• Changed demeanor, like mood swings
   
• Frequently stepping away, like asking to go to the restroom a lot at school

“They want to go smoke because they’re addicted already. They need that time. They have to go hide,” says Thompson, a breast health navigator. “Same thing at home. They constantly go to their room or bathroom.”

• New odors coming from your child or their belongings. Williams, a radiation therapist, notes that the smell could be good, like minty.
   
• Listen for kids using new phrases. Vapes are also called hookahs, pens, tank systems and mods.

Adults should also know the changing look of vapes. Boyd says they could be in plain sight in your child’s room, and you could miss them. Vapes can look like computer flash drives, ink pens, key fobs, candy canisters and even handheld video games.

Talking to kids

First and foremost, Boyd suggests taking a loving tone when talking to kids about the dangers of vaping. Don’t start by accusing them of wrongdoing.

“Gather information. Encourage them to open up. Make it a safe place,” Boyd says. “If they don’t feel comfortable talking to mom or dad, maybe try somebody at church, an older sibling, a school counselor or a teacher. Find those accountability people.”

If your child has a hard time opening up, talk to their pediatrician so they can broach the subject at the next appointment. During the appointment, offer to step out of the room so the child isn’t nervous to talk about their habits.

Thompson adds to keep kids active. If you’re playing backyard baseball with them, you know they’re not vaping.

“We want you to be healthy and live a long life,” she adds, suggesting words to use with your child. Not to mention the money you’ll save.

What about smoking?

How does smoking a traditional cigarette or cigar play into all this?

Boyd says some people see vaping as a way to quit smoking. She says that’s a bad idea. Talk to your health care provider instead about medication and other options.

At OSF Moeller Cancer Center, Boyd, Thompson and Williams offer a smoking cessation program. Providers can refer patients to the program, or they can self-refer by calling (618) 474-6791. OSF then connects the person with resources to quit and provides regular check-ins. Schools, businesses and community groups can also call to see how they can benefit from the program.

“Working on oncology, we see the back end. We see patients who have been 30-year smokers. They have a CT scan, and they find an abnormal mass,” Thompson recalls. “So we try to catch them early. We have younger patients who are seeing their primary care provider. Their provider says they’ve been smoking for five years, and they put the referral in. Well, we just saved them 25 years of smoking if we can get them to stop now.”

“Don’t see it as a failure,” if you can’t quit right away or if you relapse and smoke a few, Boyd adds. “Try again. We’re not all made the same. Quitting looks different for everyone”

Interview clips - Karen Boyd

Interview clips - Heather Thompson

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You’ve likely heard of bronchitis, an illness that impacts the larger lung airways and leaves you feeling short of breath and just generally yucky.

This fall and winter, here’s another respiratory illness with “bronch” in the name to be aware of, especially if you have young kids: bronchiolitis. It’s an ailment that Awad Alyami, MD, an OSF HealthCare pediatrician, sees often this time of year.

The basics

Dr. Alyami says bronchiolitis is an infection of the bronchioles, or the small airways that branch out in the lungs.

“When they become infected, there is a lot of mucus. It makes it harder to breathe,” Dr. Alyami explains.

Other symptoms include fever, runny nose, cough and dehydration. Bronchiolitis is “easily spread,” Dr. Alyami says, through respiratory droplets, like when you cough. The illness is most common in children, especially kids under two. Other high-risk groups include babies born prematurely, with chronic lung disease, with heart disease present at birth and with immune system deficiencies.

“There are also environmental risk factors, like babies who are exposed to smoke and babies who attend day care,” Dr. Alyami adds. Attending day care, he explains, will expose a child to illnesses, no matter how clean the place is.

Cause, diagnosis and treatment

Dr. Alyami says other viruses like influenza and COVID-19 can cause bronchiolitis, but respiratory syncytial virus (RSV) is the most common cause.

