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  • Should your toddler have access to your digital devices?

    You’ve probably heard your pediatrician offer this advice: no television for children under two years of age. In fact, the American Academy of Pediatrics has discouraged the use of screens of any kind (television, video, tablets, iPad or iPhones, to name a few) for toddlers.

  • What to expect at your child's therapy evaluation

    Your child has been referred to Occupational Therapy, Physical Therapy or Speech Therapy. So, what's next? First of all, don't dread this appointment. Therapists can be a wealth of information and you will leave that first appointment with some useful tools. Part of a therapist’s job is to share valuable information with you about your child- both their strengths and weaknesses. Their job is to help your child reach their maximum potential and equip you to be an expert about your child’s abilities. This is a good thing.

    For All Evaluations

    Bring your child in comfortable clothing that allow full movement Make sure they are well rested Bring any specific equipment they use such as walkers, splints, or communication devices Be prepared to share concerns you or your doctor may have Provide a list of their medications Be prepared to leave for part of the session if asked (so that therapist can build rapport and see how your child works on their own)

    What to bring for Feeding Concerns

    A hungry kiddo Food you’re sure your child will eat Food you have tried to give your child but they haven’t accepted A drink your child typically accepts: bottle, sippy cup, straw cup, etc. A list of their allergies or recent notes from any specialists

    What to Bring for School Related Concerns

    A copy of their 504 Plan, IEP, Behavior Contract or Health Plan A letter from the teacher expressing any specific concerns (if possible) A sample of their written work from class (if this is a concern) Report a from the school psychologist or therapist (if it’s available)

    During the Evaluation

    Let the therapist take the lead but feel free to comment if you feel your child is not showing their full potential. Be as specific as possible. Remember, you are the expert on your child and the therapist is getting a one-time snapshot. Any information on how your child typically functions is very much appreciated. During the evaluation, your therapists will gather valuable information on how your child responds- or doesn't respond- to certain tasks. The therapist is likely to approach your child in a specific way to achieve a desired outcome. For this reason, resist the urge to help your child complete tasks presented. Remember, therapists are looking to build rapport with your little one and form a partnership with you to ensure your child’s success. They’ll definitely let you know if they need you to jump in and help out.

    After your Evaluation

    Ask the therapist for their professional opinion on what strengths they observe in your child and what areas of concern they have. Would they recommend referrals to other professionals or further testing? If therapy is recommended, how often will they need to be seen to achieve their goals? What skills does the therapist see your child achieving through their intervention? How much work at home will be required to achieve these results? Although most of the recommendations will come during your child’s treatment sessions, you can still leave the evaluation equipped with something beneficial for your child. Ask for a few suggestions on what you can work on at home while you await your first therapy session. Therapists want to build your child’s skills and maximize their strengths so they’ll have great suggestions for toys and fun activities to help your child achieve their goals.

  • Surviving a preschooler’s separation anxiety

    I’ve come to believe that separation anxiety is the straw that breaks the backs of many moms. We can carry our heavy loads through many child-rearing deserts, but we Mom-camels collapse under the pressure of children suffering from separation anxiety. Our children cry as we leave them, and we cry our guilty little hearts out as soon as we are out of our children’s sight. We are left with those lingering questions: Should I leave them? Are they going to be okay? Am I a terrible mother for leaving my child?

  • What we do now may affect our future children’s genetics

    We are all aware that mothers who smoke while they are pregnant run a higher risk of having children who are premature, smaller than they should be, or stillborn. This is likely due to reduced oxygen supply to the baby through mom’s diseased body and to toxins shared by mom with baby. We also know that children who are exposed to second-hand smoke have a higher risk of developing respiratory diseases like asthma, chronic lung disease and even cancer due to direct lung damage from inhaled smoke.

    What you do with your body early in life can affect future generations

    But recent data suggests that a father’s behavior even years prior to conception may affect the health of his children and future generations. For example, early paternal smoking has been associated with increased body mass in children. Paternal alcoholism has been associated with smaller birth weights in babies, and hyperactivity in children. Most recently, smoking even early in life has been found to be associated with an increased risk of certain forms of asthma in a man’s children. A study which was recently presented at the European Respiratory Society International Congress looked at 13,000 men and women and found that non-allergic asthma was significantly more common in children whose fathers smoked before the age of 15. In addition, the longer the father smoked, the higher the risk of his child having this kind of asthma. Interestingly, the same link was not found in children whose mothers smoked before they conceived.

  • A letter to my daughter’s teacher on her first day of school

    I don’t know you and you don’t know me, but today you become one of the most important people in my life. You are the one. The one who I’ve entrusted to take care of my girl in my absence. The one who I’ve tasked with teaching her things that I cannot. The one who will make an indelible mark on her little soul that will forever shape her perspective of learning.

