UC Davis Health | University of California, Davishttps://health.ucdavis.edu UC Davis Health is charged with discovering and sharing knowledge and providing the highest quality care to our community. Our ultimate goal is to advance health both in our local community and around the globe. 202107_uc-davis-medical-center-ranks-as--1-hospital-in-sacramento-among-the-best-in-the-us Tue, 27 Jul 2021 07:00:00 GMT UC Davis Medical Center ranks as # 1 hospital in Sacramento, among the best in the U.S. <p><em>U.S. News &amp; World Report </em> named UC Davis Medical Center as one of the nation's Best Hospitals, the #1 hospital in Sacramento and among the top 10 in California.</p> Today, U.S. News & World Report once again named UC Davis Medical Center as one of the nation's Best Hospitals. The publication also ranked the medical center as the #1 hospital in Sacramento for at least the 10th year in a row and among the top 10 in California.

Nationally, UC Davis Medical Center is ranked in the top 50 for nine adult specialty services, including cancer, cardiology, gynecology and geriatrics. In addition, the hospital earned “high performing” designations for 12 common adult procedures and conditions— twice as many as last year.

“This ranking is only possible due to the outstanding expertise and compassion of our health care teams,” said David Lubarsky, CEO of UC Davis Health. “Even with the challenges of the pandemic, our dedicated teams have continued to deliver, at great personal risk, the highest quality of subspecialty and emergency care in Northern California. While the award goes to the facility, the credit goes to the amazing job our 16,000 doctors, nurses and administrative and support personnel do every day for every patient we have the honor to treat.”

The hospital's rankings page appears on the U.S. News website. These national rankings complement the four nationally ranked pediatric specialty areas for the UC Davis Children’s Hospital announced by U.S. News last month.

U.S. News ranking for hospitals

U.S. News ranks hospitals and medical centers annually in a range of specialties, using results from a survey of physicians and care-related quality measures. Based on its annual survey of nearly 5000 hospitals nationwide, it assesses hospital performances in 16 specialties or specialty areas, from cancer to urology.

“While the award goes to the facility, the credit goes to the amazing job our 16,000 doctors, nurses and administrative and support personnel do every day for every patient we have the honor to treat.”

— David Lubarsky
CEO of UC Davis Health

Hospital rankings are determined by an extensive analysis of data including hospital volume, nurse staffing, a hospital’s ability to develop and sustain high-quality care, patient experience, and expert opinion surveys of board-certified physicians.

“UC Davis has been among the best hospitals in the nation in the magazine's survey every year it has been evaluated,” said Brad Simmons, chief administrator of UC Davis Medical Center and its children’s hospital. “I am so proud of our physicians, nurses and staff who are dedicated to providing excellent health care. These national rankings are a reflection of their constant hard work.”

High performance in common adult procedures and conditions

The annual “Best Hospitals” report provides valuable information for patients who need quality care for a surgery, challenging condition or other health problems.

In addition to ranking specialty services, U.S. News rated hospitals as “high performing,” “average,” or “below average” relative to other rated hospitals in treating patients 65 and older. In 2021, the hospital was rated as “high performing” in:

  • Abdominal aortic aneurysm repair
  • Acute kidney failure
  • Chronic obstructive pulmonary disease (COPD)
  • Colon cancer surgery
  • Diabetes
  • Heart attack
  • Heart failure
  • Hip replacement
  • Lung cancer surgery
  • Pneumonia
  • Stroke
  • Transcatheter aortic valve replacement (TAVR)

“Our hospital’s outstanding ratings are the result of many factors, including our world-class faculty physicians who provide expert and compassionate care while training the next generation of diverse physician leaders,” said Allison Brashear, dean of the UC Davis School of Medicine.

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202107_uc-davis-health-fixes-babys-heart-defect-using-echocardiography-only-strategy Tue, 27 Jul 2021 07:00:00 GMT UC Davis Health fixes baby’s heart defect using echocardiography-only strategy <p>Cedric Taylor was born at 25 weeks. Like many premature babies, he was born with patent ductus arteriosus (PDA), a condition in which the ductus arteriosus, a blood vessel in the heart, does not close spontaneously after birth.</p> Cedric Taylor was born at 25 weeks. Like many premature babies, he was born with a heart defect called patent ductus arteriosus (PDA).

PDA is a condition in which the ductus arteriosus, a blood vessel in the heart that is open before birth to divert blood from the lungs to the body, does not close spontaneously after birth.

Of the four million annual births in the U.S., about 1.5% (60,000) of babies are born severely premature with very low birth weight (less than 3.3 pounds). Twenty percent (12,000) of these have a significant PDA.

Without treatment for PDA, excessive blood flow to the lungs can increase pressure in the pulmonary arteries. It can lead to significant medical problems, including acute kidney injury, brain bleeds, ischemic injury of the intestines, pulmonary vascular disease and heart failure. With excessive blood to the lungs, the respiratory system deteriorates and babies experience a decreased tolerance to feeding, resulting in poor weight gain.

For more than three years, UC Davis Health has been successfully performing PDA closures in the cardiac catheterization lab on babies as small as 600 grams or 1.3 pounds.

By implanting an Amplatzer Piccolo Occluder medical device, the world’s smallest FDA-approved PDA device, through a catheter in the groin, doctors can close the ductus arteriosus without surgery. Patients can see dramatic improvements in lung function immediately as shown on their chest X-rays.

In Taylor’s case, the procedure posed challenges. Taylor weighed 930 grams (2.05 lbs.) at the time of the procedure.  His kidneys weren’t functioning well, caused by poor blood flow due to the large PDA. The use of contrast (dye) needed to take pictures (angiograms) during the procedure was risky.


The procedure was guided by echo images from Jay Yeh.

“In order to close the PDA, we have to give him contrast to be able to take X-ray pictures before and after the occlusion and see the anatomy clearly. We need the angiograms to make sure we are placing the Piccolo medical device into the proper position. But the contrast used can potentially cause further harm to the kidneys that are already not working well. It was a difficult catch-22 situation,” said interventional cardiologist and chief of pediatric cardiology Frank Ing, who would perform the PDA closure.

It was too risky. So, the team came up with a new strategy: a PDA closure guided only by heart ultrasound, better known as echocardiography (echo) without contrast or angiograms.

A new way to PDA

Is it possible to solely use echo to help guide the placement of the Amplatzer Piccolo Occluder device without traditional angiography? Could echo replace angiography, which uses contrast and X-rays to show the anatomy of the PDA?

Ing discussed the novel strategy with fellow pediatric cardiologist and medical director of the pediatric echocardiography lab Jay Yeh.

“It’s not always easy to see blood vessels by echo,” Yeh said. “But Taylor had an echo a couple of days prior. I felt pretty confident that I could see the position of the device in the PDA and ensure that the device would not cause flow obstruction to nearby blood vessels. I felt that I could guide Dr. Ing to the proper position for the device implant, based on what I was seeing in the echo.”

They agreed to try it.

During the cardiac catheterization procedure, Ing passed a thin catheter into a blood vessel in Taylor’s groin and moved it up into the heart, only guided by echo images provided by Yeh, to locate the PDA. Inserting the Amplatzer Piccolo Occluder medical device into the catheter and into the PDA, Dr. Ing was able to successfully release the device to block the abnormal blood flow of the PDA.

In less than two hours, the procedure was complete.

Taylor’s kidney function significantly improved the next morning. A post-PDA echo revealed that no residual PDA remained. The procedure was an overwhelming success.

“I am aware of only a few interventional cardiologists in the country who have done this,” Ing said. “I am proud that we were able to help this baby using a team approach.”

Cedric Taylor’s mom Candra is just thankful that this procedure has made a big difference to her son’s health overnight.

“I appreciate Dr. Ing for taking the risk and making the best decision for Cedric, due to certain circumstances. Dr. Ing did great with reassuring that he only had confidence that the procedure would be successful,” said Taylor.

Cedric will not require any additional PDA procedures. The device will remain in place for Cedric’s lifetime.

“Baby Cedric clinically is doing much better. We are happy and growing. Only ups and gains from here!” Taylor said.

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https://health.ucdavis.edu/health-news/children/uc-davis-health-fixes-babys-heart-defect-using-echocardiography-only-strategy/2021/07
202107_childrens-virtual-bereavement-art-group-starts-in-august Mon, 26 Jul 2021 07:00:00 GMT Children’s Virtual Bereavement Art Group starts in August <p>The UC Davis Child Life and Creative Art Therapy Department will host &ldquo;Remembering Together: Virtual Bereavement Art Group,&rdquo; focusing on grief and processing loss through self-expression and art for children next month.</p> The UC Davis Child Life and Creative Art Therapy Department will host “Remembering Together: Virtual Bereavement Art Group,” focusing on grief and processing loss through self-expression and art for children next month.

The group dates and time will be based on age:

  • Ages 6-11: Aug. 17, 24 and 31 from 4-5:30 p.m.
  • Ages 12-16: Aug. 19, 26 and Sept. 2 from 4-5:30 p.m.

Each workshop will be facilitated by a certified child life specialist and a registered art therapist, trained in bereavement and child development.

The three-session workshop will teach them tools to express and process difficult emotions related to loss.

To register, please fill out the family questionnaire by Monday, Aug. 2. If you have questions, please email supportgroupsforchildren@ucdavis.edu.   

After registration, participants will receive art materials and necessary information to participate in the virtual group.  

The group is funded by New York Life and is provided free of charge to the public.

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202107_childrens-hospital-leaders-surprise-walmartsams-club-employees-during-cmn-campaign Fri, 23 Jul 2021 07:00:00 GMT Children’s hospital leaders surprise Walmart/Sam’s Club employees during CMN campaign <p>Visits from UC Davis Children&rsquo;s Hospital&rsquo;s CEO and other top hospital staff during the annual event provided a boost for staff. By recognizing the importance and impact of their fundraising efforts, leadership hopes each team member realizes that every dollar makes a difference.</p> Saving lives and lifetimes is a team effort. That’s why UC Davis Children’s Hospital  leadership, including UC Davis Health Chief Operating Officer, Brad Simmons, recognized the dedication of  Walmart/Sam's Club employees by making personal appearances at area stores during the annual Children’s Miracle Network Hospitals’ (CMN) campaign.

As a long time CMN partner, Walmart/Sam’s Club has been integral in raising funds for UC Davis Children’s Hospital and Simmons’ visit was just one way to acknowledge and rally the team.

“Having Brad visit the Antelope Walmart store to support the team was very impactful,” said Tony Hazarian, executive director of development for the UC Davis Medical Center. “His support and leadership, as well as that of the CMN team, Judie Boehmer and her nurses, helps underscore the important role individual employees play in the health of local kids. We could not provide world class care without the dedication of corporate partners like Walmart/Sam’s Club and their teams.” 


Walmart and Sam’s Club locations across the greater Sacramento region will continue fundraising efforts through Sunday, July 25.

The campaign runs through Sunday, July 25. Donate online, in-store at the register or through self-checkout.

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202107_uc-davis-nicu-receives-gold-level-beacon-award-for-excellence Mon, 19 Jul 2021 07:00:00 GMT UC Davis NICU receives gold-level Beacon Award for Excellence <p>The Neonatal Intensive Care Unit (NICU) at UC Davis Children&rsquo;s Hospital is now the 12th in the U.S. to receive a gold-level Beacon Award for Excellence from the American Association of Critical-Care Nurses. It is the only hospital in Northern California to receive this honor.</p> The Neonatal Intensive Care Unit (NICU) at UC Davis Children’s Hospital is now the 12th NICU in the U.S. to receive a gold-level Beacon Award for Excellence from the American Association of Critical-Care Nurses (AACN). It is the only hospital in Northern California to receive this honor. 

The Beacon Award for Excellence — a significant milestone on the path to exceptional patient care and healthy work environments — recognizes caregivers who successfully improve patient outcomes and align practices with AACN’s six Healthy Work Environment Standards. These standards are skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition and authentic leadership.  

“We are so proud to receive this award,” said Sheryl Ruth, nurse manager of the UC Davis NICU. “This award recognizes the quality of care and commitment to constant improvement, while providing an environment that empowers nurses.”

AACN President Beth Wathen applauds the commitment of the caregivers at the UC Davis NICU for working together to meet and exceed the high standards set forth by the Beacon Award for Excellence.

“The Beacon Award for Excellence is a testament to a team’s commitment to providing safe, patient-centered and evidence-based care to patients and families. Creating healthy and supportive work environments empowers nurses and other team members to make their optimal contribution,” Wathen explained. “Achieving this award is an honor that brings such joy to those who have worked so hard to achieve excellence in patient care and positive patient outcomes.”

The gold-level Beacon Award for Excellence signifies an effective and systematic approach to policies, procedures and processes that include engagement of staff and key stakeholders; fact-based evaluation strategies for continuous process improvement; and performance measures that meet or exceed relevant benchmarks. UC Davis Children’s Hospital’s NICU earned a gold award by meeting the following evidence-based Beacon Award for Excellence criteria:

  • Leadership Structures and Systems
  • Appropriate Staffing and Staff Engagement
  • Effective Communication, Knowledge Management, and Learning and Development
  • Evidence-Based Practice and Processes
  • Outcome Measurement

About the Beacon Award for Excellence: Established in 2003, the Beacon Award for Excellence offers a road map to help guide exceptional care through improved outcomes and greater overall patient satisfaction. U.S. and Canadian units where patients receive their principal nursing care after hospital admission qualify for this excellence award. Units that receive the Beacon Award for Excellence meet criteria in six categories: leadership structures and systems; appropriate staffing and staff engagement; effective communication, knowledge management, and learning and development; evidence-based practice and processes; and outcome measurement. To learn more, visit www.aacn.org/beacon or call 800-899-2226.

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, Calif., the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than half a million acute and critical care nurses and includes more than 200 chapters in the United States. The organization’s vision is to create a health care system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. To learn more about AACN, visit www.aacn.org, connect with the organization on Facebook at www.facebook.com/aacnface or follow AACN on Twitter at www.twitter.com/aacnme.

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https://health.ucdavis.edu/health-news/children/uc-davis-nicu-receives-gold-level-beacon-award-for-excellence/2021/07
202107_annual-cmn-miracle-balloon-campaign-at-dq-raises-money-for-uc-davis-childrens-hospital Wed, 14 Jul 2021 07:00:00 GMT Annual CMN Miracle Balloon campaign at DQ raises money for UC Davis Children’s Hospital <p>Record hot temperatures are just one reason to visit your local Dairy Queen through July 31. Helping save local kids&rsquo; lives is another. The CMN Miracle Balloon campaign is on now, raising money for UC Davis Children&rsquo;s Hospital.</p> July in Northern California often means record temperatures and the desire to go somewhere cool. Enter local Dairy Queen restaurants. 11 area locations  are once again offering customers a chance to do something cool: help sick and injured children like Avery who nearly drowned but received lifesaving care at UC Davis Children’s Hospital.

Now through July 31, you can help DQ continue to make a huge impact in the local community by donating to CMN at UC Davis through the purchase of a Children’s Miracle Network (CMN) Miracle Balloon. Every dollar raised stays local to help UC Davis Children’s Hospital provide world-class care for pediatric patients in 33 local counties.


There’s a Blizzard in the forecast! Visit one of 11 participating locations across the greater Sacramento region to donate to CMN at UC Davis.

DQ has been a CMN partner since 1984, raising more than $159 million for local children’s hospitals across North America. Northern California customers can add to that total by purchasing a Miracle Balloon at participating locations in the following cities: Truckee, Roseville (Douglas Boulevard), Citrus Heights, Orangevale, Sacramento (Arden Way, Fruitridge Road), Stockton, Manteca, Vacaville, Yuba City and Redding.

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https://health.ucdavis.edu/health-news/children/annual-cmn-miracle-balloon-campaign-at-dq-raises-money-for-uc-davis-childrens-hospital/2021/07
202107_girl-with-nager-syndrome-receives-life-changing-care-to-help-her-eat-breathe Tue, 06 Jul 2021 07:00:00 GMT Girl with Nager syndrome receives life-changing care to help her eat, breathe <p>Born with Nager syndrome, Lily Jones had craniofacial challenges, no ear canals and extremely short forearms at birth. The UC Davis Cleft and Craniofacial team partnered with her and her parents, Nick and Elysia Jones, to help improve her life.</p> When 8-year-old Reno resident Lily Jones first came to UC Davis Health, she could only open her jaw four millimeters. It affected her speech, her breathing and eating. 

Her first UC Davis visit was in January of 2017. She had already endured more than 15 surgeries and would require more. 

Jones was born with Nager syndrome. It’s a rare condition with only about 100 cases being reported in the medical literature. Jones faced craniofacial challenges, including the absence of ear canals and extremely short forearms. The UC Davis Cleft and Craniofacial team partnered with her and her parents, Nick and Elysia Jones, to help improve her life. 

"Lily and her family have challenged us as a team to be innovative when treating airway, speech and feeding, all the while, striving for a balance and optimal quality of life,” said Craig Senders, director of the program and Jones’ surgeon. 

Surgeries, hardware pave way for childhood rituals

Within a year, UC Davis experts expanded Jones’ jaw to 15 millimeters. 

“It doesn't sound like a lot, but for her it's huge," said Elysia Jones. “She was able to enjoy her first peanut M&M.” 

Jones also could stick out her tongue at her brother for the first time, which delighted her.  

Over the past four years, Jones underwent six more surgeries and continued to make strides. One of those required her team to use distraction hardware, a device with screws that attaches to both sides of the jawbone. The screws are gradually turned to create a longer jawbone and more space for her tongue. 

A bittersweet checkup


This is Lily Jones when she arrived at UC Davis in 2017.

Just shy of 12-years-old, Jones loves to laugh, sing and dance. She still enjoys her peanut M&Ms, but she’s added cheeseburgers and tacos to her repertoire as well. A feat credited to the fact that at her most recent and final appointment in June, she opened her mouth 20 millimeters. 

The moment was bittersweet as the Jones family prepares to move to Dallas. 

“Lily, Elysia, and I cried at our appointment with Dr. Senders when we had to say goodbye,” Nick Jones said. “We will miss the whole craniofacial team, especially Dr. Senders and the primary nurses we had. We were able to create great friendships and relationships with them.” 

Her parents credit Lily’s great attitude for her perseverance through life’s challenges, and the UC Davis team for expanding not only her jaw but her opportunities in the future. 

“All the way from check-in and pre-op to the Pediatric Intensive Care Unit, everyone was always so accommodating,” Nick Jones explained. “The care we received at UC Davis has been amazing.” 

Related stories

8-year-old girl with rare craniofacial condition goes through 18th surgery

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202107_undiagnosed-celiac-disease-is-one-local-familys-cautionary-tale-for-other-parents Fri, 02 Jul 2021 07:00:00 GMT Undiagnosed celiac disease is one local family’s cautionary tale for other parents <p><span>It was obvious one-year-old Piper was sick, but what was wrong? When her parents could not get answers, they turned to UC Davis Children&rsquo;s Hospital.</span></p> Piper was a healthy baby. Born at 10 pounds, she was well above average in birth weight. But as Piper approached her first birthday, her parents became concerned. Every time their daughter ate, food went right through her and she was not gaining weight. 

“Piper was so sick,” said Piper’s mom, Courtney. “After soiling her diapers repeatedly during the day, she’d wake up two or three times a night and her crib would be a wet swamp. She was vomiting at least once a day. She would have night terrors almost every night.” 

Piper’s parents took their daughter to her pediatrician multiple times and even to another children’s hospital, but still had no answers. Piper’s condition was worsening, and her parents were starting to panic. 

“Piper’s stomach was extremely distended, but you could see her ribs and spine. Everything was swollen and she was so lethargic,” recalled Piper’s mom. “By this time, she was only eating red and purple popsicles and drinking milk, and she was too weak to walk.” 

The night before they took her to UC Davis Children’s Hospital, her mom feared the worst. 

“I thought we were losing her,” Courtney said. “But we were not going to give up. We had to find the right medical providers.” 

Getting answers

Determined to save their daughter’s life, Piper’s parents brought her to the Pediatric Emergency Department at UC Davis Children’s Hospital. They quickly determined that the care team was not going to give up either. 

“Piper was immediately admitted, and they began running lab work. We were finally going to get answers,” Courtney said. “Once the care team reached a probable diagnosis, the team continued to run tests to rule everything else out. The team wanted to be sure it had the correct diagnosis and that there weren’t multiple causes for her symptoms.” 

“The UC Davis team saved Piper’s life, but it didn’t stop there. The aftercare we received was fabulous. It’s the best medical experience we’ve ever had.”

Piper was ultimately diagnosed with celiac disease and was in celiac crisis

“Common symptoms of celiac disease include diarrhea, vomiting, poor weight gain, abdominal pain or rashes. Left untreated, it can cause long-term issues, including cancers of the intestinal tract,” said UC Davis pediatric gastroenterologist, Kelly Haas. “Plus, as was the case with Piper, there is a severe, life-threatening type of celiac disease. Although quite rare, this requires more intensive treatment and nutritional support.” 

Although relieved to finally have an answer, the family was shocked the signs had been missed by other medical providers.

“Even though Piper showed all the classic symptoms of celiac disease, she had never been tested for celiac, despite being seen by multiple other medical providers. We could not get any answers until we came to UC Davis,” Courtney said. “The care team ran every possible test to figure out what was wrong.” 

Collaboration was key to recovery


Piper is now a healthy, happy 3-year-old who enjoys spending time with her sisters and jumps for joy when she discovers new, gluten-free treats.

It took 18 days in the hospital to nurse Piper back to health. During this time, Piper’s family witnessed the collaboration of the care team and it became even more obvious to them they were in the right place. In addition to the medical treatments for Piper’s condition, the family had access to the additional services their daughter needed, plus the family support that made this traumatic journey a little easier. 

From physical therapy and speech therapy, to nutrition, sleep assistance, sibling support, more toys and activities than one could imagine, and a very accommodating cafeteria, Courtney says the UC Davis Children’s Hospital team went above and beyond. 

“The UC Davis team saved Piper’s life, but it didn’t stop there. The aftercare we received was fabulous. It’s the best medical experience we’ve ever had,” Courtney said. “Piper made a full recovery and has grown accustomed to a gluten-free lifestyle. At 3 years old, she has learned to ask if a food contains gluten before she eats it. Piper is happy, affectionate, observant and surprisingly, she is the tallest child in her preschool class. We are so thankful for UC Davis Children’s Hospital!” 

Related stories

Undiagnosed celiac disease is one local family’s cautionary tale for other parents - CBS13 

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202106_overcoming-the-odds-despite-challenges-of-spina-bifida Wed, 30 Jun 2021 07:00:00 GMT Overcoming the odds despite challenges of spina bifida <p>At this year&rsquo;s Bear Creek High School graduation ceremony in Stockton, 17-year-old Ben Brogger walked gracefully onto the stage and delivered an inspiring speech to the graduating seniors. It was a moment that Adriana and Dan Brogger weren&rsquo;t sure they would ever witness when their son was diagnosed with spina bifida in the womb.</p> Every graduation ceremony includes speeches from a graduating senior or two. Attendees expect that.

But at this year’s Bear Creek High School graduation ceremony in Stockton, 17-year-old Ben Brogger defied others’ expectations and the odds.

When he walked gracefully on to the stage to deliver an inspiring speech to fellow graduates, it was a moment that his parents, Adriana and Dan, weren’t sure they would ever witness. Ben Brogger was born with spina bifida.

“Now I can recognize Ben’s gait anywhere. He walks with confidence. He has a swagger. It’s incredible to see. If you didn’t know he had spina bifida, you may not realize from seeing him,” said his mom, who remembers her son’s early days when she was told he might be wheelchair-bound for life.

Ben Brogger has been breaking barriers like this since day one. Once told he might never walk, he began walking at 15 months, then running. In high school, he followed in the footsteps of his two older brothers and joined the varsity wrestling team in high school.

“The biggest blessing with Ben is that he refuses to see spina bifida as something that will hinder him. He is such a resilient human being,” Adriana Brogger said. “When I think back to those early days, I was just clinging to hope and wanting to know what his future could look like. Now we’ve reached his high school graduation, I see there is still so much to look forward to in his future.”

An explanation with a dose of humanity

Adriana Brogger was seven months pregnant when a routine ultrasound revealed that something was wrong with her third son. Doctors initially thought her unborn baby had anencephaly, a congenital condition in which parts of the brain and skull are missing. She was referred to UC Davis Health by her obstetrics and gynecology doctor in Stockton. Additional testing confirmed her baby had myelomeningocele, also known as spina bifida.

Spina bifida occurs when spinal tissue fails to fuse properly during the early stages of pregnancy. It can lead to a range of lifelong cognitive, mobility, urinary and bowel disabilities. It affects 1,500 to 2,000 children in the U.S. every year.

“When I heard it was myelomeningocele, it seemed so foreign and I felt disconnected from it. I fell into a depression, but I have a lot of faith. I said that God will see us through this,” Adriana Brogger said. “I listened to the specialists at UC Davis. Everything they explained to me came with a dose of humanity. It was comforting during a difficult time.”

Benjamin Brogger arrived, via scheduled caesarean section, weighing 7 pounds, 12 ounces. Hours later, UC Davis pediatric neurosurgeon James Boggan began operating to repair Ben’s spine.  

“Dr. James Boggan was my angel, who performed surgery on his teeny, tiny little body,” Adriana Brogger said. “Dr. Boggan was so kind, so quiet and calm. He told me, ‘Your baby is going to be okay. What we will try to do in this surgery is close this up and connect these nerve endings.’”  

The path to a bright future

The surgery was successful – the first of many successful surgeries – what Adriana Brogger calls miracles – that would set her son onto a path with a bright future.


Benjamin Brogger had surgery to repair his spina bifida shortly after birth.

Many babies with spina bifida have fluid in the brain (also known as hydrocephalus), which can require shunt placement. Ben Brogger did not need a shunt.  

Doctors diagnosed Ben Brogger with chiari malformation type II. This condition can affect the ability to swallow. Fortunately, it did not pose a problem for him. His mother was able to nurse him from birth, providing nutrient-rich breastmilk to help him grow and develop.   

Boggan would continue to care for Ben Brogger for many years, always working to preserve and maximize his patient’s neurological function and independence.

“Ben’s care was made easy by his determination and perseverance and his family’s faith,” Boggan said. “The dedicated multidisciplinary team of specialists worked together to provide Ben’s family with the support they needed.”

Specialists like UC Davis pediatric urologist Eric Kurzrock performed multiple surgeries on Ben over the years.

“When you care for children from infancy to adulthood, they become family. Patients with neurogenic bladder (bladder problems caused by neurologic damage) and bowel disorders require constant and intense attention from their family and providers. So much can go wrong,” Kurzrock said.

But in Ben Brogger’s instance, so much went right. He underwent surgeries that included an antegrade continence enema (ACE) procedure and bladder augmentation surgery. They gave him the gift of independence and autonomy and freed him from needing a colostomy.

“Ben is blessed with parents who are compassionate, informed and proactive. We spent years discussing different surgical options and the many risks,” Kurzrock said. “Thankfully the reconstruction was successful and Ben has the opportunity to chase his dreams.”  

Those dreams now include becoming a lawyer. He heads to San Joaquin Delta College in the fall to join the Pathway to Law program.

Ben’s parents weren’t the only ones watching with pride on his graduation day this month. His UC Davis pediatric neurosurgeon Marike Zwienenberg also watched the ceremony online with pride. Seeing patients celebrate big and small victories is part of the joy of being a pediatric surgeon, said Zwienenberg.

“Living with spina bifida is challenging and Ben has picked every opportunity along the way to overcome it, which says a great deal about his character and grit,” Zwienenberg said. “Dr. Boggan provided excellent surgical care to him as an infant. On behalf of our health care system, I am super proud we have been able to support him where needed.”

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https://health.ucdavis.edu/health-news/children/overcoming-the-odds-despite-challenges-of-spina-bifida/2021/06
202106_the-danger-of-button-batteries Tue, 29 Jun 2021 07:00:00 GMT The danger of button batteries <p>Button cell batteries, the flat, coin-shaped batteries found in many toys, watches and remote controls, can do serious internal damage if accidentally swallowed. UC Davis pediatric emergency physicians warn families to keep these batteries secure and out of children&rsquo;s reach.</p> Button cell batteries, the flat, coin-shaped batteries found in many toys, watches and remote controls, can do serious internal damage if accidentally swallowed. UC Davis pediatric emergency physicians warn families to keep these batteries secure and out of children’s reach.

“One of the most frightening emergencies we see are children who accidentally swallow these small batteries. Within moments of ingestion, the current from the battery can start burning through your throat, and that can kill you,” said Jonathan Kohler, medical director of pediatric trauma at UC Davis Children’s Hospital. “Kids who swallow these batteries may require emergency surgery and can have devastating long-term injuries.”

More than 1,250 cases of accidental button battery ingestion were reported from 2019-2020 to the National Battery Ingestion Hotline.  More than half of those were swallowed by children under the age of 6.

Parents who suspect that their child has swallowed a button battery should contact the California Poison Control System at 800–222-1222 and immediately take their child to the emergency room.

“A swallowed button battery is one of the biggest medical emergencies there is. Every minute counts. There are some things parents and doctors can do to minimize the damage, but you have to contact poison control and go to the emergency room immediately,” Kohler said.

Kohler shares this important advice for parents:

  • Call the emergency room on your way there to tell them that you’re bringing in a child who swallowed a battery so they can be ready for you when you arrive.
  • If you can’t get your child to the emergency room immediately by yourself, call 911 and ask for an ambulance.

Poison Control also provides the following tips for protecting young children.

  • Never leave batteries sitting out.
  • Check household devices to be sure that the battery compartments are secured.
  • Don’t allow children to play with batteries or products that have easily accessible batteries.
  • Alert family members who wear hearing aids to keep their batteries out of the reach of small children at all times.
  • Don’t insert or change batteries in front of small children.
  • Don’t leave batteries where they might be mistaken for food.
  • Batteries stuck in the esophagus, nose or ears must be removed as quickly as possible to avoid severe damage.
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https://health.ucdavis.edu/health-news/children/the-danger-of-button-batteries/2021/06
202106_annual-walmart-and-sams-club-campaign-benefiting-local-kids-kicks-off-monday Fri, 25 Jun 2021 07:00:00 GMT Annual Walmart and Sam’s Club Campaign benefiting local kids kicks off Monday <p>Help kids live better when you shop. All donations to Children&rsquo;s Miracle Network Hospitals (CMN) stay local to help treat sick and injured kids in UC Davis Children&rsquo;s Hospital&rsquo;s 33-county service area.</p> Children’s Miracle Network Hospitals’ (CMN) long-time partner, Walmart/Sam's Club, is poised and ready for the annual CMN in-store campaign. Beginning Monday, June 28, associates will encourage customers to #HelpKidsLiveBetter by donating at the register, at self-checkout or online. All funds raised will stay local to benefit kids treated at UC Davis Children’s Hospital.

“Since pandemic restrictions have been lifted, we can’t wait to see what local stores do during this year’s campaign,” CMN at UC Davis program director Michelle Tafoya said. "During COVID, teams raised significant funds but had to pare back some of their efforts. This year, look out! Our Walmart and Sam’s Club associates are some of the most creative and dedicated people out there, so it will no doubt be a fun, high-energy campaign.”

UC Davis Children's Hospital leadership, including nurse managers who are on the front lines of pediatric care, will make the rounds as they did last year, meeting with associates to share pediatric patient stories and the impact of dollars raised on patient care. This "appreciation tour" is one way to let the stores know how valuable their contributions really are.

“As the only local CMN Hospital, it’s critical that UC Davis Children’s Hospital continues to provide the highest quality of care to our patients,” said Patient Care Services executive director Judie Boehmer. "Thanks to our partners and our community, we’ve been able to provide the care kids need, even during COVID-19. We are profoundly grateful to Walmart and Sam’s Club for their unwavering support and commitment to local kids through their dedication to CMN.”

The CMN campaign at Walmart and Sam's Club runs through July 25. All funds raised stay local to support research, education, programs and clinical care at UC Davis Children’s Hospital.

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https://health.ucdavis.edu/health-news/children/annual-walmart-and-sams-club-campaign-benefiting-local-kids-kicks-off-monday/2021/06
202106_childrens-miracle-network-cmn-awards-grants-to-uc-davis-childrens-hospital-for-2021-2023 Thu, 17 Jun 2021 07:00:00 GMT Children’s Miracle Network (CMN) awards grants to UC Davis Children’s Hospital for 2021-2023 <p>From blood pressure monitoring to cellular therapy for neuroblastoma treatment, UC Davis Children&rsquo;s Hospital continues to be on the cutting edge thanks to generous donations from CMN. This year&rsquo;s grant winners are the best of the best in pediatric clinical care and research.</p> Eleven grants totaling $352,554 have been awarded by Children’s Miracle Network (CMN) at UC Davis to clinicians and researchers at UC Davis Children’s Hospital. Grants in the amount of $152,554 will enhance the clinical care of children, while $200,000 was awarded for research directly improving the health and welfare of children.