“You need to see a doctor if your baby has trouble breathing at any time,” Dr. Alyami advises. “Or if your baby is younger than three months and they have a fever. Or if they are older than three months and they have a fever for more than three days. Or if the child has signs of dehydration, like if they are making fewer wet diapers than normal.”

Unlike the flu and COVID-19, there is no test for bronchiolitis. But, a health care provider may swab your nose anyway to see if you have another virus. Other tests like a chest x-ray may be done. And the provider will also examine you and ask about your health history to come up with a diagnosis.

Treatment involves making you feel comfortable until symptoms resolve.

“One of the most important things is nose suction as needed,” Dr. Alyami says. “When we suction the nose and keep it clean, it’s easier to breathe.”

A bulb suction is the most common device to do this. When you’re really stuffed up, you can use nasal spray or drops to make the secretion thinner. Then, use the suction. You can also use a humidifier if your home’s air is dry. Dr. Alyami says these devices and medicines are widely available in retail stores.

You can treat the fever with over-the-counter medication. Drink fluids to stay hydrated.

“Typically, day three to day five are the peak of symptoms,” Dr. Alyami says. “After five days, they start to improve. Symptoms can last seven to 14 days. And typically, the cough lingers for a little longer.”

In serious cases, your child may have low oxygen and need to be admitted to the hospital. There, doctors will use an oxygen tube inserted into the nostrils to help breathing. In rare cases, a doctor will put a breathing tube down the child’s throat.

Prevention

Want your child to avoid all this? Preach healthy habits, especially in fall and winter when respiratory illnesses peak. Wash your hands thoroughly. Cough and sneeze into your elbow or a tissue. If you’re sick, stay away from others.

Dr. Alyami adds that since RSV is the main cause of bronchiolitis, you should look into the RSV vaccine. This cold weather season, the vaccine is available for certain groups, like older adults, infants and pregnant women. Talk to your primary care provider if you have questions.

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Bronchiolitis in children
Advice for when the holidays spread more than Christmas cheer

There’s plenty to think about when raising children – education, developing social skills and keeping them healthy.

That’s why preventive care is so important. Called well-child visits, these appointments are just as important as treating your child when they are sick. These visits with a pediatrician or family practice physician are also a chance to monitor your child’s growth and development, prevent sickness and address any other issues, especially in the first year of life.

“Those visits during that time are very important so we can catch any abnormalities quicker and get them addressed in a timely manner,” says Chasity Caperton, MD, a pediatrician with OSF HealthCare.

During a well-child visit, parents and providers can discuss nutrition, physical activity, sleeping habits or any other health-related issues. Regular visits can also detect any potential problem, making them easier to manage or treat. Vaccinations are also a key aspect of many well-child visits.

In the first year of life, visits are typically scheduled when the child is two, four, six and nine months and around their first birthday.

“That time is important for the baby to grow and thrive,” says Dr. Caperton. “That's also the ages that we typically do a lot of the vaccinations and after that, they space out some to where they're every six months initially, until they reach the age of two, and then they become yearly.”

While you can’t really prepare a younger child on what to expect during a visit, Dr. Caperton recommends talking with older children about what might take place during their appointment. That may include vaccines like a flu shot.

“You should let them know that I'll be asking them questions on their diet, their physical activity,” adds Dr. Caperton. “They might get a screening for depression, for instance. It’s better if they’re prepared.” 

Dr. Caperton says it’s important to talk with a child at a level they can understand. “If you're talking with a four-year-old, you get down there and try to use words that they understand. You approach them differently than you would a 15-year-old,” she says. “Teenagers require a different approach. Don't try to use their slang. It's not going to work. Talk to them like adults, not like children, because they want to be treated as adults.” 

Regardless of the child’s age, it’s important for parents to be present for the appointment.

“A lot of parents will not come to their well-child at certain ages, thinking it's not necessary. But it is very necessary to ensure the health of your child,” says Dr. Caperton. “There are many things that we catch at a well-child visit. We catch murmurs, high blood pressure, many different things to treat that we otherwise would not have caught.”

