Water Safety

by Dr. Jennifer Cardwell
Summer is here and we are all ready to enjoy our pools and local water parks!  Here are some tips to keep your children safe.
Drowning is the leading cause of injury-related death in children.  Toddlers and male adolescents are at the highest risk for drowning.  Most victims of nonfatal drowning recover fully with no neurologic deficits, but severe long-term neurologic deficits are seen with extended submersion (greater than six minutes), prolonged resuscitation efforts, and lack of early CPR.
Most infants drown in bathtubs and buckets, whereas the majority of preschool-aged children drown in swimming pools.  Alcohol is the leading risk factor for fatal drowning in adolescents, contriuting to 30-70% of recreational water deaths among US adolescents and adults.
Prevention of Drowning Recommendations:
  1.  Parents and caregivers should never (not even for a moment!) leave young children alone while in or near bathtubs, pools, hot tub, or wading pools or anywhere there is standing water.
  2. Be aware of drowning risks associated with hazards in the home.
    1. Infant bath seasts can tip over or they can slip out of them.  Infants can drown in even a few inches of water, so an adult should always be with them.
    2. Empty containers of water from pails and buckets immediately after use.
    3. Either place a lock on the toilet or stay with young children and don’t leave them alone in the bathroom.
    4. Prevent unsupervised access to the bathroom, swimming pool or open water.
  3. If you have a pool, it should be surrounding by a fence with a self-latching gate.
  4. Learn CPR!
  5. Swimming should be the first sport your child learns.  The AAP recommends swim lessons as a layer of protection against drowning that, for many children, can began as young as one year of age.
  6. Wear life vests when you are on a watercraft.
  7. Jumping or diving into water can results in devastating spinal injury.  The first entry into any body of water should be feet first.
Water Park Safety:
  1.  Know the rules of the water parks.  Follow ride directions and especially the size and weight restrictions.  Smaller riders can be thrown from the ride.
  2. Know your swimmer and how confident they are in the water.  Wave pools carry the biggest drowning risk because they can be chaotic with a large number of people.  This can make it difficult to spot a swimmer in trouble.  Close parental supervision is so important!
  3. Know what’s in the water.  The Centers for Disease Control and Prevention state that most people have about 0.14 grams of feces on their bottoms that can rinse off and contaminate the water.  They reported that in one year, 58% of public pools tested positive for EColi, which is a marker for fecal contamination.  Yuck!  Tell your kiddo never to drink pool water and take them to the bathroom once an hour and check swim diapers every 30-60 minutes.  If your child has diarrhea, do not go to the pool.
  4. Know who’s watching.  Some water parks have lifeguards, some don’t.  Make sure you assign a responsible adult who knows how to swim to watch your children.
  5. You might want to wear water shoes to help prevent slips and falls.
  6. Consider having your child wear a life jacket, especially if they are not a strong swimmer.
The American Academy of Pediatrics Website (http://www.aap.org) contains educational material for parents from the Injury Prevention Program about home water hazards for young children, life jackets, pool and water safety and has links to other water-safety information.
Have a great summer everyone!
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Dr. Jennifer Cardwell’s K.C. Baked Beans

Ingredients
28 oz can of Bush’s Original Baked Beans, drained
3/4 cup of KC Masterpiece Original Barbecue Sauce
1 Granny Smith apple, peeled and chopped
1/2 medium sweet onion, chopped
1/4 cup of golden raisins
1/4 cup of packed light brown sugar
1/2 tsp cumin
1/2 tsp tumeric
1/2 tsp paprika
3 slices of Boar’s Head fully cooked bacon, roughly chopped

Instructions
Grease 2 quart baking dish
Mix all the ingredients together
Bake at 350 degrees for 30 minutes

Dock A Tot, Owlet and Safe Sleep Practices

Hey guys.  It’s Dr. Cardwell (the Mrs.).  I have been hearing so much recently from my parents with newborns regarding Dock A Tot and the Owlet, that I thought it might be a good idea to discuss these and review safe sleeping practices for your newborn.

But let me first begin by telling you that I’m not judging you.  I know you love and want the best for your baby.  I also know how exhausting it is to take care of a newborn and you would do almost anything for just a little bit more sleep.  I also know that you want to provide the safest environment for your baby.  In short, safety trumps sleep.

My advice is based on the recommendations of the American Academy of Pediatrics as well as the U.S. Consumer Product Safety Commission.

A new study was just released in the May 2019 issue of Pediatrics entitled, “Infant Suffocation Deaths in the Sleep Environment Attributable to Soft Bedding, Overlay, and Wedging.”  They reviewed the cases of 250 infants who died from an external airway obstruction in an unsafe sleep environment between 2011 through 2014.  The study found the deaths might have been prevented with safe sleep practices.  The most common characteristics were non-supine sleeping (not sleeping on the back) and sleeping in an adult bed.

 

Here are the safe sleep practices, as recommended by the AAP:

Back to sleep for every sleep.

Use a firm sleep surface.

Breastfeeding is recommended.

Room-sharing with the infant on a separate sleep surface is recommended.

