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Bear Essentials Online - August 2011

Articles in this issue

Immunizations Provide More Help Than Hurt

Vaccine-preventable diseases are at record lows. However, there are still many babies and children who are not getting the necessary vaccinations.

After pregnancy and breastfeeding, protection against many diseases stops, and children must be protected some other way. Immunization will create immunity for your child/children against various diseases. Vaccinations involve an injection of an antibody of a disease or virus, causing the body to fend off the disease. The body then forms immunity against the disease if the virus were to try to attack the body in the future.

Many parents worry that vaccinations will do more harm than help. Although there have been some reported adverse effects, reactions to vaccines are very rare, and the health risks related to these diseases are far greater than those posed by their vaccines.

It is important that children get many of these vaccines before entering school, as babies and toddlers are extremely vulnerable to a host of different diseases and can pick them up easily anywhere and from anyone. As children begin to enter school, immunization records are required in almost all schools, and all vaccines need to be up-to-date.

Simple tricks to help your child get through his or her shots:
  • Try to help focus your child’s mind on something else. Ask that the doctor or nurse draw a smiley face on his or her skin and give the shot in the smiley face’s nose. Afterward, your child has a fun drawing to show friends.
  • Pretend to blow up a big balloon with your child. Suck in as much air as you can, then start blowing big puffs of air as if you were trying to break the record for the world’s largest balloon. Your child will concentrate more on the invisible balloon than the actual shot.
  • Bring along a favorite stuffed animal. Getting shots can be hard so having a comfort item handy will help ease the pain of the needle.
For more information about immunizations, visit the CDC’s website, or go to the Children’s National Immunization page.

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A Guide for Young Athletes in the Heat

Too much heat can decrease an athlete’s performance and lead to heat cramps, heat exhaustion, and heat stroke. Below is a rundown of each.

Heat cramps are the mildest of heat-related injuries. Heat cramps are involuntary contractions of exercising muscles, particularly the calf muscle. Rest, massage, and hydration are the best remedies should your young athlete have heat cramps.

Heat exhaustion is more severe than heat cramps, and results from an inadequate cardiac response to heat stress. Common symptoms include fatigue, weakness, lightheadedness, poor coordination, and headaches. Athletes should be moved to a shaded area to help bring down core body temperature. If it’s severe, rapid cooling with ice water immersion is essential.

Heat stroke is the most severe of the heat-related injuries. Heat stroke occurs when the body fails to regulate its own temperature and body temperature continues to rise, often to 105°F or higher. Signs of heat stroke include unconsciousness for longer than a few seconds, seizure, moderate to severe difficulty breathing, fast heart rate, sweating that may be heavy or may have stopped or severe vomiting and diarrhea.

Heat stroke is a medical emergency. After calling 911, do the following to lower core body temperature:
  • Move your child out of direct sunlight.
  • Remove unnecessary clothing, and place him or her on his side to expose as much skin surface to the air as possible.
  • Sponge or spray cool water, and fan your child to lower the body temperature.
  • Apply ice packs to the groin, neck, and armpits, where large blood vessels lie close to the skin surface.
Children’s National is in Your Neighborhood

Our Sports Medicine physicians have worked with other providers to create regulations, policies, guidelines, and recommendations on event participation under various environmental conditions, like heat. Sports medicine services are provided in Washington, DC, at the Sheikh Zayed campus, at the Regional Outpatient Centers in Montgomery County and Annapolis, and at the Children’s National Specialists of Virginia, LLC, an affiliated private practice of Children's National.

To make an appointment, call 202-476-BEAR (2327)

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Back to School: How to Wear a Backpack

With the start of the school year around the corner, here are a few things to keep in mind to keep your child free from backpack injuries.
  • Children should carry no more than 10 percent to 15 percent of their body weight in his or her backpacks. Limit what your child loads in their backpacks.
  • Your child should be able to easily walk or stand upright with a backpack. Pack the heaviest items closest to his or her back.
  • Encourage your child to bend at the knees when lifting a backpack.
Choosing a Backpack: Problems and Solutions

Problem: When your child’s backpack is filled with heavy books and other items, the force of the weight causes your child to be pulled backward. To compensate for the weight, your child may arch forward, causing the spine to compress unnaturally. Children may also round their shoulders to compensate, possibly resulting in shoulder, neck, and back pain.
Solution: When purchasing backpacks, look for ones that have wider straps and a waist belt. Both will help distribute the weight more evenly across the body.

