All posts by CHOC Children's

Potatoes: A Winter Comfort Food

By Janelle Sanchez, RD, clinical dietitian at CHOC Children’s

Whether they are mashed, roasted, baked, or served as pancakes, hash browns, or scalloped, potatoes are a delicious comfort food perfect for this winter season! Today the potato is produced in more than 100 countries and is the fourth largest food crop worldwide, following wheat, corn, and rice.

With more than 4,000 potato varieties, the debate continues as to which is the best.

Russets are classically used for baking, french fries, hash browns, mashed potatoes, and potato pancakes because of their ability to hold together. Waxy potato varieties are best for making chowder, potato salad, and scalloped potatoes. Learn more about cooking with different varieties.

You may be asking, “Are potatoes healthy?” Of course they are! Let’s take a look at their composition:

  • Carbohydrates– Despite the common misconception that carbohydrates make you gain weight, we know a balanced diet without excessive intake of any food or food group is healthy. That being said, potatoes are primarily composed of carbohydrate, your body’s most important source of energy.
  • Potassium– Potatoes with skin are packed with potassium, an essential element your body needs. Diets high in potassium may reduce the risk of hypertension and stroke.
  • Vitamin C– This is important for healthy skin and gums, and may also help support the body’s immune system.
  • Vitamin B6 –Some of the functions in this extremely versatile vitamin include converting food into glucose to be used for energy, maintaining normal nerve function, and contributing to protein metabolism.
  • Antioxidants Substances like carotenoids and anthocyanins help prevent the damaging effects of oxidation on cells throughout your body. It is best to include an assortment of colors and kinds of potatoes in your diet, as the amount and types of antioxidants are dependent on the potato variety.
  • Calories vary depending on the potato variety. For example a large russet potato provides about 300 calories, versus a large sweet potato at 160 calories.

There are a few ways to create a health-conscious potato dish. Choose to bake instead of fry those sweet potato fries, french fries and tater tots. Brush potatoes with a little olive oil and seasonings or herbs to flavor instead of butter. When picking out toppings or additives, select low-fat or nonfat dairy products including cheese, sour cream, cream cheese.

Try these tasty recipes for a healthy way to incorporate potatoes into your family’s diet.

Out with the French Fries, in with the Oven Fries:

Ingredients:

  • 2 large Yukon Gold Potatoes, cut into wedges
  • 4 teaspoons extra virgin olive oil (just enough to lightly coat)
  • ½ teaspoon salt
  • ½ teaspoon dried thyme

Preparation:

  1. Preheat oven to 450°F.
  2. Toss potato wedges with oil, salt and thyme (if using). Spread the wedges out on a rimmed baking sheet.
  3. Bake until browned and tender, turning once, about 20 minutes total.

Nutrition

Recipe makes servings. Per serving: 102 calories; 5 g fat (1 g sat, 4 g mono); 0 mg cholesterol; 13 g carbohydrates; 0 g added sugars; 2 g protein; 1 g fiber; 291 mg sodium; 405 mg potassium.

Source: www.eatingwell.com

Warm up with a bowl of Healthy Potato and Vegetable Soup:

Ingredients:

  •  1 teaspoon olive oil
  • 2 ounces pancetta, chopped
  • 1 cup chopped onion
  • 3 garlic cloves, minced
  • 2 cups cubed peeled acorn squash
  • 2 cups diced peeled red potato
  • 1/2 cup chopped celery
  • 1/2 cup chopped carrot
  • 1 teaspoon dried basil
  • 1/4 teaspoon ground cinnamon
  • 1/4 teaspoon dried thyme
  • 1 (28-ounce) can whole tomatoes, drained and chopped
  • 2 (14 1/2-ounce) cans fat-free, less-sodium chicken broth
  • 4 cups chopped kale
  • 1 (15.5-ounce) can navy beans or other small white beans, rinsed and drained

Preparation:

Heat oil in a Dutch oven over medium-high heat. Add pancetta; sauté 3 minutes. Add onion and garlic; sauté 3 minutes. Add squash and next 6 ingredients (squash through thyme), stirring to combine; cook 4 minutes, stirring occasionally.  Add tomatoes; cook 2 minutes. Stir in broth; bring to a boil. Reduce heat; simmer 8 minutes. Add kale; simmer 5 minutes. Add beans; simmer 4 minutes or until potato and kale are tender.