A sports physical, which includes monitoring heart, mental health and any other issues, such as follow-up after a concussion, can be included in a well-child visit. And some pediatricians will let you schedule back-to-back appointments if you have two children. Make sure to check with your provider’s office first.

For more information about well-child visits, visit the OSF HealthCare website.

Interview Clips

The Sisters’ impact

Sister Leopolda passed away in 1994 at age 81. But the impact she and the other Sisters made on OSF Saint Anthony’s is still felt today.

Sister M. Christine Crowder began at the hospital in the 1960s and worked alongside Sister Leopolda.

“Sister Leopolda was so kind and hard-working but always for the Lord. She was so dedicated,” Sister Christne says. “She would take the most difficult patients. The ones who needed the most care. If we were missing a nurse, she would put an apron on and give out medicine. If a housekeeper called off, she would start scrubbing floors.

“When I was working on the floor with her, I’d say ‘202 would like a pain pill,’” Sister Christine also recalls. “Sister Leopolda would say ‘202 is not a person. Mrs. Jones would like a pain pill.’ That spoke to the respect and dignity she showed to our patients.”

Marci Well then and now

Carol and Marci Well are still not sure of the exact ailment Marci caught in 1972. But she recovered with no lasting effects. And she quickly became intrigued by the medical field. Family photos of Marci as a child show her dressing up as a Sister and “playing nurse.” Now, Well, 54, has been a pediatrician in Canton, Illinois, for more than two decades.

“I had Band-Aids on all my dolls and stuffed animals,” Marci Well says. “It felt like I was destined to take care of people.”

“It really touched my heart when she said that,” Sister Christine says. “It’s so meaningful to hear that one of our Sisters influenced a person to work in the medical field with children.”

Learn more

Read more about how OSF provides compassionate care close to home in Alton here.

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‘Patients were treated like family’

You’re pregnant, and it won’t be long before you’re ready to welcome your new bundle of joy. You’ve got your check list covered, but you still need to find a pediatrician.

So, how do you go about finding the best one for you and your child?

According to Chasity Caperton, MD, a pediatrician at OSF HealthCare, the best time to start looking is three months before your baby is due. That will give you enough time to research your options.

If you're new to the area where you live, start by searching for pediatricians on your insurance company's website or contact the American Academy of Pediatrics (AAP). Most pediatricians' offices make time for expectant parents to visit. Call the office to set up an appointment.

There are several factors to consider when looking for a pediatrician, says Dr. Caperton.

“You have to look at the practice as a whole,” she says. “Are they taking new patients? Some practices might not be for some reason. Do they take your insurance? That’s very important. And check the availability of the doctors. What hours are they open? Are they open on weekends?”

A family might choose a pediatrician, or they could decide to use a family practice physician. But doctors aren't the only people in a pediatrics office who care for children. Nurse practitioners (NPs) and physician assistants (PAs) also see young patients. They are trained to give shots, examine children for health problems and prescribe medicines — just like a doctor can do.

“A family physician sees patients from birth to end of life; they have the full age spectrum. A pediatrician specializes in birth to age 18 or 21, but it depends on the practice. They have more in-depth knowledge, especially when it comes to behavioral and developmental issues,” says Dr. Caperton. “Oftentimes, a family physician will refer a child with complex medical issues to a pediatrician, due to this in-depth knowledge.”

Make a list of questions

When meeting with a prospective pediatrician, make sure you are prepared with questions. “You should ask anything you want to ask,” says Dr. Caperton. "Are our personalities going to mesh? Because that is very important.”

Other topics you might want to cover are breastfeeding, the use of antibiotics and other medicines and vaccines.

“I believe that vaccines are very important. There is a lot of misinformation out there from various sources,” says Dr. Caperton. “I would urge every parent to talk to their provider about vaccines. The provider can give you more in-depth studies if you want. You can discuss the risk and the benefits.”

Dr. Caperton adds that not every pediatrician is going to be the right fit for your family. And that’s OK. That’s why it’s important to meet and discuss key issues.