Keep soft objects and loose bedding away from the infant’s sleep area.

Consider offering a pacifier at naptime and bedtime.

Avoid smoke exposure during pregnancy and after birth.

Avoid alcohol and illicit drug use during pregnancy and after birth.

Avoid overheating.

Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.

Media and manufacturers should follow safe sleep guidelines in their messaging and advertising.

Avoid the use of commercial devices that are inconsistent with safe sleep recommendations.

 

The U.S. Consumer Product Safety Commission recommends:

Using a crib, bassinet, or play yard that has not been recalled.

Soft bedding such as pillows and thick comforters have been removed.

There are no loose or missing parts or slats in the crib, bassinet or play yard.

Place infants on the back to sleep.

Have a tight-fitting mattress.

All hardware is tightly secured.

 

Is Co-sleeping safe?  No.

The AAP recommends that you share a bedroom with your baby, but not the same sleeping surface, preferably until the baby turns 1, but at least for the first six months.  Room-sharing decreases the risk of SIDS by as much as 50 percent.

Do we recommend Dock A Tot?  No.

The Dock A Tot is marketed for us as an in-bed co-sleeper.  They even recognize on their website that it is not recommended by the American Academy of Pediatrics.  Our office does follow the guidelines set forth by the AAP, so we cannot recommend use of the Dock A Tot.

Do Owlet and other vital sign monitors prevent SIDS? No.

The use of these monitors has not been shown to decrease the incidence of SIDS.  They may give parents a false sense of security and also, they have not been tested or calibrated for accuracy.

 

Guys, I get it.  Some of you may be reading this and think, “I co-slept with my first-born and she’s fine.  We both slept wonderfully, and I loved that experience.  It made breastfeeding so much easier!”  Or your grandmother will tell you, “I put all four of my babies on their bellies to sleep and they slept all night!”  I hear you, but, of course, not every newborn that co-sleeps will die from SIDS.  However, SIDS is the leading cause of death in healthy infants from 1-12 months of age. So, stay committed and stay strong! Put your newborn in ONLY their crib, bassinet or play yard to sleep.  Your baby’s safety is our top priority.

CPPFM Doctor Recommended Snacks

We have been sharing healthy recommendations all week on Facebook, Instagram, and Twitter for Every Kid Eat Healthy Week. We wanted to end the week with our Cedar Park Pediatric & Family Medicine Doctor’s favorite recommended snacks:

Dr. Keegan

  • Yogurt
  • Fruit (sometimes with nut butters)
  • Nuts

Dr. Moore

  • String cheese
  • Yogurt

Dr. Jennifer Cardwell

  • Fresh fruit: my kids like mandarin oranges
  • Nuts: I keep at work the Emerald 100 calorie packs of almonds and walnuts
  • String cheese

Dr. Brent Cardwell

  • Nuts: Almonds
  • Vegetables: Carrots
  • Trail Mix

Medical Home

We believe that having a medical home where a family can go to be welcomed, listened to and taken care of in a compassionate manner is important.  It is at this medical home where your child’s physician can spend time addressing all of your concerns and perform a comprehensive medical exam.  This experience cannot be replicated by a physical exam performed at a school or in a retail pharmacy.

As your child’s primary care provider, we have knowledge of your child through being a partner with you by caring for them throughout their childhood.  We know your child’s social situation, their activities, their hopes and dreams for their future as well as their medical history.  We can review their immunizations and provide education and administration of these vaccines, if required.  We can assess and obtain needed laboratory, vision and hearing screening.  We can also provide refills of medications and referrals to specialists.

We can provide all of these services and fill out your child’s sports physical forms for school.  In addition, as long as we have a well-child checkup on file in the last year, you can drop off your child’s sports physical form and we will complete it for you without an additional visit to our office!

We want to be partners with you in keeping your children happy and healthy.  The best way to do this is to keep your annual well-child checkups with us.

Blog post by Dr. Jennifer Cardwell

Sports Physicals

We believe that having a medical home where a family can go to be welcomed, listened to and taken care of in a compassionate manner is important.  It is at this medical home where your child’s physician can spend time addressing all of your concerns and perform a comprehensive medical exam.  This experience cannot be replicated by a physical exam performed at a school or in a retail pharmacy.

As your child’s primary care provider, we have knowledge of your child through being a partner with you by caring for them throughout their childhood.  We know your child’s social situation, their activities, their hopes and dreams for their future as well as their medical history.  We can review their immunizations and provide education and administration of these vaccines, if required.  We can assess and obtain needed laboratory, vision and hearing screening.  We can also provide refills of medications and referrals to specialists.

We can provide all of these services and fill out your child’s sports physical forms for school.  In addition, as long as we have a well-child checkup on file in the last year, you can drop off your child’s sports physical form and we will complete it for you without an additional visit to our office!

We want to be partners with you in keeping your children happy and healthy.  The best way to do this is to keep your annual well-child checkups with us.

Student Athlete 2

Written by Dr. Jennifer Cardwell.