Nutrition:

Recipe makes 4 servings. Per serving: 349 calories; 10.4 g fat (3.3 g sat, 4.6 g mono, 1.4 g poly); 10 mg cholesterol; 55 g carbohydrates; 14.4 g protein; 10.5 g fiber; 405 mg potassium

Source: www.myrecipes.com

Developing Healthy Dental Habits in Children with Special Needs

Helping your child develop a dental hygiene routine can be complicated if other medical conditions are present. Dental care is the most common unmet need among children with special needs, according to the American Academy of Pediatrics. In honor of Children’s Dental Health Month, Richard Mungo, D.D.S., a pediatric dentist and chair of pediatric dentistry at CHOC Children’s, offers tips on dental health to parents of children with special needs.

Mungo, Richard

“The most important thing for parents to remember is that dental health is an essential part of their child’s overall health,” Mungo says. “It’s not something extra. It’s an essential part of their overall wellbeing.”

Children with special needs can have a higher incidence of cavities and oral problems because it’s harder to brush their teeth, says Mungo. Cavities are bacterial infections that if left untreated could spread to other parts of the body that may already be compromised by preexisting conditions.

Introducing Children to the Dentist

Children with special needs may experience extra levels of anxiousness related to visiting the dentist. Mungo encourages parents to help in desensitizing patients to the new environment:

  • Bring a favorite toy, or an iPad and headphones to make your child feel comfortable and remind them of home
  • Schedule appointments at the part of the day when your child feels best.
  • In scheduling, attempt to have the same exam room and personnel available for each appointment to create a comfortable pattern and sense of routine

Finding the Right Pediatric Dentist

Your child’s pediatrician is a good source for recommendations on pediatric dentists who work with children with special needs, says Mungo. The pediatric dental staff can help you create a daily dental care routine that is specifically tailored to your child, including the right type of adaptive toothbrush that meets their needs.  Healthy Smiles of OC, in partnership with CHOC, is another resource. Funded in part by the Children and Families Commission of Orange County, Healthy Smiles is working with community pediatricians, pediatric dentists and schools to bring dental treatment, education and preventative care to the medically underserved community.

CVICU Intensivists Play Critical Role for Heart Patients

In honor of American Heart Month, we spoke to Dr. Michele Domico, medical director of CHOC’s cardiovascular intensive care unit (CVICU), on the importance of having a cardiac intensivist on a child’s heart surgery team.

Domico, Michele

Q: What role does the cardiac intensivist play in a patient’s overall care?

A: Heart patients will be seen by several doctors during their stay in CHOC’s CVICU. In addition to their cardiovascular surgeons making rounds in the unit, patients will also be regularly visited by their cardiologists who will also manage their care after they go home. But in addition to that care, pediatric heart patients also need a critical care specialist on hand at all times who can care for any unexpected complications that may arise. CHOC’s CVICU has an attending physician in the unit at all times, day or night, to care for our heart patients, and not all heart programs have that.  We are also the only place in Orange County that performs neonatal and pediatric open-heart surgery, and have outcomes above the national averages for overall survival rate and neonatal survival rate.

Q: Why is it important for parents to make sure there is a cardiac intensivist on their child’s heart surgery team?

A: General intensivists have training in treating infections, traumas, cardio-respiratory disorders, and other severe problems that may arise. A cardiac intensivist has additional training in caring for exclusively for the most critically ill cardiac patients with severe and rare heart disorders. Patients benefit from having cardiac intensivists on their care teams because they’re prepared to care for any complication that may occur.

Patients with certain heart conditions may require a series of surgeries throughout their childhood. Since there is a cardiac intensive care specialist on call in the CVICU at all times, we really get to know the families we care for. There’s not a single patient who comes to the CVICU for their second surgery that we don’t remember from their first operation. That continuity of care means peace of mind for parents, knowing their child’s heart team knows everything about them.

Q: Why is it important for children to see a pediatric subspecialist for their heart condition?