Each year, applications are accepted by Children’s Miracle Network (CMN) for both clinical services and research grants. Each application must demonstrate how the project or research contributes to UC Davis Health Strategic Goals and/or UC Davis Medical Center Institutional Goals. The amount of funds awarded each year is determined by the CMN Executive Committee and chief executive officer of UC Davis Medical Center.

Clinical services grants funded for 2021-2023 for UC Davis Children’s Hospital:

  • Extra-Corporeal Life Support (ECLS) simulation, high fidelity – Stephanie Mateev
  • Pupillometer to assess critically ill children ­­– Sopon "Liz" North
  • Ambulatory blood pressure monitoring for the diagnosis and management of pediatric hypertension – Stephanie Nguyen
  • UC Davis Children's Hospital pediatric inflammatory bowel disease (IBD) patient information guide – Daphne Say
  • Joint effort between wound care and perioperative services to reduce pressure-related injuries in pediatric surgical patients – Jenni Prevatt
  • Decreasing radiation exposure in pediatric PICC placement – Kathryn Garson
  • Modern ultrasound to improve pediatric difficult intravenous access in the Department of Radiology – Douglas Wright

Research grants funded for 2021-2023 for UC Davis Children’s Hospital:

  • Preductal Oxygen Saturation Target In Term (POST IT) and late preterm neonates with hypoxemic respiratory failure or pulmonary hypertension – Heather Siefkes
  • Neurobehavioral and functional characterization of human CNKSR2-related disease in mouse and zebrafish animal model systems – Joseph Shen 
  • Bowel and bladder function in the ovine myelomeningocele model – Maheen Hassan 
  • Engineered placental mesenchymal stem cells as a cellular therapy vehicle for neuroblastoma treatment – Erin G. Brown, Dr. Anthony Philipps Award recipient 

Special consideration was given to junior faculty members and junior investigators. Faculty mentors reviewed the proposals prior to submission and included a letter of support and a current National Institutes of Health (NIH) biosketch, as applicable.

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https://health.ucdavis.edu/health-news/children/childrens-miracle-network-cmn-awards-grants-to-uc-davis-childrens-hospital-for-2021-2023/2021/06
202106_uc-davis-childrens-hospital-again-named-among-nations-best Tue, 15 Jun 2021 07:00:00 GMT UC Davis Children’s Hospital again named among nation’s best <p>UC Davis Children&rsquo;s Hospital has been recognized as a Best Children&rsquo;s Hospital for 2021-22 by U.S. News &amp; World Report in four pediatric specialty areas: neonatology, nephrology, orthopedics and urology.</p> June 15, 2021 – UC Davis Children’s Hospital has been recognized as a Best Children’s Hospital for 2021-22 by U.S. News & World Report.

The annual Best Children’s Hospitals rankings and ratings, now in their 15th year, are designed to assist patients, their families and their doctors in making informed decisions about where to receive care for challenging health conditions. 

UC Davis Children’s Hospital is nationally ranked among the nation’s 50 best in these four specialty care areas:   

  • 25th nationally in nephrology
  • 29th nationally in neonatology
  • 22nd nationally in orthopedics
  • 37th nationally in urology

The orthopedics and urology rankings were awarded in collaboration with Shriners Hospitals for Children – Northern California, UC Davis Children’s Hospital’s longstanding partner in caring for children with burns, spinal cord injuries, orthopedic disorders and urological issues. 

“We are so pleased to be in the top 50 best children’s hospitals once again according to U.S. News,” said Brad Simmons, chief administrator of UC Davis Medical Center and its children’s hospital. “Congratulations to our whole team for providing the highest standards of care to our pediatric patients and their families.” 

For 2021-22, U.S. News ranked the top 50 centers in each of these 10 pediatric specialties: cancer, cardiology & heart surgery, diabetes & endocrinology, gastroenterology & gastrointestinal surgery, neonatology, nephrology, neurology & neurosurgery, orthopedics, pulmonology & lung surgery and urology.   

“When choosing a hospital for a sick child, many parents want specialized expertise, convenience and caring medical professionals,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “The Best Children's Hospitals rankings have always highlighted hospitals that excel in specialized care. As the pandemic continues to affect travel, finding high-quality care close to home has never been more important.” 

The Best Children's Hospitals methodology factors objective measures such as patient outcomes, including mortality and infection rates, as well as available clinical resources and compliance with best practices. To calculate the Best Children’s Hospitals rankings, U.S. News gathered relevant data from children’s hospitals in early 2020 and from pediatric physicians and other healthcare organizations in 2021; because of the pandemic, data collection from children’s hospitals was not repeated in 2021. 

RTI International, a North Carolina-based research and consulting firm, collected and analyzed data from 118 children’s hospitals and surveyed thousands of pediatric specialists. More than 100 pediatric specialists and other experts provided input through methodology working groups. 

This year’s rankings will be published in the U.S. News & World Report’s “Best Hospitals 2022” guidebook, available in stores Oct. 5.

About UC Davis Children’s Hospital

UC Davis Children's Hospital is the Sacramento region's only nationally ranked, comprehensive hospital providing care for infants, children, adolescents and young adults needing primary, subspecialty and critical care. It includes the Central Valley's only pediatric emergency department and level I pediatric trauma center, which offers the highest level of care for its critically ill patients, as well as a level I children’s surgery center. The children's hospital includes the state-of-the-art 49-bed neonatal and 24-bed pediatric intensive care and pediatric cardiac intensive care units. For more information, visit children.ucdavis.edu.

About U.S. News & World Report

U.S. News & World Report is the global leader in quality rankings that empower citizens, consumers, business leaders and policy officials to make better, more informed decisions about important issues affecting their lives. A multifaceted digital media company with Education, Health, Money, Travel, Cars, News and 360 Reviews platforms, U.S. News provides rankings, independent reporting, data journalism, consumer advice and U.S. News Live events. More than 40 million people visit USNews.com each month for research and guidance. Founded in 1933, U.S. News is headquartered in Washington, D.C.

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https://health.ucdavis.edu/health-news/children/uc-davis-childrens-hospital-again-named-among-nations-best/2021/06
202106_want-to-help-sick-sacramento-children-then-scoop-scoot-on-july-16 Fri, 11 Jun 2021 07:00:00 GMT Want to help sick Sacramento children? Then ‘Scoop Scoot’ on July 16 <p>Scoot over to William Land Park on Friday, July 16 at 6:30 p.m. for the California Family Fitness Scoop Scoot 2021. The family-friendly event raises funds for the UC Davis Child Life and Creative Arts Therapy Department, which supports kids while they are in the hospital.</p> When children face long or short hospital stays, the experience can be scary and isolating for them.

But people from across the Sacramento region will have the chance to brighten those stays for hundreds of children.

The California Family Fitness Scoop Scoot 2021 is scheduled for Friday, July 16 at 6:30 p.m. at William Land Park. The family-friendly event raises funds for organizations including the UC Davis Child Life and Creative Arts Therapy Department. Child Life works to minimize the anxiety of hospitalization, increase understanding and strengthen coping skills while helping children to continue their typical growth and development.

“Scoop Scoot always makes for a fun summer evening with ice cream and music in the park,” said Diana Sundberg, manager of the UC Davis Child Life and Creative Arts Therapy Department. “We certainly appreciate the community support that keeps us ‘scooting’ along through their generous donations!”

This year, to adhere to health and safety guidelines, participants walk or run around a one-mile loop inside the park. Ice cream, a beer garden (for those 21 and older) and the course are open from 6 to 8 p.m. To help with social distancing and to avoid a mass start at 6:30 p.m., participants can start any time they'd like. It’s a bit different from past events, but no less enjoyable.

Participants can enjoy a scoop of Vic’s Ice Cream, with choices of mint chocolate chip, orange sherbet or vanilla, topped with Ginger Elizabeth chocolate fudge sauce and/or fleur de sel caramel sauce. The beer garden is available for those over 21 years of age.

Registration is $5. For more information and to register online, visit scoopscoot.org.

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https://health.ucdavis.edu/health-news/children/want-to-help-sick-sacramento-children-then-scoop-scoot-on-july-16/2021/06
202106_extra-extra-read-all-about-it-in-the-latest-issue-of-the-pediatric-press Mon, 07 Jun 2021 07:00:00 GMT Extra, extra, read all about it in the latest issue of The Pediatric Press <p>The Pediatric Press, the online newsletter of UC Davis Children's Hospital, has published its summer issue. The summer edition includes stories about hospital awards, research developments, patient milestones, new clinic openings&nbsp;and other successes within&nbsp;the pediatric&nbsp;units.</p> The Pediatric Press, the online newsletter of UC Davis Children's Hospital, published its summer issue today.

This newsletter helps to communicate news and developments within the children's hospital. The goal is to connect and unite children's hospital faculty and staff, as well as provide information to employees throughout UC Davis Health and the general public. 

The summer newsletter includes stories about hospital awards, research developments, patient milestones, new clinic openings and other successes within the pediatric units.

Read the newsletter.

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https://health.ucdavis.edu/health-news/children/extra-extra-read-all-about-it-in-the-latest-issue-of-the-pediatric-press/2021/06
202106_cardiac-arrest-save-a-life-in-five-steps-with-guidance-from-project-adam-sacramento Fri, 04 Jun 2021 07:00:00 GMT Cardiac arrest: Save a life in five steps with guidance from Project ADAM Sacramento <p>CPR/AED Awareness Week is a solemn reminder of cardiac arrest statistics. The good news? UC Davis has free education and training available so you can provide lifesaving assistance through a program called project ADAM.</p> Cardiac arrest statistics tell a daunting story. According to the American Heart Association, more than 350,000 cardiac arrests - when the heart malfunctions and stops beating unexpectedly - occur outside of the hospital each year and 90 percent of those people die. Unlike a heart attack - when blood flow to the heart is blocked but the person is still talking and breathing - nearly 70% of these cardiac arrest incidents occur at home which means it is likely happening to someone you love. With summer fast approaching and more people working remotely, it's even more important to revisit the five steps to save a life: 

Step 1 - Recognize sudden cardiac arrest (SCA): Watch for a sudden collapse or fainting. Someone who has just experienced sudden cardiac arrest will lose consciousness. Check for a pulse and breathing while attempting to determine if the person is alert.

Step 2 - Call 911

Step 3 - Start CPR: Push hard, push fast - no mouth-to-mouth contact is needed. Recent guidelines developed by the American Heart Association promote Hands-Only CPR as an acceptable way to help a victim suffering from cardiac arrest.

Step 4 - Shock: Use an AED

Step 5 - Fast Access to EMS (Emergency Medical Services)


Project ADAM at UC Davis Health is a no-cost program that can help you learn CPR and AED training.

Cardiac emergency preparedness is vital wherever you live and work, so that’s why Project ADAM staff and volunteers facilitate no-cost CPR and AED education and hands-on training at a variety of community events throughout the year. Project ADAM is committed to saving lives by empowering schools and communities to be prepared for sudden cardiac arrest (SCA), providing the foundation for schools to develop their program and become Heart Safe. Achieving Project ADAM’s Heart Safe School designation means that your school is prepared to appropriately respond to sudden cardiac arrest on campus, thereby increasing potential to save the life of a student, a staff member or visitor. Contact Project ADAM for more information: 916-627-9533.

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https://health.ucdavis.edu/health-news/children/cardiac-arrest-save-a-life-in-five-steps-with-guidance-from-project-adam-sacramento/2021/06
202106_rapid-whole-genome-sequencing-leads-to-better-outcomes-for-babies-lower-medical-costs Fri, 04 Jun 2021 07:00:00 GMT Rapid whole genome sequencing leads to better outcomes for babies, lower medical costs <p>A study published today outlined the success of Project Baby Bear, a real-world quality improvement program designed to test the clinical and economic value of using rapid Whole Genome Sequencing to diagnose and guide treatment for infants with unexplained rare disease.</p> The evidence is in: A state-funded Rapid Precision Medicine program led by Rady Children’s Hospital-San Diego yielded life-changing outcomes for critically ill infants at five California hospitals while significantly reducing health care costs. UC Davis Children’s Hospital and the UC Davis Mind Institute were key participants in the research.

A study published today in the American Journal of Human Genetics outlined the success of Project Baby Bear, a real-world quality improvement program designed to test the clinical and economic value of using rapid Whole Genome Sequencing (rWGS ®) to diagnose and guide treatment for infants with unexplained rare disease.

Employing the most comprehensive diagnostic testing available, Rady Children’s Institute for Genomic Medicine used rWGS to analyze the genetic code of 184 infants in intensive care who were covered by Medi-Cal. The results provided doctors and families with vital information that empowered them to make life-altering medical decisions resulting in shorter hospital stays, targeted personalized care and fewer costly, invasive procedures.

“It’s very rare to be able to use the most advanced medical technology to both improve a child’s life and save money, yet Project Baby Bear proved it’s possible,” said David Dimmock, senior medical director of the institute. “We identified the exact cause of rare, genetic diseases in an average of three days, instead of the four to six weeks standard genetic testing offers. This allowed physicians to deliver timely treatment tailored to the baby’s specific condition, in some cases avoiding irreversible health consequences.”

Rapid WGS proved to be a valuable tool in clinical decision-making. Among the infants sequenced, rare genetic diseases that explained the baby’s admission to intensive care were diagnosed in 74 babies, or 40%. 

Guided by the vital information provided by rWGS, clinicians were able to provide precision medicine that changed care for 58 babies, or 32%. Conclusive diagnosis allowed doctors to make treatment plans with more confidence. Results from genome sequencing also empowered parents to join physicians in making informed care decisions.

“The study highlights the importance of using state-of-the-art rapid genome sequencing technology in our most vulnerable population – neonates and acutely sick infants from historically underserved communities – to provide precision medical care based on accurate diagnosis,” said Suma Shankar, director of the UC Davis Precision Genomics Clinic and co-lead of the UC Davis site for Project Baby Bear.

“Many families felt relief in knowing and understanding the cause for their baby’s illness and the ability to receive cutting edge therapies based on receiving rare specific diagnosis early on in the course where timing is crucial to prevent long term disability,” said Shankar, who is also a UC Davis MIND Institute faculty member.

In addition to changes in treatment, rWGS resulted in avoidance of other costly procedures such as tracheostomies or gastric tube insertions, eliminated the need for further testing and led to fewer days in the hospital.

“These findings show that rWGS should be considered early for infants admitted to intensive care when the cause of the child’s condition is unknown.” said Patrick Frias, president and CEO of Rady Children’s Hospital. “Project Baby Bear has demonstrated that it’s feasible and effective to use rWGS to inform precision medicine for the most vulnerable infants; it achieves both improved health outcomes and cost savings.”

Project Baby Bear was funded by the State of California as a $2 million Medi-Cal pilot. Participation was limited to acutely ill babies enrolled in Medi-Cal who were admitted to intensive care between November 2018 and May 2020.

Patient blood samples were sent to RCIGM for sequencing and interpretation from regional neonatal and pediatric intensive care units at the following participating hospitals: UC San Francisco Benioff Children’s Hospital Oakland; UC Davis Children’s Hospital (Sacramento); Valley Children’s Hospital (Madera); CHOC Hospital (Orange County) and Rady Children’s Hospital–San Diego.

Encouraged by the early success of Project Baby Bear, the State of Florida and State of Michigan have since initiated their own publicly funded rWGS demonstration projects.

The California Legislature is currently considering adopting AB114, the Rare Disease Sequencing for Critically Ill Infants Act, introduced by Assemblymember Brian Maienschein (D-77). Also pending is a federal bill, Ending the Diagnostic Odyssey Act, introduced by San Diego Congressman Scott Peters (D-52).

The study referenced in this release is: "Project Baby Bear: Rapid Precision Care Incorporating rWGSin 5 California Children’s Hospitals Demonstrates Improved Clinical Outcomes and Reduced Costs of Care" (AJHG-D-21-00121R1) The American Journal of Human Genetics. DOI: 10.1016/j.ajhg.2021.05.008. 

Related links

Project Baby Bear shows genomic sequencing for infants in intensive care yields life-changing benefits and medical cost savings

UC Davis Children's Hospital joins program to test critically ill newborns

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202106_uc-davis-childrens-hospital-welcomes-new-facility-dog-daniels-video Thu, 03 Jun 2021 07:00:00 GMT UC Davis Children’s Hospital welcomes new facility dog Daniels (video) <p>The newest employee at UC Davis Children&rsquo;s Hospital has a wet nose and a wagging tail! Facility Dog Daniels works in the Pediatric Intensive Care Unit (PICU) to help calm, comfort and motivate young patients going through medical procedures and long hospital stays.</p>
This video is best viewed in Chrome, Firefox or Safari.

The newest employee at UC Davis Children’s Hospital doesn’t wear scrubs or use a stethoscope. 

He comes to work with a wet nose and a wagging tail to do a job only a canine can! Facility Dog Daniels works in the Pediatric Intensive Care Unit (PICU) to help calm, comfort and motivate young patients going through medical procedures and long hospital stays. 


Daniels with his handler, Kristen Cady, who is a child life specialist who works in the UC Davis Pediatric and Cardiac Intensive Care Unit (PICU/PCICU).

Daniels was provided free of charge by Canine Companions, a national nonprofit that provides expertly trained service dogs to adults, children and veterans with disabilities, and to professionals working in medical, rehabilitation, physical therapy and other settings. Daniels joins three other Canine Companions facility dogs who work at UC Davis Children’s Hospital— Huggie, Paloma and ZeeBee. 

Facility Dog Daniels, a two-year old yellow Labrador Retriever, knows more than 40 commands. His training enables him to calm and motivate young patients who face big challenges. 

Daniels and his handler, Child Life Specialist Kristen Cady, graduated from Canine Companions intensive Team Training course in April. Since then, they’ve brought love and light to hospitalized children. Daniels’ sweet personality and calm demeanor are perfect for the PICU. He is always willing to lean in for a hug and is very gentle when he climbs in bed for cuddles. 

“Daniels has been a wonderful addition to the PICU! We’ve had some great interactions and I am sure there will be many more to come,” Cady said. 

Recently, Daniels and Cady partnered with the UC Davis physical therapy team to support a child who hesitated to get up and move around. But after a game of ‘hide and seek’ with Daniels, the boy moved more confidently and wanted to take charge of walking his new four-legged friend. 

Daniels joins a patient in the PICU playroom at UC Davis Children’s Hospital.

“By the end, he was smiling and interacting with Daniels, his nurse and myself,” Cady said. 

Daniels also provides procedural support, helping children to cope successfully through what can be quite stressful experiences. He also supports parents, offering comfort as they await their child’s return from a surgery or begin to process a new diagnosis. 

“The presence of Daniels has brought moments of joy and stress relief for the PICU staff, and we are excited about all of the ways he will continue to benefit our entire unit. Daniels has already made such an impact at the hospital, and we can’t wait to see all he does in the future!” Cady said.

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202106_heather-siefkes-receives-2021-eli-gold-prize Tue, 01 Jun 2021 07:00:00 GMT Heather Siefkes receives 2021 Eli Gold Prize <p>Heather Siefkes, assistant professor in the UC Davis Department of Pediatrics, received the 2021 Eli Gold Prize. Siefkes works in the Pediatric and Cardiac Intensive Care Unit at UC Davis Children&rsquo;s Hospital and is the medical director of Project ADAM Sacramento.</p> Heather Siefkes, assistant professor in the UC Davis Department of Pediatrics, has received the 2021 Eli Gold Prize. Siefkes works in the Pediatric and Cardiac Intensive Care Unit at UC Davis Children’s Hospital and serves as medical director of Project ADAM Sacramento, which helps schools prepare for a sudden cardiac emergency through AED and CPR training.

The prize was named for Eli Gold, former professor and chair of the UC Davis Department of Pediatrics, who supported and encouraged many young aspiring pediatricians. The annual award of $3,000 supports winners’ research and career development.

“In her relatively short time in our department, through a unique combination of focus, persistence and vision, Dr. Siefkes has established herself as a leader in clinical research,” said Jennifer Plant, division chief of pediatric critical care medicine at UC Davis Children’s Hospital, who nominated her for the award. “Dr. Siefkes has also made considerable contributions to the Department of Pediatrics, related to service, education and clinical work. She is a thorough and thoughtful clinician worthy of recognition for the quality of her work.”

Siefkes’ research interests include early detection of critical congenital heart disease in newborns and outcomes related to pediatrics critical care medicine. She has earned a Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grant and a UC Davis CTSC KL2 scholar grant to improve critical congenital heart disease (CCHD) detection in newborns by measuring their blood flow levels in addition to blood oxygen levels.

The Eli Gold Award is open to any junior faculty member in the department who has achieved prominence in clinical, teaching, research or community service. The criteria for identifying the award recipient includes innovation, impact on child health, and impact on UC Davis Children’s Hospital or its community. The award winner is invited to give a lecture on a topic of his or her choice at a Pediatric Grand Rounds.

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https://health.ucdavis.edu/health-news/children/heather-siefkes-receives-2021-eli-gold-prize/2021/06
202105_three-dimensional-models-provide-road-map-to-cloacal-repairs-video Fri, 28 May 2021 07:00:00 GMT Three-dimensional models provide road map to cloacal repairs (video) <p>Three-dimensional printed models, created at the 3D PrintViz Lab on the UC Davis Health campus, have helped surgical teams plan for cloacal surgery in children. These models provide a veritable road map that makes all the difference.&nbsp;</p>
This video is best viewed in Chrome, Firefox or Safari.

(SACRAMENTO) — Cloacal repair is a delicate surgical procedure that many pediatric surgeons will never encounter in their lifetime.

But UC Davis pediatric surgeon Payam Saadai specializes in this type of surgery. He is committed to helping children born with a cloaca to have the best possible future.  

One in 50,000 girls are born with a cloaca, which is a rare, congenital malformation in which the genital tract, the urinary tract and the colorectal or intestinal tract end together in one channel, instead of being three separate structures.  

The surgery to reconstruct those three separate structures takes place in a single surgery and is a collaborative effort by a team of experienced pediatric surgeons, pediatric urologists, interventional radiologists, gynecologists and other specialists.


Payam Saadai

“No two cases are the same,” said Saadai, who performs four to five cloacal repairs on infants each year at UC Davis Children’s Hospital in close collaboration with UC Davis pediatric urologist Eric Kurzrock. He waits until babies are nine months to a year old before performing this life-changing surgery. “Everyone is a little different. The way the structures connect is different. Some connect very high up in the belly. Some of them connect really low down. Sometimes, there will be abnormalities related to the urological tract or the gynecological tract that can confuse things. If you go into surgery without a good road map, you could run into complications.”

Three-dimensional printed models have helped the surgical teams plan for this complex surgery. These models provide a road map of sorts that is making all the difference.  

A complex anatomy in 3D

Each cloacal model is made at the 3D PrintViz Lab on the UC Davis Health campus, based on two-dimensional scans of the patient’s anatomy from radiology and 3D imaging known as cloacagrams. 

Osama Raslan, associate professor of radiology at UC Davis Health and co-founder of the 3D PrintViz Lab, has partnered with Saadai to provide the custom models needed to help the surgical team visualize the complexity of the anatomy, plan for the surgery and anticipate complications.

“Models do what two-dimensional scans can’t do. 3D takes away the guesswork,” Raslan said. “You can hold the 3D model and change the positioning in your hands. You can see different perspectives in a way that you can’t with X-rays.”

The benefits of 3D models over 2D scans

The 3D lab uses FDA-approved software to create the models. Models are printed on site.  

By inputting 2D images and scans into the software, Raslan can separate the organs or systems that the surgeons are interested in seeing. He can also color code them to highlight different organs or body systems.  

Some advantages of the 3D model over 2D scans:

  • Models are portable and replicate the exact size of the patient’s organs and anatomy.
  • Models can be made of sterile materials and brought into the operating room. Surgeons can refer to the model during surgery.
  • Models can be assembled or disassembled, allowing clinicians to take apart and reconstruct the anatomy.
  • Surgeons can move the model around and flip it, providing different perspectives from all sides.
  • Models can help parents understand what will be taking place during surgery.
  • Models can be a teaching tool for medical residents and fellows so they can see the complex anatomy and the surgical planning required.

Raslan is grateful that his lab can use this technology to help surgeons be successful, especially in complex cases like cloacal repair. 

“This technology can drastically change a patient’s life for the better. That’s the most important reason why we’re doing this,” Raslan said.

Saadai remembers a time when he didn’t have access to 3D models to complete cloacal repairs. He said that the outcome was still the same. It just took longer and was more challenging to get the same results. Thankfully he doesn’t have to work in that environment any longer.

“If we didn’t have the 3D modeling here at UC Davis, it would be more difficult to achieve the same results. Most centers don’t have this capability. Most surgeons who do this cloacal repair don’t have access to 3D models. We’re in a very unique situation here at UC Davis. I feel very lucky,” Saadai said. 

Related stories

Mixed reality goggles, 3D printing aid in surgical planning to separate craniopagus twins
Surgical precision: 3D printing improves outcomes for patients

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https://health.ucdavis.edu/health-news/children/three-dimensional-models-provide-road-map-to-cloacal-repairs-video/2021/05
202105_record-setting-month-of-giving-at-jersey-mikes-raises-80k-for-uc-davis-childrens-hospital Thu, 27 May 2021 07:00:00 GMT Record-setting month of giving at Jersey Mike's raises $80K for UC Davis Children's Hospital <p>Jersey Mike&rsquo;s Sacramento-area franchises raised more than $80,000 for UC Davis Children&rsquo;s hospital in March, setting a new record during the chain&rsquo;s annual Month of Giving fundraiser. Sick and injured kids across 33 local counties benefit from Jersey Mike&rsquo;s efforts.</p> Jersey Mike's Subs franchises in the greater Sacramento area raised a collective $80,363.95 for UC Davis Children’s Hospital during the chain's annual Month of Giving. This was the third year area stores partnered with Children’s Miracle Network (CMN) Hospitals, the fundraising arm of UC Davis Children’s Hospital. 

Local restaurants accepted donations throughout the month of March, building to the Day of Giving on March 31. On that day, 100 percent of sales were donated. Participating locations included Fairfield, Woodland, Vacaville, Sacramento, Rocklin, Roseville, Folsom, Rancho Cordova and Elk Grove. All funds support research, equipment, programs and patient care for sick and injured children in the children’s hospital’s 33-county service area. 


Stocking up on snacks to support UC Davis Children’s Hospital.

“I can’t thank Jersey Mike’s and their customers enough for rallying to raise so much money for CMN at UC Davis,” said Michelle Tafoya, program director of Children’s Miracle Network at UC Davis. “The pandemic led to the cancellation of the 2020 Month of Giving. I was thrilled just to be able to participate this year. And then to get the news that they raised more than $80,000, I was blown away. Wow. Just wow. We can help so many more kids with their support.”

The chain raised $15 million overall to help more than 200 charities nationwide during the company’s 11th annual fundraising campaign. This total is double the amount raised in 2019 when the company donated $7.3 million to local charities. Since Month of Giving began in 2011, Jersey Mike’s has raised $47 million for hospitals, youth organizations, food banks and more.

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https://health.ucdavis.edu/health-news/children/record-setting-month-of-giving-at-jersey-mikes-raises-80k-for-uc-davis-childrens-hospital/2021/05
202105_childrens-miracle-network-at-uc-davis-announces-local-2021-champion Tue, 25 May 2021 07:00:00 GMT Children’s Miracle Network at UC Davis announces local 2021 champion <p>A patient since before he was born, Casey Dyke has lived his best life, thanks to UC Davis Children&rsquo;s Hospital donors. He&rsquo;s now the Children&rsquo;s Miracle Network Champion representing UC Davis for 2021.</p>
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Each year, Children’s Miracle Network (CMN) Hospitals across the U.S. and Canada identify a “champion” in their local community to represent kids treated at their children's hospital. This year, Casey Dyke of Roseville has been named CMN champion for UC Davis Children’s Hospital through 2021.

Dyke was in utero when doctors told his parents a crucial heart valve was missing. Just days after birth, he had his first heart surgery. By the time Dyke was 4 years old, he had four complex heart surgeries. His parents estimate that he spent a year in the Pediatric Cardiac and Intensive Care Unit (PCICU).

Now 16, Dyke has been able to live a regular life with the help of CMN donors, his UC Davis Children’s Hospital care team and his parents, Michael and Gina, who are proud their son is the 2021 champion.

"It's amazing that a boy born with the odds against him can go on to have such a normal life,” said Gina Dyke, Casey’s mother. “I'm extremely grateful for what UC Davis has done for him.”

Casey Dyke as a newborn Casey Dyke had four heart surgeries by the age of 4.

The family has spent years advocating for the charitable needs of sick and injured children in UC Davis Children’s Hospital’s 33-county service area. Now, their son can tell his own story.

“We are so excited to have Casey as our champion,” said Michelle Tafoya, program director of Children’s Miracle Network at UC Davis. “The Dykes have been dedicated to saving and improving children’s lives since Casey was a toddler. Now, by sharing his own experience, Casey can continue that legacy of giving back by inspiring people to support sick and injured kids just like him.”

The CMN Costco campaign runs through May 31.

 

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https://health.ucdavis.edu/health-news/children/childrens-miracle-network-at-uc-davis-announces-local-2021-champion/2021/05
202105_ulfat-shaikh-appointed-to-the-childrens-hospitals-associations-next-generation-of-quality-committee Fri, 21 May 2021 07:00:00 GMT Ulfat Shaikh appointed to the Children’s Hospitals Association’s Next Generation of Quality committee <p><span>Ulfat Shaikh, medical director for health care quality and professor of pediatrics at UC Davis Health, has been appointed to the Children&rsquo;s Hospitals Association&rsquo;s Next Generation of Quality Steering Committee. The committee includes 11 members representing children&rsquo;s hospitals across the country.</span></p> Ulfat Shaikh, medical director for health care quality and professor of pediatrics at UC Davis Health, has been appointed to the Children’s Hospitals Association’s Next Generation of Quality Steering Committee. The committee is made up of 11 members representing children’s hospitals across the country.

“The COVID-19 pandemic and resulting rapid expansion of care in ambulatory, telehealth and community settings has clearly shown us that children’s hospitals are part of health systems that go well beyond the walls of a hospital,” Shaikh said. “Pioneering children’s hospitals are evolving to the next generation of quality through this expanded approach of ‘children’s health systems.’ Being on Children's Hospital Association's Next Generation of Quality Steering Committee gives me the opportunity to contribute to these forward-looking efforts at a national level.”

Enhancing quality, patient safety and equity is a priority for the Children’s Hospitals Association. The association is working with children’s hospitals and health systems to address quality gaps, make improvement an integral part of health care delivery and support hospitals as they work to accelerate progress toward improvement of health outcomes, experience, and value for children and families.

The committee will continue to advance quality strategies, evaluate models for the future, and contribute insights to help guide this journey for children’s hospitals.

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https://health.ucdavis.edu/health-news/children/ulfat-shaikh-appointed-to-the-childrens-hospitals-associations-next-generation-of-quality-committee/2021/05
202105_uc-davis-medical-centers-obstetric-anesthesia-service-named-center-of-excellence-- Fri, 14 May 2021 07:00:00 GMT UC Davis Medical Center’s obstetric anesthesia service named Center of Excellence <p>The Society for Obstetric Anesthesia and Perinatology this week&nbsp; announced that UC Davis Medical Center has attained its prestigious Center of Excellence designation. The medical center was one of 17 institutions and programs globally to earn the designation this year.</p> The Society for Obstetric Anesthesia and Perinatology (SOAP) this week announced that UC Davis Medical Center has attained the prestigious SOAP Center of Excellence (COE) designation

UC Davis Medical Center is one of 17 institutions and obstetric anesthesia programs globally to have attained the SOAP Center of Excellence designation this year. It is valid for four years. 

“I'm proud to join our clinical director, Dr. [Julie] Fowler, and the rest of the faculty to receive this designation,” said Maria Cristina Gutierrez, academic director of the obstetric anesthesia service at UC Davis Health. “This is the result of the efforts of a cohesive team that strives to provide the best quality of care for women during their delivery at UC Davis. We will continue to ensure that safety and excellence in patient care remains our top priority in our institution.” 

The SOAP Center of Excellence designation sets a benchmark for expected care that helps improve national standards by providing quality metrics for institutions that offer obstetric anesthesia care. 

The criteria for the designation cover various domains, including personnel and staffing; equipment, protocols, and policies; simulation and team training; obstetric emergency management; cesarean delivery and labor analgesia care; recommendations and guidelines implementation; and quality assurance and patient follow-up systems. The criteria were generated by expert consensus and incorporate evidence-based recommendations. 

“Our team is thrilled to receive this Center of Excellence designation. I'm so proud of the hard work and dedication of all our obstetric teams who worked together to achieve this goal. We are committed to providing the highest standards of care for both mother and baby, and will continue to ensure that their safety, comfort, and wellbeing is our primary goal during such an important and exciting time,” said Julie Fowler, clinical director of the obstetric anesthesia service, which is a specialty within the Department of Anesthesiology and Pain Medicine at UC Davis Health.