Problem: Messenger bags and over-the-shoulder bags that rely on one shoulder will cause your child to lean to one side to offset the extra weight. This lean may cause your child to develop lower and upper back pain and strain his or her shoulders and neck.
Solution: Carry only a few books at a time. Advise your child to make frequent stops at their locker or cubby to alleviate the weight. If possible, ask your school for a second set of books and keep one set at home for homework.

Problem: Tight, narrow straps can dig into your child’s shoulders, pinching nerves and interfering with circulation.
Solution: Consider purchasing a backpack with wheels. Backpacks on wheels may be an alternative to regular backpacks. Be sure to check school guidelines before purchasing.


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Weight Training in Kids: Benefits and Risks

Weight training, also known as resistance training, involves enhancing muscle strength and size as a component of a fitness program. With supervision, weight training can be safe and effective for young athletes. However, there are heath benefits and risks to consider.

Recent studies show that if weight training is of sufficient duration, intensity, and volume, prepubertal training can be beneficial. Advantages include bone mineralization, loss of body fat, improvement of motor skills and sports performance, and psychological benefits such as improved mood and better sleep. Until the time of puberty, when testosterone begins to be produced, young athletes do not see gains in muscle mass.

Although weight training can improve neuromuscular control in children, growth plate and overuse injuries can still occur due to attempting to lift too much weight, scheduling weightlifting too often, and/or performing power lifting maneuvers e.g. clings. The same muscular results from strength training as teens and young adults will not be seen because of hormonal influences.

Things to keep in mind:
  • Young athletes should always be directly supervised in the weight room.
  • Using the correct technique consistently is important.
  • Adult training machines can be too large and have weight increments that are too heavy for young athletes in addition to using his or her own body as resistance, such as with calisthenics. Free weights, rubber tubing, and medicine balls may be more appropriate training equipment.
  • Weight training exercises should consist of two to three 20 to 30 minute nonconsecutive training sessions per week.
  • A good performance routine includes six to eight different exercises, beginning with one light set of eight to 15 controlled movement repetitions per exercise.
  • A gradual increase in resistance 5 to 10 percent, typically 2 to 5lbs. and sets over time is recommended for pre-adolescent athletes.
There is still much to learn about the benefits and risks of youth weight training since many early studies show inconsistent results stemming from insufficient design quality, duration, and methods.

Children’s National Medical Center provides a full range of orthopaedic and sports medicine services for children and teens at state-of-the-art inpatient, outpatient, and intensive care units, as well as our Regional Outpatient Centers located throughout the Metropolitan Washington area.

To make an appointment, call 202-476-BEAR (2327)

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Sweet Summer Strawberry Smoothie
Preparation time: 5 minutes

  • 2 ice cubes
  • 1 cup milk
  • 1/3 cup cottage cheese
  • 2/3 cup frozen strawberries
  • 1 ½ tsp. sugar
  • 1 tsp. vanilla extract
  • Pour all of the ingredients into the blender.
  • Put the lid on the blender and blend for 45 to 60 seconds until smooth.
  • Pour your smoothie into a glass and enjoy.
1 serving per 1 large glass


Let us know what you think about this recipe at

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Parent's Letter Project

Parents of children who have been treated at Children’s National Medical Center can write letters of advice and support to families undergoing similar treatments. Kyra’s mom was comforted to know that she had world-renowned specialists caring for her daughter who was missing an X chromosome.
Read her Parent’s Letter Project letter

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Children’s Eye Health and Safety Month

August is Children’s Eye Health and Safety Month! Read about our Division of Ophthalmology and meet the team.

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