simple things we did to make our transition home a little easier.

1.  Involve your kids early and often in the entire adoption process.
When we started the adoption process, our girls were 6 months and 2.  For the 18 months it took to bring our son home our girls were very involved.  It was all they knew.  The worst thing you can do is spring it on them. Let them in from the beginning and it will relieve some stress.

2.  Pictures and more pictures.
From the day we got our pictures of Losiah from the adoption agency, we littered our home with them. Not only in my wallet and on my phone, but everywhere. Closets, cribs, walls, laptops, doors … we even found a picture my daughter had put inside her Barbie house.

He bacame a part of our family by sight alone. It was as if we had met him, were missing him, and were waiting to get him AGAIN.

3.  Allow your biological children to struggle.
When we got home the worst thing we could have done was to act like everything was perfect.  So we didn’t.

Our girls were frustrated that someone was taking some of their time and they reacted at times. In those moments, remember to not shut down those feelings.  They are real and true. We talked about them and never reprimanded them for it. In the long run the tantrums were replaced with wrestling with their new brother. Our girls can’t imagine life without their brother now or then.

Hope these thoughts help. Let us know in the comment section anything that worked for your family.

Carlos

I’ve always been grateful for Monroe Carell Jr. Children’s Hospital at Vanderbilt. As a parent, I’ve long referred to it as “one of my favorite Nashville resources that I hope I don’t need.”

However, as a parent of three children, I have needed it on several occasions. Two of my three children are boys, so we’ve made our fair share of trips to the ER. In addition, my kids have several doctors there, and I’ve always found the staff to be skilled, attentive and all around great with children. My respect and appreciation took on a whole new perspective when I became a volunteer at the hospital.

I own a labrador retriever named Owen. He goes to work with me every day, and he’s crazy about kids. It became obvious to me months into my journey with him that he’d be an amazing therapy dog (once he stopped being a squirrely puppy). I researched the process, took him for a screening, enrolled him in school and many months later, we found ourselves interviewing to volunteer at Vanderbilt.

Every other Friday, we spend the morning with children, teenagers and families in the 6th floor Hematology/Oncology Infusion Clinic. It remains one of my favorite parts of the week. I’ve met so many resilient youngsters and strong parents joined together to fight cancer and other diseases.

Owen is on hand while a child is having blood drawn or chemotherapy administered, offering comfort or distraction, whatever is most needed in the moment. Sometimes I talk with teenagers about a book they’re reading or some great app they’ve discovered on the iPad, while we pet Owen. Recently a young toddler walked him for half an hour around the clinic, pausing only long enough to have her levels checked and then off we went again. Always, the nurses and staff on the 6th floor treat him like a rock star, and he enjoys that treatment.

I can’t quite explain what it is that animals bring to the table that’s different than what we bring as humans. It’s something unconditional – acceptance without judgment or hesitation, comfort without limitation or words, relationship with no strings attached.

Equally so, I can’t quite explain what happens each time we step off the elevator and begin our visits. I can only say that I believe we all benefit from the arrangement. Owen gets a heavy dose of attention and affection, kids and families get (I hope) a needed distraction from what brought them to the hospital that day, and I get a chance to meet some of the more courageous individuals I’ve met.

I remain grateful that a place like Monroe Carell Jr. Children’s Hospital at Vanderbilt exists for all of us that need it.

DAVID THOMAS, L.M.S.W., is a family therapist, speaker, and the author of seven books, including the best-selling Wild Things: The Art of Nurturing Boys (Tyndale House Publishers). He and his wife, Connie, have a daughter and twin sons. They make their home in Nashville, TN.