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https://health.ucdavis.edu/health-news/children/uc-davis-medical-centers-obstetric-anesthesia-service-named-center-of-excellence--/2021/05
202105_uc-davis-health-now-enrolling-children-ages-12-17-for-novavax-coronavirus-vaccine-trial Fri, 07 May 2021 07:00:00 GMT UC Davis Health now enrolling children ages 12-17 for Novavax coronavirus vaccine trial <p><span>UC Davis Health will soon launch a stage 3 clinical trial for a new coronavirus vaccine for children ages 12-17 with the National Institutes of Health (NIH) and Novavax. The two-year study aims to enroll 100 participants.</span></p> UC Davis Health will be testing a new vaccine for children ages 12-17 to support the fight against COVID-19. It will soon open as an extension of the current, stage 3 clinical trial with the National Institutes of Health (NIH) and Novavax locally led by Stuart Cohen, chief of the Division of Infectious Diseases and director of Hospital Epidemiology and Infection Prevention at UC Davis Health. The pediatric portion will be led by Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital.

The two-year pediatric portion of the study aims to enroll up to 3,000 adolescents in the U.S., with 100 participants at UC Davis Health.

How does the vaccine work?

The Novavax vaccine, called NVX-CoV2373, contains a subunit from the spike protein in SARS-CoV-2, the virus causing COVID-19. The spike protein is the main target for development of immunity. The subunit is combined with an adjuvant, a boosting agent to improve the body’s immune response to the vaccine. When this combination enters the body, it triggers an immune response to the spike protein and creates antibodies to fight it.

“The vaccine contains protein antigens that cannot replicate or cause COVID-19. The antibodies generated to the vaccine will help protect the body from the real, fully-potent virus,” Cohen said.

UC Davis Health is part of Novavax’s Adult Phase III trial which includes approximately 30,000 participants. The vaccine, a two-dose regimen, is not yet approved for Emergency Use in the U.S. It is currently under review by the Food and Drug Administration (FDA).

Who can participate?

Study enrollees:

  • Must be 12 to 17 years old
  • Are physically healthy
  • Have not been diagnosed with COVID-19 in the past
  • Are not participating in any other COVID-19 research trials
  • Not prescribed immunosuppressant or corticosteroid medication
  • Can be HIV-positive if the HIV is well-controlled

This study will require in-person visits to UC Davis Medical Center. At these visits, the study team will thoroughly explain all procedures and answer any questions. If both the child and their guardian consent to participation, the team will assess the child's health. They will also gather a blood sample, inject the vaccine or a placebo, and observe the child for 30 minutes. The child will come back after three weeks to get the second shot.

As it is a blind, randomized trial, neither the participants nor the researchers will know who gets the vaccine and who receives the placebo.

“Thousands of children have been hospitalized and hundreds have died due to COVID-19. We need to vaccinate children both to protect them and to decrease transmission in our communities,” Blumberg said. “This is why it is important to make sure that there are safe and effective vaccines for all ages.”

Participants will receive compensation. For more information or to sign up, visit the study’s webpage.

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https://health.ucdavis.edu/health-news/children/uc-davis-health-now-enrolling-children-ages-12-17-for-novavax-coronavirus-vaccine-trial/2021/05
202105_sacramento-girl-supports-uc-davis-facility-dog-program-with-bat-mitzvah-gifts Tue, 04 May 2021 07:00:00 GMT Sacramento girl supports UC Davis Facility Dog program with Bat Mitzvah gifts <p><span>The word mitzvah means &ldquo;good deed,&rdquo; and Sacramento resident Meredith Bluth celebrated her Bat Mitzvah last month with a very good deed indeed: she invited her friends and family to donate to the UC Davis Facility Dog program.</span></p> The word mitzvah means “good deed,” and Sacramento resident Meredith Bluth celebrated her Bat Mitzvah last month with a very good deed indeed: she invited her friends and family to donate to the UC Davis Facility Dog program.

Bluth had wanted to give back to a charity to mark her 13h birthday and the Jewish coming-of-age ritual  – and found the UC Davis Children’s Hospital Facility Dog program fund.

“Meredith loves dogs and helping kids, so the donation request was a natural fit,” said Alexa Bluth, Meredith’s mother. 

Meredith received presents as part of her virtual celebration, and many people also donated to help the facility dogs. So far, Meredith has helped raise $1,427. Gifts have come from Southern California, Arizona, Massachusetts and New Jersey.


Zeebee is one of the facility dogs at UC Davis Children’s Hospital. This photo was taken pre-pandemic.

Donations to the UC Davis Facility Dog program help to support the care of Huggie, Paloma, Zeebee and Danny that have been provided free of charge to UC Davis Children’s Hospital from Canine Companions for Independence. Facility dogs are specially trained canines that enhance the health care environment for young patients. They help children through challenging treatments and provide comfort and support. Donations help pay for the dogs’ medical care, food, grooming, supplements, supplies and toys to keep the dogs healthy, happy and ready to support kids in need.

“We are so grateful to Meredith for giving back to our facility dog program,” said Tony Hazarian, executive director of development at UC Davis Medical Center. “By supporting our dogs, she is also supporting our kids who rely on our dogs for support during their hospitalization.”  

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https://health.ucdavis.edu/health-news/children/sacramento-girl-supports-uc-davis-facility-dog-program-with-bat-mitzvah-gifts/2021/05
202105_unexpected-medical-condition-prompts-early-delivery-for-moms-sixth-pregnancy- Mon, 03 May 2021 07:00:00 GMT Unexpected medical condition prompts early delivery for mom’s sixth pregnancy <p><span>When Antelope resident Martel Calabretta was pregnant with her sixth baby, she was a seasoned veteran. But early on, she realized that baby number six was a very different pregnancy and required the specialty care that UC Davis Health provides.</span></p> When Antelope resident Martel Calabretta was pregnant with her sixth baby in 2019, she was a seasoned veteran. But early on, she realized that it was a very different pregnancy and required the specialty care that UC Davis Health provides.

Early ultrasounds determined that her unborn baby had a rare condition known as vascular ring. This is a congenital heart anomaly where the aorta or its branches form a ring around the trachea, also known as the windpipe, and the esophagus, which is the tube that connects the throat to the stomach.

At 24 weeks, Martel also had a medical issue unrelated to her baby’s condition: a sharp pain on her right side and swelling in her feet. These were symptoms of preeclampsia, a disorder that affects 5 percent of pregnant women which is characterized by high blood pressure, protein in the urine, and can lead to organ damage, if left untreated. 

About a week later, she was admitted to UC Davis Medical Center under the supervision of UC Davis Health obstetrician Bahareh Nejad, who also oversaw three of Martel’s other pregnancies.

“It’s been a privilege to partner with Martel in her pregnancies and see her family grow over the years, with such joy and love,” Nejad said. “I have cared for her and her beautiful family, as I would do a member of my own family. I am grateful for the trust she has placed in me to help her bring each cherished little baby into this world.”    

An early delivery

But complications soon followed. When Martel’s blood pressure began to rise to dangerous levels, doctors rushed her into cesarean section (C-section) surgery to protect her own health and that of her baby.

Benito Calabretta was born on March 12, 2020. He weighed just one pound, 1.3 ounces - a micro preemie.

“His eyes weren’t even open yet. He was so incredibly tiny and surreal. I remember looking at his 10 tiny fingers and his 10 tiny toes and just being in awe of this miracle of his one-pound life,” Martel recalled. 

He spent the next nine months in the UC Davis Neonatal Intensive Care Unit (NICU), getting the care he needed from the designated Level IV nursery, the highest level NICU available.

“I had never been in a NICU before. I never experienced that with any of my other kids,” Martel Calabretta said. “But the team there became our family. Doctors, nurses, respiratory therapists and so many more … they are so special to us and such an appreciated blessing. We would see them every day and a lot of nights - which was a big deal during the height of COVID. The care they provided was not only the best, but also genuine and heartfelt.”

In his first months of life, Benito underwent heart surgery by UC Davis Pediatric Heart Center surgeons to repair his vascular ring.

He also had his patent ductus arteriosus (PDA) closure through interventional catheterization. The ductus arteriosus is an artery in the heart that normally closes after a full-term birth. But for many premature babies, this artery can’t close on its own and, or, does not close completely, leading to the condition called PDA. Twenty to 60% of all premature babies have PDA which can put them at risk of serious illness and disease, if not treated.

A special Christmas gift

Benito graduated from the NICU two days before Christmas.

“That was our Christmas present,” said Calabretta, who was beaming with excitement to have her baby home for the holidays.

Benito has required a tracheostomy tube and ventilator to help him breathe, as well as a gastrostomy tube, or G-tube, a surgically placed device in the stomach for feedings, both of which he should outgrow.

Despite his prematurity, he is developmentally on track.

These days, Benito still regularly sees specialists at UC Davis Health including physicians from ear, nose and throat, gastroenterology, pulmonology and cardiology. But he also has time to play with his siblings and enjoy family life, including a trip to the snow this past winter where he went sledding for the first time.

“Our faith in God, our family and our amazing UC Davis team are the only way we survived the emotional NICU rollercoaster,” Calabretta said. “We are so thankful for their knowledge, experience and their tender care.”

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https://health.ucdavis.edu/health-news/children/unexpected-medical-condition-prompts-early-delivery-for-moms-sixth-pregnancy-/2021/05
202104_little-magnets-are-a-big-health-hazard-when-swallowed- Tue, 27 Apr 2021 07:00:00 GMT Little magnets are a big health hazard when swallowed <p>They are colorful, bite-size, fun to play with, and capable of punching holes in your intestines if swallowed. UC Davis experts warn parents to steer clear of neodymium magnets. Often called rare-earth magnets, these are the strongest magnets available commercially.</p> They are colorful, bite-size, fun to play with, and capable of punching holes in your intestines if swallowed.

UC Davis experts warn parents to steer clear of neodymium magnets. Often called rare-earth magnets, these are the strongest magnets available and they are easy to buy.  

“These magnets can do a lot of damage, require surgery, or even cause death when swallowed. We are seeing more cases in our emergency room,” said Jonathan Kohler, medical director for pediatric trauma at UC Davis Children’s Hospital.  

These magnets are sold loose and come in bright colors, often used as stress-relief desk toys or building kits, but easy for a small child to put in their mouth and swallow. For teens, these magnets can mimic decorative body piercings when two magnets are placed on either side of the tongue, lips or cheeks – where they can be accidentally swallowed.   

“When swallowed, these magnets can attach to each other through the bowel, leading to fistulas, which are abnormal connections between two parts inside of the body, or they can create holes in the intestines,” said UC Davis pediatric gastroenterologist Sunpreet Kaur

What to do if your child has swallowed magnets

If a parent discovers that their child has swallowed magnets, they should call poison control immediately at 800-222-1222 and take their child to the emergency room right away, Kaur said.


See what happens when these magnets are swallowed. Source: American Academy of Pediatrics.

“The sooner they get to the emergency room, the higher the chances that we can get the magnets out of the stomach. The longer they wait, the magnets can pass the stomach and then we cannot reach them and they may require surgery,” Kaur said.

If left untreated, the magnets can form holes in the GI tract. 

Neodymium magnets have been sold under names such as Buckyballs, Neocube and Zen Magnets.

In 2012, the Consumer Product Safety Commission halted the sale of high-powered magnet sets and introduced a rule to take them off the market. The U.S. Court of Appeals overturned the rule in 2016.   

An analysis of the National Poison Data System from 2008 to 2019 in the Journal of Pediatrics reported a 444% increase in magnet injuries from 2018 to 2019 when high-powered magnets sets re-entered the market.

Related links

UC Davis Health doctor warns parents of deadly small magnets children swallow - Fox 40

Digestive danger: Candy-color magnets ripping open kids’ bowels, UC Davis doctors warn - Sacramento Bee

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202104_new-ultrasound-equipment-means-fewer-needle-pokes-and-less-stress-for-pediatric-patients Fri, 23 Apr 2021 07:00:00 GMT New ultrasound equipment means fewer needle 'pokes' and less stress for pediatric patients <p>Since veins are harder to see in children, ultrasound guided assistance is a game changer for kids and medical staff. Thanks to a Children&rsquo;s Miracle Network Hospitals grant, placing a needle is now much easier.</p> From lab draws to intravenous (IV) placement, needles can be particularly frightening for pediatric patients. This experience is often further complicated by the fact that children’s veins are harder to see, meaning more “pokes”. But a new portable ultrasound machine at UC Davis Children’s Hospital – funded by a Children’s Miracle Network Hospitals (CMN) grant – gives the care team a tool that helps minimize needle placement attempts and more importantly, lessen the stress and pain involved. 

“We have had so much success using this device,” said Jonathan Trask, critical care nurse at UC Davis Health and author of the CMN grant. “When we’re able to directly visualize kids’ small veins and have ultrasound guided access, our placement rate increases dramatically. It’s all about making the patients more comfortable and this device helps us better help the kids.” 

Fewer “pokes” mean decreased anxiety and pain for patients, and there’s  a positive effect on staff as well. 

“When you have to try multiple times to obtain vascular access, it can make the patient more fearful and  can be upsetting to the family,” said Children’s Hospital nurse educator Michelle Linenberger. “No care provider wants to make the hospital experience harder than it already is, so this  amazing technology allows us to expedite quality care and make  the IV placement  much less traumatic for all involved.” 


Veins are much easier to see thanks to images generated by the ultrasound.

This new ultrasound device is just one example of UC Davis Children’s Hospital and CMN’s commitment to comfort and pain management solutions for pediatric patients. Specialized programs like the pediatric pain team provide inpatient and outpatient consults and provide guidance on pain management and therapeutic options in collaboration with patients, families and care providers. Another CMN grant funded initiative, the Comfort Commitment, aims to create a plan to increase a patient’s comfort level  during  procedures to  improve the quality of care. 

“I am so incredibly grateful to CMN for the generous donation so we could purchase this equipment,” Trask said. “It is already paying dividends as we reduce and mitigate patients’ pain, one child at a time.”

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https://health.ucdavis.edu/health-news/children/new-ultrasound-equipment-means-fewer-needle-pokes-and-less-stress-for-pediatric-patients/2021/04
202104_join-the-st-baldricks-virtual-shave-party Thu, 22 Apr 2021 07:00:00 GMT Join the St. Baldrick’s virtual shave party! <p>COVID-19 safety precautions are prompting a virtual version of this year&rsquo;s Sacramento St. Baldrick&rsquo;s Shave Party to raise money for childhood cancer research. So far, more than $23,000 has been raised to help fight pediatric cancer.</p> UC Davis Children’s Hospital pediatricians are going above and beyond the call of duty by going bald for childhood cancer research, and the world can watch. Tomorrow, April 23,  the annual St. Baldrick’s Sacramento shave party goes virtual at noon. 

So far, the UC Davis Pediatric Shavees have raised $5,552 for St. Baldrick’s. The team is a partnership between the UC Davis Comprehensive Cancer Center and Keaton’s Child Cancer Alliance. 

UC Davis pediatricians Mitch Ratanasen, Eric Crossen and Erik Orlando Fernandez y Garcia make up the top donor team. Fernandez y Garcia, alone, has raised $2,562 for St. Baldrick’s

“I grow my hair to donate to charities that create wigs for kids who have cancer,” said Fernandez y Garcia. “This year, I noticed that donations to St. Baldrick's were down because of COVID-19, so I thoughtwhy not let my shaved hair raise money for St. Baldrick’s, too?”  

Fernandez y Garcia said that he participated in St. Baldrick’s as a way of honoring his mother, who died of colon cancer in 2004. 

“I grew up in the Meadowview neighborhood, and it is so important to give back to your community, especially if it has carried a heavier cancer burden than other areas,” said Fernandez y Garcia. 

Other teams participating this year include Hair Goes Nothing, Cue Balls, Gear Heads for Kids and the UC Davis Police Department

Shavees seek financial pledges as they go bald for St. Baldrick’s, which is usually held at the cancer center auditorium on St. Patrick’s Day. This year, participants went to the Supercuts at 1589 W. El Camino Ave. in Sacramento where, for free, they were shaved bald for the camera. Others videotaped themselves at home as someone shaved their hair off. Videos of the head shavings were collected and have been uploaded to the St. Baldrick’s event site in preparation for the virtual shave party tomorrow night. So far, area teams have raised $26,607, with a goal of hitting $30,000 by tomorrow. 

The St. Baldrick’s Foundation, a volunteer-powered charity, funds more childhood cancer research grants than any organization except the federal government. Every two minutes a child in this country is diagnosed with cancer and one in five children diagnosed with cancer will not survive. Since St. Baldrick’s began, the five-year survival rate has risen from about 79% to 85%, but there are still cancers no child survives. 

It’s not too late to donate!

Go to the UC Davis Comprehensive Cancer Center registration site to support your favorite St. Baldrick’s shavees. To find out more, contact Catrina Arcularius at 916-276-5080 or email her at Catrina.Arcularius@childcancer.org

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202104_childrens-miracle-network-partner-costco-will-raise-funds-for-uc-davis-childrens-hospital-in-may Thu, 22 Apr 2021 07:00:00 GMT Children’s Miracle Network partner Costco will raise funds for UC Davis Children’s Hospital in May <p>Costco members and employees are not letting the pandemic stand in the way of making a difference for sick and injured kids. Shop online or in-store during Miracle Month and donations stay local to help kids treated at UC Davis Children&rsquo;s Hospital.</p> Beginning May 1, Children’s Miracle Network Hospitals’ biggest partner in hope will once again give shoppers the opportunity to support children treated at UC Davis Children’s Hospital. May is Miracle Month at Costco and despite the pandemic, the campaign is on track to run from May 1-31. 

All month long, shoppers will be invited to donate at checkout. A total of 18 Costco locations from Redding to Tracy will raise money in support of UC Davis Children’s Hospital. All funds raised locally stay local to support research, programs, equipment and clinical care. 

Although employees will maintain a focus on safety - with face coverings, register plexiglass and no small miracle balloons - they are determined to engage with customers to help them understand that kids can’t wait. 

“We are so grateful to Costco and its employees for their enthusiasm and dedication to this campaign,” said Michelle Tafoya, program director of Children’s Miracle Network at UC Davis. “Despite the many challenges of the pandemic, the teams remain committed to changing kids’ health and have found creative ways to share their enthusiasm and the mission of CMN at UC Davis with customers. The key is that these employees are in it for the kids. That’s why they ask and will keep asking. Every dollar makes a difference.” 

Costco participates in this month-long fundraising campaign at all warehouses in the United States and Canada. The annual Miracle Balloon Campaign is the primary source of the fundraising effort made by Costco and its partnership with Children’s Miracle Network Hospitals. Costco Wholesale has raised $464 million for Children’s Miracle Network Hospitals in the U.S. and Canada since 1987. Currently, more than 600 Costco locations participate in this fundraising campaign for their local Children’s Miracle Network Hospital.

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https://health.ucdavis.edu/health-news/children/childrens-miracle-network-partner-costco-will-raise-funds-for-uc-davis-childrens-hospital-in-may/2021/04
202104_ihi-and-daisy-foundation-honor-uc-davis-nurses-for-commitment-to-patient-care Mon, 19 Apr 2021 07:00:00 GMT IHI and DAISY Foundation honor UC Davis nurses for commitment to patient care <p>UC Davis Neonatal Intensive Care Unit (NICU) clinical nurse specialist Christa Bedford-Mu has been announced as the individual award recipient at this year&rsquo;s 2021 DAISY Awards for Extraordinary Nurses in Patient Safety, presented in collaboration with the Institute for Healthcare Improvement (IHI). Children&rsquo;s Hospital nurse educator Michelle Linenberger also received an Honorable Mention from the DAISY Foundation and IHI.</p> UC Davis Neonatal Intensive Care Unit (NICU) clinical nurse specialist Christa Bedford-Mu is the individual award recipient at this year’s 2021 DAISY Awards for Extraordinary Nurses in Patient Safety, presented in collaboration with the Institute for Healthcare Improvement (IHI). She is being honored for her clinical improvement achievements and unwavering commitment to supporting and educating the families of infant patients.

A trained wound treatment associate, Bedford-Mu has collaborated with several surgical units across UC Davis Medical Center to spread standardized approaches to multiple types of complex wounds and skin integrity issues. Her work, including implementation of a neonatal checklist, has contributed to significant reductions in post-operative complications, faster healing, and decreased risk of infection, which have led to reductions in lengths of stay and use of health care services. In addition, she has supported patient families with important post-discharge resources and the launch of a telehealth project to improve the NICU-to-home transition.

“Christa’s incredible dedication has helped infants and their families receive top-notch, innovative care and experience better outcomes,” said Toby Marsh, chief patient care services officer at UC Davis Medical Center. “Her consistent collaboration has ensured the highest quality, evidence-based care is implemented not only within UC Davis Medical Center, but across UC Davis Health and other community hospitals.”


Michelle Linenberger received an Honorable Mention from the DAISY Foundation and IHI.

Children’s Hospital nurse educator Michelle Linenberger also received an Honorable Mention from The DAISY Foundation and IHI. Linenberger received this special recognition for her commitment to a relationship-based culture, serving as an advocate for peer support, and her contributions to exceptional patient care in underserved communities.

“I am so incredibly honored to celebrate Christa and Michelle. They show patients compassion and extraordinary love, and through their efforts, they make the world a better place,” Marsh said.

Bedford-Mu and Linenberger will receive their awards at the IHI Patient Safety Congress 2021, which brings together people who are passionate about ensuring safe, equitable care for all. The virtual event will take place May 11-13.

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202104_sib-sacs-program-aims-to-provide-support-to-pediatric-patients-brothers-and-sisters Mon, 12 Apr 2021 07:00:00 GMT Sib Sacks program aims to provide support to pediatric patients’ brothers and sisters <p>Having a sick or injured child is stressful for the whole family, including brothers and sisters. Enter Sib Sacks, a Children&rsquo;s Miracle Network Hospitals-funded Child Life program designed to address siblings&rsquo; unique needs.</p> When a child is hospitalized, an enormous amount of stress is placed on a family. Routines are disrupted and much of the attention shifts toward the patient. Research has shown that this is often at the expense of siblings, who are at an increased risk of suffering emotional and psychological distress. That’s why UC Davis Children’s Hospital Child Life Specialists, Jessica Vroman and Joanna Davis, created the Sib Sack program. 

“Siblings experience significant changes when hospitalization occurs. These children feel left out or even resentful,” Davis said. “Sib Sacks were developed to help address the unique needs of patients’ brothers and sisters, particularly in the NICU where siblings can’t visit and parents often spend more time at the baby’s bedside than at home. This program was designed to foster positive coping skills and normalize the hospital experience for the whole family.” 

Funded by a Children’s Miracle Network Hospitals grant, the Sib Sack includes items like a “Worry Eater”, a stuffed monster with a zippered mouth that encourages siblings to write down their fears and place them in the Worry Eater’s mouth to be eaten up. Each sack also includes a coloring book, crayons, a small notebook, a stress ball, a superhero cape, and a Beads of Courage sibling kit. 

By creating a more inclusive, family-centered experience during hospitalization, Davis hopes to further improve the high quality care UC Davis Children’s Hospital and the Child Life and Creative Arts Therapy Department provide on a regular basis. 

“By incorporating siblings’ specialized needs into our care plan, we demonstrate to the entire family that we value each individual and realize hospitalization affects more than just the patient,” Vroman said. “Sib Sacks are a way to recognize and validate feelings and help foster communication, creativity, self-expression and most importantly, strengthen family ties. Although we just started giving the Sib Sacks out this year, the response has been great! Patient families appreciate knowing that we’re thinking of everyone, not just the sick or injured child.”

 

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https://health.ucdavis.edu/health-news/children/sib-sacs-program-aims-to-provide-support-to-pediatric-patients-brothers-and-sisters/2021/04
202104_unexpected-birth-in-uc-davis-medical-center-parking-garage- Fri, 09 Apr 2021 07:00:00 GMT Unexpected birth in UC Davis Medical Center parking garage <p>Off-duty Adventist Health Lodi Memorial labor and delivery nurse came to the rescue when Madison Fritter gave birth in the UC Davis Medical Center parking garage.</p> Auburn resident Madison Fritter thought she could make it. This was her second child and she thought she had more time. Her baby had other plans.

After her water broke in the middle of the night last month, Madison labored at home for about eight hours. Her contractions at home were far apart and very light when she headed to UC Davis Medical Center to deliver her baby.

“My contractions were moderate on the drive, but they picked up very suddenly only in the last few minutes of the drive. By the time my husband Michael parked the car, the baby was crowning,” Madison said.  

Walking into the hospital wasn’t an option. The baby was coming … and quick.

Michael and Madison’s sister Zoi sprang into action, grabbing blankets, pillows and shirts from the car to make a soft place to lie down. Madison’s mother was in a second car, bringing out sheets. A passing employee helped Madison get safely down onto the ground.

Within seconds, her baby boy was born and Zoi was there to catch him.  

Labor and delivery nurse and new mother Jenna Ricks heard a commotion in the parking garage and saw Madison lying right in front of her car.

When she realized Madison had just given birth, she stepped up to help.

“I am usually the one who runs to these situations, but on this day, I was just focusing on being a new mom. I didn’t think I would be helping someone give birth that day, but she needed help and it’s what I do,” said Jenna, who is a labor and delivery nurse at Adventist Health Lodi Memorial. 

Jenna helped with the delivery of the placenta and ensured that she was controlling blood loss. Meanwhile, Michael ran to the hospital front entrance for help. A security guard called the fire department to transport her into the emergency room. Jenna stayed with Madison until she was taken by gurney into the ER and saw that she was in good hands.


Baby Maverick was born 8 pounds, 2 ounces.

Baby Maverick was born 8 pounds, 2 ounces and is a healthy and happy baby boy, now at home with a unique birth story to someday tell.

“I’m thankful for Jenna,” said Madison, who said that they are now Instagram friends. “She really made sure that I was going to be okay. Everyone I encountered was there for me at the right time.”

Jenna said that the encounter was also life-changing for her.

She had just given birth a week before to her son Miles, who was very sick in the UC Davis Neonatal Intensive Care Unit (NICU).

“To be a part of this moment gave me the last bit of strength I needed to get through the rest of his hospitalization,” said Jenna.  Miles is now home and healthy. “If you believe in God or the universe, this was kismet. It was a celestial moment. She could have been anywhere, but she was right in front of my car.”

Related links

Auburn mother gives birth in UC Davis Medical Center parking garage with help of man named "Dave" - ABC10

Mother gives birth inside UC Davis Medical Center parking garage - KCRA

Baby Born In Parking Garage Of UC Davis Medical Center - CBS13 

Giving birth in a parking garage - Good Day Sacramento

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https://health.ucdavis.edu/health-news/children/unexpected-birth-in-uc-davis-medical-center-parking-garage-/2021/04
202104_even-before-covid-19-pandemic-youth-suicide-already-at-record-high Thu, 08 Apr 2021 07:00:00 GMT Even before COVID-19 pandemic, youth suicide already at record high <p>Isolation and distancing are amplifying challenges that children and teens already experience. Experts are worried that studies being conducted now will show a continued increase in suicide rates, which have been going up over the last decade.</p> Suicide rates have been on the rise. For the past 10 years, children and teens have been taking their own lives at alarming rates.

UC Davis Health adolescent medicine physician Laura Kester says the challenges that children and teens normally face have been amplified by isolation and distancing during the pandemic.

The rate of suicide for those ages 10 to 24 increased nearly 60% between 2007 and 2018, according to the Centers for Disease Control and Prevention (CDC). The CDC reported that suicide was the second leading cause of death among people ages 10-34 in 2018.

“I have most definitely felt the mental health challenges reflected in patient needs and interactions with me,” Kester said. “It unfortunately has been a hard time for adolescents, as for so many.”

We asked Laura Kester some frequently asked questions about teen suicide and what to watch for.

What are signs that parents should be looking for?

Many of the warning signs of suicide are also symptoms of depression, such as your child expressing that he or she feels like a burden, losing interest in usual activities or schoolwork, withdrawing from family and friends, neglecting one’s appearance, increasing substance use or acting out.

Other common signs include:

  • Increased anxiety
  • Unnecessary risk-taking
  • Feeling trapped or in unbearable pain
  • Lack of response to praise
  • Looking for a way to access lethal means
  • Increased anger, rage or irritability
  • Extreme mood swings 
  • Problems focusing
  • Running away
  • Expressing hopelessness
  • Changes in eating and sleeping habits that result in sleeping too little or too much and eating too little or too much
  • Talking, posting, or obsessing about death or wanting to die
  • Making plans for suicide
  • More physical complaints often linked to emotional distress, such as stomachaches, headaches, and extreme tiredness (fatigue)
  • Making plans or efforts toward committing suicide or writing a suicide note
  • Giving or throwing away important or favored possessions

What can you do as a parent if you’re concerned about your child contemplating suicide?

As a parent or guardian, try to be open in your communication with your child or children: let them know that you love them, support them, and are there to talk and listen. Try not to let them spend too much time alone. Pay attention to changes in behaviors or signs of withdrawal from regular activities. Safely secure all medications, substances or weapons at home.

If your child says they are anxious, depressed, want to hurt themselves or don’t want to be alive, do not downplay how they are feeling. It is important to take the warning signs seriously. If you are concerned and your child already has a mental health provider, contact that person for what you should do next. If your child doesn’t have one or if you are unable to reach that person, you should take your child for a full mental health evaluation.

What is the treatment for suicidal thoughts or ideation?

Treatment should be comprehensive and address physical and mental health needs. Mental health needs include therapy or family therapy. Family therapy can be important especially for adolescents, because of where the person is in life. Family members are the closest to the patient and also at times can be part of the stress factor. Treatment depends on factors like age and severity of the needs and can include inpatient, partial treatment, intensive outpatient or outpatient therapy. Treatment may also include medication.

Physical health needs include sleep, nutrition and physical activity, which all contribute to mental health, especially with adolescents. 

If you or someone you know are having thoughts of harming yourself, please reach out for help.

Additional Resources/ References

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https://health.ucdavis.edu/health-news/children/even-before-covid-19-pandemic-youth-suicide-already-at-record-high/2021/04
202104_wireless-monitors-mean-kids-receiving-intensive-care-will-soon-be-back-on-the-move- Mon, 05 Apr 2021 07:00:00 GMT Wireless monitors mean kids receiving intensive care will soon be back on the move <p>In the past, UC Davis Pediatric and Cardiac Intensive Care Unit patients were dependent on in-room monitors to provide critical vitals to staff. But now, a CMN-funded monitor conversion will give kids some freedom while hospitalized.</p> When COVID-19 protocols allow hospitalized children to leave their rooms again, patients in the pediatric intensive care unit and pediatric cardiac intensive care unit (PICU/PCICU) at UC Davis Children’s Hospital will be able to roam freely. Thanks to a Children’s Miracle Network Hospitals (CMN) grant, wireless technology is now in place. That means patients will be able to walk the halls of the unit, go for a ride in a wagon or stroller or go to the playroom while still being safely monitored. 

“Before the upgrade, when a patient wanted to move around, we couldn’t always accommodate them. They needed to stay connected to an in-room monitor so we could see the vital statistics of all patients centrally,  in real-time,” said nursing manager Virpal Donley. “And when kids were mobile, we’d have to detach the in-room monitor. Of course, we could still view vitals on the small screen, but we lost the ability to see it on our shared monitors. This upgrade changes that.” 

Now, wireless monitoring throughout the unit means patients can be out of their rooms and staff will still have access to their vitals via central screens, regardless of where the children are in the unit. It’s a win-win for staff and patients, and one more thing to look forward to post-COVID-19. 

“Once we can allow patients to safely leave their rooms and meet in group spaces, the children being treated in the PICU can experience some freedom. They can play in the playroom. They can enjoy just being kids. That’s the most important part,” said Judie Boehmer, executive director, patient care services at UC Davis Health. “I am so grateful to CMN for providing us with this technology to help normalize the hospital environment and provide the best experience for our pediatric patients and their families.”

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202104_child-with-mis-c-receives-life-saving-care-at-uc-davis-childrens-hospital Fri, 02 Apr 2021 07:00:00 GMT Child with MIS-C receives life-saving care at UC Davis Children’s Hospital <p>Six-year-old Santiago came down with chills that quickly progressed to a rash, high fever, headaches, vomiting and diarrhea. This is his journey with MIS-C, the condition that is associated with COVID-19 that affects children.</p> Six-year-old Santiago Alvarado’s first signs of Multisystem Inflammatory Syndrome in Children (MIS-C), the severe condition associated with COVID-19 that affects children, were some simple chills.

“He was playing outside and said, ‘Mom, I’m cold.’ He wasn’t interacting with the kids. He wasn’t being himself,” said Yesenia Alvarado, Santiago’s mother.