Asking friends and family for referrals is a good place to start, but it shouldn’t be your main resource. If you know someone who didn’t hit it off with their pediatrician, it doesn’t mean you and your child won’t.

“The ideal fit would be if you feel comfortable talking to them about everything,” says Dr. Caperton. “You're not having to censor your words. They are listening to what you say. They are empathetic to what you're saying. They take you seriously. That, to me, is a good fit.”

The bottom line is simple. Choosing the right pediatrician will help you feel confident about your baby's care.

“I want people to know that every office is different. Every provider is different,” Dr. Caperton emphasizes. “Decide what is important to you in regards of care to your child. Do your research and make sure you visit the office.”

Here are some things to consider as you decide which pediatrician is right for your family. *

• Is the pediatrician's office conveniently located? Is it easily accessible by car or public transportation?
• Are the office hours convenient for your schedule? If you are a working parent, you might want evening or weekend hours.
• What is the doctor's policy on taking and returning phone calls? Is there a nurse in the office who can answer routine questions? Do they prefer to use OSF MyChart to communicate?
• Do you sense a sincere interest by the doctor in your child’s problems, including any health issues they might have?
• How are visits for acute illnesses handled? For example, can you make an appointment on short notice if your child needs to see the pediatrician because of a cold, sore throat or ear infection?
• Does the doctor communicate clearly to explain illnesses and treatments, and ensure that all your questions are answered?

*Source American Academy of Pediatrics

For more information on pediatrics, visit the OSF HealthCare website. 

 

Interview Clips 

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Well-child visits to the pediatrician and keeping up with recommended vaccines are the best things parents can do to protect their kids and communities from serious vaccine-preventable diseases that can easily spread or become life threatening. 

Despite this, American children appear to be falling behind when it comes to routine vaccinations. According to data recently published by the Centers for Disease Control and Prevention (CDC), national vaccine coverage among kindergarten children during the 2020-2021 school year dropped from 95% to lower than 94%. While that might not seem like a big decline at face value, the 1% dip represents more than 35,000 children.

 Dr. Rebecca Sierra is an OSF HealthCare pediatrician in Bloomington, Illinois. She says the downward trend in inoculations is most likely a side effect of the pandemic.

 “I think the problem has been with COVID just getting people into the office, keeping them up to date on their visits and up to date on their vaccines,” explains Dr. Sierra. “So I think because people were trying to stay away, or maybe not enrolling in school, we've kind of missed the opportunity to vaccinate some of those kids.”

 Dr. Sierra says while her office has not seen a sharp decline in the demand for routine vaccinations, the CDC’s findings remain concerning. A decrease in vaccination rates could result in fewer communities maintaining herd immunity for preventable diseases like measles, mumps and whooping cough.

 “We want a certain percentage of kids to be vaccinated in order to have herd immunity to keep those viruses out of the community. So as that number goes down, we're increasing the risk of those viruses like measles and things that we don't typically see making a comeback and circulating again,” says Dr. Sierra.

Dr. Sierra says the key to bucking this trend is for parents to keep up with yearly well-child visits. These visits are an important component to keeping up with routine immunizations, allowing pediatricians to remind parents about recommended vaccines and vaccination schedules and to address any concerns parents may have regarding their child’s health.

 “If they haven't had a routine physical within the last year they definitely need to check in and make sure that there's nothing that we're missing,” she urges. “I know a lot of offices do go through and try to contact some of those patients, but we don't always have up to date contact information. So definitely, if they haven't been seen by a provider within the last year, I would definitely reach out and make sure that we're not missing anything for them.”

If you have questions about your child’s vaccination schedule or about vaccines in general, Dr. Sierra recommends reaching out to your child’s pediatrician. You can also check for overdue vaccinations, ask questions or schedule an appointment on OSF MyChart.

 If your child doesn’t have a pediatrician you can find one at osfhealthcare.org.