A: Adult cardiac doctors are trained on structurally normal hearts, where all the pieces of the heart puzzle are intact and everything is in the right place. But children with congenital or acquired heart conditions may have missing or misplaced pieces of their hearts and need specialized care. As pediatric heart specialists, we see patients every day who have unique and severe heart conditions, so we are especially able to care for them.

Learn more about the life-saving equipment and expertise available to patients in CHOC’s Heart Institute.

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Zika virus: What parents should know

With news and concern about the Zika virus growing, a CHOC Children’s infectious disease specialist explains what parents and mothers-to-be need to know about the virus.

Zika virus is a mosquito-transmitted disease that can cause rash and fever in adults and children, but seldom prompts hospitalization, says Dr. Antonio Arrieta, president of CHOC’s medical staff.

However, babies born to women who were infected with Zika virus while pregnant may be at risk for developing microcephaly, a condition marked by an unusually small head at birth, often reflecting limited brain development, he says.

Zika originated decades ago in Uganda, but has spread through Southeast Asia, the Pacific lslands and the Americas – including Brazil, where physicians in recent months noticed a substantial uptick in the number of babies born with microcephaly, Dr. Arrieta says.

To that end, the Centers for Disease Control has cautioned pregnant women or women trying to become pregnant about traveling to several countries, including Cape Verde, Mexico and Samoa, as well as places in the Caribbean, Central America and South America. See the CDC’s website for the most recent travel information.

The CDC advises pregnant women who have traveled to these locations and experienced fever, rash, joint pain or red eyes during or recently after their trip to consult their doctor.

Further, routine imaging will alert pregnant women who have traveled to affected countries if their baby is at risk for microcephaly, Dr. Arrieta says.

The virus is transmitted by a specific species of mosquito, Aedes spp, which is found in some areas of the United States. The best way to protect against bites is to wear insect repellent, particularly during spring and summer, Dr. Arrieta says.

He cautions that pregnant women should first consult with their obstetrician regarding safety of different insect repellent formulations.

More information about the Zika virus – including travel alerts – is available on the CDC’s website.

CHOC Children’s Begins NICU Expansion

To enhance its patient- and family-centered care experience and meet the growing demand for services, CHOC Children’s Hospital has launched an expansion to its neonatal intensive care unit.

The build-out will create 36 private patient rooms with amenities to allow parents and guardians to comfortably stay overnight with their critically ill babies receiving highly specialized care at CHOC.

“Every parent wants to stay as close to their baby as possible, especially when the infant needs a high level of medical attention,” said Dr. Vijay Dhar, medical director of CHOC’s NICU. “The expansion to CHOC’s NICU will offer parents and guardians reassurance that they’ll be nearby while their baby receives the highest level of care. As an organization committed to patient- and family-centered care, CHOC is proud to soon offer private rooms to our smallest patients and their parents.”

CHOC NICU Patient Room

Expected to open in summer 2017, the new solo rooms on the fourth floor of the state-of-the-art Bill Holmes Tower will replace the current pod-style beds in CHOC’s Level 4 NICU. A potential second phase of construction could add more beds.

Private NICU rooms are setting a new standard for improved patient outcomes. A recent study published in the journal Pediatrics found that infants cared for in single-family rooms weighed more at discharge and gained weight more rapidly than those who received care in an open design. Also, they required fewer medical procedures, had increased attention, and experienced less stress, lethargy and pain. The researchers attributed these findings to increased maternal involvement.

Further, the private-room setting provides the space and privacy that parents need to be more intimately involved in the care of their baby, including breast-feeding and skin-to-skin contact, and parents can stay overnight with their child. In addition, private rooms give staff more access to and interaction with the family and patient.

CHOC’s expanded unit will also feature a multipurpose family room, sibling activity room, additional office space and other enhanced amenities.

CHOC NICU Main Waiting Room

A fundraising campaign by CHOC to raise $22 million is underway to complete the project. To that end, CHOC has received a $100,000 gift in support of the project from Ray Zadjmool and Nazy Fouladirad on behalf of Tevora, an Orange County information security consulting firm. A room in the unit will be named in honor of the gift.