She thought maybe it was the flu. It was January – typically flu season.

She didn’t want to think it was the novel coronavirus and really didn’t want to think of MIS-C. She had read about how serious it can be and how it affects kids ages 4-12. She was worried.

The Centers for Disease Control and Prevention (CDC) reported that as of Feb. 1, 2021, the number of cases meeting the definition for MIS-C in the United States surpassed 2,000. The CDC reports that California has been the hardest hit, with more than 250 reported cases. It has disproportionately affected Black and Hispanic/Latino children.

A 105-degree fever leads to the ER

As days passed, Santiago’s condition worsened. Fevers. Stomach pain. A rash that look like little red dots on his stomach and back.

Yesenia had a video visit from their home in Stockton with her son’s local pediatrician. He suggested that they come in person for an appointment the next day. By the next day, though, Santiago was much worse with vomiting, diarrhea and a soaring fever of 105 degrees that wasn’t controlled by Tylenol or ibuprofen. His eyes and his hands were red. He complained of headaches.

Yesenia took him to the emergency room at Adventist Health Lodi Memorial and they tested him for COVID-19. His result was positive. From there, he was transferred to UC Davis Children’s Hospital for the specialty care that he needed. This was possible, thanks to UC Davis Health’s patient-centered partnerships with more than two dozen hospitals across Northern California, part of the academic health system’s work to improve access to care across the region.

“The common symptoms we see with MIS-C are fever, rash, gastrointestinal signs like vomiting and diarrhea. But many systems may be involved, including the lungs, the kidneys, even the brain and the heart. These children tend to be really sick, so parents won’t miss this,” said Natasha Nakra, pediatric infectious diseases physician at UC Davis Children’s Hospital, whose team has treated nearly two dozen children for MIS-C.

Two rounds of IVIG therapy

Santiago was diagnosed with MIS-C based on his fever and multisystem involvement. Laboratory tests confirmed this, showing markedly elevated levels of inflammation. A blood test confirmed a past COVID-19 infection.

He received intravenous immune globulin (IVIG) therapy, which is given in cases of severe disease. He was also treated with steroids and low-dose aspirin as a blood thinner because patients with MIS-C are at increased risk for blood clots. 

“Children generally respond very well to therapy, with prompt resolution of fever and feeling better,” Nakra said. “If they don’t respond to this first-line therapy, there are other treatments that we can give.”

In Santiago’s case, he needed IVIG therapy twice – but then felt much better.

“With that second dose, his rash went away. He stopped complaining of any pain and the headaches were gone,” Yesenia Alvarado said.  

He spent 10 days in the hospital then was discharged back home.

“It was our first time at UC Davis, and it was an amazing experience,” Yesenia Alvarado said. “Everyone was so nice to us.”

Follow-up care after MIS-C

Santiago has had follow-up care with the UC Davis Health pediatric cardiology team to check on his heart function since MIS-C can create inflammation of the arteries. Two weeks after he was discharged from the hospital, an echocardiogram showed that his heart was working normally. He continues to take low-dose aspirin. 

“Santiago seems back to normal now,” Yesenia Alvarado said. “We did notice a change in his appetite since he was on steroids. He was very hungry, but otherwise he is back to his usual self. We are thankful.”

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https://health.ucdavis.edu/health-news/children/child-with-mis-c-receives-life-saving-care-at-uc-davis-childrens-hospital/2021/04
202104_beads-of-courage-offers-visual-reminder-of-the-strength-resilience-of-young-patients--video Fri, 02 Apr 2021 07:00:00 GMT Beads of Courage offers visual reminder of the strength, resilience of young patients (video) <p>Emily Love&lsquo;s journey with leukemia is memorialized in beads. Every poke, every procedure, every hospitalization, measured in colorful little treasures. It&rsquo;s a visual story that could span the length of a room. Find out how the Beads of Courage program has supported our patients for more than 12 years.</p>
This video is best viewed in Chrome or Firefox.

Emily Love‘s journey with leukemia is memorialized in beads. Every poke, every procedure, every hospitalization, measured in colorful little treasures.

It’s a visual story that could span the length of a room.

There’s a large black bumpy bead that represents her mobility challenges. Emily’s refusal to walk was one of the first indications that something was wrong before her diagnosis.

The blue star represents surgery for her bone marrow biopsy.

The musical note was given to her for participating in music therapy at the hospital.

“Emily’s beads are reminders that she can overcome any test or procedure because she has already survived so much,” said Christina Love, Emily’s mother. “Now more than six years after treatment, Emily has this strand of beads as a tool to tell the story of her courage in her fight against leukemia.”

It’s the beauty of Beads of Courage, a national non-profit organization that integrates the use of beads, the earliest art form known to humans, as visible, tangible symbols of human experiences that need and deserve to be expressed. UC Davis Children’s Hospital has been a Beads of Courage member hospital for more than 12 years. There are currently 17  Beads of Courage member hospitals in California.  


Patient Emily Love wears her Beads of Courage.

At UC Davis Children’s Hospital, the Beads of Courage program supports cancer, heart, and neonatal intensive care unit (NICU) patients, as well as children with chronic conditions. The program has been funded in the past by the Keaton Childhood Cancer Alliance, Children’s Miracle Network at UC Davis and by the Child Life fund. It is currently supported solely by Donut Dash donations and by its founder Zack Wandell.

Every string of beads is different, based on the medical journey of the child. Different colored beads represent challenges that children faced:

  • Black beads are given for every poke
  • Yellow beads represent hospital stays
  • Act of Courage artist-made glass beads honor courage displayed during a milestone treatment
  • The Purple Heart bead is presented at the completion of treatment

“[Beads of Courage] brings some happiness into some awful situations and I’m just really thankful for it,” said Laura Little, who has two children with kidney disease who have participated in Beads of Courage program. She was so moved by the program at UC Davis Children’s Hospital that she decided to get a tattoo of Beads of Courage on her forearm.

Jenny Belke, Certified Child Life Specialist in the UC Davis Pediatric Infusion Room, said that the beads are a powerful reminder of what these children have endured with strength and bravery, one bead at a time.

“Many of our patients end up having hundreds of beads. It gives parents the opportunity to talk with their children, using the beads to show them, ‘This is everything you have been through. You were tough and you had courage, and we got through it as a family,’” Belke said.

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https://health.ucdavis.edu/health-news/children/beads-of-courage-offers-visual-reminder-of-the-strength-resilience-of-young-patients--video/2021/04
202103_pediatric-kidney-stone-program-adds-new-clinic-location Wed, 31 Mar 2021 07:00:00 GMT Pediatric kidney stone program adds new clinic location <p>UC Davis Health opens a second pediatric kidney stone clinic today in Sacramento. Located in the Glassrock Clinic, this new clinic provides comprehensive, multidisciplinary care for pediatric patients with kidney stone disease.</p> UC Davis Health opens a second pediatric kidney stone clinic today in Sacramento. Located in the Glassrock Clinic, this new clinic provides comprehensive, multidisciplinary care for pediatric patients with kidney stone disease.

In order to help manage pediatric kidney stone patients who are at high risk for kidney stone recurrence, this clinic brings together the knowledge and extensive experience of pediatric nephrologists, endourologists, a pediatric registered dietitian and a social worker. The team emphasizes imaging surveillance and dietary and medical prevention for recurrent kidney stone disease.

“We now provide a multidisciplinary team approach to care,“ said pediatric nephrologist Maha Haddad, who is part of the team. “The clinic offers a one-stop shop, so patients can see the team during one visit to manage and treat current kidney stone disease and prevent future kidney stones.”

Kidney stones have become more common in children and teens in the past 20 years, according to the American Academy of Pediatrics. Kidney stones occur when minerals and other substances normally found in urine join to form a hard stone in the urinary tract.

New patients can request a referral to the pediatric kidney stone clinic by calling 800-2-UCDAVIS (1-800-282-3284). Referring physicians can call 800-4-UCDAVIS (1-800-482-3284) and choose option 2.

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202103_hospitalized-kids-benefit-from-jersey-mikes-day-of-giving-this-wednesday-march-31 Tue, 30 Mar 2021 07:00:00 GMT Hospitalized kids benefit from Jersey Mike's 'Day of Giving' this Wednesday, March 31 <p>Jersey Mike&rsquo;s restaurant&rsquo;s 11th annual &lsquo;Day of Giving&rsquo; caps off month-long fundraiser for charity. Local franchisees to give all proceeds to help kids treated at UC Davis Children&rsquo;s Hospital.</p> Jersey Mike’s Subs continues its tradition of giving this Wednesday, March 31, when local stores will donate 100 percent of sales to UC Davis Children’s Hospital. It’s the Day of Giving, the culmination of a month-long fundraising event held annually in March. 

This nationwide Month of Giving fundraiser encourages Jersey Mike’s customers to donate throughout the month and on the final day of the event, March 31, franchise owners donate proceeds to the local charity. For the third year, area stores partnered with Children’s Miracle Network Hospitals (CMN) - the fundraising arm of UC Davis Children’s Hospital. All funds raised support research, equipment, programs and patient care for sick and injured children in the children’s hospital’s 33-county service area.  

“We are thrilled Jersey Mike’s chose to support us again in 2021,” said Michelle Tafoya, CMN at UC Davis program director. “The last year has been tough on a lot of businesses and nonprofits so having local franchise owners continue to show their commitment to kids’ health is especially impactful.” 

Since the first fundraiser in 2011, Jersey Mike’s annual Month of Giving has raised more than $32 million total for charities across the United States. The restaurant chain hopes to raise a record-breaking $8 million in 2021.

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https://health.ucdavis.edu/health-news/children/hospitalized-kids-benefit-from-jersey-mikes-day-of-giving-this-wednesday-march-31/2021/03
202103_transplant-provides-new-hope-for-14-year-old-with-chronic-kidney-disease Mon, 29 Mar 2021 07:00:00 GMT Transplant provides new hope for 14-year-old with chronic kidney disease <p>More than a year ago, 14-year-old Aija Hall and her mother Angela Lasseter received the devastating news that she had focal segmental glomerulosclerosis (FSGS), a disease in which scar tissue develops on the parts of the kidneys that filter waste from the blood.</p> Their lives changed in an instant.

More than a year ago, 14-year-old Aija Hall and her mother Angela Lasseter received the devastating news that she had chronic kidney disease.

She went from being a healthy pre-teen one day to being hospitalized at Kaiser Roseville with very high blood pressure, high creatinine levels (creatinine is a chemical that indicates if your kidneys are working well) and rapid heart rate the next day. She was having fluid buildup in her body.

The doctors took a biopsy and the results came back.

“They said, “It looks like both kidneys are gone,” Lasseter said.  

Aija was transferred to UC Davis Children’s Hospital to receive the specialty kidney care that she needed. Its pediatric nephrology program is ranked 25th nationally by U.S News & World Report’s Best Children’s Hospitals rankings in 2020-2021.

At UC Davis Children’s Hospital, she was diagnosed with focal segmental glomerulosclerosis (FSGS), a disease in which scar tissue develops on the parts of the kidneys that filter waste from the blood (glomeruli).

She would need dialysis. She had a long road ahead.

Dialysis – a bridge to transplant

Surgeons placed catheters in Aija’s neck and her belly to prepare her for dialysis treatment. Within a day or two after surgery, she began hemodialysis in the hospital. Slowly, her fluid buildup and swelling went down. Her numbers stabilized.

She would need 11 hours of dialysis every day. The UC Davis pediatric outpatient peritoneal dialysis program was a lifeline. The program is the only one in inland Northern California that offers home dialysis for patients as young as 10 years old or 44 pounds.

“I originally thought no. I was too stressed out. But I thought about it and prayed about it. I became her nurse at home,” Lasseter said.

She trained with pediatric dialysis nurse Bertha Ramirez-Preciado. Lasseter learned how to perform dialysis at home. The hospital delivered the machine to her home along with all of the needed supplies and fluids.   

“They give you everything you need and teach you step by step,” Lasseter said. “We’ve built really great relationships with the team and they have provided as much support as I needed.

By the summer of 2020, Aija was placed on the donor list for a kidney transplant. Her blood type was B positive, which is very rare. Lasseter knew she would wait much longer for a kidney donor with her blood type.  

“We held on,” Lasseter said.

Kidney transplant provides new hope

Her family will forever remember Feb. 2, 2021 as the day that Aija got a new kidney.

“I answered the phone and they said, ‘We have a kidney for her.’”

It was the call they had waited for … and it came more than one year after her diagnosis.

The UC Davis kidney transplant team took care of her. The UC Davis kidney transplant team ranks No. 7 in the country for total volume of kidney transplants and No. 1 in California for total number of deceased donor kidney transplants.

Now Lasseter is learning how to provide care for Aija post- transplant, juggling clinic visits three times a week, making sure that her daughter is drinking enough fluids and takes her anti-rejection medication at the correct times.

She said the journey has shown her what her daughter is capable of. It makes her proud to see what she has overcome.

“She is a fighter. She has a strong personality and she has faith. She never gave up. Even when she was really sick, she said, ‘Can I go to school?’ During the pandemic, she would still attend school regularly through distance learning,” she said.

Lasseter wants to share her story to let other families know that there is hope and that they can do it, too.

“If I can do it, they can do it. It’s so doable at home. Whenever you are in survival mode for your child, you can find the strength,” Lasseter said. 

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https://health.ucdavis.edu/health-news/children/transplant-provides-new-hope-for-14-year-old-with-chronic-kidney-disease/2021/03
202103_pediatric-patients-shine-at-creative-arts-festival-video Wed, 17 Mar 2021 07:00:00 GMT Pediatric patients shine at Creative Arts Festival (video) <p>The UC Davis Child Life and Creative Arts Therapy Department held their third annual Creative Arts Festival safely at the West Wind Drive-In Theater in Sacramento. A virtual art gallery highlighted 19 pieces of patient-made art and 17 patient-made films were screened.</p>
This video is best viewed in Chrome or Firefox.

In light of the COVID-19 pandemic, the UC Davis Child Life and Creative Arts Therapy Department needed to reimagine how they would honor their patients and safely celebrate the third annual Creative Arts Festival this year. 

In previous years, the festival has been an in-person red carpet gala with patients and their families gathering to view a gallery of patient-created artwork and movies. UC Davis Children’s Hospital’s partnership with BayKids Studios brings creative filmmaking to hospitalized children to improve their morale, self-confidence and sense of hope. 

The team dreamed big and found a new venue: the West Wind Drive-In Theater in Sacramento. 

“Patients and their families were able to attend the festival and receive their awards from the safety of their cars. It was truly a magical night, from touring through a virtual gallery of patient-created artwork, to watching their amazing films on a big screen,” said art therapist Katie Lorain. 

Nearly 50 patients and their families attended, along with 45 staff members. The evening began with a virtual art gallery, highlighting 19 pieces of art created by hospitalized children. This was followed by a slideshow awards presentation and film screening of 17 patient-made films, facilitated by BayKids Studios. The team announced each film individually and presented an award to each filmmaker before the screening. The artists received a photo book of all of the artwork as an award and filmmakers received personalized Oscars called “The Greatest Davis Awards.” 

“Instead of clapping, artists were celebrated by honking horns and cheering from cars. The creativity of the artists and the support from the attendees filled the air, making us all feel like we were closer than we actually were, demonstrating how art really does bring people together,” Lorain said. 

Links to some of the films that were screened

Riley’s X-Wing Fighter – Riley Blum
Jessenia’s Adventure – Jessenia Muro
Paloma the Dog – Isabella Garabay
The People - Yazmyne Zamudio Owens
Stay with Me – Jasmin Schwab
My Trip of Radiation - Anna Vande Pol
My Life with Sickle Cell – Amie Sesay
Yoshi’s Adventure - Cadel Perdue
Back in Black – Mimi Hall
Avengers Endgame – August Wold
13 Corners – Bill Hobson
Charlotte’s Nail Show - Charlie Morales

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202103_girl-gets-life-saving-dialysis-at-home-through-peritoneal-dialysis-program-video Thu, 11 Mar 2021 08:00:00 GMT Girl gets life-saving dialysis at home through peritoneal dialysis program (Video) <p>Launched in 2016, the outpatient peritoneal dialysis program at UC Davis Children&rsquo;s Hospital provides pediatric patients and their families with training on home-based peritoneal dialysis, while patients await a kidney transplant. It has been a lifeline for parents like Aija Hall.</p>
This video is best viewed in Chrome or Firefox.

Angela Lasseter has been performing dialysis at home for her 13-year-old daughter Aija, after she was diagnosed with chronic kidney failure last year.

“Aija needed dialysis for 11 hours every day so we learned to do this at home,” she said.

She was able to do so thanks to the outpatient peritoneal dialysis program at UC Davis Children’s Hospital. Medical staff train pediatric patients and their families to perform home-based dialysis while patients await a kidney transplant. The program was launched in 2016 and UC Davis Children’s Hospital is the only one in the region to offer outpatient dialysis for patients under 10 years of age or 44 pounds.

“They give you everything you need and teach you step by step,” Lasseter said. “We’ve built really great relationships with the team and they have provided as much support as I needed. If I can do this, anyone can do this,” she said. Lasseter performed dialysis at home for daughter for one year, until Aija successfully received a kidney transplant in January.

Some of the program’s highlights and its successes:

  • Zero exit site infections
  • Decreased peritonitis rates
  • High patient satisfaction levels
  • Virtual visits (telehealth appointments) for patients within the 33-county area that the hospital serves
  • Timely referrals to transplant in collaboration with the UC Davis Transplant Center
  • Provides home dialysis training in English and Spanish from two dedicated dialysis nurses
  • Offers home visits and 24/7 access to an on-call nephrologist for urgent questions and needs
  • Includes access to a patient support group where families on dialysis can connect with each other.
  • Dialysis machine, all supplies and fluids are delivered to the home
  • UC Davis Children’s Hospital is a member of the Standardized Care to Improve Outcomes in Pediatric Endstage Kidney Disease (SCOPE) collaborative, which prevents infections in children and adolescents on peritoneal dialysis and hemodialysis using large-scale collaboration to identify and spread effective interventions across pediatric care settings.

“Our patients have excellent outcomes and incredibly low infection rates. Many of our children require dialysis for 10-12 hours a day. Our program enables them to get that care safely at home from their parents or caregivers,” said UC Davis pediatric nephrologist Maha Haddad, who leads the program. “I’m very proud of the training that our team provides. We have not had one family refuse this training.

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https://health.ucdavis.edu/health-news/children/girl-gets-life-saving-dialysis-at-home-through-peritoneal-dialysis-program-video/2021/03
202103_duffle-bags-filled-with-essentials-give-sense-of-autonomy-dignity-to-at-risk-foster-youth Wed, 10 Mar 2021 08:00:00 GMT Duffle bags filled with essentials give sense of autonomy, dignity to at-risk foster youth <p>When children are discharged from the hospital and go into foster care, they typically leave with all of their possessions in a plastic bag. Now, thanks to pediatric social workers at UC Davis Children&rsquo;s Hospital, these children receive a MAARY bag to help during this difficult transition. MAARY is an acronym for Marginalized and At Risk Youth.</p> When children are discharged from the hospital and go into foster care, they typically leave with their few possessions in a plastic disposable bag. 

Now, thanks to pediatric social workers at UC Davis Children’s Hospital, those children receive a MAARY bag to help during this difficult transition. MAARY is an acronym for Marginalized and At Risk Youth. 

“Our aim is to provide an age-appropriate bag filled with a few personal items and toiletries that marginalized and foster care patients can call their own,” said UC Davis Licensed Clinical Social Worker DeAnne Bilotta Clark. “The goal is to help provide a sense of autonomy and dignity to our marginalized, at-risk and foster youth during an unstable and difficult time in his or her life.” 

MAARY bags are funded through donations made to the UC Davis Patient Assistance Support Fund, which also supports other projects for UC Davis Health patients and families. 

Each duffle bag includes a blanket, a pair of socks, a bag with toiletries (for school age children and older) and a night light for toddlers.   

UC Davis pediatric social workers anticipate that 24-30 pediatric patients a year will benefit from a MAARY bag. Since this program started last November, seven bags have been given out and have been welcomed warmly by these patients. 

“Seeing the smile on a child’s face when given something special they can call their own, this shows the true resiliency our kiddos have, to be able to show joy even in the most traumatic of situations,” Clark said.

 

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https://health.ucdavis.edu/health-news/children/duffle-bags-filled-with-essentials-give-sense-of-autonomy-dignity-to-at-risk-foster-youth/2021/03
202103_how-to-help-your-child-through-loss-sickness-due-to-covid-19 Fri, 05 Mar 2021 08:00:00 GMT How to help your child through loss, sickness due to COVID-19 <p>Since the pandemic started, many parents have wondered how to help their child(ren) cope with their fears and anxiety. In many cases, they&rsquo;re also helping children handle the illness or loss of a loved one due to COVID-19 as. Certified Child Life Specialist Marisa Martinez answers some frequently asked questions and provides tips and resources for parents and families.</p> Since the pandemic started, many parents have wondered how to help their child(ren) cope with their fears and anxiety. In many cases, they’re also helping children handle the illness or loss of a loved one due to COVID-19 as. Certified Child Life Specialist Marisa Martinez answers some frequently asked questions and provides tips and resources for parents and families. 

How should parents start conversations with their children to help address any fears or anxiety that they may have about COVID-19?

When helping children deal with their fears and anxieties, it is important to have open-ended conversations with the child to learn what misconceptions they may have and to be able to address their questions. This coloring book created by a Certified Child Life Specialist helps to explain coronavirus in an age-appropriate way. 

When children do ask questions, we do not always have the answers or know how to answer. This resource created by a child life student helps address children’s questions about COVID-19. If you are someone who likes podcasts, you can also listen to this podcast episode about using appropriate language while talking with children. 

Both children and adults see a lot of information through the news, social media and conversations between family and friends about this virus. Even if you think the children are not listening or do not understand, it is important to know that children are great observers and listeners but are sometimes not the best interpreters. Especially for children who are 7-8 years old and younger. Developmentally they can have a stage of “magical thinking” that influences their brain in a way that makes it difficult to separate reality from fantasy and this can create more misconceptions.

UC Davis Children’s Hospital will host a Facebook Live about child life month on March 31. Do you have questions?
Submit them here.

What are ways to help children when they have a sick family member or friend in the hospital?

When a loved one is in the hospital and critically ill due to COVID-19 or any other circumstances, saying goodbye from afar can be difficult when visiting is not allowed. Children need opportunities and choices to say goodbye to help them cope with the death. 

Some suggestions: 

  • Write a letter to their loved one
  • Draw a picture that they can choose to keep or send to their loved on in the hospital
  • Write a poem or song
  • Make a list of things they have learned from their loved one
  • Make a stone garden
  • Plant a tree
  • Bury a time capsule 

Here are more ideas from our Child Life and Creative Arts Therapy Department.   

How can we help our children cope with the loss of a loved one?

If someone in your life has died due to COVID-19, death and dying may be a concept you’re dealing with in your home. By encouraging your children to ask questions and by providing honest, age-appropriate information about death, you can help your child better understand and cope with this situation. 

Some ways to help your child: 

  • Allow your child to see your emotions. They will realize that sadness is a natural reaction to sorrow and loss and may feel more comfortable sharing their feelings with you. 
  • Make sure your child understands that the body has “stopped working” because of (fill in with clearly stated medical reason). 
  • Further explain by stating that the body is “no longer able to do the things it used to such as breathe, move, eat, see, hear, touch, taste, smell, grow, talk, play, think and feel.” 
  • Use concrete language, such as “die,” “dying,” and “dead,” instead of euphemisms such as “went to sleep,” “went away” or “we lost her/him.” Children think very literally. These phrases are unclear and may cause worry related to going to sleep, going away or getting lost. These phrases can also make it challenging for the child to understand the finality of the situation. Emphasize how the nurses and doctors tried everything possible to help their family member. 
  • It is important to remember that kids learn and process the world around them through play. Try to take advantage of being at home and use this time to engage with your children in games, toys, puzzles, books, music and art. This time in play may also help you recognize some of your child’s misconceptions and fears. 

It’s great to offer opportunities for children to engage in self-expressive activities, including art projects for loved ones, and you can utilize virtual tools to remain connected with friends and family. Try to make a routine for the day, when possible, so the child knows what to expect and has a sense of normalcy throughout the week. In this article you will find guidance on how to promote emotional resiliency and emotional regulation. 

These are trying times and many people are connected from this shared experience of being away from family members and feeling afraid of the unknown. Remember to lean on your loved ones and have open communication about what is going on and what can help you. 

What are some tips that you would recommend to help parents cope?

It is important to go easy on yourself as a parent/caregiver and remember that parental coping and self-care can positively impact your children’s coping. Everyone is balancing a lot and if you are able to do the smallest amount of self-care those are positive steps to promote effective coping. 

Some self-care ideas:

  • physical exercise
  • mindfulness
  • reading a book
  • getting in touch with your spirituality
  • deep breathing
  • taking a hot shower
  • finding time for gratitude   

For more resources related to COVID-19 and children’s coping and understanding, please visit the Association of Child Life Professionals

Related links

How to explain death and dying to your child

How to help children say goodbye from afar

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https://health.ucdavis.edu/health-news/children/how-to-help-your-child-through-loss-sickness-due-to-covid-19/2021/03
202103_when-to-start-potty-training-what-age-should-kids-start-and-do-boys-really-take-longer Wed, 03 Mar 2021 08:00:00 GMT When to start potty training: what age should kids start (and do boys really take longer)? <p>What parents need to know about potty training: What age should you start? Do boys really take longer? Why are kids learning at later ages? Here&rsquo;s the breakdown.</p> Potty training is an important developmental milestone. But sometimes it can be more stressful on the parents than it is for kids! 

Most children complete potty training by 36 months. The average length it takes kids to learn the process is about six months. Girls learn faster, usually completing toilet training two to three months before boys do. Firstborn children also tend to take longer to learn than their younger siblings, who pick up cues from the older kids. 

On their podcast Kids Considered, pediatricians Dean Blumberg and Lena van der List of UC Davis Children’s Hospital shared these five do’s and don’ts for potty training. Follow these tips to get started. 

1. DON’T start at an age you feel you need to. DO wait until your child is ready: physiologically, cognitively and emotionally.

For physiological readiness, your child must be able to control the sphincter, the muscle that holds and empties the bladder and rectum. This usually happens around 12-18 months. 

For developmental readiness, your child should be able to get to the toilet on their own, sit down, pull their pants up and down, and be able to communicate to you or another caregiver that they need to go. 

For emotional readiness, your child might show an interest in being potty trained. For example, they might go to the same spot in the house when they need to go. They might tell you when they want their diaper changed. Or they could show that they can hold it in for longer periods, like waking up from a nap with a clean diaper. This usually happens after age 2. 

2. DO get potty gear that makes the process easy and fun.

Consider getting a small potty seat. Or outfit your own toilet with an insert and stepstool. Let toddlers pick out the color or design! Getting underwear designed with your child’s favorite characters also makes training more exciting – make sure to get many pairs in case of accidents! Another tip: allow your child to play on the potty, starting with sitting on it fully clothed, so they can get used to it. Toilet training-themed books, videos, songs and games can also get your child more involved in the training process. 

3. DO be consistent and give lots of praise, DON’T force it or punish your child.

Create a plan for consistency. A common strategy is taking your child to the potty every 30 or 60 minutes for the first couple of days. If that goes well, try to extend the periods between tries; good times to encourage your child to use the toilet include upon waking up in the morning, after meals, before and after naps, and before bedtime. 

Choose a word your family is going to use for pee and poop. Stick to it! 

If your child doesn’t end up going after a minute or two on the toilet, don’t force it. Get up, move on and try again later. If they have an accident, don’t punish them. Help them clean up, show them what to do with their dirty underwear and how to change into new ones. 

Praise your child every time they make it to the potty, even if things don’t go as perfectly as you would like. Reward them with sticker charts in the bathroom or treats like a small candy – rewards are highly motivating for little kids! 

4. DO be prepared for common issues.

If your toddler is afraid of flushing or sad to see their poop disappear, try making it a fun game, like waving bye-bye as it floats away. 

Boys may have more success sitting down. Some might make a big mess standing up. Either way, this is all fine while training. 

Some kids may only want to potty with one parent. Others may want to go only at their daycare because their peers do. Encourage success where you can. 

If your child is struggling with constipation while pooping, consult your pediatrician before starting potty training. 

5. DON’T be frustrated if you experience setbacks.

Eighty percent of families will experience setbacks. Even if your child is successful making it to the bathroom during the day, it’s very common for them to still need diapers or pull-ups during naps and overnight. Most kids, by age 6, will be able to get through a night’s sleep without having an accident.

If your child isn’t making progress, stop the process and try again in another two or three months. Don’t let family or friends make you feel you have to do it a certain way or on a certain timeline. Every family and child’s situation is different!

Related links

Kids Considered – Potty Training episode

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https://health.ucdavis.edu/health-news/children/when-to-start-potty-training-what-age-should-kids-start-and-do-boys-really-take-longer/2021/03
202103_first-stem-cell-clinical-trial-for-spina-bifida-treatment-announced Mon, 01 Mar 2021 08:00:00 GMT First stem cell clinical trial for spina bifida treatment announced <p>A UC Davis Health team today announced the launch of the world&rsquo;s first FDA-approved human clinical trial to treat the most serious form of spina bifida. The trial involves the use of stem cells, applied during a surgery before birth.</p> A UC Davis Health team today announced the launch of the world’s first, FDA-approved human clinical trial using stem cells before birth to treat the most serious form of spina bifida

The condition is a birth defect that occurs when the spine and spinal cord don't form properly. Without treatment, an exposed spinal cord causes severe neurological damage, resulting in problems that can include lifelong cognitive, mobility, urinary and bowel disabilities.  

The one-of-a-kind treatment will be delivered while the baby is still in the mother’s womb (in utero). It will be the standard surgical procedure combined with the use of a unique stem cell “patch” to repair the defect before birth. 

The team anticipates seeing improvements for those born with the most severe form of spina bifida known as myelomeningocele (MMC). 

“Currently, the standard of care for our patients is fetal surgery, which, while promising, still leaves more than half of children with spina bifida unable to walk independently,” said Diana Farmer, professor and chair of surgery at UC Davis Health and principal investigator on the study. “There is an extraordinary need for a treatment that prevents or lessens the severity of this condition. Our team has spent more than a decade working up to this point of being able to test such a promising therapy.” 

In the United States, four babies a day are born with spina bifida (about 1 in every 2,700 live births each year). The condition leaves a portion of the spinal cord and nerves exposed without any bone or skin covering them. It causes a variety of problems because the spinal cord controls a person’s ability to move their legs and walk. It can also lead to extra fluid in and around the brain (hydrocephalus), causing brain injury. 


Stem cells are placed on the spinal cord using a special patch during fetal surgery (before birth) to repair the spina bifida defect.

Farmer, stem cell bioengineer Aijun Wang, and the clinical fetal treatment team led by Shinjiro Hirose, plan to treat six patients. During their procedure, the fetal surgeon will place a biological scaffold of special stem cells (in this case, placental mesenchymal stem cells) directly over the exposed spinal cord. The surgeon will then close the opening in the baby’s back to allow the tissue to regenerate and protect the infant’s spinal cord. 

The clinical trial, known formally as the “CuRe Trial: Cellular Therapy for In Utero Repair of Myelomeningocele,” is funded by the state’s stem cell agency, CIRM. Working with the UC Davis School of Veterinary Medicine, the team tested the stem cell patch and surgical repair in animals with the MMC defect. They found that it enabled the animals born with spina bifida to walk. It also showed that the stem cell treatment was safe in animals. 

“We anticipate being able to safely and successfully repair the birth defect that occurs when the protective tissue around a baby’s developing spinal cord fails to fully close before birth,” said Wang, an associate professor of surgery and biomedical engineering, and co-director of UC Davis’ surgical bioengineering laboratory. “Our cellular therapy approach, in combination with surgery, should encourage tissue regeneration and help patients avoid impairments throughout their lives.” 

Farmer and Wang’s team has generated the stem cells for the study from placental tissue. The cells are known to be among the most promising type in regenerative medicine. They have been produced and screened in a highly specialized facility within UC Davis’ Institute for Regenerative Cures in Sacramento.

“We’ve been preparing for this  important clinical trial for many years,” said Jan Nolta, director of the UC Davis Stem Cell Program. “We often call these mesenchymal stem cells the ‘paramedics’ of the body because they produce healing factors. They are ideal for repairing damaged tissues in something like spina bifida. Plus, our Good Manufacturing Practice (GMP) facility ensures that the stem cells will be free of infection and properly specialized according to FDA guidelines.”


Babies who have this surgery will be closely monitored to evaluate effects of the stem cells.

Wang and Farmer said the incidence of spina bifida in California, with a disproportionately high rate among babies of Hispanic or Latino descent, makes their study all the more timely and important.