  • Easing your child’s anxiety about the new school year

    “Are you excited about going back to school?”

  • Kids should sleep in. Schools should start later, say pediatricians

    If you have a middle or high school student in your home, you may have noticed that their sleep habits have changed as they’ve entered adolescence. They stay up late, find it hard to get up early in the morning and struggle with sleepiness throughout the day. Take heart. It’s not that your kid is being lazy or rebellious. There are real, biological changes happening in their bodies as they mature that make getting enough quality sleep a real challenge.

  • Living to the beat of a normal heart: Cameron's story

    Four years ago when Heather was 36 weeks pregnant, she went in to her doctor’s office for what she thought would be a routine check-up. However, her OB/GYN, Dr. Emma Fritz, told her she needed to go immediately to Winnie Palmer Hospital for Women & Babies, as her unborn son’s heart needed emergency treatment. As a flurry of emotions rushed over her and her husband, Ryan, they put complete faith in the hands of the specialists at Winnie Palmer Hospital and Arnold Palmer Hospital who would soon care for their baby boy.

    Expecting the unexpected leading up to Cameron’s birth

    Heather was used to going in for testing at her OB/GYN’s office several times a week throughout her pregnancy. Her unborn son, Cameron, had been diagnosed with an irregular heartbeat in the early stages of Heather’s pregnancy, requiring frequent check-ups to monitor his condition. Going in for her 36-week appointment, Heather wasn’t expecting anything out of the ordinary. But one look at her doctor and she knew this time, things were different.

  • Tips from a pediatrician on how to have a successful school year

    Another school year has already started. Does your child gladly go to bed on time and jump up refreshed at 0-dark-thirty to pop into school clothes and get to school energized? Or are you fighting to get him to bed, dragging him out in the morning, getting him to the bus with no food in his tummy? If the second scenario is yours, I think I can help you. Even if you relate best to the first scenario, maybe there is something here for you, too!

    Sleep is more important than food!

    I tell my patients, and this is true, that you can go without food longer than you can go without sleep. Sleep supports so many body functions that without enough sleep, your child will not learn, play, or grow well. For starters, get the electronics (TV, phones, games) out of children’s bedrooms. Those should be used socially anyway, and they interfere with both falling asleep and staying asleep. Bedtime should be about the same time every night, even on weekends, and should be early enough to guarantee at least eight hours or so of uninterrupted sleep (up to ten hours for younger children). If your child’s summer bedtime has been ridiculously late, try moving bedtime up by 15 minutes or so every few nights, not allowing for naps or “sleeping in,” so that her clock will gradually reset to a healthy schedule.

    But food is important, too!

    Breakfast is, indeed, the most important meal of the day. Without breakfast, your child’s body will produce calories for the morning by breaking down muscle to release stored energy. This process also produces some chemicals that make your child crabby and groggy. Children who don’t eat breakfast don’t feel or think as well as those who do. That does not mean that your child needs to eat two eggs, bacon, toast, and juice at 6 AM. But it also does not mean that they should have a pop tart and call that breakfast. Even the grumpiest teenager can gag down an instant breakfast drink and a half a banana, or a smoothie made with fruit and yogurt, or a piece of toast with peanut butter and half an apple. A perfect breakfast should include a complex carbohydrate (like whole grain bread or cereal for example), some dairy source for calcium (milk, yogurt), some protein (meat, milk, legume like peanut butter), and a fruit and/or vegetable. A small glass of milk with half a turkey sandwich with lettuce and tomato is a great breakfast, and you could send the other half sandwich for lunch! If your child “is not hungry,” that makes sense, but it does not mean he does not need the fuel. He can eat on the bus or in the car.

    Refill the tank mid-day

    A slice of pizza, juice, and a bag of chips is not a good lunch. If your child buys lunch at school, he can be taught to eat smart; school lunches do provide fruit and vegetable choices. Drinks are healthier now, too; most children (including teens) should only drink milk and water. Everything else (juice, soda, sports drinks) is just sugar-water. Energy drinks are not only empty calories, but also potentially toxic chemicals that interfere with sleep, affect heart rate and blood pressure, and who knows what long term effects that we don’t know yet. Packing a lunch for your child is a great option. I have done it now essentially every day for 17 years. It takes me 15 minutes each morning and my kids leave with a healthy sandwich or hummus and pita, a whole fruit, a bag of berries or grapes, another bag of veggies (carrots, peppers, sliced cucumber, grape tomatoes), one treat (like a 100 calorie bag of cookies or crackers) and a flavored water beverage. When my older children were in high school they actually had friends ask if they could send me money each week so I could make them lunches, too! Children are smart people. If you teach them well, they will get it!