Cardwell Family Salmon Recipe

Hey guys, it’s Dr. Cardwell (the Mrs.).  Health and wellness are something that I am passionate about.  I enjoy learning about how eating well, exercising and having good sleep habits help us to be the healthiest version of ourselves. Research has shown that eating together as a family promotes a healthier body weight, lowers the risk of disordered eating and lowers the risk of your children using  cigarettes, drugs and alcohol.  It can lead to better self-esteem and lower rates of depression.

Now don’t get me wrong—I love chocolate and ice cream (and an occasional glass of red wine) as much as the next person.  And our two daughters are really busy with all of their activities and Brent frequently will have meetings or still be working in the evenings.  But I try my best to make dinner on most days of the week.

I’ve been asked by patients and friends the details on how I get dinner on the table, so I thought I’d share with you the specifics of what I do every week.

On Saturday, I sit down at the computer and review our calendar.  We use google calendar and Brent and I share our calendar together, so I know what he’s doing every day (I’ve got to keep an eye on that boy!). I use this Momagenda Weekly Meal Planner Pad.  It costs $16.95 and includes an area to write down what you plan to have for lunch and dinner.  I write down everyone’s schedule for that week and then I decide how much time I’ll have to make dinner.  Sometimes if I know I’m going to be busy all day, I’ll choose a slow-cooker meal to put together first thing in the morning.  I try to only have red meat no more than once a week and we typically have a fish, usually salmon, at least once a week.   I try to make dinner Sunday, Monday, Tuesday and Thursday every week.  Brent is in charge of making dinner on Wednesday because that is the day I work late, but honestly, he usually just orders take-out or if it’s nice weather, he’ll grill.  We tend to eat out on the weekends or have something that we can make quickly at home.  If I’m feeling really awesome, I’ll plan my lunch as well, but usually I don’t.

For years, I subscribed to Cooking Light magazine and that is where I would get 99% of the recipes I use. I would look through it and tear out the pages of the recipes I wanted to try and then put them in a three-ring binder under tabs like soup, salad, rotisserie chicken recipes, slow-cooker recipes, chicken, etc.  After I make the recipe, I make a note to myself on the recipe page who really loved the meal or if it was a favorite.  I go through the binder occasionally and pull the recipes that weren’t a hit.  I was really sad this year because they stopped the print edition of Cooking Light and replaced it with Eating Well magazine.  It seems to be just as good, although I’ve only received a few magazines so far.  I like their concept because all of their recipes are developed taking into consideration specific target goals for calories and sodium.

I keep this Mead Magnetic Notepad on my refrigerator and when we run out of something, each family member can write it down.  Once I choose my recipes, I write down all the ingredients that I will need.  In the last month, my HEB started curbside service and honestly, I don’t know how I survived before.

So, that’s the nitty-gritty details of how I keep my family fed every week.  I’ve included our favorite salmon meal that I make almost every week.  It is so good and so good for you!  I promise if you try it, you’ll like it!  Let me know your thoughts and feel free to share any healthy recipes of your own!

Cardwell Family Salmon Meal

Ingredients:

Central Market Quick Heat White & Red Quinoa, 8.8 oz

Kraft Avocado Oil Mayo—2 tbs

Central Market Organics Baby Spinach and Baby Kale, 5 oz

H-E-B Cut Butternut Squash, 16 oz

Fresh Atlantic Salmon Center Cut Tray Pack, Farm Raised

French’s Honey Mustard—1 tbs

Olive Garden Light Italian Dressing—1 tbs

Pam Organic Olive Oil No-Stick Cooking Spray, 5 oz

Salt

Magic Seasoning Chef Paul Prudhomme’s Seafood Blend

Turmeric

Instructions:

  1. Heat oven for 400 degrees
  2. I rinse off and pat dry my fish to get any fish scales off of the meat side
  3. Mix together the mayo, honey mustard and dressing. I don’t really measure these things people, I just look at it and hope for the best
  4. Sprinkle the seafood magic onto the meat side of the salmon
  5. Pour and spread the mayo mixture onto the meat side of the salmon and put the salmon skin-side down on a cookie tray lined with Reynold’s wrap and sprayed with non-stick spray
  6. Pour out the butternut squash onto another cookie tray lined with Reynold’s wrap and sprayed with non-stick spray
  7. Sprinkle the roasted butternut squash with salt and turmeric. Spray the squash with cooking spray and swirl it around to evenly coat
  8. Put both the salmon and the squash into the oven. After 20 minutes, take the fish out and re-set the oven for 400 degrees. Take the squash out and shake it around, then put it back in for another ten minutes.
  9. While the salmon and squash are baking, rinse and dry the spinach and kale. I like to roughly chop them up so I’m not getting huge pieces, but that’s just me.
  10. When the squash is almost done cooking, put in the quinoa for 90 seconds (follow the directions).
  11. To serve, I use bowls. I put the quinoa in first, then the butternut squash, then the spinach, then the salmon.  Sometimes I’ll top with toasted walnut pieces.  You may also like a little salad dressing on top too—whatever it takes to make this recipe your own!