“A successful treatment for MMC would relieve the tremendous emotional and economic cost burden on families,” Farmer added. “We know it initially costs approximately $532,000 per child with spina bifida. But the costs are likely several million dollars more due to ongoing treatments, not to mention all the pain and suffering, specialized childcare, and lost time for unpaid caregivers such as parents.”

Farmer has been working toward this human clinical trial for spina bifida for more than a decade. She launched the Fetal Care and Treatment Center at UC Davis Children’s Hospital with Hirose in preparation for advancing the standard of care. Generous research grants from CIRM also enabled her research team to explore a full range of clinical approaches prior to securing FDA approval for their first human patients.

Patients in the clinical trial will be monitored by the research team for 30 months after they are born to fully assess the stem cell surgical procedure’s safety and effectiveness.

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https://health.ucdavis.edu/health-news/children/first-stem-cell-clinical-trial-for-spina-bifida-treatment-announced/2021/03
202102_easter-basket-supplies-needed-for-hospitalized-children Fri, 26 Feb 2021 08:00:00 GMT Easter basket supplies needed for hospitalized children <p>UC Davis employees, students and the public are invited to make Easter special for children hospitalized at UC Davis Children&rsquo;s Hospital this year, by helping to provide Easter baskets filled with goodies. The UC Davis Child Life and Creative Arts Therapy Department is currently accepting donations for Easter basket supplies through their Amazon wish list.</p> UC Davis employees, students and the public are invited to make Easter special for children hospitalized at UC Davis Children’s Hospital this year, by helping to provide Easter baskets filled with goodies.

The UC Davis Child Life and Creative Arts Therapy Department is currently accepting donations for Easter basket supplies through their Amazon wish list. Items requested range from $4 Mad Lib books to $20 Play-Doh eggs.

“We hope we can bring some cheer to our patients and their families who are spending Easter in the hospital. We would love to provide them with the tradition of Easter baskets,” said Katherine Macdonald, programming coordinator in the UC Davis Child Life and Creative Arts Therapy Department.

Items purchased through the Amazon wish list will be delivered directly to the hospital. Items must be received by April 1, 2021.

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https://health.ucdavis.edu/health-news/children/easter-basket-supplies-needed-for-hospitalized-children/2021/02
202102_casey-dyke-lives-normal-teen-life-after-12-surgeries-for-tricuspid-atresia-cholesteatoma-video Thu, 25 Feb 2021 08:00:00 GMT Casey Dyke lives normal teen life after 12 surgeries for tricuspid atresia, cholesteatoma (video) <p>Casey Dyke has been told he is a mended little miracle. With 12 surgeries for tricuspid atresia and cholesteatoma under his belt, he is now 16 years old and living his best life.</p>
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Casey Dyke has been told he is a mended little miracle. 

When his mother Gina Dyke was pregnant, a routine ultrasound and prenatal testing at UC Davis Health revealed that her unborn son had a missing tricuspid valve (a congenital heart defect known as tricuspid atresia). He would need a series of surgeries to repair the defect after birth. 

Casey was Gina and Michael’s first baby and the news was devastating. 

"We literally didn't know if he was going to make it, and we were scared to ask," said Gina Dyke. "All you're thinking is, 'He has to live.’” 

“Dr. Raff is a superhero,” said Michael Dyke. “He was really there for Casey and he really helped us with what we were going through as new parents.”   

Gina was induced and Casey was born three weeks early, after doctors saw that his heart rate was dropping in the womb. Casey’s first surgery – the Norwood procedure to reconfigure his heart and circulatory systems – took place only 10 days after his birth. Over the next four years, Casey would have four open-heart surgeries, all performed by UC Davis pediatric cardiothoracic surgeon Gary Raff from the UC Davis Pediatric Heart Center

“Dr. Raff is a superhero,” said Michael Dyke. “He was really there for Casey and he really helped us with what we were going through as new parents.”   

Raff said that being able to participate in the care of a critically ill child is a big responsibility.

“It’s why we do what we do. It’s not just our surgical expertise that we provide but also patient-centered care, making sure we are taking care of the family during their time of need and helping them see there is a bright future ahead,” Raff said.   

The Dyke family turned to UC Davis Health once more when they learned that Casey was having trouble hearing. He had more surgeries ahead. There were ear tubes – twice – and then he had his adenoids removed. His ear surgeon Rodney Diaz found the answer:  Casey had a cholesteatoma, a fluid-filled cyst that can develop behind the ear drum, and it was surgically removed. The cholesteatoma caused permanent damage to his left ear. He wears a hearing aid, but it doesn’t hold him back from living his life.  

All in all, Casey has had 12 surgeries. Gina and Michael Dyke estimate that he spent a year in the UC Davis Pediatric and Cardiac Intensive Care Unit (PICU/PCICU) at UC Davis Children’s Hospital, off and on, recovering from those surgeries and battling other health problems during his childhood. It has become a home away from home. The team has become like family, they said.   

Now 16 years old, Casey is living a normal teenage life. He enjoys photography, fishing and being outdoors. He is smart and is considering a career in engineering. His future is bright.   

"It's amazing that a boy born with the odds against him can go on to have such a normal life. I'm extremely grateful for what UC Davis has done for him," Gina Dyke said. 

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https://health.ucdavis.edu/health-news/children/casey-dyke-lives-normal-teen-life-after-12-surgeries-for-tricuspid-atresia-cholesteatoma-video/2021/02
202102_boy-receives-life-changing-cardiac-catheterization-for-rare-heart-condition Wed, 24 Feb 2021 08:00:00 GMT Boy receives life-changing cardiac catheterization for rare heart condition <p>Twelve-year-old Dane Gaffney had an extremely rare case that many pediatric cardiologists may see once in their career or not at all. Coarctation of the aorta is usually caught early in infancy and if left untreated as an infant, is fatal.</p> It was an extremely rare case that many pediatric cardiologists may see once in their career or not at all.

Twelve-year-old Dane Gaffney came to the UC Davis pediatric cardiology clinic last month with high blood pressure and a heart murmur.

 An initial ultrasound of his heart showed a congenital heart defect (CHD) called coarctation of the aorta (COA). He was brought to the Cath Lab. An aortic angiogram (a test that uses X-ray imaging to see blood vessels in the heart) revealed that Dane, in fact, had no blood flow down the aorta, the major vessel that supplies blood to the lower half of his body. Instead, multiple tiny collateral vessels came off the aorta in the upper half of the body, made their way through the chest and re-entered the lower half of the aorta. This severe abnormality is usually caught early in infancy and if left untreated as an infant, is fatal. 

“The fact that he made it to the age of 12 without any symptoms of having this congenital heart defect is unfathomable, especially since he was so active in sports. His body had an uncanny way of maintaining blood flow to the lower body via a vast network of tiny collateral vessels,” said Frank Ing, chief of pediatric cardiology at UC Davis Children’s Hospital

Dane enjoys basketball, mountain biking and skiing. His congenital heart defect never slowed him down. 

COA occurs when a part of the aorta (the main artery that carries blood from the heart to the body) is narrowed. In Dane’s case, a part of the aorta most likely started as a narrowing and progressed to becoming completely blocked. Ing suspects that it probably occurred over a long period of time, allowing his body to develop a network of pathways to get blood around the blockage.   


Dane Gaffney skiing this past winter.

“The analogy of this problem is this: A 10-lane highway is like the aorta and cars going along the highway is the blood. If there’s an accident and eight lanes are blocked with only a two-lane highway for cars to drive through, what do the cars do?” Ing asked. 

“They exit off the freeway and take local streets and alleys until they can get back on the highway further down where it’s opened back up. The local streets and alleys are the collaterals. In Dane’s extreme case, the highway was completely blocked, but his body was able to make many small collaterals, so he didn’t have any symptoms other than high blood pressure.”  

To open up the proverbial highway again, Ing performed an interventional cardiac catheterization.  

Ing inserted two tiny catheters into two blood vessels from Dane’s groin, one to the aorta above the blockage and one below the blockage. He used a thin, stiff wire to thread across the blockage from above into the lower aorta and then snared that wire with the catheter in the lower aorta. Using the wire as a rail, Ing initially inflated a tiny balloon at the blockage to widen the area and then serially enlarged the area with sequentially larger balloons. Finally, he implanted a covered stent to keep the vessel open. 

The procedure took more than seven hours and successfully repaired Dane’s heart defect. Dane was left with no scars, except for two tiny puncture holes where the catheters were inserted. Dane stayed in the hospital overnight and was released the next day. No big open-heart surgery to recover from since the procedure was minimally invasive. His blood pressure normalized immediately after the procedure. 


Images of Dane’s aorta before and after the stent implant. In the second image, notice the tiny collateral vessels are gone and the main vessel is wide open.

“Everyone at UC Davis Children’s Hospital was great. The thing I liked the most was that the doctors and nurses spoke directly to Dane, making sure that he knew what was going on, instead of only talking directly to Scott and me. I thought that was really cool,” said Dawn Gaffney, Dane’s mother. 

Dane will continue to be monitored by Ing as he grows. No surgeries are in his future. 

As Dane grows into adulthood, the implanted stent will be further widened to accommodate his growth.  Fortunately, all future procedures can be interventional and non-surgical, which can be completed in the Cath Lab. The stent that Ing selected can be further dilated to the normal adult-size aorta.  Currently, Dane is scheduled to have another Cath procedure in six months to further widen the stent. 

“Dane is pretty much back to normal now,” said Dane’s dad Scott Gaffney. “He can’t do anything jarring for the next six weeks but then he can gradually get back to normal activity. We are extremely thankful.”

 

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https://health.ucdavis.edu/health-news/children/boy-receives-life-changing-cardiac-catheterization-for-rare-heart-condition/2021/02
202102_after-bumpy-start-to-life-thea-gets-care-she-needs-from-uc-davis-health Mon, 22 Feb 2021 08:00:00 GMT After bumpy start to life, Thea gets care she needs from UC Davis Health <p>Shortly after birth, Thea experienced trouble breathing. She was transferred to UC Davis Children&rsquo;s Hospital, where she was diagnosed with Stickler Syndrome with Pierre Robin Sequence, two genetic disorders that can cause vision, hearing and joint problems, as well as a U-shaped cleft palate and breathing difficulties.</p> Thea Olender’s first days of life were dramatic.

She was born in her parents’ car on the way to Sierra Valley Memorial Hospital in Grass Valley. Within minutes of arriving there, Thea began having difficulty breathing and the team transferred her to Mercy San Juan Medical Center in Carmichael for care.

An early X-ray appeared to show that Thea’s esophagus and trachea were fused together. It would require specialty care that UC Davis Children’s Hospital could provide, so Thea was transferred.

This was possible thanks to patient-centered partnerships with more than two dozen hospitals across Northern California, as UC Davis Health works to improve access to care for people across the region.

“We had great prenatal care and we were thrown into this great unknown, with a baby who couldn't breathe. We had no warning that this could happen,” said Mary Olender, Thea’s mother.

Later X-rays showed that Thea’s esophagus and trachea actually were not fused together. But genetic testing revealed that Thea was born with Stickler Syndrome with Pierre Robin sequence, two genetic disorders that can occur together, causing vision, hearing and joint problems, as well as a U-shaped cleft palate and breathing difficulties.

“The NICU team really engulfs you and does everything they can to make you feel completely cared for. I felt like I became part of a small family that truly cared for my baby.”

— Mary Olender

Part of the NICU family

It was a lot to take in at first.

“We have eight other kids between us, and to spend nearly six weeks in the NICU was absolutely life altering. We weren't prepared and we really had to rally,” Olender said. “The NICU team really engulfs you and does everything they can to make you feel completely cared for. I felt like I became part of a small family that truly cared for my baby.”

Olender recalls the reassurance of having a care team available to answer all of her questions at all hours. She remembers small kindnesses like the child life specialist who brought books for Mary to read to Thea and interacted with Mary’s other children when they visited the hospital.

“Spending time in the NICU is an experience I will really never forget. It's very surreal, and I am truly indebted to the team there,” she said.

Life after her hospital stay

After she was discharged from the hospital, Thea continued to receive care from the UC Davis Pediatric Gastroenterology Team, where she received a Gastrostomy Tube (G-Tube), a surgically placed device that provides direct access to the stomach for feeding, for the first 18 months of life. She no longer needs a G-tube.

Thea also had ear tubes placed and her jaw and palate repaired by the UC Davis Cleft and Craniofacial team before she turned one year old. She continues to be followed annually by this care team to ensure her hearing and development are on track.

Now nearly 3 years old, Thea enjoys imaginative play and spending time with her cats and chickens at home. She is an animal lover.

“Thea is thriving and doing amazing, and we are continually thankful for our UC Davis team!” said Olender.

 

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202102_transport-nurses-day-recognizes-team-for-life-saving-care Thu, 18 Feb 2021 08:00:00 GMT Transport Nurses Day recognizes team for life-saving care <p> The UC Davis Children&rsquo;s Hospital Transport Team specializes in bringing an advanced level of care to infants and children at surrounding community hospitals, where&nbsp;appropriate resources may not be available.</p>
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UC Davis Children’s Hospital has a dedicated children’s transport team available to a 33-county area – and sometimes beyond – 24 hours a day, seven days a week. The team specializes in bringing an advanced level of care to infants and children at surrounding community hospitals, where appropriate resources may not be available. Today is Transport Nurses Day and we celebrate this team.

More than 700 children are transported each year to UC Davis Children’s Hospital by members of the Children’s Hospital Transport Team. Transport team members have extensive experience and training to perform this specialized role. When a critically ill or injured newborn, infant, or child needs a higher level of care, the team is dispatched to transport them quickly and safely to UC Davis Children’s Hospital. 

Who is the UC Davis Children’s Hospital Transport Team?

The team is comprised of 30 expanded role nurses with pediatric and neonatal critical care backgrounds and supervised by a UC Davis neonatologist or pediatric intensivist. When a transfer request for a higher level of care comes in, the attending physician at UC Davis Children’s Hospital discusses the case with the sending physician on a conference line, while the transport nurses listen in. 

When a decision is made to send the team, they then select the most efficient form of transport possible. They can fly with a contracted flight company using a fixed-wing aircraft or helicopter or go by ground in the specialized UC Davis Children’s Hospital ambulance.

The UC Davis Children’s Hospital transport program started in 2004. In their first year, the team completed 300 to 400 transports.

“The transport team is, many times, the first interaction patients and families have with UC Davis Children’s Hospital,” said Laura Kenny, assistant program manager of the Children’s Hospital Transport Team.  

What care do transport nurses provide?

The best care begins with the right training, but also requires the right equipment. The transport team nurses are trained to intubate and manage ventilators, when necessary. Inhaled nitric oxide is available for neonatal and pediatric patients with pulmonary hypertension. Two state-of-the-art transport isolettes, or incubators, are available. These isolettes are equipped with the latest medical equipment to aid in providing the high level of care required for the most vulnerable neonatal patients. High-flow nasal cannula is also available for both neonatal and pediatric patients.    

The UC Davis Children’s Hospital ambulance is funded by the Children's Miracle Network at UC Davis

For questions and additional information regarding the UC Davis Children’s Hospital Transport Team, please contact Laura Kenny, assistant program manager, at 916-734-1033. 

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202102_uc-davis-childrens-hospital-annual-report-now-available Wed, 17 Feb 2021 08:00:00 GMT UC Davis Children’s Hospital Annual Report now available <p>The latest edition of the UC Davis Children&rsquo;s Hospital Annual Report is now available. The publication covers2019-2020, an historic year that included the coronavirus and the separation of craniopagus twins.</p> The latest edition of the UC Davis Children’s Hospital Annual Report is now available. The publication covers a year in review from 2019-2020.

“Although these are unprecedented times, our pediatric academic medical center has been steadily going strong,” said Satyan Lakshminrusimha, Diana Farmer and Judie Boehmer in their welcome letter. “We’ve drawn more national recognition in patient care, research and quality improvement initiatives. Recognition is important to our mission, but what we are most proud of is the extraordinary care and comfort we continue to provide to children and their families throughout the region.”

The annual report includes an overview of the past year, including ways that our clinicians were leaders during the COVID-19 pandemic, patient testimonials, research breakthroughs, new distinctions and more.

View the annual report online or download the printed version.

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202102_uc-davis-medical-center-recognized-for-higher-quality-in-maternity-care- Thu, 11 Feb 2021 08:00:00 GMT UC Davis Medical Center recognized for higher quality in maternity care <p>UC Davis Medical Center is proud to be recognized by Blue Shield of California with a Blue Distinction Centers (BDC) for Maternity Care designation, as part of the Blue Distinction Specialty Care program.</p> UC Davis Medical Center is proud to be recognized by Blue Shield of California with a Blue Distinction® Centers (BDC) for Maternity Care designation, as part of the Blue Distinction Specialty Care program.

Racial and ethnic disparities are persistent and widespread across maternal healthcare, primarily driven by socioeconomic status, geographic location, and implicit provider bias. Compared to similarly developed countries such as Canada, Germany, and Australia, the United State has the highest maternal mortality rate (MMR), at approximately 17.4 deaths per 100,000 live births, with the MMR steadily increasing since 2000[1]. According to the CDC, non-Hispanic Black women are two to three times more likely to die from preventable or treatable pregnancy-related complications compared to white women[2].

To help address these gaps in care and to help ensure the better health of mothers, The Blue Cross Blue Shield Association enhanced its quality evaluation for the Maternity Care program to address key factors driving the United States’ maternal health crisis such as preventable or treatable pregnancy-related conditions, high utilization of Caesarean sections, and racial and ethnic disparities in maternal healthcare. In 2018, facilities that received designations under the Blue Distinction Centers for Maternity Care program cared for more than 40% of Blue Cross and Blue Shield commercially insured women giving birth across the country.

UC Davis Medical Center is proud to be recognized by Blue Shield of California for meeting the rigorous BDC quality selection criteria for maternity care set by the Blue Distinction Specialty Care program.

In 2020, the Blue Distinction Centers for Maternity Care Program was expanded beyond traditional outcome measures to include assessments of internal quality improvement, data collection and dissemination, and internal protocols that better address clinical quality and equity issues in maternity care. New in the evaluation cycle, facilities must collect race ethnicity data, have a maternal quality improvement program, commence drills and simulations for adverse events, and have dedicated protocols and procedures for the management of hypertension and hemorrhage. In addition, they must meet clinical outcome metrics at a higher standard than required previously. Specifically, the rate for low risk first time cesarean sections (NTSV c-section rate, PC-02) has been aligned with the revised Healthy People 2020 goals. Facilities eligible for the Blue Distinction Centers for Maternity care show statistically significant differences in key clinical outcomes compared to their peers.

Since 2006, the Blue Distinction Specialty Care program has helped patients find quality specialty care in the areas of bariatric surgery, cancer care, cardiac care, cellular immunotherapy, fertility care, gene therapy, knee and hip replacement, maternity care, spine surgery, substance use treatment and recovery, and transplants, while encouraging healthcare professionals to improve the care they deliver. Research shows that, compared to other providers, those designated as Blue Distinction Centers demonstrate better quality and improved outcomes for patients.

All companies and trademarks listed above are the property of their respective owners and used for identification purposes only,  and are in no way associated or affiliated with the Blue Cross Blue Shield Association. Use of these trademarks does not imply endorsement. The Blue Cross® and Blue Shield® names and symbols and Blue Distinction® are registered trademarks of the Blue Cross Blue Shield Association.

About Blue Shield of California

Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable. Blue Shield of California is a tax paying, nonprofit, independent member of the Blue Cross Blue Shield Association with over 4 million members, 6,800 employees and more than $20 billion in annual revenue. Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare service plans in California. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have an impact on California communities.

For more news about Blue Shield of California, please visit news.blueshieldca.com.

Or follow us on LinkedIn, Twitter, or Facebook.

About the Blue Cross Blue Shield Association
The Blue Cross Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through The Health of America Report series and the national BCBS Health IndexSM. For more information on BCBSA and its member companies, please visit bcbs.com. We also encourage you to connect with us on Facebook, check out our videos on YouTube, follow us on Twitter and check out our blog.

About Blue Distinction Centers
 Blue Distinction Centers (BDC) met overall quality measures, developed with input from the medical community. A Local Blue Plan may require additional criteria for providers located in its own service area; for details, contact your Local Blue Plan. Blue Distinction Centers+ (BDC+) also met cost measures that address consumers’ need for affordable healthcare. Each provider’s cost of care is evaluated using data from its Local Blue Plan. Providers in CA, ID, NY, PA, and WA may lie in two Local Blue Plans’ areas, resulting in two evaluations for cost of care; and their own Local Blue Plans decide whether one or both cost of care evaluation(s) must meet BDC+ national criteria. National criteria for BDC and BDC+ are displayed on www.bcbs.com. Individual outcomes may vary. For details on a provider’s in-network status or your own policy’s coverage, contact your Local Blue Plan and ask your provider before making an appointment. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for noncovered charges or other losses or damages resulting from Blue Distinction or other provider finder information or care received from Blue Distinction or other providers.

[1] https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm

[2] https://www.cdc.gov/mmwr/volumes/68/wr/mm6835a3.htm?s_cid=mm6835a3_w

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202102_carmichaelcitrus-heights-clinic-now-offers-pediatric-gastroenterology-services Wed, 10 Feb 2021 08:00:00 GMT Carmichael/Citrus Heights Clinic now offers pediatric gastroenterology services <p><span>Pediatric gastroenterology services are now offered at the UC Davis Health Carmichael/Citrus Heights Clinic. UC Davis pediatric gastroenterologists Arthur de Lorimier and Kelly Haas will provide service at this clinic twice a month.</span></p> Pediatric gastroenterology services are now offered at the UC Davis Health Carmichael/Citrus Heights Clinic.


The Carmichael and Citrus Heights Clinic now offers GI services to pediatric patients.

UC Davis pediatric gastroenterologists Arthur de Lorimier and Kelly Haas will provide service at this clinic on the first and third Thursday of each month from 8:30 a.m. to 4:30 p.m. The team is currently accepting patient referrals from other hospitals. 

“Families can receive care closer to home, now that we have expanded our world-class pediatric GI care to the Carmichael and Citrus Heights Clinic,” said de Lorimier.

The team currently treats the following conditions:

  • Allergic enteropathy
  • Biliary tract disease
  • Constipation encopresis
  • Crohn's disease
  • Diarrheal disorders
  • Eosinophilic esophagitis and GI allergy
  • Inflammatory bowel disease
  • Inherited metabolic and immunological defects involving the intestine
  • Intestinal failure
  • Malabsorptive conditions - food cannot pass properly from the small intestine to the rest of the body (celiac disease)
  • Pediatric gastroesophageal reflux
  • Pediatric liver disease
  • Peptic ulcer disease
  • Recurrent abdominal pain
  • Short bowel syndrome

The clinic is located at 7551 Madison Ave., Citrus Heights. To schedule an appointment, call 800-UCD-4-KIDS or 916-734-7439. Find out more about the clinic.

 

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202102_uc-davis-health-paper-shows-how-simulation-education-helps-learners-identify-report-patient-safety-hazards Tue, 09 Feb 2021 08:00:00 GMT UC Davis Health paper shows how simulation education helps learners spot patient safety hazards <p>A paper was recently published in Pediatric Emergency Care highlighting the success of a simulation activity focused on helping health professions students and trainees identify and report patient safety hazards in the emergency department.</p> Almost a year before the coronavirus pandemic began, quality improvement leaders at UC Davis Health and educators at the UC Davis Center for Simulation and Education Enhancement created a simulation activity to help health professions students and trainees identify and report patient safety hazards in the emergency department.

The success of the activity is outlined in a paper recently published in Pediatric Emergency Care, a journal for both pediatricians and emergency physicians focused on publishing clinically relevant information about caring for sick and injured children. The paper, entitled “‘Good Catch, Kiddo’ – Enhancing Patient Safety in the Pediatric Emergency Department Through Simulation,” highlights how simulation is beneficial in helping learners identify and report hazards.

Ian Julie, associate professor of emergency medicine and medical director for the simulation center, said the results show the participants – which included second-year and fourth-year medical students, emergency medicine interns and pediatric interns – identified safety hazards at comparable rates despite having varying levels of education.

“There is great value in this type of training for a wide range of learners,” Julie said. “It’s one thing to hear about patient safety hazards, but we were able to provide an interactive situation where the potential for hazards can be identified and reported in a true-to-life fashion.”

“We saw a significant boost in self-efficacy for all the learners, with the largest increase in second-year medical students starting clinical clerkships,” said JoAnne Natale, professor of pediatrics and director for quality and safety at UC Davis Children’s Hospital. “It was exciting to see such a marked change.”

During the activity, three to five learners went into a simulated pediatric emergency department room for 10 minutes to take note of as many potential hazards to patient safety as they could find, such as a missing patient identification band, choking hazards, incorrect patient discharge paperwork, fall hazards, and an undated intravenous catheter.


Health professions students and trainees identify patient safety hazards as part of a simulation activity in 2019. (pre-pandemic photo)

Hazards related to situational safety, patient identification, infection risk and treatment errors were identified at the highest frequency. Safety hazards associated with the electronic health record were identified at the lowest frequency and included multiple patient charts and unsigned orders open.

“This activity reinforced how important it is to prioritize training around proper use of the electronic health record so that breaches in privacy and security do not occur,” said Ulfat Shaikh, lead author of the paper, professor of pediatrics, and medical director of health care quality at UC Davis Health. “We must continue to foster a culture of transparency by using non-punitive reporting systems to track and prevent medical errors and other safety hazards.”

“Our work shows that students and trainees view their clinical environments with fresh eyes and can pick up safety hazards before they result in harm to patients; they can play an integral role on clinical teams to help health systems deliver safe and high-quality care,” Shaikh added.

Learners finished the simulation activity by watching an instructional video on reporting errors and near-misses using UC Davis Health’s incident reporting system. Through an evaluation survey, instructors found that participants included the demonstration of the system among the most useful parts of the 60-minute training, as well as active, team-based learning with peers.

A virtual version of the training was developed in response to the coronavirus pandemic and is being enhanced this year with the goal of expanding the training to more departments and learners across the health system.

“We’d like to eventually offer this training to frontline clinicians in all health professions and to provide continuing education credits,” Shaikh said.

Faculty interested in learning how to transition traditional simulation curriculum to an online environment are encouraged to email hs-simcenter@ucdavis.edu.

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202102_panda-express-donation-of-444604-supports-emotional-wellbeing-of-pediatric-patients Tue, 09 Feb 2021 08:00:00 GMT Panda Express donation of $444,604 supports emotional wellbeing of pediatric patients <p>Panda Express' annual fundraising efforts positively impact local patients and families. The restaurant chain donated nearly $450,000 raised in 2020 to Children&rsquo;s Miracle Network at UC Davis Children&rsquo;s Hospital.</p> Friday, February 12, 2021, marks the beginning of Lunar New Year, a celebration of family and friends coming together to feast and welcome the new year. It is also the culmination of another year of fundraising by Panda Express, totaling $444,604 for Children’s Miracle Network at UC Davis Children’s Hospital in 2020. 

These funds from the Panda Cares Foundation support the Child Life and Creative Arts Therapy department, staffed by professionals who help minimize the anxiety of hospitalization, increase understanding, strengthen coping skills and help children continue their typical growth and development. 

“From the beginning, Child Life set us up for success. The team tailored everything to meet the needs of Marshall and our family,” pediatric patient mom, Kyle Westbrook, said. Her son Marshall was diagnosed with B-cell high-risk acute lymphoblastic leukemia and was treated at UC Davis Children’s Hospital and the UC Davis Comprehensive Cancer Center. “Not only was our child getting the best medical care, we were all learning how to cope. They offered skills and ideas well beyond the confines of the hospital room.”

Specialized programs like the pediatric pain team are also funded by Panda Express donations. The team provides inpatient and outpatient consults and provides guidance on pain management and therapeutic options in collaboration with patients, families and care providers. 


With help from Panda Express, pediatric patient Marshall Westbrook enjoyed just being a kid during his cancer treatment

“Programs like this address the mental, emotional, physical and spiritual needs of children, bringing them courage and hope to heal and thrive,” said Michelle Tafoya, program director of CMN at UC Davis. “We are so grateful for the ongoing partnership with Panda Express and look forward to continuing our holistic approach to kids’ health with Panda’s support.” 

Since 2007, Panda Express has been raising money for millions of kids treated at Children’s Miracle Network Hospitals by asking for donations at the register all year long. Funds donated stay local and benefit patients and families in the area. In 2020, Panda Express associates and guests donated to 131 Children’s Miracle Network Hospitals, bringing the total to more than $100M over the lifetime of this partnership.

 

 

 

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202102_spirit-halloween-breaks-record-raises-101694-for-hospitalized-children-despite-pandemic- Fri, 05 Feb 2021 08:00:00 GMT Spirit Halloween breaks record, raises $101,694 for hospitalized children despite pandemic <p>UC Davis Children's Hospital's Child Life and Creative Arts Therapy department gets a big boost from local specialty store.</p> COVID-19 has impacted children’s hospitals everywhere. UC Davis Children’s Hospital is no exception. Some donations did decline in 2020, but Spirit Halloween’sSpirit of Children’ program was a welcome exception. The retailer donated a record-setting $101,694 to the Child Life and Creative Arts Therapy department, which provides emotional support for pediatric patients and families and is dependent on donations.

Thanks to the record donation, the Child Life Fellowship continues to thrive and expand, giving more pediatric patients, siblings, parents and caretakers access to tools and programs that help minimize anxiety, strengthen understanding of hospitalization and bolster coping skills.

“I am continuously in awe of the Spirit Halloween team’s dedication and support to always raise the bar! This year is a perfect example. Despite COVID-19 and limitations on shopping, local stores raised a record-setting $101,694! It’s unbelievable and will make a huge difference to our department, the patients, the fellowship program and upcoming child life professionals,” said Diana Sundberg, UC Davis Child Life and Creative Arts Therapy manager.

Annual donations from Spirit Halloween’s Spirit of Children foundation fund this program which provides additional training and supervision for individuals aspiring to be certified child life specialists. The UC Davis Child Life Fellowship program has provided nearly 20 six-month child life fellowships over the past 11 years.

After their training, fellows are often hired by the department. Donations from Spirit of Children have enabled the department to expand career staffing to the children’s surgery centerpediatric infusion center and pediatric radiology

“There are now two full-time child life specialists at the Children’s Surgery Center and we both were part of the fellowship program,” said Child Life Specialist, Jamie McHugh. “We are so grateful for all Spirit has done for us.”

The previous three years, Spirit of Children donations have also helped fund a student educator. This better positioned the child life student education program to apply for and receive an Association for Child Life Professional Internship Accreditation. UC Davis Children’s Hospital was the first hospital in Northern California to receive this accreditation and the third in the state.

“Spirit Halloween’s support over the years has allowed us to continue to expand services to support sick and injured children through life-altering events,” Sundberg said. “Thanks to Spirit Halloween and Spirit of Children, we can offer the highest quality services to pediatric patients and their families at UC Davis Children’s Hospital.”

The specialty retail store has donated more than $600,000 to UC Davis Children’s Hospital during the past decade, with every cent going toward the Child Life and Creative Arts Therapy department.

About Spirit Halloween

Spirit Halloween is the largest Halloween specialty retailer in the country with over 1,300 locations in strip centers and malls across North America. Celebrating almost 40 years in business, Spirit is the premier destination for all things Halloween, offering one-stop shopping for everything from costumes and décor, party goods to accessories. In addition to being a fun and interactive event for shoppers, Spirit stores offer complete selections of costumes and accessories for infants/toddlers, children, ‘tweens, teens and adults, along with exclusive décor you won’t find anywhere else.

About Spirit of Children

At the heart of Spirit Halloween is Spirit of Children, a program which focuses on making hospitals less scary for kids and their families. Since its inception in 2007, Spirit of Children has raised more than $77 million for Child Life departments at hospitals across the country. Donations to Spirit of Children stay within local communities, with 100 percent of funds going toward a child’s life. Spirit encourages customers to help make a difference in a child’s life this Halloween season by donating at their local Spirit Halloween or spreading awareness via Facebook and Instagram using #SpiritofChildren.

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202102_nursing-leader-judie-boehmer-named-board-president-of-sacramentos-ronald-mcdonald-house Thu, 04 Feb 2021 08:00:00 GMT Nursing leader Judie Boehmer named board president of Sacramento’s Ronald McDonald House <p>Judie Boehmer, a nursing executive at UC Davis Health, has been appointed board president for Sacramento&rsquo;s Ronald McDonald House.&nbsp;</p> Judie Boehmer, executive director of hospital and clinics for Patient Care Services at UC Davis Health, has been appointed board president for Sacramento’s Ronald McDonald House.

The 38-room facility near UC Davis Children’s Hospital is a ‘home away from home’ for families who must travel at least 30 miles to seek medical treatment for their child.

Boehmer’s new role will be to lead the organization’s board of directors in continuing to enhance the charity’s culture, vision and foundation.