Interview Clips - Dr. Rebecca Sierra

Across the United States, parents of formula-fed infants are being met with empty store shelves, as a nation-wide shortage of baby formula continues.

 In February there was a massive baby formula recall from a major supplier in the U.S., Abbott Nutrition, after reports of infant hospitalizations and two deaths were linked to a bacterial infection stemming from formula. The Michigan-based plant has been shut down since – adding fuel to an already volatile situation, as formula availability was previously strained by supply chain issues.

 Dr. Terry Ho is an OSF HealthCare pediatrician. He says he and his peers are getting questions daily from parents wondering what to do if their formula supply dries up completely.

 “Definitely it has been an issue, and we're getting a lot of phone calls and contacts from families about what's the next step and what to do. And that's really what we recommend families to do, is contact us. Contact your pediatrician and we can hopefully help guide you on how to manage, and what we can do to help you through this,” says Dr. Ho.

 Some parents concerned about their formula supply have resorted to stockpiling formula – buying as much as they can, no matter the brand or type. Many retailers are putting purchase limits in place to discourage formula hoarding. Dr. Ho applauds this effort, as certain specialty formulas are the sole nutrition option for thousands of babies with special medical needs, making an empty formula shelf especially problematic for their parents.

 “Some kids with some different medical conditions require a specialty formula, so we don't want to just run out and buy whatever formula is on the shelf. We want you to follow the recommendations, the limitations that are that are being set at stores. I think a lot of stores right now have some limits as to what you can get. And we also want you just to get what you need, because ultimately what we've seen through the pandemic is that a lot of times stockpiling leads to excess anyway, and there are, again, families out there that may need that formula,” he says.

 Also concerning - as parents have become more desperate, some are turning to outdated advice or formula recipes they get from family members or find online. Dr. Ho strongly recommends against this. Not only are the at-home recipes lacking in needed nutrition, creating your own formula concoctions could be dangerous.

 “Right now we're getting a lot of questions from families about different posts they're seeing on social media. We're seeing a lot of different old recipes for formula that used to be a thing. What we know is that those aren't exactly the best methods and safe methods to feed your child,” warns Dr. Ho. “Formula is a complex blend of nutrients, proteins, minerals, vitamins that are really difficult to duplicate at home. In addition, the formula recall really stemmed from a bacterial contamination that was found in the formula. We run that risk by making formula at home as well. There's a lot of chance that you may contaminate the formula as you're preparing it, and so we really want to shy away from making your own formula.”

 Watering down formula to make it last longer can also be a dangerous decision. Too much water in baby formula not only changes its nutritional profile, but also changes the composition of the formula, increasing the risk of causing a harmful electrolyte imbalance in a child.

 Cow’s milk is a viable option for some children, but Dr. Ho recommends talking to your child’s pediatrician before introducing it as part of your child’s diet.

 “That is something that we want you to contact us with because there is a little bit of a gray zone. We normally recommend holding off on starting milk until your child turns one. But in a situation like this, there may be some children that actually can get that milk a little bit earlier, but we want to help walk you through that and make sure that your child would do well with that and wouldn't have any issues,” says Dr. Ho.

 While the Abbott plant is expected to reopen and start production in the coming weeks, a noticeable change to supply could still be months away. Until then, both the Illinois Department of Human Services and Michigan’s Health and Human Services Department have resources on their websites for parents in search of formula, including specifics for WIC program participants. Dr. Ho says pediatricians are also available to help guide parents through accessing services. The bottom line, he says, is to keep an open line of communication with your child’s doctor.

 “We want to be your contact for questions about health for your child, both when they're sick or ill, but also on their day-to-day health, which includes their general diet. And so if you have those questions, we want you to reach out. You should be able to reach out to us whether through a phone call or through our MyChart or through the internet, or if you are in the office. These are questions that we receive daily from families, and we want to be able to help guide you through these difficult situations.”

 If you don’t have a pediatrician, you can find one at osfhealthcare.org.

Interview Clips - Dr. Terry Ho, OSF HealthCare Pediatrician