“We are very happy to support CHOC in the work they do for our community, our neighbors, and our kids,” said Zadjmool, Tevora’s chief executive officer.

Other donors who have contributed to the project include the estate of Martha Sheff; the late Margaret Sprague; the estate of Ruth Miller; Credit Union for Kids; the Tinkerbell Guild;  Richard and Bobby Ann Stegemeier; Dr. Sherry Phelan & John H. Phelan, Jr.; Ashly and Brandon Howald; and the estate of Florence Jones.

CHOC NICU Corridor Nurse alcove

For several decades, CHOC has served infants requiring the highest level of care. CHOC’s neonatal services currently offer 67 beds at CHOC Orange and the CHOC Children’s NICU at St. Joseph Hospital, 22 beds at CHOC Children’s at Mission Hospital, and a team of premier neonatologists who provide coverage at hospitals throughout Southern California.

A suite of specialized services comprises the CHOC NICU: the Surgical NICU, which provides dedicated care to babies needing or recovering from surgery; the Small Baby Unit, where infants with extremely low birth weights receive coordinated care; the Neurocritical NICU, where babies with neurological problems are cohorted; and the Cardiac NICU, which provides comprehensive care for neonates with congenital heart defects.

CHOC’s NICU was recently named one of the nation’s “top 25” by U.S. News & World Report, reflecting CHOC’s unwavering commitment to the highest standards of patient care and safety.

To learn more about the NICU expansion, visit http://www.choc.org/nicuinitiative.

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Alcohol & Drug Abuse in Teens

As adolescents become more independent, parents often worry about their teens making healthy decisions, including staying away from drugs and alcohol. In honor of National Drug and Alcohol Facts Week, we spoke to Dr. Harvey Triebwasser, director of adolescent medicine at CHOC Children’s, and Dr. Alfonso Bustamante, a CHOC psychologist, about what parents can do to prevent alcohol and drug abuse in teens.

Warning Signs

The most common misconception among parents is the belief that “my kid would never do drugs,” says Bustamante.

Parents play a crucial role in identifying possible warning signs of substance abuse in their child. But, outward appearance, school performance, or even extra-curricular activities are not necessarily indicators of drugs and alcohol abuse. Instead, parents should be aware of extreme changes in their teen’s mood, sleep patterns, and eating habits. Since these can also be signs of adolescent development, look for drastic changes, rather than minor shifts in habit.

Teens may abuse alcohol and drugs for a variety of reasons, says Triebwasser, including:

  • Negative peer pressure
  • Family tensions
  • Access to cash, alcohol and drugs
  • Trauma
  • Pressure to perform at school, in the home, or in extra-curricular activities

Parents who are mindful of these potential triggers can be proactive in preventing their teens from turning to drugs or alcohol as a coping mechanism.

Abuse Prevention

Parents must verbalize rules and expectations, including consequences for breaking rules. Quality communication is the key to building trust in the home, says Triebwasser.

They should also model the behavior they expect from their children, adds Bustamante. If a teen sees adults in their home abusing alcohol or drugs, they are more likely to experiment with substances themselves, he says.

Adults should also properly store and dispose of prescription medications. Behind alcohol and marijuana, prescription and over-the-counter drugs are the most commonly abused substances by Americans ages 14 and older, according to the National Institute of Drug Abuse.

Getting Help

A wide range of health services are available to teens at CHOC, provided my male and female physicians who specialize in adolescents.

Psychologists can also be part of the healthcare team, and address the needs of the whole family.

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Diagnosing and Treating Common Thyroid Problems in Kids

Although a thyroid test is conducted during newborn screenings in California, symptoms of endocrine disorders may not appear until closer to puberty. The endocrinology team at CHOC Children’s is regionally recognized for patient care and provides comprehensive diagnoses and treatments for endocrine disorders.

In this episode of CHOC Radio, Sandy Preasmyer, a nurse practitioner on CHOC’s Endocrinology team, discusses:

  • Warning signs parents can look for that may reflect a possible thyroid issue
  • The most common thyroid problems in kids, and how CHOC’s endocrinology specialists treat them
  • How CHOC’s endocrinology specialty programs enhance quality of life for patients

Hear more from Sandy in this podcast.