“We are so honored and excited to have Judie as our next board president for Ronald McDonald House Charities Northern California,” said Catherine Ithurburn, the group’s CEO. “Her expertise, experience and leadership will be a wonderful asset to the charity. We look forward to her tenure and the future of the campers, children and families we serve at the Sacramento Ronald McDonald House and at Camp Ronald McDonald at Eagle Lake.”

Since joining UC Davis Health in 1988, Boehmer has held various positions, including staff nurse, nurse educator and nurse manager. Today, her responsibilities include UC Davis Children's Hospital, the University Birthing Suites and Women's Pavilion, as well as the Children’s Hospital Surgical Program and various other programs at the health system.

The facilities Boehmer will be working with include several dozen rooms and a pair of two-bedroom apartments for parents needing a convenient place to stay while a child is being treated at the hospital. Families have the privacy of their own rooms and share common kitchens, living room and laundry spaces. There are special rooms set up with toys, computers and video game consoles to entertain patient siblings. The house also provides a welcome respite from the hospital for parents who face the long-term hospitalization of their child.

Ronald McDonald House Charities Northern California has been dedicated to creating, supporting and implementing programs that improve the lives of children and their families since 1992. While guests are asked for a $20 donation per night, no family is ever turned away from the house because of an inability to pay.

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202102_nicu-graduation-celebrates-milestone-for-families- Wed, 03 Feb 2021 08:00:00 GMT NICU graduation celebrates milestone for families <p>UC Davis Children&rsquo;s Hospital has created a new tradition to help families mark a special milestone when leaving the neonatal intensive care unit: A NICU graduation.</p> Being discharged from the Neonatal Intensive Care Unit (NICU) is a monumental moment for many families. UC Davis Children’s Hospital has created a new tradition to mark that milestone: A NICU graduation.

Every baby who leaves the NICU receives a traditional graduation cap, a certificate and the Dr. Seuss book “Oh Baby! Go Baby!” Families also have an opportunity to take pictures with their new graduate using a personalized picture board prop for the occasion.

“After spending what are often stressful and difficult weeks or months in the hospital with their newborn infant, the NICU graduation signifies for the family a celebration of going home. For the care team, it is an opportunity to wish each family farewell,” said Katherine MacDonald, programming coordinator with the UC Davis Child Life and Creative Arts Therapy Department.

NICU graduations are facilitated by the UC Davis Child Life and Creative Arts Therapy Department, which runs solely on donations from the community. It’s through the generosity of donors that they can continue funding this program.

“We want every family to feel celebrated in these huge milestones and accomplishments,” said certified child life specialist Joanna Davis, who works in the NICU.

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202101_first-of-its-kind-health-clinic-for-foster-children-opens-in-sacramento- Fri, 29 Jan 2021 08:00:00 GMT First-of-its-kind health clinic for foster children opens in Sacramento <p>UC Davis Health has partnered with the Sacramento County Health Center to open a first-of-its-kind clinic in Sacramento to provide medical care for children in the foster care system.</p> UC Davis Health has partnered with the Sacramento County Health Center to open a first-of-its-kind clinic in Sacramento to provide medical care for children in the foster care system.

Located in the Sacramento County Health Center, it’s called the CIRCLE clinic, which stands for Comprehensive Integration of Resilience into Child Life Experiences. The clinic opened last November at 4600 Broadway.

CIRCLE Clinic team
The CIRCLE clinic team includes, from left to right, Albina Gogo, Serena Yang, Scott Akins, Brandi Hawk, Lisa Rasmussen and Katy Carlsen.

The Sacramento County Health Center is a Federally Qualified Health Center that provides primary care and behavioral health services to low income residents of Sacramento County.  

The purpose of the CIRCLE clinic is to: 

  • offer a medical home for the children and adolescents of Sacramento County involved in child welfare
  • offer primary pediatric care from UC Davis pediatricians
  • coordinate specialty care
  • coordinate and provide mental health services in partnership with the UC Davis CAARE Center
  • screen and refer for any behavior and developmental concerns in partnership with providers at the UC Davis MIND Institute
  • connect the child and family with appropriate resources in the community
  • offer appropriate follow-up and communication to close the loop with child welfare providers

“The key part of this model is to provide care coordination, not only with child welfare but also with those involved in the child’s life in a child-centered manner. We have integrated general pediatricians, mental care professionals, behavioral therapists and child psychiatrists, along with public health nurses and the county’s child welfare,” said UC Davis volunteer clinical faculty member and pediatrician Katy Carlsen, who has helped spearhead these efforts and donated funds to make this clinic possible. A UC Davis endowment has also been established to generate funds.

UC Davis pediatrician Albina Gogo has been part of a workgroup for the past three years to create this clinic and works there part time.

“Adverse Childhood Experiences (ACEs), including being in the foster care system, can create trauma and impact the health and wellbeing of children. The CIRCLE clinic provides comprehensive, trauma-informed, culturally-sensitive health care to help instill resilience into these children’s lives, resulting in better long-term health outcomes and more stable foster home placements,” Gogo said.

So far, the team has seen about a dozen pediatric patients.

“I was super excited when I heard about it,” said Monica Foote, a former foster child who is now a foster parent, who came to the clinic for the first time this month. “I experienced a lot of trauma in the system and it did affect my physical health. I’m glad that there is a clinic like this. It’s really touched my heart.” 

For more information about the Circle Clinic, call 916-874-9670.

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202101_new-motility-testing-now-available-for-pediatric-gi-patients Tue, 26 Jan 2021 08:00:00 GMT New motility testing now available for pediatric GI patients <p>Maheen Hassan brings new expertise to the Sacramento region, offering motility testing for pediatric gastroenterology patients. Tests now available include esophageal manometry and anorectal manometry.</p> When Maheen Hassan began working at UC Davis Children’s Hospital last October, she brought with her new expertise to the region: motility testing for pediatric gastroenterology (GI) patients.

GI motility involves the muscles, nerves and hormones of the gut working together to propel food and then stool out of the body. If any of these components fail to work properly, patients can end up with motility problems in their gut.

“The motility testing we offer can help diagnose kids with severe, but oftentimes nonspecific symptoms, like trouble swallowing, vomiting, or constipation. It can also help decide if a condition requires surgery or if it can be medically managed,” Hassan said.

Two motility testing services are available at UC Davis Health:

Esophageal manometry: A test that studies how the muscles of the esophagus contract and relax to move food and drink into the stomach. This helps diagnose those with swallowing difficulties with diagnoses such as achalasia, a condition in which your lower esophageal sphincter muscle doesn’t relax to allow food to enter your stomach.

Anorectal manometry: A test that measures nerve reflexes and muscle tone to assist children with constipation. This can help diagnose pelvic floor dyscoordination, sensory impairment, or Hirschsprung’s disease, a birth defect in which the last part of the digestive track lacks nerves and thus the ability to move feces.

Hassan also has a dual appointment at Shriners Hospitals for Children – Northern California, offering additional motility testing services of the stomach, small bowel and large bowel, as well as test the distensibility of certain muscles in the gut.

Hassan treats newborns to age 18 and accepts referrals throughout Northern California. Her expertise is not available in other Northern California hospitals.

“Since there aren’t other physicians in Northern California providing GI motility testing, I’ve been receiving a lot of referrals from both within and outside of the Sacramento area. I’m happy to bring this new service line to help children and families here in Sacramento and beyond,” Hassan said. 

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202101_uc-davis-pediatric-heart-patient-enters-rock-your-scar-contest Fri, 22 Jan 2021 08:00:00 GMT UC Davis pediatric heart patient enters Rock Your Scar contest <p>Two-year-old Leo Woo has already had two successful heart surgeries, thanks to UC Davis pediatric cardiothoracic surgeon Gary Raff. Leo&rsquo;s parents Sarah Ehrman and Chris Woo have entered Leo in this year&rsquo;s Rock Your Scar, a national contest hosted by Mended Little Hearts to raise awareness about congenital heart defects.</p> Two-year-old Leo Woo has already had two successful heart surgeries, thanks to UC Davis pediatric cardiothoracic surgeon Gary Raff.

Leo’s parents Sarah Ehrman and Chris Woo have entered Leo in this year’s Rock Your Scar contest, a national contest hosted by Mended Little Hearts to raise awareness about congenital heart defects.

It is a way for the family to share what they have been through and to connect with others who have also battled with congenital heart conditions.  

Ehrman had a normal pregnancy and did not know that Leo had any health problems until four days after he was born.

“He was turning a little bit blue. [The doctor] pulled him aside again to check him and figured out his oxygen levels in his right hand and right foot (weren't) matching up, and she heard a heart murmur,” Ehrman said.

Woo was transferred to UC Davis Children’s Hospital, where he was diagnosed with hypoplastic left heart syndrome (HLHS), a complex cardiac defect in which all structures on the left side of the heart are underdeveloped. Without treatment, HLHS is fatal.

Woo had what’s known as the Norwood procedure, the first in a series of three open-heart surgeries, in which Raff successfully redirected blood flow and rebuilt areas of his heart. Raff also performed the Glenn surgery on Woo, which successfully redirected blood flow from the upper body to the lungs. The third surgery in the series is still to come.

Woo has also had six cardiac catheterizations from UC Davis chief of pediatric cardiology Frank Ing to improve blood flow.

“We are thankful for the care that Leo has received from UC Davis,” Ehrman said. “Leo is doing great.”

Vote for Leo Woo here. The public can vote every day until Jan. 31. Winners will be announced during Congenital Heart Defect Awareness Week, Feb. 7-14.

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https://health.ucdavis.edu/health-news/children/uc-davis-pediatric-heart-patient-enters-rock-your-scar-contest/2021/01
202101_virtual-car-seat-education-inspections-now-available-at-uc-davis-health Thu, 21 Jan 2021 08:00:00 GMT Virtual car seat education, inspections now available at UC Davis Health <p>The public can receive free, virtual car seat education and inspections, as well as socially distant car seat installations in English and Spanish, thanks to the UC Davis Trauma Prevention and Outreach Department.</p> Need help installing a car seat? You can get free, virtual education and inspections as well as socially distant car seat installations in English and Spanish from the UC Davis Trauma Prevention and Outreach Department


Cathy Morris leads a virtual car seat education class.

“During the COVID-19 pandemic, we want families to know we continue to offer our resources and expertise to ensure that their car seats are installed correctly,” said Misael Chavarin, community education specialist at UC Davis Health.

These resources include:  

  • Free community car seat classes are available in English and Spanish through Zoom. They cover the California child passenger safety law, car seat weight and height limits and proper car seat harness use. The virtual class also includes a car seat installation demonstration in the rear-facing and forward-facing positions. 
  • Free car seats. To qualify, the parent or caregiver must be in need of a car seat and receive government assistance (e.g. WIC, Cal Fresh, Medi-Cal or Cal Works). 

The top 5 most common car seat mistakes

1) An incorrect seat for the child’s height and weight
2) The seat is not installed tightly enough
3) The child is turned forward facing too early
4) The harness is too loose or not buckled properly
5) The car seat is expired

  • Virtual car seat inspections through Zoom, ensuring that car seats have been installed correctly. This is a free service. 
  • Socially distant car seat installation. The public can make an appointment and a member of the team will install their car seat for free. Masks are worn and a limited amount of time is spent inside of the car.   

For more information, visit the UC Davis Trauma Prevention and Outreach Department’s website or call 916-734-9798 to make an appointment.

 

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https://health.ucdavis.edu/health-news/children/virtual-car-seat-education-inspections-now-available-at-uc-davis-health/2021/01
202101_fewer-behavior-problems-in-young-foster-care-kids-after-pc-care-program Thu, 14 Jan 2021 08:00:00 GMT Fewer behavior problems in young foster care kids after PC-CARE program <p>A new study finds that young children in the foster care system demonstrated fewer behavior problems after participating in an innovative seven-week intervention. The program is called PC-CARE, and was pioneered at UC Davis CAARE Center.</p> Young children in the foster care system demonstrated fewer behavior problems after participating in an innovative seven-week intervention. The program is called PC-CARE, and was pioneered at UC Davis CAARE Center, which provides patient care, teaching, research and prevention initiatives on behalf of abused and neglected children and  high-risk youth. These findings were published in Children and Youth Services Review

The study presented preliminary findings from the Fostering Secure Placements program, a collaboration between the UC Davis CAARE Center and Sacramento County’s Department of Child, Family, and Adult Services (DCFAS).  The program offers PC-CARE to foster caregivers of children ages 1-5 in a new foster care placement for 90 days or less in Sacramento County. 

“We are honored to work with and make a difference in the lives of these young children in foster care and their caregivers,” said Brandi Hawk, lead author of the study and co-developer and supervisor of the PC-CARE program at the UC Davis CAARE Center. “Through our collaboration with DCFAS, we have found that PC-CARE, a program we developed, is associated with improvements in behaviors, relationships, and placement stability for young children in foster care.” 

The goals of the program were to improve children’s adjustment to their new homes and to increase placement stability. It was funded through Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Child Traumatic Stress Network

PC-CARE is for children ages 1-10 who have or are at risk of developing problems in the caregiver-child relationship.  Study participants included 153 children, who participated with their foster caregivers and a PC-CARE provider. 

PC-CARE is composed of one assessment and six intervention sessions. The skills taught each week included:

  • Session 1: positive communication skills, transitions, creating a compliance-friendly environment
  • Session 2: selective attention, redirecting, modeling, calming strategies
  • Session 3: rules, choices, when-then/if-then statements
  • Session 4: giving effective commands, removal of privileges
  • Session 5: redo, hand-over-hand (placing one’s hands over a child’s hands to help them complete a movement, if appropriate), recovery
  • Session 6: collect behavioral measures; review all the skills; including which worked best for the child-caregiver; develop plans for managing future behavior problems 

“Although children in foster care are at high risk for developing mental health concerns, this brief program was associated with reductions in those concerns,” Hawk said. “Children showed improvements in challenging behaviors, trauma symptoms, self-regulation, adaptive behaviors and caregiver-child relationships. Children who completed PC-CARE experienced fewer placement disruptions at both one and six months after services than children who did not complete services.” 

These findings suggest that utilizing PC-CARE may help young foster children adjust to new homes and support placement stability for these children.   

Co-authors of the study were Susan G. Timmer, Lindsay A.F. Armendariz, Deanna K. Boys and Anthony Urquiza, of UC Davis Children’s Hospital.

   

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https://health.ucdavis.edu/health-news/children/fewer-behavior-problems-in-young-foster-care-kids-after-pc-care-program/2021/01
202101_six-tips-for-teaching-kids-to-swallow-pills Fri, 08 Jan 2021 08:00:00 GMT Six tips for teaching kids to swallow pills <p>For many children, taking medicine is literally a tough pill to swallow. At UC Davis Children&rsquo;s Hospital, child life specialists teach kids this new skill of swallowing pills, when liquid medicine and chewable tablets are not options. The team shares six tips.</p> For many children, taking medicine is literally a tough pill to swallow.

At UC Davis Children’s Hospital, child life specialists teach kids this new skill of swallowing pills, when liquid medicine and chewable tablets are not options.

“Here at the hospital, we practice using different sized candy in jello or coat a candy with a spoonful of applesauce, pudding or even butter,” said certified child life specialist Marisa Martinez. “This helps children remove the focus of taking a pill and think they are just swallowing jello.”

The UC Davis Child Life and Creative Arts Therapy team typically start with Nerds and work up with each successful swallow to Tic Tacs, M&Ms, then Mike and Ikes if they need a pill that large.

The team also recommends the following six tips for swallowing pills, as adapted from Ramsey Pediatrics:

  1. Sit up or stand up straight.
  2. Don’t talk.
  3. Breathe through your nose.
  4. Gargle fluids before you begin swallowing
  5. Drink some of your preferred liquid or swallow your preferred food (jello, pudding, etc.) before taking the pill.
  6. Swallow twice to make sure the pill goes down.

“Practice makes perfect. Swallowing ‘pretend’ pills over and over can help kids become more confident,” Martinez said.

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https://health.ucdavis.edu/health-news/children/six-tips-for-teaching-kids-to-swallow-pills/2021/01
202101_mixed-reality-goggles-3d-printing-aid-in-surgical-planning-to-separate-craniopagus-twins- Mon, 04 Jan 2021 08:00:00 GMT Mixed reality goggles, 3D printing aid in surgical planning to separate craniopagus twins <p>The surgical team that separated conjoined twins Abigail and Micaela had access to equipment and technology that did not exist 10 years ago, including mixed reality imaging goggles that map out the brain and blood vessels and 3D printed models of the twins&rsquo; skulls as they prepared to successfully separate the two girls.</p> Conjoined twins Abigail and Micaela Bachinskiy were born connected at the skull and brain.  It’s a rare condition called craniopagus twins which occurs once in every 2.5 million births.

At nine months old, Abigail and Micaela were successfully separated in a marathon surgery at UC Davis Children’s Hospital on Oct. 24 and 25, 2020. It was the culmination of months of planning and intense preparation that would be – for most of the surgical team – the most complicated case of their careers.

“No two conjoined twins born are the same. Each case is different. Their anatomy is different. There are no textbook models of how you separate the twins,” said Michael Edwards, lead pediatric neurosurgeon on the case. 

But technology was on their side. From mixed reality imaging goggles that map out the brain and blood vessels to three-dimensional 3D printed models of their skulls, the team had access to equipment and technology that did not exist 10 years ago to help them plan and practice this surgery with precision.

Mixed reality goggles help visualize operation plan

The surgical team spent months carefully tracking the twins’ growth through MRI and CT scans, which revealed that the twins shared some bone, brain, blood vessels and soft tissue.

Mixed reality goggles used this imaging data to create a three-dimensional view inside the twins’ skulls. The surgery team had a vantage point into the babies’ unique anatomy from every possible angle. 

“You can look from the top, the side, the bottom, you can rotate the 3D model. You can walk into it and look backward to see where you are,” Edwards said.  

A view inside the goggles showed a complex network of blood vessels which the team would need to detangle and separate during the separation surgery.

“By working in three dimensions, we have a better idea of what things are actually going to look like when we are in surgery. It adds a significant margin of safety,” Edwards said. “With these new techniques, we have the ability to view the anatomy from any perspective, wipe away the bone, look at the dura. Wipe away the dura and look at the brain and vasculature.”

The team could plan the operation in three dimensions on this virtual system and identify potential pitfalls without risk to the babies. They could also rehearse working in complicated areas, so they knew what to expect in the operating room.

3D printing of their skulls


Michael Edwards and Granger Wong examine the 3D model of the twins’ skulls.

Harnessing the power of three-dimensional printing, the team was able to use three-dimensional models of the twins’ skulls and blood vessels to assist in their planning.

“The alternative is a two-dimensional picture. That automatically requires the surgeon and the team to have the ability to conceptualize what this would be like in three dimensions. It’s not so easy to understand,” Edwards said. “We’re working with a 3D baby in a 3D world. Two-dimensional images don’t provide us with all the information that we need or can use.”

Private vendor KLS Martin made custom 3D printed models of the twins’ skulls that were primarily used by UC Davis Children’s Hospital team, based on CT and MRI scan information. UC Davis Children’s Hospital also received models from the 3D PrintViz Lab, a state-of-the-art facility on the UC Davis Sacramento campus.

“You can see how the twins are connected. They are asymmetrical. They are not joined back to back. It’s more of a side to back configuration,” said Granger Wong, chief of the UC Davis Division of Plastic and Reconstructive Surgery and lead plastic surgeon on the twins’ case. “Luckily we exist in a time with this technology.”   

Based on these models, Wong knew the exact amount of new skin that would be needed to cover the area on their heads after separation. He then custom designed a tissue expander, based on those measurements, to ensure that there would be enough skin to cover the girls’ heads after separation.

“We do something called tissue expansion to create new skin. We place something that resembles a deflated balloon under the scalp skin. Very slowly, we inflate it with saline, or salt water, and that blows up like a balloon and stretches the scalp thus generating new skin,” said Wong, who inserted the custom designed tissue expander in the twins’ skull during a surgery in June.

After the tissue expander was fully inflated, 3D scanning and analysis was again used, this time to confirm that the necessary skin had been created. Virtual software was then employed to determine the optimal design of incisions in the skin to determine the best pattern of the scalp flaps for reconstruction. The expander was removed during the separation surgery. 

Abigail and Micaela celebrated their first birthday on Dec. 30, 2020, happy and healthy at home with their family, with bright futures ahead.

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https://health.ucdavis.edu/health-news/children/mixed-reality-goggles-3d-printing-aid-in-surgical-planning-to-separate-craniopagus-twins-/2021/01
202012_virtual-toy-drive-raises-more-than-21000-for-hospitalized-kids- Mon, 28 Dec 2020 08:00:00 GMT Virtual Toy Drive raises more than $21,000 for hospitalized kids <p>The holidays were merry and bright for hospitalized kids at UC Davis Children&rsquo;s Hospital, thanks to more than $21,000 that was raised during this year&rsquo;s Virtual Toy Drive. The toy drive provided free toys for every hospitalized child, from infants through teens. Toys were also given to pediatric patients in the UC Davis Comprehensive Cancer Center&rsquo;s pediatric infusion room as well as to children served by the UC Davis CAARE Center.</p> The holidays were merry and bright for hospitalized kids at UC Davis Children’s Hospital, thanks to $21,376 that was raised during this year’s Virtual Toy Drive. Additional donors contributed by purchasing items from the hospital’s Amazon wish list, which delivered items directly to the hospital.

“As this year has been difficult for so many people both emotionally and financially, I was concerned about how we were going to provide for the children during the holiday season,” said Diana Sundberg, manager of the UC Davis Child Life and Creative Arts Therapy Department. “The community has once again surpassed my expectations with their generosity and giving. The response and support have been amazing!”

The toy drive provided free toys for every hospitalized child from infants through teens. Toys were also given to pediatric patients in the UC Davis Comprehensive Cancer Center’s pediatric infusion room as well as to children served by the UC Davis CAARE Center

Additional funds will be used to support pediatric patients throughout 2021, providing toys, art supplies, music supplies, treasure box prizes and giveaways during their hospitalization as well as visits to the Comprehensive Cancer Center and MIND Institute. Children who celebrate their birthday in the hospital will also receive gifts, thanks to the generosity of donors.    

“What we have found with the pandemic and the closing of our community play spaces, is that we require a larger supply of play items to meet the needs of the children at their bedside,” Sundberg said. 

For those who did not have a chance to donate and would like to make a contribution, our child life fund is still accepting donations. The child life team also has a year round Amazon wish list.

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https://health.ucdavis.edu/health-news/children/virtual-toy-drive-raises-more-than-21000-for-hospitalized-kids-/2020/12
202012_miracle-babies-formerly-conjoined-twins-abigail-and-micaela-home-for-christmas Thu, 24 Dec 2020 08:00:00 GMT ‘Miracle babies’: Formerly conjoined twins Abigail and Micaela home for Christmas <p>Christmas came early for the Bachinskiy family today: formerly conjoined twins Abigail and Micaela were discharged from UC Davis Children&rsquo;s Hospital and will be spending their first Christmas together at home. The 11-month-old craniopagus conjoined twins, born connected at the head, were separated in a 24-hour separation surgery.</p> Christmas came a little early for the Bachinskiy family: formerly conjoined twins Abigail and Micaela were discharged from UC Davis Children’s Hospital yesterday (12/23) and will be spending their first Christmas together at home.

“I think it’s the best present of my life, to be home with them, my nice, beautiful, healthy girls,” said mom Liliya Miroshnik.

The 11-month-old craniopagus conjoined twins, born connected at the head, were separated in a 24-hour separation surgery that spanned October 24-25. They have spent nearly two months recovering at UC Davis Children’s Hospital.

“They are healthy and happy and their futures are bright,” said pediatric neurosurgeon Michael Edwards, who has been caring for the girls since birth. He stopped by to wish them well and walk them out. “So many people in our hospital, at all levels, have been touched by these girls and their story,” he said.  

It was a bittersweet sendoff for the hospital staff, many of whom have been involved in the girls’ care for nearly a year. “It’s been an emotional roller coaster,” said clinical nurse specialist Dawn Harbour, who spent much of the morning caring for and cuddling both girls, now nicknamed Abby and Mica.


Nurse Aida Benitez helps Liliya Miroshnik transport the twins and their belongings as they begin their journey home

“It’s just miraculous that they’re separated,” said Harbour, fighting back tears. “We’re just in awe and so thankful that we got to be part of a miracle here at UC Davis.”

Hospital staff members waved and clapped as the girls traveled via wagon through the hallways on their way out, and several accompanied them all the way outside to say goodbye.

It was another milestone in a year packed with them. Parents Liliya and Anatoliy have dubbed them “miracles”: the birth of their girls, taking them home for the first time via the UC Davis Children’s Hospital ambulance, a tissue expander surgery to create enough scalp skin for their separation, their successful separation surgery and seeing each other for the first time. 

“We’ve been praying for this day and praise God, it’s here,” Liliya said.

And now, a Christmas wish of finally being home together as a family under the same roof with their three sons and twin daughters. A Christmas miracle made possible by the team from UC Davis Children’s Hospital.


The twins are greeted by friends and family, including their three brothers, as hospital staff says farewell.

“The UC Davis team is the best. We are really thankful for everyone here. They will always be part of our family because we will always see their work in the girls,” Liliya said. 

Watch the five-part video series about Abigail and Micaela’s patient journey.

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https://health.ucdavis.edu/health-news/children/miracle-babies-formerly-conjoined-twins-abigail-and-micaela-home-for-christmas/2020/12
202012_deftones-donate-52500-to-uc-davis-childrens-hospital-through-adopt-a-dot-campaign- Thu, 17 Dec 2020 08:00:00 GMT Deftones donate $52,500 to UC Davis Children’s Hospital through Adopt-a-Dot campaign <p>Closing out 2020 on a very positive note, Deftones have completed their &lsquo;Adopt-a-Dot&rsquo; fundraiser and made a donation of $52,500 to UC Davis Children&rsquo;s Hospital. The Grammy Award-winning band&nbsp;<a href="https://deftones.com/">Deftones</a> launched their philanthropic campaign in September called&nbsp;<a href="https://deftones.com/Adopt.">&lsquo;Adopt-a-Dot&rsquo;</a>&nbsp;based on their album<em>,&nbsp;&ldquo;</em>Ohms.&rdquo; The cover art, created by Frank Maddocks, features thousands of pixelated dots, and fans could make a charitable donation for one or more dots. Donors uploaded photos to Deftones.com/Adopt,&nbsp;adding yet another dimension to the artwork and claiming a spot of their own.</p> Closing out 2020 on a very positive note, Deftones have completed their ‘Adopt-a-Dot’ fundraiser and made a donation of $52,500 to UC Davis Children’s Hospital. 

The Grammy Award-winning band Deftones launched their philanthropic campaign in September called ‘Adopt-a-Dot’ based on their album, “Ohms.” The cover art, created by Frank Maddocks, features thousands of pixelated dots, and fans could make a charitable donation for one or more dots. Donors uploaded photos to Deftones.com/Adopt, adding yet another dimension to the artwork and claiming a spot of their own.

In addition to the children’s hospital, Deftones also donated $52,500 to Live Nation’s ‘Crew Nation,’ a global relief fund for live music crews who have been impacted by COVID-19.

"With pride, today we’re making our Adopt-A-Dot donations to UC Davis Children’s Hospital and Crew Nation,” said the band in a statement. “Hopefully these will go to making things a little easier for those facing challenging times. This wouldn’t have been possible without the support of our fans and friends that contributed to this campaign. We sincerely thank you all."

ABOUT THE ART

"Ohms’ album art is an iconic rendering of a suspended, chance moment in time. As with Deftones’ music and lyrics, the definitive meaning of the imagery invites and relies on interpretation from the viewer. From a dreamy gaze above, to sadness, hope, despair, optimism and a longing for connection, the emotions conveyed are endless and infinitely evolving." - Frank Maddocks Creative Director, Deftones

ABOUT UC DAVIS CHILDREN'S HOSPITAL

UC Davis Children’s Hospital is the Sacramento region’s only nationally ranked, comprehensive hospital for children, offering children and their families the highest level of care for virtually every pediatric condition.

ABOUT CREW NATION

Live music inspires millions around the world, but the concerts we all enjoy wouldn’t be possible without the countless crew members working behind the scenes. As COVID-19 puts concerts on pause, we want to extend a helping hand to the touring and venue crews who depend on shows to make a living.

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https://health.ucdavis.edu/health-news/children/deftones-donate-52500-to-uc-davis-childrens-hospital-through-adopt-a-dot-campaign-/2020/12
202012_pregnant-mom-battles-covid-19-delivers-baby-while-in-icu Thu, 10 Dec 2020 08:00:00 GMT Pregnant mom battles COVID-19, delivers baby while in ICU <p>Diana Estrada-Arauza was the picture of health. She was 33 years old. No preexisting conditions. But when she was seven months pregnant, she became sick with the coronavirus and was admitted to the ICU to get the acute care that she and her unborn baby needed.</p> Diana Estrada-Arauza was the picture of health. She was 33 years old and seven months pregnant. No chronic diseases or conditions.

But while on maternity leave this fall, she got sick with COVID-19. She was hospitalized at a nearby hospital and discharged before she was ready.

She knew she needed a second opinion and turned to UC Davis Medical Center, where she works as a postpartum medical-surgical nurse.

“I felt really sick. I couldn’t breathe. I had my dad take me to UC Davis,” said Diana, who said her oxygen saturation level was 84 percent due to the coronavirus. Normal oxygen saturation levels should be between 95 and 100 percent.  

Within minutes of arriving at the UC Davis emergency room, Diana was triaged and rushed into a room, where the team started an IV and put her on oxygen.

After one day in the hospital, she was transferred to the Intensive Care Unit (ICU).

“I was getting worse and I couldn’t breathe,” she said. She was getting 60 liters of oxygen through a high flow nasal cannula, but it wasn’t helping. “I remember them telling me that if things took a turn for the worse, they would need to intubate me.”


The first time that Diana Estrada-Arauza met her baby Sergio. Here with her baby’s father, Sergio Limon.

She asked if she could call her family and let them how she was doing. She said she squeezed her nurse’s hand while she made that emotional phone call. “I said, ‘Please tell my babies that I love them,” she said.

A tube was placed in her windpipe, which was connected to a ventilator to keep the oxygen flowing.

Shortly after she was intubated, the baby’s heart rate dropped.

“The baby wasn’t doing well, and we needed to get him out,” said Debra Wright, director of maternity services. “We called her partner and let him know that we would need to move forward on an emergency C-section to save her baby’s life.”

Baby Sergio was born at 33 weeks and was intubated in the delivery room for respiratory failure. He was only on a ventilator for a few hours. He tested negative for COVID-19 and stayed in the UC Davis Neonatal Intensive Care Unit for 10 days.

“Sergio did very well and only stayed in the NICU to get bigger, keep his temperature normal and learn how to feed,” said UC Davis neonatologist Mark Underwood.

During that time, Diana remained in the ICU. She stayed in prone position, mostly face down for about two weeks.

Diana met Sergio for the first time over Zoom.


Baby Sergio

Among the memories that Diana has from those 30 days in the hospital, she recalls the kindness of her health care team. The nurse who held her hand while she made the difficult call to her family. The team who gathered gifts to welcome her baby. The video tribute her health care team made for her and her baby.

“The team just walked me through this one day at a time. I’m very thankful. They took good care of me. The doctors and nurses were very thorough and reassuring. They helped me with everything I needed in ways that I didn’t even expect,” said Diana.

Now back at home in Sacramento, Diana is happy to be feeling well again and to have her newborn baby Sergio by her side.

“It was a very scary time. I feel very lucky,” said Diana.

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https://health.ucdavis.edu/health-news/children/pregnant-mom-battles-covid-19-delivers-baby-while-in-icu/2020/12
202012_spanish-radio-station-listeners-donate-267794-to-help-kids-- Wed, 09 Dec 2020 08:00:00 GMT Spanish radio station listeners donate $267,794 to help kids <p>Long-time Children&rsquo;s Miracle Network Hospitals media partner comes through in 2020, raising much needed funds for UC Davis Children&rsquo;s Hospital.</p> Sacramento’s Entravision radio stations teamed up for the annual Children’s Miracle Network (CMN) radiothon which raised a total of $267,794 to support pediatric programs, equipment, research and patient care at UC Davis Children’s Hospital. The 2020 event took place over three days last month after being postponed in August due to the COVID-19 pandemic.

UC Davis Children’s Hospital faculty, staff and several patient families took part in local, on-air interviews, including last year’s CMN at UC Davis champion, Jackson Manning, who persevered through serious complications from Type 1 diabetes. Participating local stations included Radio La Suavecita 104.3La Tricolor 99.9 and 100.9 and Hot 103.5, Radio Fuego, among other national stations. More than 1,000 new donors tuned in and supported the effort, bringing the total number of CMN at UC Davis donors to 1,447.

Entravision raises millions of dollars annually for the 170 Children’s Miracle Hospitals across the U.S. and Canada. Under the theme of “Un Million Para Los Niños” (One Million for the Children), the Radiothon runs on 34 of Entravision’s owned and operated stations.