    Spend quality time, but don’t hover

    Your child needs you, but, honestly, not as much as you need her. Asking about school, offering to help with homework or personal issues, helping to set goals to do her best: that is your job. Living her life is not. Helicopter parents are harmful, not helpful. That said, help your child to set up a routine after school so that there is a quiet place to focus on homework, time for physical activity (at least an hour each day), very limited passive “screen time” (less than two hours a day). Be available if she needs help. A family dinnertime, even if it is late, is a great time to talk about the day, to listen and to plan. Organizing in the morning should be your child’s job. You can double check for a while that things are all being completed, packed and turned it, but let it be her job.

    Expect issues

    Listen to your child so that you can help him with what he really needs help with and not with what you want to help with. Don’t be afraid to be MOM (Mean Old Mom), setting limits or making rules that “other kids parents don’t…” Seek help, either from your pediatrician or from a counselor, if you don’t know what to do or say. They don’t come with instructions! Most important, be open and honest with your children. Ask them how they feel and tell them how you feel. You are not your child’s best friend, but you are her best ally. Have a happy and successful year!

  • Get to know Dr. Jeffery Johnson, pediatric nephrologist at the Hewell Kids’ Kidney Center

    The Hewell Kids' Kidney Center at Arnold Palmer Hospital oftentimes becomes a home-away-from-home for many children needing outpatient dialysis treatment in Central Florida. The Hewell Kids' Kidney Center cares for children who have been diagnosed with with kidney-related disease such as end-stage kidney disease and obesity-related kidney disorders, as well as those who have undergone a kidney transplant. The team consists of several pediatric nephrologists, nurse practitioners, renal nurses, nutritionists, and social workers. The team recently welcomed it's newest member, Dr. Jeffery Johnson, pediatric nephrologist, in June of this year. Get to know Dr. Johnson in the Q & A below!

    Where did you grow up?

    I grew up all over since my dad was in the Air Force. We finally settled in Ohio when I was in high school and then I moved to California in my adult years. I had lived in Los Angeles, CA for the past 14 years before moving to Orlando.

    Where did you go to school?

    For my undergraduate I went to Washington University in St. Louis, MO and then attended Case Western Reserve School of Medicine in Cleveland, OH for medical school.

    What did you want to be when you were a little kid?

    I wanted to be a soccer player, even though I was horrible! I didn’t know I wanted to go into the field of medicine until halfway through college. I thought I wanted to do medical research, but after I started doing it I realized it wasn’t for me. With medicine, there is something new every day, which keeps me going.

    What was your first job?

    I worked in a games department at a local amusement park. It was a lot of fun. I worked there in high school and through my first year of college.

    What are your hobbies?

    I run a lot – almost every day. Today I’ll be running eight miles. I like to scuba dive and travel. Bali was probably my most favorite place I’ve traveled to so far.

    What is your favorite sports team?

    The Cincinnati Bengals even they break my heart every year!

    How did you get into pediatric nephrology?

    It was when I did a pediatric nephrology rotation as part of my medical training that I knew that was what I wanted to do – it was very interesting to me.

    How did you know you wanted to work with kids?

    It was probably after my second or third month of working in the adult emergency room that I felt called to work in pediatrics. My mom and sister are both elementary school teachers, so I’ve spent most of my life being around and working with kids.

    When did you start at Arnold Palmer Hospital and what is it like working at the Hewell Kids’ Kidney Center?

    I moved to Orlando for this job and have been here since June 2014. One of the things I love about working here is the team that I am a part of. Everyone is fun and easy to work with. We usually all eat lunch together. It’s like a family here, which is evident in how we care for our patients. We take a team approach in being able to provide comprehensive care to our patients, and everyone is usually on the same page as far as what the protocol should be and what the treatment plan should look like.

    What is it like working with the whole family and not just the patient?

    It’s a fine balance, because I always try to acknowledge and engage the child while also working with the parents and families. But it’s something that I really enjoy. It might not always be an easy day at work, but being able to care for kids and knowing that I am helping them is a great feeling.

    What is one piece of advice that you always communicate to families and patients?

    I think one of the most important things in our patient population is for them to be taking their medicine. In our transplant population, most of them are on an immunosuppressant, and if they don’t take their medication for a few days, they could end up losing their kidney or having recurrent kidney disease. It’s important for me that they understand the importance of taking their medicine and that the family ensures that they will follow through with the treatment plan at home.

    What would you say has been your greatest accomplishment?

    I would say it was when I took over the dialysis unit at Children’s Hospital of Los Angeles. I had to basically redo the unit and start over from scratch, building it from the ground up.

    What is one thing that patients and families wouldn’t otherwise know about you?

    I want families to know that I am honest with them, whether I have good or bad news to share. I would want my physician to be honest with me, so I try and do the same for our families.

    Click here to learn more about the Kids’ Kidney Center at Arnold Palmer Hospital