Affiliated with The University of Texas Medical School at Houston

 You might think strokes only happen to older adults. But it’s one of the

top 10 causes of death in children and teens. Childhood strokes most often happen before age 1, and babies can even have them before or right after birth.

“A stroke occurs when blood flow to the brain is interrupted, either by a blocked or burst blood vessel,” says Ian Butler, M.D., a pediatric neurologist affiliated with Children’s Memorial Hermann Hospital and professor of child and adolescent neurology at The University of Texas Medical School at Houston.

“Because strokes are often linked to old age, parents and doctors may not suspect them in young patients.”

Teens and children sometimes have the same stroke symptoms as adults. These include headaches, trouble seeing or speaking, and weakness or numbness on one side of the body. However, they’re also more likely to experience signs such as passing out, seizures, breathing prob-lems and trouble swallowing.

When it comes to treatment, every moment counts. Take a child with

these signs to the Emergency Center. The doctors there will perform imaging tests to diagnose or rule out a stroke.

Risk factors for heart and vascular disease lead

TreaTing STreSS inconTinence afTer Pregnancy 2

BudgeT-friendly Summer acTiviTieS for KidS 3

KeeP children Safe ThiS Summer 4

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Childhood strokes: More common than parents know

HeALTH HiGHLiGHTsFOR PARenTsn e w s F r o m c h i l d r e n ’ s m e m o r i a l h e r m a n n h o s p i ta l S U M M E R / FA L L 2 0 1 0

to most adult strokes. These conditions are less common in young people. In children, strokes are often linked to congenital heart defects, head or neck injury, infections such as chicken pox, blood clotting disorders and sickle cell disease. In one-third of cases, an underlying cause isn’t found.

“To treat a childhood stroke, doctors first try to determine the cause,” says Dr. Butler. “Most often, they’ll stabilize your child by giving oxygen, stopping seizures and controlling fever. They’ll then give medications that thin the blood. Surgery can also help in some cases.”

After a stroke, some children have life-long difficulties, including trouble with speech and language. Between 10 percent and 30 percent of children who have one stroke may have another one, so they must be watched closely, especially in the first days and weeks afterward. ■

The Children’s Neuroscience Center at Children’s Memorial Hermann Hospital provides education and support services for many neurological disorders. Learn more at childrensmemorialhermann.org.

 Sometimes, pregnancy puts a lot of stress on the body, including the bladder.

Carrying a baby’s weight can weaken a woman’s bladder-control muscles.

“Up to 24 percent of new moms develop stress urinary incontinence,” says Gazala Siddiqui, M.D., a urogynecologist affiliated with Children’s Memorial Hermann Hospital and an assistant professor of obstetrics and gynecology at The University of Texas Medical School at Houston. “They may leak urine if they lift something heavy, sneeze, cough or laugh. Bladder control can return on its own after childbirth. But when it doesn’t, pelvic floor muscle physiotherapy, including Kegel exercises, may help.”

A Combined Approach Is Shown EffectiveIn a recent study, researchers divided subjects into three groups. Two groups received weekly rehabilitation sessions with a trained profes-sional, which consisted of electrical stimula-tion, biofeedback and a supervised exercise program. In addition, one group took part in deep abdominal muscle training. The third group of women had no training of any kind – only eight weekly massage sessions.

More than 70 percent of women who used exercises and electrical stimulation for eight weeks had no leaks. Beforehand, the women had suffered from weekly leakage after giving birth. The additional abdominal training proved to be unhelpful.

What about those lucky women who had massages for eight weeks? They might have been more relaxed, but they didn’t see any improvement in their bladder-control problems.

Trainers Improve ResultsPelvic floor muscle physiotherapy involves Kegel exercises, which work the same muscles you use to stop the flow of urine. Kegel exercises have long been praised for helping with urinary incontinence. While these exercises may seem easy enough to do at home, research shows that women who are supervised by trained professionals have better results. ■

Without treatment, incontinence may last for years. If you’re a new mom and still have urinary leaks six weeks after giving birth, talk with your doctor. For a physician referral, call 713.222.CARE (2273) or visit childrensmemorialhermann.org.

When It’s Time to See the Pediatric Ophthalmologist

Your pediatrician will screen your child’s eyes at birth and at regular checkups. But there are times when a trip to a spe-cialist – the pediatric ophthal-mologist – is the best option.

“Pediatric ophthalmologists are trained to diagnose, treat and manage all children’s eye problems, as well as prescribe eyeglasses and contact lenses. They are also skilled at recog-nizing the sometimes subtle signs of an eye problem that a baby or young child cannot describe,” says Helen Mintz-Hittner, M.D., a pediatric ophthalmologist affiliated with Children’s Memorial Hermann Hospital and a professor at The University of Texas Medical School at Houston.

Children should have their eyes checked at age 6 months, at age 3 or 4 and at age 5 or 6. Of course, if you notice any of these symptoms, contact your doctor: • Persistent watery eyes • Frequent rubbing of

the eyes • Sensitivity to light • White or yellow material

in the pupil • Redness that doesn’t

go away • Pus or crust in the eyes • Crossed or wandering eyes • Squinting • Drooping or bulging eyes

or eyelids

Concerned about your child’s eyesight? Talk with a pediat-ric ophthalmologist. Call 713.222.CARE (2273) or visit childrensmemorialhermann.org for a physician referral.