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https://health.ucdavis.edu/health-news/children/spanish-radio-station-listeners-donate-267794-to-help-kids--/2020/12
202012_holiday-round-up-for-kids-campaign-underway-at-local-ace-hardware-stores Mon, 07 Dec 2020 08:00:00 GMT Holiday Round Up for Kids campaign underway at local Ace Hardware stores <p>Shop for the holidays and sick and injured kids get a gift, too. Ace Hardware encourages customers to round up their change this holiday season to help pediatric patients in Northern California.</p> This holiday season, participating Ace Hardware locations are giving customers the opportunity to round up their purchase to help kids treated at Children’s Miracle Network Hospitals like UC Davis Children’s Hospital. The annual campaign is now underway, and shoppers can either round up to the nearest dollar or donate online.

Ace Hardware has more than 5,000 stores around the world, the majority of which are independently owned and operated by local entrepreneurs. Emigh Ace Hardware, Ace Hardware Chico, Ace Hardware Turlock, Davis Ace, Roseville Ace Hardware and Woodland Ace are among the locally owned stores participating in support of UC Davis Children’s Hospital.Since becoming a CMN Hospitals partner in 1991, Ace Hardware stores have raised  $122 million for CMN Hospitals across the country. The Ace Hardware Holiday Round Up for Kids campaign continues through Dec 25.

 

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https://health.ucdavis.edu/health-news/children/holiday-round-up-for-kids-campaign-underway-at-local-ace-hardware-stores/2020/12
202012_kidney-and-brain-injuries-linked-to-diabetic-ketoacidosis- Fri, 04 Dec 2020 08:00:00 GMT Kidney and brain injuries linked to diabetic ketoacidosis <p>UC Davis Health experts have identified factors that make children with diabetic ketoacidosis more likely to experience acute kidney injury. The results may eventually lead to new options and better treatments for the dangerous condition.&nbsp;</p> A multi-center research study led by UC Davis Health experts has identified factors that make children with diabetic ketoacidosis (DKA) more likely to experience acute kidney injury. 

The researchers also found that children who experience acute kidney injury are more likely to experience subtle cognitive impairment and demonstrate lower IQ scores. They said the findings indicate a pattern of multiple-organ injury from DKA, which is a serious but common complication of type 1 diabetes. The results may also eventually lead to new options and better treatments for diabetic ketoacidosis.  

The study, “Frequency and Risk Factors of Acute Kidney Injury During Diabetic Ketoacidosis in Children and Association With Neurocognitive Outcomes,” was published online today in JAMA Network Open

“A number of recent studies have shown that organ injuries in children with diabetic ketoacidosis occur more frequently than we previously thought,” said Nicole Glaser, a professor of pediatrics whose main clinical focus is type 1 diabetes in children. “We now know that acute kidney injury commonly occurs in children with DKA. And we’ve also found lower IQ scores and worse memory in children who have suffered DKA. Together, it strongly suggests an underlying physiological cause that connects these injuries across the body.” 

The researchers studied 1,359 episodes of diabetic ketoacidosis in children. Acute kidney injury occurred in 584 (43%) of those episodes, and 252 of those episodes (43%) were classified as representing more severe cases of kidney injury, either stage 2 or 3. Children with kidney injuries also had lower scores on short-term memory tests during diabetic ketoacidosis, as well as lower IQ scores three to six months after recovering from the condition. The differences persisted even after adjusting for the severity of DKA and demographic factors such socioeconomic status. 

 “We wanted to look at these issues in a more prospective manner,” said Sage Myers, an attending physician in the Emergency Department at Children’s Hospital of Philadelphia and first author of the study. “With 13 participating emergency departments in the Pediatric Emergency Care Applied Research Network [PECARN], we had the ability to not only study the frequency of acute kidney injury in these children but the underlying factors associated with injury, and whether there is an association between the occurrence of acute kidney injury and cerebral injury, which would suggest a possible linkage between the mechanisms of injury underlying both.” 

Having the data from DKA cases evaluated prospectively in hospitals across the country represents the gold standard in research information. It offers a reliable pathway to pursue further studies. And that could provide better treatment guidance for clinicians and more hope for children with diabetes and their families. 

“If we can identify how kidney injury occurs during diabetic ketoacidosis, it can help in the development of new therapeutic and preventive strategies,” said Nathan Kuppermann, professor and chair of emergency medicine at UC Davis Health, and senior author and co-principal investigator of the study. “We’re also hoping to focus future research on how diabetic ketoacidosis causes simultaneous, multi-organ injuries such as what we demonstrated in this study." 

In addition to co-authors Glaser, Myers and Kuppermann, other PECARN study authors were Jennifer L. Trainor, Lise E. Nigrovic, Aris Garro, Leah Tzimenatos, Kimberly S. Quayle, Maria Y. Kwok, Arleta Rewers, Michael J. Stoner, Jeff E. Schunk, Julie K. McManemy, Kathleen M. Brown, Andrew D. DePiero, Cody S. Olsen, T. Charles Casper, and Simona Ghetti. 

The study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant U01HD062417) and the Emergency Medical Services for Children Network Development Demonstration Program of the Maternal and Child Health Bureau, Health Resources and Services Administration. 

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https://health.ucdavis.edu/health-news/children/kidney-and-brain-injuries-linked-to-diabetic-ketoacidosis-/2020/12
202012_pediatric-heart-center-hosted-international-conference Wed, 02 Dec 2020 08:00:00 GMT Pediatric Heart Center hosted international conference <p>The UC Davis Pediatric Heart Center hosted an international pediatric cardiology conference via Zoom this fall with the pediatric cardiology team from Sejong Cardiac Hospital in Seoul, South Korea.</p> The UC Davis Pediatric Heart Center hosted an international pediatric cardiology conference via Zoom in late October with the pediatric cardiology team from Sejong Cardiac Hospital in Seoul, South Korea.

Each center presented a patient case for discussion to share expertise and provide mutual learning. UC Davis pediatric cardiologists, nurse practitioners and echocardiograph technicians were in attendance along with Sejong Cardiac Hospital’s team.

“Sejong is one of the leading hospitals taking care of congenital heart disease (CHD) patients in Asia. This collaboration may expand to research projects and sponsorship for other types of conferences,” said Frank Ing, chief of pediatric cardiology at UC Davis Children’s Hospital.

UC Davis Health is actively engaged in partnering with hospitals, peer universities, research institutions and government agencies across the globe in order to facilitate a wide variety of intellectual interactions and exchanges.

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https://health.ucdavis.edu/health-news/children/pediatric-heart-center-hosted-international-conference/2020/12
202012_a-new-emergency-waiting-room-designed-just-for-kids-- Tue, 01 Dec 2020 08:00:00 GMT A new emergency waiting room, designed just for kids <p>The UC Davis pediatric emergency department today unveiled a brand new waiting room, specially designed for kids. Boasting bright colors and a child-friendly design, this new 500-square-foot area provides a comfortable space for young patients and their families that is private and separate from the adult emergency waiting area.</p> The UC Davis pediatric emergency department today unveiled a brand new waiting room, specially designed for kids.

Boasting bright colors and a child-friendly design, this new 500-square-foot area provides a comfortable space for young patients and their families that is private and separate from the adult emergency waiting area. The space has been under construction for the past four months. It replaces the pediatric emergency waiting room that opened in 2010, located in a different space within the Pediatric Emergency Department.

“No one wants to visit the ER, especially during a pandemic,” said Claudio Alvarado, assistant nurse manager of the pediatric emergency department. “We are seeing more families choosing to delay care, even emergency care, during this time. But we want to provide reassurance and comfort to families, when they have to come see us for a trauma or emergency. We want this space to be an inviting place for children during a stressful time.”

Today also marks the move of the pediatric emergency department to a new patient-care area or “pod,” which will provide three additional emergency beds, dedicated to children.

Other hallmarks of the UC Davis Pediatric Emergency Department:

  • Advanced equipment and technologies that are specially designed and appropriately sized for children.
  • Certified child life specialists who can provide support through play, self-expressive activities and age-appropriate medical preparation and education.
  • A staff of eight attending physicians who are specially trained in pediatric emergency medicine, and who understand the subtle nuances of caring for critically ill or injured children.
  • Fourteen dedicated pediatric emergency beds. Twelve of these beds are private with a door for additional security and privacy. These are grouped together in a pediatric emergency “pod,” so children are not placed near adult patients. Two pediatric emergency beds are part of the Resuscitation Bay, separated by a curtain, so the emergency team can work on two children with acute care needs simultaneously.  
  • The Sacramento region’s only level I pediatric trauma center — one of only a handful in California. A Level I pediatric trauma center can provide total care for every injury. The trauma center also serves as a referral resource for hospitals throughout Northern California, western Nevada and southern Oregon.

“A trip to the emergency department can be a scary time for a child,” said Esther Lee, pediatric core committee chair and registered nurse at the UC Davis Pediatric Emergency Department. “Our goal is to not have our pediatric patients wait to be seen. But if they have to, we want to decrease the stressors by making a child-friendly environment for them. We strive to help improve care for our little friends and decrease their fears while they are being treated at the UC Davis Pediatric Emergency Department.”

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https://health.ucdavis.edu/health-news/children/a-new-emergency-waiting-room-designed-just-for-kids--/2020/12
202011_give-a-holiday-gift-to-a-child-in-the-hospital-from-the-comfort-of-home Mon, 23 Nov 2020 08:00:00 GMT Give a holiday gift to a child in the hospital from the comfort of home <p>The second annual Virtual Holiday Toy Drive for UC Davis Children&rsquo;s Hospital is now live. Those interested can make a donation or purchase through an Amazon wish list.</p>
This video is best viewed in Chrome or Firefox.

The second annual Virtual Holiday Toy Drive for UC Davis Children’s Hospital is now live. This virtual toy drive is in lieu of the hospital’s traditional drive through and drop off event.

“We are encouraging the community to support the children virtually through two different giving platforms, in an effort to help keep the community healthy and in accordance with COVID-19 safety guidelines,” said Diana Sundberg, manager of the UC Davis Child Life and Creative Arts Therapy Department.

The public can:


The Virtual Holiday Toy Drive runs through Dec. 24.

Both platforms will provide gifts for all of the pediatric patients this holiday season, as well as provide toys and games throughout the year for the hospital playrooms, patients’ birthdays and other celebrations and milestones. The toy drive will end on Dec. 24, 2020.

“We invite the community to join us in making the holidays brighter for our patients and families, as this year has brought unique difficulties,” Sundberg said. “We know this season will look very different. We hope that our virtual toy drive will make it easy and safe for people to give. The support of the community means so much to us.”

 

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https://health.ucdavis.edu/health-news/children/give-a-holiday-gift-to-a-child-in-the-hospital-from-the-comfort-of-home/2020/11
202011_despite-cardiac-tumors-and-hydrops-baby-beats-the-odds Tue, 17 Nov 2020 08:00:00 GMT Despite cardiac tumors and hydrops, baby beats the odds <p>When her baby was diagnosed in the womb with multiple cardiac tumors and hydrops, Tabitha Downs relied on the UC Davis Children&rsquo;s Hospital team to help save her unborn baby&rsquo;s life.</p> After five years of trying to get pregnant and then a miscarriage, Tabitha Downs and her husband received the good news they had hoped for: She was pregnant.

Everything seemed fine, until a routine ultrasound at 19 weeks revealed a very slow fetal heartbeat on the fetal Doppler monitor. A normal fetal heart rate is between 110 and 160 beats per minute. Her baby’s was in the 90s.

Tabitha returned the next week and her baby’s heart rate was in the 200s. Her obstetrician in Marysville referred her to the UC Davis Fetal Care and Treatment Center, inland Northern California’s first comprehensive fetal diagnosis and therapy center.

On Tabitha’s first visit to UC Davis, they performed an ultrasound. It was there that she discovered that her baby had hydrops, a condition in which large amounts of fluid build up in the baby’s tissues and organs, causing swelling. She had fluid in her stomach, her skin and around her heart and lungs. This condition is typically fatal when experienced this early in pregnancy. Tabitha then had a fetal echocardiogram, an ultrasound of the fetal heart, where it was found that her baby had multiple cardiac tumors.

“I [emotionally] lost it. I never expected that news,” said Tabitha. “We were told that it was very unlikely that she was going to survive. They explained that she was very sick. They would continue to monitor her.”

Tabitha returned for weekly ultrasounds and echocardiograms to check her baby’s heart’s rhythm and function. She required multiple hospitalizations for days at a time to manage her baby’s fast heart rate and hydrops. UC Davis fetal cardiologist Sherzana Sunderji was able to eventually control the baby’s heart rate with two different cardiac anti-arrhythmic medications. Sunderji also identified a medication used in kidney transplant patients, sirolimus, that was found to shrink cardiac tumors.


Tabitha Downs and her daughter Savannah with pediatric cardiologist Sherzana Sunderji at a recent appointment.

“Tabitha began taking the medication and within three weeks, her tumors started to regress and the hydrops improved. Unfortunately, her triglycerides were also rising with this medication, so she had to stop,” Sunderji said.

Sunderji, along with the UC Davis Maternal-Fetal Medicine team, devised a plan of care and monitoring.  Within a month, the hydrops resolved on its own, apart from the fluid that her baby had in her heart until she was born.

“The good news is that the tumors didn’t grow larger after that. And then it was just a waiting game,” Tabitha said. “I remember making it to 32 weeks, which was her best chance for survival. And then we tried for 34 weeks and we made it. We kept trying for the next goal.”

Baby Savannah was born in September, when Tabitha was 39 weeks, 2 days. Savannah spent three weeks in the UC Davis Neonatal Intensive Care Unit (NICU) and then was sent home. She continues to have regular appointments with Sunderji to monitor her tumors.

“I am so grateful to Dr. Sunderji and her team. I truly feel without them I wouldn’t be sitting here holding my baby girl. I’ve always wanted to be a mom and Dr. Sunderji and the weekly fetal echocardiograms we went to helped save my daughter’s life. She forever has a special place in my heart,” Tabitha said.

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https://health.ucdavis.edu/health-news/children/despite-cardiac-tumors-and-hydrops-baby-beats-the-odds/2020/11
202011_state-stem-cell-agency-funds-clinical-trial-for-spina-bifida-treatment Thu, 12 Nov 2020 08:00:00 GMT State stem cell agency funds clinical trial for spina bifida treatment <p>California&rsquo;s stem cell agency awarded funding to UC Davis Health researchers for the first human clinical trial using stem cells to treat spina bifida.</p> California’s stem cell agency (CIRM) today awarded a $9 million grant to Diana Farmer and Aijun Wang to help launch the world’s first human clinical trial using stem cells to treat spina bifida, a birth defect that occurs when the spine and spinal cord don't form properly.

Farmer, professor and chair of surgery at UC Davis Health, in collaboration with Wang, recently received approval from the U.S. Food and Drug Administration (FDA) for their groundbreaking treatment that combines fetal surgery with a special stem cell therapy.

Now, with the generous CIRM funding, the team will be able to launch their one-of-a-kind treatment in the coming months. It will be delivered while the baby is still in the mother’s womb (in utero). The complex procedure, with its unique use of a stem cell “patch,” could improve outcomes for children who are born with the severe form of spina bifida known as myelomeningocele.

Farmer and Wang will generate a type of stem cells -- mesenchymal stem cells -- from placental tissue. The cells are known to be among the most promising type of cells in regenerative medicine.

“This is truly an historic opportunity,” said Jan Nolta, director of the UC Davis Stem Cell Program and the university’s Institute for Regenerative Cures. “Drs. Farmer and Wang will be using stem cells that are known to be safe and helpful in repairing damaged tissues. We often call them the ‘paramedics’ of the body because they produce healing factors, which are crucial for treating something like spina bifida.”


Aijun Wang

Wang, an associate professor of surgery and biomedical engineering, and co-director of UC Davis’ surgical bioengineering laboratory, is a leader in developing cellular therapies that promote tissue regeneration. He and Farmer hope to successfully repair the spina bifida birth defect that occurs when the protective tissue around a baby’s developing spinal cord fails to fully close before birth.

Without treatment, an exposed spinal cord causes severe neurological damage. The resulting problems can be a range of lifelong cognitive, mobility, urinary and bowel disabilities.  The birth defect affects approximately 1,500 to 2,000 children each year in the U.S.

Farmer has been working for years to gain approval and funding for a human clinical trial to address spina bifida. She launched the UC Davis Children’s Hospital Fetal Care and Treatment Center (with pediatric surgeon Shinjiro Hirose) and UC Davis Children’s Surgery Center several years ago. The new CIRM grant complements previous funding from the agency. The earlier grant enabled Farmer and Wang to manufacture and evaluate their specialized stem cells for safety and efficacy.

The UC Davis Health team is preparing to recruit pregnant women whose babies have been diagnosed with spina bifida to test the combined surgery and stem cell procedure. The clinical trial is expected to begin in early 2021.

Clinical trial participants will be treated at the centers Farmer helped establish. UC Davis Children’s Hospital and Shriners Hospitals for Children — Northern California will provide the follow-up care.

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https://health.ucdavis.edu/health-news/children/state-stem-cell-agency-funds-clinical-trial-for-spina-bifida-treatment/2020/11
202011_new-effort-to-help-children-manage-pain- Fri, 06 Nov 2020 08:00:00 GMT New effort to help children manage pain <p>UC Davis Children&rsquo;s Hospital patients can now receive help for their pain from an interdisciplinary team of pediatric pain consultants who take a holistic approach.</p> UC Davis Children’s Hospital patients can now receive help for their pain from an interdisciplinary team of pediatric pain consultants who take a holistic approach. The team is available for inpatient and outpatient consults and can provide guidance on pain management and therapeutic options in collaboration with patients, families and care providers.

“The experience of pain is always physical, emotional, and cognitive. It is real and impacts a child’s life in many ways,” said UC Davis psychologist Brandi Hawk, who is part of the pediatric pain consultants team. “To provide the best care for our patients, we need to assess and address all three aspects of pain before, during, and after any potentially painful procedure and in long-term care for patients with chronic pain conditions.”

The UC Davis Pediatric Pain Consultants team includes a core group of specialized physicians and a pediatric pain medicine psychologist, along with care from pediatric pharmacists, pain pharmacists, palliative care specialists, child life and creative arts therapists and physical and occupational therapists.

“For any professional, it is easy to get stuck focusing on what we always do or see. As pediatric pain consultants, we are able to see patients through a different lens to help referring physicians find new ways to support their patients,” Hawk said.

This team is funded by a Children's Miracle Network at UC Davis grant. 

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https://health.ucdavis.edu/health-news/children/new-effort-to-help-children-manage-pain-/2020/11
202010_rare-set-of-conjoined-twins-successfully-separated-in-24-hour-surgery-at-uc-davis-childrens-hospital Thu, 29 Oct 2020 07:00:00 GMT Rare set of conjoined twins successfully separated in 24-hour surgery at UC Davis Children’s Hospital <p>Nine-month-old conjoined twins Abigail and Micaela Bachinskiy are recovering at UC Davis Children&rsquo;s Hospital after surgeons successfully separated them in a marathon surgery on Oct. 23 and 24.</p> View our five-part video series of the first-ever separation of conjoined twins at UC Davis Children's Hospital. 

Nine-month-old conjoined twins Abigail and Micaela Bachinskiy are recovering at UC Davis Children’s Hospital after surgeons successfully separated them in a marathon surgery on Oct. 24 and 25.

The North Highlands (Sacramento County) twins were born connected at the head, a condition called craniopagus twins. Conjoined twins are already extremely rare, but craniopagus twins are even more so. Only two percent of conjoined twins are born fused at the head. Craniopagus twins occur in approximately one in every 2.5 million births.

The 24-hour surgery took place in the UC Davis Children’s Surgery Center in an operating room that was custom-built for this level of surgical complexity. This was the first separation of conjoined twins at UC Davis Children’s Hospital. The team of experts included more than 30 people: surgeons, nurses, anesthesiologists and other key surgical staff. They were led by pediatric neurosurgeon Michael Edwards, chief of plastic surgery Granger Wong, director of pediatric anesthesiology Rajvinder Dhamrait and Children’s Surgery Center nursing lead Aida Benitez.

“This is a landmark surgery for us at UC Davis Children’s Hospital,” said Edwards, who has had previous success separating conjoined twins. “Abigail and Micaela are doing well and recovering in our Pediatric Intensive Care Unit, thanks to an amazing team effort dedicated to ensuring these very rare twins have the best shot at a healthy life ahead. We are honored to have helped with their birth, cared for them since, and to now give them the chance to live independent and separate lives.”

Planning for the birth of conjoined twins

UC Davis Health has provided care for Abigail and Micaela from the start — even before birth.

Mom Liliya, 33, received the news that she was pregnant with conjoined twins when she was 11 weeks pregnant. Her doctor referred her to the UC Davis Fetal Care and Treatment Center for the extensive prenatal care she needed. It is the only comprehensive fetal diagnosis and therapy center in inland Northern California.


Liliya with Abigail and Micaela in the NICU

A fetal MRI provided more details about the anatomic structures of the twins. Conjoined manikin dolls were developed based on the MRI. This helped the team identify challenges with the twins’ positioning and assisted in planning for their delivery.

Simulations and scenarios were practiced for months to prepare for numerous possible risks: compromised airways, collapsed lungs, the need for a CPAP machine to aid in breathing or IV placement. CPAP headgear was custom-designed for each girl. The choreography was practiced and repeated for each scenario.  

Abigail and Micaela were born at UC Davis Children’s Hospital on Dec. 30, 2019. They spent seven weeks in the Neonatal Intensive Care Unit (NICU) before going home.

“We have felt so much support from staff. We have received so much help, so much advice. It has made us feel at home here,” Liliya said.

Separating twins conjoined at the head

Surgeons decided to separate the conjoined twins at nine months of age. They did not want to wait longer.

“As they get older, there are more risks of shared blood vessels and organs becoming larger or more entwined. The upcoming flu, COVID-19 and RSV season was also a concern,” lead plastic surgeon Granger Wong said.

To prepare for the procedure, the surgical team spent months carefully tracking the twins’ growth through MRIs and CT scans.


Abigail and Micaela

In June, Wong’s team placed custom-designed tissue expanders underneath the skin of the girls’ heads to encourage more skin to grow. This would ensure enough skin to cover the exposed area of their skulls upon separation.

High-tech preparation for the surgery included the 3D printing of multiple models of the twins’ fused skulls. The models allowed the team to plan and practice the surgery with a high degree of precision. Surgeons also were able to explore inside the twins’ heads with the use of mixed reality goggles. The technology provided an augmented view of the complex network of blood vessels the team would need to detangle and separate – before ever bringing the twins into the operating room.

The surgical team and family kept in close touch in the months leading up to the procedure. The surgeons made routine house calls to the family’s home, so the family would not need to come to the clinic for checkups amid the COVID-19 pandemic.

The separation surgery

Finally, this past Saturday, the practicing became reality for a team of more than 30 surgical professionals.   

With so many key players in one space, each with a distinct role to play, the team members were divided by color. Leaders Edwards, Wong, Dhamrait and Benitez donned black caps. Team Purple took care of Micaela, while Team Orange cared for Abigail; they donned surgical caps in either purple or orange for easy visibility in the operating room. Surgical residents wore grey caps and could assist with either girl. Purple and orange masking tape were used to label equipment for the respective teams in the operating room.


Members of the surgery team.

Overall command and control were led by Dhamrait and Benitez.

The plastic surgeon made the initial incisions. “It was like a choreographed ballet,” said Wong, who also created the design of skin flaps, removed the expanders and reconstructed the skull and scalp after the twins were separated.

Surgical challenges included dividing large veins and brain matter that connected the twins so they could have independent circulatory systems. The team performed a fistula ligation, a process that involved clipping and separating shared veins. During the surgery, the twins required five position changes, all of which posed potential complications. They also needed blood transfusions during the procedure.

Edwards announced, “Cranial separation!” when the babies were officially separated at 3:28 a.m. The surgical team clapped and cheered.

“After 10 months of preparation, we were witnessing what we had all envisioned for the girls and we were overcome with emotion and joy,” said Benitez. “I will never see 3:28 on a clock again and not think of the moment that Abi and Mica became two separate babies.”

Conjoined twins separated: “It was flawless”

Dhamrait led a team of six anesthesiologists who administered anesthesia and medication to maintain the twins’ blood pressure during and after separation. The twins’ shared anatomy complicated each anesthetic. “We were fortunate that we had anesthetized the twins four times prior,” said Dhamrait, who has taken part in a conjoined twins separation before. “It was flawless, with all contingencies covered.”


Edwin Kulubya, Michael Edwards, Rajvinder Dhamrait, Liliya and Aida Benitez

Throughout the 24-hour procedure, Benitez provided regular updates to the family, who was praying and nervously awaiting news about their girls.

Twenty-four hours later, on Sunday morning, the previously joined twins were resting comfortably — and separately — in their room in the UC Davis Pediatric Intensive Care Unit.

“Everything went well. It felt almost impossible to separate them, but God and the doctors and nurses at UC Davis made it possible. We are so thankful,” Liliya said. 

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https://health.ucdavis.edu/health-news/children/rare-set-of-conjoined-twins-successfully-separated-in-24-hour-surgery-at-uc-davis-childrens-hospital/2020/10
202010_four-tips-to-help-children-adjust-to-daylight-saving-time Fri, 23 Oct 2020 07:00:00 GMT Four tips to help children adjust to daylight saving time <p>Daylight saving time starts 11/1. Follow these four tips to help you and your kids adjust to the time change.</p> Next month, the clocks will turn back by an hour for daylight saving time. Cue the usual exhaustion. But UC Davis pediatrician Lena van der List offers four tips for families to help them ease into this new routine. Planning ahead is key, she said. 

    1. Set your child’s alarm 10 minutes later each morning, a week before the time change. “If your toddler wakes up before the alarm, just sit with them in their darkened room until it is time to get up. Then turn on the lights and start your day,” van der List said.
    2. Alternatively, move your child’s bedtime so it is 10 minutes later each day, starting one week before the time change. By doing this a little each day, it may help lessen the drastic one-hour change that will happen on Nov. 1.
    3. Some families prefer to extend wake times in between naps (by about 10 minutes to prevent an overtired or cranky toddler) that can help prepare for the "fall back" of the bedtime. 
    4. While a melatonin supplement can be helpful, you should discuss this with your child’s pediatrician before starting any new supplement. “A better method may be to augment your natural melatonin,” said van der List. “Get outside when it is light out. Turn off all screens at least an hour before bed, and keep to a regular nighttime routine: brush, book and bed.” 
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    https://health.ucdavis.edu/health-news/children/four-tips-to-help-children-adjust-to-daylight-saving-time/2020/10
    202010_epilepsy-expert-selected-as-neurology-department-chair Tue, 20 Oct 2020 07:00:00 GMT Epilepsy expert selected as neurology department chair <p>The UC Davis School of Medicine appointed internationally recognized neurologist Amy Brooks-Kayal professor and chair of the UC Davis Department of Neurology.</p> The UC Davis School of Medicine appointed internationally recognized neurologist Amy Brooks-Kayal professor and chair of the UC Davis Department of Neurology, effective this month. She also will hold the department’s Andrew John Gabor, M.D., Ph.D., Presidential Chair in Neurology.

    Brooks-Kayal is known globally for her work as a neurologist and researcher who has led advances in epilepsy, pediatric neurology and neuroscience. Her research has identified cellular and molecular changes involved in the transition of the brain from normal to epileptic, with the goal of developing therapies that target that transition.

    “Dr. Brooks-Kayal’s distinguished leadership and commitment to the academic missions of clinical care, education and neuroscience research have resulted in new therapies to improve the lives of people with neurological diseases,” said Allison Brashear, dean of the UC Davis School of Medicine. “Her leadership will enhance our neurology department’s considerable strengths in basic, translational and clinical neuroscience.” 

    Brooks-Kayal was most recently chief of Pediatric Neurology, professor of Pediatrics, Neurology and Pharmaceutical Sciences, and co-director of the Translational Epilepsy Research Program at the University of Colorado School of Medicine. For more than 20 years, she has led research focused on preventing seizures and associated cognitive changes. That research has been funded by the National Institute of Neurological Disorders and Stroke (NINDS).

    “Dr. Brooks-Kayal has long been an international leader in neurology research, education and mentoring, and patient care,” said Nina F. Schor, deputy director of NINDS. “Her vision has guided her division at the University of Colorado and the many national organizations she has served to achieve success in improving the lives of patients and families who deal every day with neurological disorders. UC Davis is fortunate to have attracted her to this leadership position.”

    Brooks-Kayal received her medical training at Johns Hopkins University, the University of Pennsylvania and Children’s Hospital of Philadelphia. She has held numerous leadership roles in the neurology, epilepsy and neuroscience research communities, including president of the American Epilepsy Society, member of the NINDS Advisory Council, chair of the National Institutes of Health, Clinical Neuroplasticity and Neurotransmitters review panel, and director of the American Board of Psychiatry and Neurology.

    A respected mentor, Brooks-Kayal has been widely sought to train graduate students, post-doctoral trainees and junior faculty in epilepsy, pediatric neurology and neuroscience. She was the principal investigator on the Neurological Sciences Academic Development Award K12 at the University of Colorado, and currently is a co-director of the national NINDS K12 Child Neurology Career Development Program.

    “What is unique about UC Davis School of Medicine’s Department of Neurology is its extraordinary breadth of expertise and its collaboration across all aspects of neuroscience ― from basic science to research developing new treatments to delivery of cutting-edge care to patients,” Brooks-Kayal said. “I look forward to continuing to expand these collaborative bridges in all facets of the department’s innovative and life-saving work.”

    Dean Brashear thanked her recruitment committee, including co-chairs Satyan Lakshminrusimha, chair of the Department of Pediatrics, and Melissa Bauman, professor of psychiatry and behavioral sciences, for leading the national search that led to Brooks-Kayal’s recruitment. She also offered special thanks to Charles S. DeCarli, professor of neurology and director of the UC Davis Alzheimer’s Disease Research Center, for his leadership as interim chair of the neurology department.

    The UC Davis Department of Neurology provides advanced care for neurological conditions such as dementia, epilepsy, movement disorders, tremor, dystonia, multiple sclerosis, neuromuscular conditions, headache and sleep disorders. The department faculty also leads investigations to improve the diagnosis and treatment of these conditions. More information about the department's team, clinics and research is on the department website.

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    https://health.ucdavis.edu/health-news/children/epilepsy-expert-selected-as-neurology-department-chair/2020/10
    202010_covid-19-is-making-halloween-2020-a-different-kind-of-scary Thu, 15 Oct 2020 07:00:00 GMT COVID-19 is making Halloween 2020 a different kind of scary <p>COVID-19 and trick-or-treating are a dangerous mix, say public health experts, and they worry about new surges in coronavirus cases because COVID-fatigued people won&rsquo;t heed the warnings.</p> The candy, trick-or-treating and general magic of Halloween for kids, their families and, really, almost everyone, has been one of the constants of American life for decades. And that is exactly why public health experts are nervous in this year of COVID-19.

    “I’m worried,” said Sheri Belafsky, a UC Davis Health physician in the Department of Public Health Sciences and the director of the Medical Surveillance Program. “You go into stores and see rows of candy that are saying, ‘This is like any other Halloween.’ But it isn’t, and we can’t pretend it is.”

    Belafsky and others fear gatherings and trick-or-treating could create large surges in transmissions of COVID-19, much the way the Memorial Day weekend and Fourth of July became almost national super-spreader events.

    Although a number of trusted sources, ranging from UC Davis Health to Sacramento County health officials to the American Academy of Pediatrics, have provided big lists of safe and fun alternatives for celebrating Halloween, the lure of trick-or-treating will be hard to contain.

    “There’s nothing like it for kids,” Belafsky said. “There’s the thrill of the hunt and of not knowing what surprises you’re going to find at the next house. When my kids were young, I tried offering them candy I had bought. They weren’t interested. They wanted to go door-to-door.”

    The allure of Halloween

    In this year of COVID-19, Halloween seems to be even more seductive. So do the lawn decorations, ads, TV shows and, of course, those candy displays. News stories and social posts quote plenty of people who say they’re worn down by COVID fatigue and just want to have some fun or to let their kids enjoy the night. This makes it all the harder to sound notes of caution.

    “To protect yourself and your community, you should not go trick-or-treating or mix with others outside allowed private gatherings this Halloween.”

    — California Department of Public Health

    “We don’t want to sound preachy,” said Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital, “but the safest thing would be not to go out at all. Many people may know that, but they don’t want to hear it because they’re exhausted. And Halloween is fun. Everyone wants some fun.”

    Blumberg filmed a video for UC Davis Health with tips for a safer Halloween. The core message says everyone from adults to kids should socially distance, wear real masks under or over their costumes (Halloween masks have slits for breathing and offer little protection) if they go out, and socialize only with their own households.