CHOC Radio theme music by Pat Jacobs.

Family Donates Hundreds of Books to Honor Daughter’s Love of Reading

Dan and Kelli Cooper’s daughter Katie was an avid reader. Growing up in Chino Hills, she always had a book in her hand. “She would tell me she couldn’t do her chores because she was busy reading,” said Kelli.

When Katie was tragically killed in the 2014 shooting at the University of California, Santa Barbara, the Coopers knew they needed to do something to honor Katie’s life and keep her memory alive.

Katie Cooper
Katie Cooper

Katie’s sorority was involved in several pediatric charities. Before she passed away, Katie had mailed an annual fundraising letter to family and friends asking for book and monetary donations that would benefit a children’s charity close to her school. The letter arrived in family and friends’ mailboxes just before her memorial service, and they saw that letter as a sign to continue Katie’s book drive, says Kelli. The Coopers learned about the Family Resource Center at CHOC Children’s, and chose it as a beneficiary in order to build its library for CHOC patients and their families. Katie had spent countless hours in the library on her school’s campus as a double major studying art history and classics with a minor in archaeology.

Hundreds of people brought book donations to Katie’s memorial service, and boxes of books came flooding in to Katie’s high school. An entire classroom at the high school where Kelli works was filled with books from people who wanted to help honor Katie’s life. Even more were dropped off at the family’s home, something that continues to happen more than one year after their daughter passed away.

“As a parent, you just want to know your kids are out there in the world doing good,” says Kelli. “Through these book donations, Katie is still giving.”

To learn more about the Family Resource Center or make a donation, call 714-509-9168.

CHOC Children’s Expands Orthopaedic Services

Young athletes in Orange County now have greater access to specialized sports medicine care as a non-surgical sports medicine specialist joins the CHOC Children’s Orthopaedic Institute. Dr. Jonathan Minor specializes in ultrasound-guided injections and procedures, as well as diagnostic ultrasound evaluations, which provide improved visualization of the body tissues. The enhanced view, so to speak, along with dynamic tissue evaluation and use of selective injections can confirm the location of pain and assist with surgical decision-making.  Ultrasound-guided injections can offer a quicker recovery and may be used to avoid surgery altogether in some patients.

Dr. Jonathon Minor

Dr. Minor’s commitment to helping young athletes return to the field stems from his own lifetime experience as an athlete. As an adult, he has completed multiple marathons and Ironman triathlons, including three Long Course World Championship races with Team USA.

His passion for sports medicine was inspired by his father, an accomplished orthopaedic surgeon.

“I was moved by my dad being able to take an injury, and just like a carpenter, put it back together,” Dr. Minor said. “As a non-surgeon, I consider myself more like an architect, laying out a floor plan, and bringing together a team of providers to treat and safely return our athletes back to the sports arena.”

After medical school and residency training, he completed a non-surgical sports medicine fellowship and an additional musculoskeletal ultrasound fellowship at Boston Children’s Hospital. During his training in Boston, he served as team physician for several collegiate and high school teams, and worked closely with the Boston Ballet.

A chance to work with the expert team at CHOC and help expand the sports medicine program led Dr. Minor back to his native California. He treats everything from ankle and knee ligament sprains to overuse injuries and concussions.  Dr. Minor is working with the experts at the Orthopaedic Institute to expand the footprint of its sports medicine program with the addition of physical therapists, new regional physical therapy locations and a new orthopaedic surgeon, Dr. Jessica McMichael.

“Given the number and caliber of athletes coming out of Orange County, I am honored to be part of a growing and highly respected sports medicine program at the CHOC Children’s Orthopaedic Institute,” says Minor.

As an avid athlete, Dr. Minor is dedicated to injury prevention, particularly overuse injuries. He offers athletes of all ages the following tips to prevent sports injuries:

  • Stay committed to a progressive training program
  • In preparation for a new sport or season, make sure your body is conditioned aerobically before training with your team
  • Consistently stretch after a warm-up and again after exercise
  • With the exception of gymnasts and ice skaters, athletes should not specialize in a single sport until they are well into high school
  • While California offers a perfect climate for year-round single sport specialization, every athlete should spend 2-4 months every year outside of their primary sport; this could involve playing a sport that uses different muscle groups, or spending the time working with a personal trainer to optimize fitness and neglected muscle groups

Learn more about CHOC’s sports medicine program.