2 Children’s Memorial Hermann Hospital Health Highlights for Parents

Exercises can treat stress urinary incontinence after pregnancy

■ Ask other family members, friends and neighbors for ideas. Invite them to join you, if possible; the more the merrier.

■ Check your local parks and recreation depart-ment Web site. They often offer free or low-cost programs, as well as maps for local parks and pools.

■ Check your local library, which should have information about happenings and perhaps travel guides to your area. The library may also have free programs to keep kids busy – and reading – all summer.

Free Time Is OK, TooWhen you’ve finished brainstorming and reviewed your calendar, you’re going to see holes – and that’s OK.

Budget-friendly summer activities for kids

childrensmemorialhermann.org Summer/Fall 2010 3

 You’ve had this problem before. School is out for the summer and

you’re scrambling to find things to keep your kids occupied – things that won’t bust your budget. With a little effort and teamwork, you can keep your children busy with healthy – and even educational – activities that are low-cost or free.

Make a PlanGather the kids to talk about the summer. Begin by reviewing the plans you’ve already made – vacations, sum-mer school or camps. A large calendar makes this easy. Then start filling in gaps with some old-fashioned brain-storming. Remind children that some ideas may need to be trimmed down so they fit the family budget.

If ideas are hard to come by, here are some ways to get those creative juices flowing:

■ Search local newspapers and Web sites for museums and other family-friendly attractions. Look for special discount days or coupons for those attractions and plan your outings accordingly.

1 cup plain low-fat or fat-free yogurt1 banana, sliced1 tsp. vanilla1 cup fruit juice or fruit chunks

1. Blend ingredients together and pour into small paper cups.2. Freeze.3. Place a plastic spoon or Popsicle stick in each cup when

yogurt mixture is half frozen.4. To serve, turn cup upside down and run hot water over it

until the Popsicle slips out. Keep the cups to use as a holder. Makes four or five small Popsicles.

Leave room for spontaneity. Go bike riding as a family. Hike a local walking trail. Picnic at a local park. Plant a backyard garden. Encourage your kids to come up with things they can organize themselves to do, such as playing cards, writing in a journal, performing a skit, doing a puzzle, reading, building a fort or conducting a treasure hunt. ■

yogurt popsicles

Find more kid-friendly recipes online. Visit childrensmemorialhermann.org/resources. You can then search for recipes under the Kids Health section.

Children’s Memorial Hermann Hospital6411 Fannin, Houston, TX 77030. Call 713.704.KIDS (5437).

Keep children safe this summer

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pAiDMemorial Hermann Healthcare System

POSTMASTER: PlEASE dElIvER

bETwEEn JUlY 12 And 16.

7737 Southwest Freeway Houston, TX 77074-1800

Memorial Hermann Healthcare System

 Many of summertime’s pleasures carry health risks for children. Pediatrician

Rachel Baker, M.D., who is with Memorial Hermann Medical Group and affiliated with Children’s Memorial Hermann Hospital, provides the following simple precautions that can help your children avoid common summer hazards.

bad bugs ■ Serious reactions to bee and wasp stings, indicated by hives, dizziness or shortness of breath, require immediate medical attention. Call 911.

■ Mosquitoes can carry West Nile virus, which can be fatal. To stay safe, consider keeping children indoors during dawn and dusk, when mosquitoes are most active. Apply an insect repellent that contains no more than 30 percent DEET.

Ensure Your Child Is Healthy for School This Fall

RediClinic, which is affiliated with Memorial Hermann, is your convenient source for back-to-school healthcare. Located inside 16 Houston area H-E-B stores, RediClinic offers school and sports physicals, along with the state-required 2010-2011 immunizations.

During a physical,* a clini-cian evaluates your child’s medical history. The exam is then performed, checking your child’s physical health from head to toe. A clinician also ensures that your child is up-to-date with immunizations.

Visit RediClinic for back-to-school healthcare today! RediClinic is open seven days a week, with no appoint-ments – www.RediClinic.com.

 * Each patient will receive a printed 

assessment with the results. Please 

be sure to bring all required forms 

related to the physical, including 

the completed health and immuni-

zation history and any required 

forms. These forms will be 

stamped by a clinician and will 

refer to the results listed on  

the RediClinic form.

Heat Hazards ■ Have children avoid vigorous activity during the hottest part of the day, between 10 a.m. and 4 p.m.

■ Be sure they drink plenty of water, especially before, during and after doing strenuous activities. They should avoid caffeinated sodas, which can cause dehydration.

water Safety ■ Teach children to swim. If you can’t teach them, enroll any child age 1 and older in swimming lessons.

■ Install a fence with a locking gate if you have a home pool.

■ Watch children at all times when they are in or near bodies of water.

■ Let them dive only in areas designated for diving, where the depth of the water is known. ■