National Blood Donor Month: Mackenzie’s Story

Before Mackenzie James-Wong was born, prenatal ultrasounds and testing diagnosed her with TAR syndrome, a rare genetic disorder that meant she was missing a bone in each forearm and had a dramatically low platelet count. Doctors also detected a heart defect that would require surgery immediately after she was born. Her mom Lindsay changed her birth plan so she could deliver at St. Joseph Hospital, and Mackenzie could immediately be under the care of nearby CHOC Children’s.

Her family’s relationship with CHOC’s Blood & Donor Services Center started when Mackenzie was in the Neonatal Intensive Care Unit (NICU).  They quickly learned how many transfusions lay ahead of them.

A healthy baby’s platelet count at birth is 50,000. Mackenzie’s was just 13,000. She needed transfusions right away. Mackenzie spent the first six weeks of her life at CHOC, and received dozens of platelet transfusions during that time. Over the next three years, she received nearly 200 blood and platelet donations.

MackenzieJamesWongNICU
Mackenzie spent the first six weeks of her life in CHOC’s Neonatal Intensive Care Unit.

“Sometimes she needed two transfusions in the same day. Eventually it slowed to every other day, and then once every 10 days, but then we regressed back to every four or five days,” said Lindsay. “The team from Blood & Donor Services visited us in the NICU, and educated us about the importance of finding regular donors who were a match for Mackenzie and who could provide a reliable and steady stream of platelet donations to fulfill her needs.”

The Blood & Donor Services Center identified two donors who were each a perfect blood and platelet match for Mackenzie. With her family’s permission, the donors heard Mackenzie’s story and how they could help. They opted into the Designated Donor Program, which allows a donor’s blood and platelets to be directed to a specific CHOC patient in need.  Mackenzie has since met her donors, who have become part of her family, Lindsay says. Every year in December, one donor dons a Santa Claus suit, grows out his beard, and brings Christmas gifts to his donation appointment for Mackenzie and her older sister. The pair of donors come to Mackenzie’s birthday party every year, and have been known to rush home from vacation to make special platelet donations if Mackenzie is in need.

Mackenzie at age four
Mackenzie at age four

Every time Mackenzie has an appointment at CHOC, she stops by the Blood & Donor Services Center with her mom to personally thank donors for helping kids just like her.

“I tell these donors every time I see them that they are literally saving my daughter’s life with every donation,” says Lindsay. “She would not be here without platelet donations. When they donate blood and platelets at CHOC, it stays at CHOC to help patients like my daughter.”

In 2015, CHOC donors supplied 45 percent of the blood and platelets needed by CHOC patients requiring a transfusion. CHOC had to purchase the remaining needed blood products from outside sources.

“Having blood and platelets come directly from our blood donor center allows us to have the freshest blood available to meet the critical needs of our patients, and support our recently opened Trauma Center,” said Colleen Casacchia, RN, manager, CHOC’s Blood & Donor Services Center. “CHOC relies on blood donors in our surrounding communities to help meet our patients’ transfusion needs. One blood donation can save two lives and only takes about one hour of time every two months.”

Donating blood and platelets at CHOC has become a family affair for Mackenzie’s relatives. Her dad, grandparents and aunts all donate blood and platelets at CHOC in honor of Mackenzie.

For Lindsay, donating blood began at a young age. She celebrated her 17th birthday by making her first blood donation. Although she isn’t a match for her daughter, she regularly donates blood at CHOC to help other patients in need.

“I can’t always give financially, but blood is something I have plenty of, and it really doesn’t take that much time out of my day,” she says.  “It was always something I was passionate about, but once it hit my family, I realized how life-saving it truly was. I want other persons to realize how important it is to donate blood and platelets, before someone in their family has a need for it.”

Learn more about donating blood and platelets at CHOC to help patients like Mackenzie.

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