    “I have real concerns about whether it is feasible to go house to house with really excitable kids and stay socially distant and safe,” Blumberg said. “I just don’t see that happening. So one way is to celebrate at home with costumes, foods, a candy hunt and Halloween movies. It won’t be the same, but it will still be fun and it will keep your family and your community safe.”

    California strongly discourages trick-or-treating.

    State health officials added their voices to the warnings about Halloween this week. Although there is no outright ban on trick-or-treating, the newly revised Guidance for Safer Halloween and Dia de los Muertos Celebrations during COVID-19 makes the state’s position clear: don’t do it.


    There are plenty of ways for kids to have a safe and fun Halloween, including family parties in your yard.

    “To protect yourself and your community, you should not go trick-or-treating or mix with others outside allowed private gatherings this Halloween season,” the state guidelines say.

    Besides the large risk of transmitting COVID-19, the household mixing and general chaos on doorsteps as kids jostle for candy would making tracing infections nearly impossible. In effect, the state said, those kinds of doorstep gatherings are not permitted under COVID-19 guidelines.

    California does allow small gatherings with people from three households maximum, and urges people to keep the groups relatively small, stay six feet apart, wear masks and hold the gatherings outside with a two-hour limit.

    Making the message heard

    How do you get across an unpopular but important public health message? Carefully and honestly, Belafsky said.

    “We’re saying this will take some sacrifice,” she said. “We have to restrain ourselves. That doesn’t always resonate because it’s not what we want to hear.”

    That, in fact, is the best point to emphasize.

    “This message isn’t sexy,” Belafsky said. “It comes down to reminding people to think about others. In the spirit of concern for our neighbors, out of a generosity of thinking about our families, extended families, friends, co-workers and everyone else, we need to delay our own fun.”

    It’s also a message to offer to children who might be disappointed about a subdued Halloween this year.

    “It’s what I tell my own kids,” Belafsky said. “We want to be part of the solution in this pandemic. We want to help get all our lives back to normal. We want to be able to see our friends again. We can do that by being as careful as we can now. This won’t be my favorite Halloween, but a lot of people will be safer if we stay home.”

    Some reasons for optimism

    “It’s what I tell my own kids. We want to be part of the solution in this pandemic. We want to help get all our lives back to normal ... This won’t be my favorite Halloween, but a lot of people will be safer if we stay home.”

    — Sheri Belafsky

    “Go back a few years when we were giving kids a lot of safety warnings about Halloween,” Belafsky said. “We said, ‘Walk in groups, go out with parents, don’t accept candy that isn’t store wrapped,’ and lots more. We can do the same thing for COVID-19. We can say, ‘You can still have fun, it’s just going to take some effort.’”

    Blumberg said it may take 2-4 weeks – through one or two incubation periods – to get a good read on whether COVID-19 infection rates spike because of Halloween or if the cautions were heard.

    And at least some people are hearing them already, he said.

    “I’ve seen skeletons on display wearing masks,” Blumberg said. “So that’s a good message.”

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    202010_pickleberry-pie-hosts-monthly-virtual-concert-series-with-uc-davis-childrens-hospital Thu, 15 Oct 2020 07:00:00 GMT Pickleberry Pie hosts monthly virtual concert series with UC Davis Children’s Hospital <p>Pickleberry Pie will perform live concerts on the UC Davis Children&rsquo;s Hospital Facebook page monthly for hospitalized patients and the public.</p> Pickleberry Pie has been visiting children’s hospitals nationwide to provide the gift of music to hospitalized children. This month, the award-winning musicians Lori and RJ will kick off a monthly Facebook Live Family Fun Night on the UC Davis Children’s Hospital Facebook channel to give kids and families an opportunity to enjoy concerts virtually during the COVID-19 pandemic.

    The concerts will be broadcast live on the third Wednesday of every month at 5:30 p.m. on Facebook.com/UCDavisChildrensHospital. The videos will be stored on the Facebook page and can be watched any time. 

    “These musical performances would have been played in person, bedside or in a playroom, pediatric intensive care unit or nurse’s station in a hospital setting. But this time, we are bringing the healing power of live music to children in the hospital as well as kids at home,” said Lori.

    Pickleberry Pie has performed in the pediatrics playroom many times over the years.

    “The concerts are always really fun both for patients and staff. We are really excited to expand the concert series to social media to also include siblings, families, past patients and our staff’s family members at home,” UC Davis music therapist Tori Steeley said.

     

     

     

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    202010_nicu-webcam-program-positively-impacts-parents-study-finds Wed, 14 Oct 2020 07:00:00 GMT NICU webcam program positively impacts parents, study finds <p>NICU parents feel more involved in their infant&rsquo;s care, more likely to provide breastmilk to their baby when they can watch their child in the NICU, thanks to a webcam.</p> Parents who can watch their baby through a webcam in the Neonatal Intensive Care Unit (NICU) feel more involved in their child’s care and are more likely to provide breastmilk feedings for their baby. These findings were published in Telemedicine and E-Health last month.

    “Our study emphasizes the importance of parental bonding in the NICU and the effect that video viewing has on families,” said Kristin Hoffman, a study investigator who started FamilyLink, a NICU webcams program at UC Davis Children’s Hospital. FamilyLink gives families the option to see their baby through a secure connection from a home computer, tablet or cellphone 24/7, when they are not at the bedside.

    The UC Davis Health study, titled “Impact of a Parent Video Viewing Program in the Neonatal Intensive Care Unit,” enrolled 119 families whose babies stayed in the UC Davis NICU for at least two or more weeks between September 2017 to September 2019. A six-month break in the study took place between April and October 2018, due to changes in study personnel.

    During this time, families were asked to complete a 14-question survey twice – once at hospital admission and once at hospital discharge. They were asked to rate a list of statements (for example, “I feel informed about my baby’s condition,” “I feel involved in my baby’s care,” and “I plan to breastfeed my baby”) on a scale from 1 (strongly disagree) to 7 (strongly agree).

    Previous research has found that parents and families report stress, anxiety and the feeling that they lack control when their babies are admitted to the NICU.  Many studies have shown that these feelings are lasting and can permanently affect the parent-child bond. But would seeing their baby more often through a webcam or video viewing system in the NICU improve how parents and families feel about their child’s hospitalization and increase the likelihood that they would breastfeed their baby?

    When parents used FamilyLink, they reported sustained intention to breastfeed or provide breast milk to the baby (83% of mothers who used FamilyLink intended to breastfeed or provide breast milk to their baby compared to 66% of mothers who did not use FamilyLink). Surveys also showed a statistically significant increase in perceived parental involvement in their baby’s care.

    “One exciting finding from our study is the observation that families who used FamilyLink were more likely to provide breastmilk for their baby. We are excited to investigate this finding further with a study currently ongoing in our NICU, looking at the volume and content of milk mothers produce while viewing their baby in comparison to pumping without the use of FamilyLink and mother's attitudes about pumping while using FamilyLink,” Hoffman said.

    The UC Davis FamilyLink program was piloted in 2017 and consisted of 10 webcams mounted on tripods, affixed to an isolette or crib and directed toward the baby. The program has grown exponentially over the years and now offers a webcam for each of the 49 beds in the UC Davis NICU, with automatic enrollment in FamilyLink at hospital admission. The FamilyLink program was funded by a Children’s Miracle Network at UC Davis grant.   

    The study authors are Kristin Hoffman, Hadley Sauers-Ford, Daniel Tancredi and James Marcin, of UC Davis Health; Ashley Hanhauser, of UC Davis; Jennifer Weber, of Phoenix Children’s Hospital; and Kristin Sohn, of the University of Nevada Reno School of Medicine.

    This project was supported by the National Center for Advancing Translational Sciences (NCATS) and National Institutes of Health (NIH), through grant UL1 TR000002.

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    202010_three-year-old-spina-bifida-patient-walks-runs-thanks-to-fetal-surgery Tue, 13 Oct 2020 07:00:00 GMT Three-year-old patient with spina bifida walks, runs, thanks to fetal surgery (video) <p>Three years ago, Chloe MacCullough received the life-changing news that her unborn child had spina bifida. She thanks the team at the UC Davis Fetal Care and Treatment Center for the surgery that changed her son&rsquo;s life.</p>
    His parents were told he would never be able to walk due to spina bifida. See what Remington can do now.

    Three years ago, Chloe MacCullough received the life-changing news that her unborn child had a neural tube defect. After further testing, her baby was diagnosed with myelomeningocele, better known as spina bifida. She was told he may never be able to walk.

    “Looking back on it, I get a little emotional thinking about how scary it was. I wish I knew then what I know now,” Chloe said. “Being a first-time mother, you envision your child’s future. And when something doesn’t line up with the way that you viewed it, it’s really hard to move past that.”

    Spina bifida occurs when spinal tissue fails to fuse properly during the early stages of pregnancy, leading to a range of lifelong cognitive, mobility, urinary and bowel disabilities. It affects 1,500 to 2,000 children in the U.S. every year.

    Only four hospitals in California specialize in fetal surgery, which can treat spina bifida in the womb. Chloe, an Esparto resident, was lucky to be living less than an hour away from one.

    After her baby’s diagnosis, Chloe’s doctor referred her to the UC Davis Fetal Care and Treatment Center, inland Northern California’s first comprehensive fetal diagnosis and therapy center. It is the Sacramento area’s only choice for on-site fetal surgery, including open fetal surgery, for spina bifida. It is led by Shinjiro Hirose, a nationally recognized fetal surgeon.  

    Chloe and Kyle MacCullough met with Hirose to discuss their options.

    “It was very stressful and there were so many unknowns, but we had a great team at UC Davis,” said Kyle MacCullough, Chloe’s husband. “Dr. Hirose was awesome. He was very good at letting us know that there was light at the end of the tunnel.”  

    After an MRI and amniocentesis ruled out any genetic abnormalities, Chloe was cleared for fetal surgery – a two-and-a-half hour operation that would change her life and her unborn baby’s future.  

    During surgery, Hirose made a caesarian-section like incision on Chloe’s uterus to expose the defect on her baby’s back. Pediatric neurosurgeon Marike Zwienenberg worked with Hirose to repair the defect so further damage would not take place in the womb.

    A groundbreaking treatment
    A UC Davis Health team has received FDA approval to test a groundbreaking spina bifida treatment combining fetal surgery with stem cells, which could improve outcomes for more spina bifida patients. A clinical trial is expected to begin in early 2021. Read more

    On Sept. 4, 2017, Chloe gave birth to Remington MacCullough at UC Davis Medical Center.  

    Spina bifida patients can develop mobility issues, bladder or bowel incontinence, and hydrocephalus, a build-up of fluid in the ventricles within the brain, which often requires a shunt to drain the fluid.

    But Remington was kicking his legs, moving around and lifting his pelvis off the bed within days of his birth. He did have hydrocephalus, but he never needed a shunt. It was a positive sign.

    Remington has continued to surprise his parents Chloe and Kyle over these last three years. Their favorite milestone? Remington’s first steps.

    “He would go a couple of steps and fall into us,” remembered Kyle. “He was laughing because we were laughing. We were really celebrating that he was able to do that.”

    Chloe remembers hoping during her pregnancy that her son could at least swing his hips and have some form of upright mobility.

    Now three years later, you would never know Remington was diagnosed with spina bifida. His parents call him curious, adventurous and a jokester. He is active and likes to run around. 

    “We made the right decision for him with the right hospital with the right doctors,” Chloe said. “Remi is a little blessing. We are so thankful.”

    “We would recommend UC Davis to anyone,” Kyle said.

    Related stories and resources

    Spina bifida MOMS trial
    Prenatal stem cell treatment improves mobility issues caused by spina bifida
    Spina bifida patient healthy, happy after fetal surgery
    Stem cell treatment for children helps dogs first
    UC Davis Health and Shriners Hospital partner to provide expertise to spina bifida patients
    Researchers seeking a cure for spina bifida get a step closer to their goal
    Alex’s story
    Learn about spina bifida (information from the U.S. Centers for Disease Control and Prevention)

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    202010_how-to-help-babies-toddlers-sleep-through-the-night Wed, 07 Oct 2020 07:00:00 GMT How to help babies, toddlers sleep through the night <p>UC Davis pediatrician Lena van der List offers sleep tips for babies, toddlers.</p> Sleep is on every parent’s mind. The American Academy of Pediatrics estimates that sleep problems affect 25 to 50 percent of children and 40 percent of adolescents. UC Davis pediatrician Lena van der List comes to the rescue to answer some frequently asked questions to help parents (and their children) sleep through the night.

    What is a normal amount of sleep for a newborn baby and for an infant? 

    • Newborns average 16-17 hours of sleep per day. They usually sleep for one to four hours at a time. Then they are awake for one to two hours before falling back asleep.
    • At four to six months, infants average about 14 hours of sleep per day.
    • Children ages 1 to 3 years should get about 12 hours per day.

    Children gradually need less sleep. By the time they are adolescents, they should get about nine hours of sleep per night.

    There’s a range of sleep that individuals need. Every child may not be right on the average. Sleep can be affected by the child’s temperament.

    Why is bedtime such a struggle for children?

    One of the causes may be separation anxiety, which starts at around eight months of age. At an early age, if children don’t see something or someone because it’s covered up or in the next room, they think it’s actually gone. In psychology, it’s called object permanence.

    If the parent puts the child down for sleep and then leaves the room, the child might experience separation anxiety. Then, the child might be so upset that they cry until the parent returns. Sometimes, parents might decide to sleep in the same room, or have the baby fall asleep in their bed, then transfer the child to their crib, but the child needs to learn how to sleep on their own.

    How long is a baby’s sleep cycle?

    Older children and adults have rapid eye movement (REM) and non-REM sleep cycles every 90-110 minutes. But the newborn sleep cycle is about half of that, every 50 minutes. REM sleep is relatively active, and sometimes the baby smiles, sucks, frowns or the arms and legs might twitch a little. At the end of the sleep cycle, sometimes there is a brief arousal. But it’s important to remember that the baby is not actually awakening. Sometimes parents think that this behavior is their baby waking up and then they pick them up and create a real awakening.

    Why does my toddler keep delaying bedtime?

    This usually occurs in kids around 2 years of age and can be a real problem. The toddler may call for one more of something. One more book read to them. One more glass of water. This can happen when parents are not setting limits. The increased attention that parents pay to the child actually reinforces this behavior. It’s important to be consistent with bedtime rules.

    Establish a routine and to stick to it. And then no back-sliding, like rewarding them by responding differently on weekends, for example, because this will just spill over into the next week.

    What are some tips to help my child sleep? 

    • The bedroom should be dark and quiet.
    • Give your child a consistent blanket, stuffed animal or favorite toy. The transitional object can really be reassuring to children as they go through the separation anxiety phase because they are comforted by it. But have multiples of every transitional object, in case one needs to get cleaned or becomes lost. These need to be exactly the same.
    • Routine is important. It should be soothing and quiet. Some examples include reading a book, singing a quiet song, praying, tucking the child in and kissing the child goodnight. For most families, that will take less than 30 minutes, but the routine is different for every family.

    What if my child’s sleep problems aren’t getting better?

    Parents should talk with their pediatrician. Most pediatricians have a lot of experience in this area.

    What if there are still problems despite talking with the pediatrician? Should my child see a sleep specialist? Or should I give my child a sleep medication?

    Check with your pediatrician regarding any sleeping medication. Seeing a specialist is a good idea to consider in some difficult cases. Some of these issues relate to behavior and parent-child interaction. A pediatrician specializing in child development might be the next step. Also, there are pediatric sleep medicine specialists who might be a helpful resource.

    Find more sleep tips for kids on our sleep page.

    Additional resources

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    202010_partnership-with-community-hospital-in-lodi-featured-in-nejm-catalyst Fri, 02 Oct 2020 07:00:00 GMT Partnership with community hospital in Lodi featured in NEJM Catalyst <p><a href="https://children.ucdavis.edu/">UC Davis Health</a>&rsquo;s partnership with <a href="https://www.adventisthealth.org/provider-careers/locations/central-california/adventist-health-lodi-memorial/">Adventist Health Lodi Memorial Hospital (AHLM)</a> was highlighted in a recent issue of <a href="https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0025?query=CON&amp;cid=DM97604_Catalyst_Subscriber&amp;bid=247484578">New England Journal of Medicine (NEJM) Catalyst</a>.</p> UC Davis Health’s partnership with Adventist Health Lodi Memorial Hospital (AHLM) was highlighted in a recent issue of New England Journal of Medicine (NEJM) Catalyst.

    The case study was authored by Pediatric Medical Director Michelle Y. Hamline, Strategic Business Specialist Kelly Forman, Director of Community Hospital Affiliations and Partnerships Khanh-Nhat Tran-Viet, Chief of the Division of Pediatric Hospital Medicine Heather McKnight, Chair of Pediatrics Satyan Lakshminrusimha, and UC Davis Health CEO David Lubarsky.

    “UC Davis has a national reputation for treating complex diseases, but care is expensive, and despite serving a vast geography, care is largely bound to the medical center in Sacramento,” reads the article summary. “A new partnership between their tertiary care academic medical center and a not-for-profit community hospital, termed ‘constructive self-cannibalism,’ designed to increase pediatric skill level and keep more patients near their homes, produced a marked increase in admissions at the community hospital as well as a reduced length of stay at the hospital.”

    The article found that although transfers to the academic medical center decreased, the severity of illness of the transferred patients increased. This increase in complexity of transferred patients benefited UC Davis, while also allowing many children with lower severity illnesses to be cared for at a hospital closer to home.

    The authors conclude, “As health care reform continues to challenge how we deliver care, it is vital that we think innovatively to create a more integrated care-delivery model. A model in which community and academic hospitals complement one another, rather than compete, serves as a winning strategy for both organizations.”

    To read the article, titled, “Constructive Self-Cannibalism: Pediatric Affiliation Between an Academic University and a Community Hospital,” visit the NEJM Catalyst website.

    Related stories

    Adventist Health Lodi Memorial celebrates partnership with UC Davis Health at community event

    Adventist Health Lodi Memorial announces level II NICU

    Adventist Health Lodi Memorial and UC Davis Health announce partnership

    UC Davis Health, Adventist Health Lodi Memorial launch telehealth ICU services

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    202009_sacramento-teens-diabetes-diagnosis-came-as-a-complete-surprise-i-was-in-shock Wed, 30 Sep 2020 07:00:00 GMT Sleepiness leads to dangerous diabetes diagnosis <p>Ameiah Williams&rsquo; 450+ blood sugar levels were a medical emergency.</p> It is well known that teenagers need more sleep than kids at other ages, but that didn’t explain why 13-year-old Ameiah Williams was falling asleep at the table while doing homework.

    “It just wasn’t like her,” Ameiah’s mom Josette Williams said. “She was completely out. It was hard to wake her.”

    Williams spoke with a doctor friend and told him what was happening with her daughter. She was surprised when he said to take Ameiah to get her blood sugar tested … now.

    At the appointment, Williams could tell something was really wrong.

    “The medical assistant’s face told a story,” Williams said. “I just didn’t know what it was.”

    She soon learned. Ameiah’s blood sugar levels had spiked and she needed to go to the UC Davis Pediatric Emergency Room immediately.

    “I had never experienced anything like this before. I was in shock,” said Williams, who also has two younger daughters. “But not Ameiah. She just rolled with it. She was so brave.”

    The teen’s blood sugar was at 456, a dangerously high level. Called hyperglycemia, this can lead to a diabetic coma where you can't awaken or respond to sights or sounds. Left untreated, a diabetic coma can be fatal.

    “High blood sugar levels occur when your body produces too little insulin, or your body cannot use insulin properly,” said pediatric endocrinologist Abigail Fruzza, Williams’ physician. “Medical treatments can include administering intravenous insulin on a continuous basis and IV fluids to treat dehydration.”

    Ameiah was admitted to the hospital, where she began treatment.


    Now 16 years old, Ameiah Williams was accepted to a two-year culinary program through her high school and longs to be a chef.

    “This was a very scary experience, but the UC Davis Children’s Hospital staff was amazing with Ameiah and with me,” Williams said. “They were so calm and assured us they had everything under control.”

    “With the help of UC Davis, nurses like Richard – he was so cool – and with my parents and church family's support and prayers, I was able to experience my treatment with positivity," patient Ameiah Williams said.

    By the time Ameiah was discharged four days later, she had learned to administer her own medication injections, manage her diet and understand her diabetes. Now, more than two years later, the almost 16-year-old is an aspiring chef who continues to manage her diabetes and visits Fruzza three times a year.

    In the meantime, her mom still keeps in contact with the UC Davis Pediatric Diabetes Clinic through MyUCDavisHealth. The tool helps her securely and confidentially communicate with the care team, review medical records and ask questions via computer, tablet or smartphone. The tool has helped Williams feel more connected between appointments.

    “I am so grateful for what UC Davis has done for Ameiah and hold them in such high regard,” Williams said. “They are like family and it’s nice knowing I can reach out any time.”

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    202009_six-tips-to-make-the-flu-shot-less-scary-for-your-child Wed, 30 Sep 2020 07:00:00 GMT Six tips to make the flu shot less scary for your child <p>Flu shot season can bring stress and anxiety for many children. Follow these 6 tips to make flu shot time less scary.</p> Flu shot season can bring stress and anxiety for many children. UC Davis child life specialist Marisa Martinez helps children cope with painful procedures while they are in the hospital. She offers these six tips to parents and caregivers to make flu shot time less scary:

    • Start with a comfort hold. Cuddle your child while they are sitting on your lap, either facing toward or away from you, leaving one of their arms free. This provides comfort and can ease anxiety.
    • Create trust and honesty with your child. Be truthful about what is going to happen when they get their shot so they know what to expect.
    • Use ice ahead of time to numb the spot of their arm where they will get their shot – and give the child the choice of which arm to use.
    • Ask them if they want to count to three before their shot – or try bringing some bubbles and have them do some deep breathing by blowing bubbles. See how many bubbles they can blow with one deep breath – and have the shot go in while they are exhaling.
    • Give your child the choice of which character band aid to use afterwards. Offer as many choices as possible.
    • Reward your child for their hard work – give them a choice of fun options (for example, a delicious treat, an activity they enjoy, an extra story at storytime) so they can decide for themselves.

    “The key here is letting children make as many decisions as you can. There’s so much that is out of their control during a flu shot, but by allowing them to make some choices, it will help them feel more in control of their situation,” Martinez said. “The goal of providing choices and setting realistic expectations is to set the child up for success for future medical appointments.”

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    202009_congenital-heart-patient-receives-continued-care-from-heart-nurse-through-the-years Tue, 29 Sep 2020 07:00:00 GMT Congenital heart patient receives continued care from heart nurse through the years <p>Born with only three functioning heart chambers instead of four, Amanda had health challenges from her very first day of life. But pediatric heart nurse Barb Goebel has helped shepherd her care into adulthood.</p> Born with only three functioning heart chambers instead of four, Amanda Kwok had health challenges from her very first day of life.

    “I found out two months before her birth about her heart defect in an ultrasound. I received a lot of love and support from my family and friends and Amanda had a lot of people praying for her. This helped me get through stressful times and stay positive,” said Linda Underwood, Amanda’s mother, who is a nurse.

    With less oxygenated blood flow, Amanda’s lips, hands and feet were sometimes purple, and she would tire easily. Amanda had her first open-heart procedure, the Glenn shunt, at six months old. Her second open-heart procedure, the Fontan procedure, was at 2 years old. The surgeries, which took place at a Bay Area hospital, helped rebuild parts of her heart and improve blood flow throughout her body.  

    The family moved from the Bay Area to Lincoln when Amanda was 6 years old and discovered that Barb Goebel, one of Linda’s friends from nursing school, was a pediatric cardiology nurse at UC Davis Children’s Hospital.

    “It was a wonderful surprise,” Underwood said. “Barb is an excellent nurse and has been such a support over the years. We’ve been very impressed with all of the care Amanda has had over the years at UC Davis Children’s Hospital.”

    For more than 15 years, Goebel has assisted the family through Amanda’s checkups, procedures and appointments.  


    Linda Underwood and Barb Goebel during nursing school.

    “Amanda is a lovely young lady. It’s so nice to see our complex heart kids grow up to be nice functioning young adults,” Goebel said. “As we continue to advance in the field of congenital heart defects (CHD), both surgically and medically, we will continue to see more children like Amanda with complex forms of CHD who are thriving well into adulthood.”

    Amanda is now 23 years old and a college graduate with a business degree. She continues to receive care from pediatric cardiologist Jay Yeh and the UC Davis Pediatric Cardiology team. She takes daily heart medication and continues to get routine tests and procedures to evaluate her cardiovascular health.

    “I’ve had a great experience. Everyone knows what they are doing and they are good at explaining everything so you know what to expect,” Amanda Kwok said.

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    202009_new-grant-will-help-rural-hospitals-care-for-moms-with-opioid-use-disorder- Mon, 28 Sep 2020 07:00:00 GMT New grant will help rural hospitals care for moms with opioid use disorder <p>UC Davis Health will help rural maternal and infant health care providers care for pregnant and post-partum mothers with opioid use disorder and their infants.</p> A UC Davis Health team was awarded a $500,000 grant by the Health Resources and Services Administration (HRSA) to develop and share best practices with rural maternal and infant health care providers. The goal is to help pregnant and post-partum mothers with opioid use disorder (OUD) and their infants, who may develop neonatal abstinence syndrome (NAS). The three-year grant starts this month.  

    Through the project, titled “Optimizing Pregnancy and Infant Outcomes in Drug (OPIOID) Addiction and NAS,” UC Davis Health physicians will provide education and training so health care teams in rural hospitals can treat and care for patients in their communities.  

    “This program aims to put evidence-based best practices into effect in rural hospitals to keep moms and babies together in their home communities,” said Kara Kuhn-Riordon, who is the grant’s co-primary investigator and a neonatologist at UC Davis Children’s Hospital. “Traditionally these moms and babies are transferred to tertiary care facilities like UC Davis Medical Center because their rural care providers and hospitals can lack the necessary knowledge, resources or comfort it takes to care for them.”

    By keeping moms and babies together, patient families are less likely to experience stress and financial burdens and could potentially benefit from early parent-child bonding and breastfeeding success.

    UC Davis Health will provide an outlet for health care providers in rural community hospitals to discuss patient cases, receive feedback from UC Davis Health clinicians and receive ongoing curriculum, including topics such as reducing stigma and bias.

    “We look forward to improving the experiences of moms and babies in rural Northern California and giving them the care they need in their own communities,” Kuhn-Riordon said.

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    202009_spina-bifida-surgery-plus-stem-cells-before-birth-could-improve-outcomes Thu, 24 Sep 2020 07:00:00 GMT Spina bifida: Surgery plus stem cells before birth could improve outcomes (video) <p>A UC Davis Health fetal surgeon and a stem cell scientist have received approval from the U.S. Food and Drug Administration to test a one-of-a-kind spina bifida treatment that combines surgery with stem cells.</p>
    This video is best viewed in Chrome or Firefox.

    A UC Davis Health fetal surgeon and a stem cell scientist have received approval from the U.S. Food and Drug Administration (FDA) to test a groundbreaking spina bifida treatment that combines surgery with stem cells. The one-of-a-kind treatment, delivered while the baby is still in the mother’s womb, could improve outcomes for children with the birth defect.


    The new treatment is a unique combination of surgery and a stem cell “patch” provided while the baby is still in the womb. (Click for larger image.) Illustrations copyright UC Regents and Zina Deretsky.

    Spina bifida occurs when spinal tissue improperly fuses during the early stages of pregnancy, leading to a range of lifelong cognitive, mobility, urinary and bowel disabilities. It affects about 1,500 to 2,000 children each year in the U.S.

    The new treatment was developed by Diana Farmer, professor and chair of the UC Davis Department of Surgery, surgeon-in-chief of UC Davis Children’s Hospital and an expert in prenatal treatment of pediatric conditions. Her chief collaborator on this work is Aijun Wang, an associate professor of surgery and biomedical engineering and leader in developing cellular therapies that promote tissue regeneration.

    Answers fueled by collaboration


    Fetal surgeon Diana Farmer has been on the path to curing spina bifida throughout her career.

    Farmer and Wang have been working for years to prepare for human clinical trials. Their preliminary work proved that prenatal surgery combined with a specific type of stem cells (human placenta-derived mesenchymal stromal cells, or PMSCs), if held in place with a biomaterial scaffold, helped lambs with spina bifida walk without noticeable disability. It is believed that the stem cells work to repair and restore spinal tissue, beyond what surgery can accomplish alone.

    When the team refined their prenatal surgery and stem cells technique for canines, the treatment also improved the mobility of dogs with spina bifida that were treated by UC Davis veterinary medicine experts.

    Now, once clinical trials funding is obtained, Farmer and Wang will recruit pregnant women whose babies have been diagnosed with spina bifida to test this combined surgery and stem cell procedure. The clinical trial is expected to begin in January or February of 2021.

    A surgeon driven to find a cure

    Farmer’s career has been defined by her passion for finding a cure for spina bifida. As a leader of the MOMS trial, she proved that in utero surgery to repair the spinal cord injury reduced the neurological deficits of spina bifida. Many children in the study, however, still required wheelchairs or leg braces.

    She recruited Wang specifically to help take that work to the next level. Together, they launched the UC Davis Health Surgical Bioengineering Laboratory to find ways to use stem cells to advance the effectiveness of surgery and improve functional outcomes for patients.


    Farmer’s chief collaborator on this work is stem cell scientist Aijun Wang.

    She also launched the UC Davis Children’s Hospital Fetal Care and Treatment Center (with pediatric surgeon Shinjiro Hirose) and UC Davis Children’s Surgery Center to provide comprehensive diagnostic, medical and surgical solutions for fetal, newborn and pediatric conditions. These centers are where clinical trial participants will be treated.  Follow-up care will take place at UC Davis Children’s Hospital and Shriners Hospitals for Children — Northern California.

    Farmer and Wang’s work has been funded by the National Institutes of Health, California Institute for Regenerative Medicine and Shriners Hospitals.

    More information about UC Davis Health — including its children’s hospital, fetal care center, surgical services and stem cell research program — is at health.ucdavis.edu.

    Related stories and resources

    Spina bifida MOMS trial
    Prenatal stem cell treatment improves mobility issues caused by spina bifida
    Spina bifida patient healthy, happy after fetal surgery
    Stem cell treatment for children helps dogs first
    UC Davis Health and Shriners Hospital partner to provide expertise to spina bifida patients
    Researchers seeking a cure for spina bifida get a step closer to their goal
    Alex’s story
    Learn about spina bifida (information from the U.S. Centers for Disease Control and Prevention)

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    https://health.ucdavis.edu/health-news/children/spina-bifida-surgery-plus-stem-cells-before-birth-could-improve-outcomes/2020/09
    202009_multiple-surgeries-at-uc-davis-childrens-hospital-save-preemies-life Thu, 24 Sep 2020 07:00:00 GMT Multiple surgeries at UC Davis Children’s Hospital save preemie’s life <p>Life-threatening condition is no match for Alfredo Moran-Arias and his UC Davis doctors.</p> Ruby Moran was 20 weeks pregnant when she was involved in a head-on collision. Although she and her unborn baby survived the car accident, weeks later, pregnancy complications would turn their world on its head.

    “It all happened so fast,” Moran said. “I was so scared.”

    Moran’s baby was not due until November, but Alfredo Moran-Arias was born at UC Davis Children’s Hospital on Aug. 18, 2019. He weighed a little over 2 pounds when he was delivered at 27 weeks gestation and was admitted to the UC Davis Neonatal Intensive Care Unit (NICU).

    “As a new mom, you imagine the birth of your child and how it’s going to go,” Moran said. “I did not picture this.”

    Moran got more troubling news a week into Alfredo’s NICU stay. Alfredo had Necrotizing Enterocolitis or NEC.

    “We had never heard of NEC so initially, we didn’t know about the prognosis,” Moran said. “When we found out, we were terrified.”

    Necrotizing enterocolitis is mostly seen in very preterm newborn infants although rarely, it can be seen in term babies as well. It’s a serious illness that causes inflammation and tissue death in the intestines. This combination can destroy sections of the intestine leading to perforation or rupture. This makes bacteria inside the intestinal tract leak into the blood stream and sometimes out into the abdominal cavity. 


    Born two months early, baby Alfredo was diagnosed with NEC, a life-threatening condition.

    “When inflammation of the intestines leads to tissue death, the segments of dead intestine have to be surgically removed and in these cases an ostomy - an opening (stoma) from an area inside the body to the outside - is required,” said Mark Underwood, chief of neonatology at UC Davis Children’s Hospital. “NEC is a common cause of death in very preterm babies like Alfredo. Those who survive sometimes require more than one surgery and can have long-term challenges with growth and development.”

    But with the help of doctors and nurses in the UC Davis NICU and skilled pediatric surgeons who operated seven times – most recently, last month – Alfredo has beaten the odds so far.

    “He’s a fighter and hasn’t given up,” Moran said. “I am so proud of him and am blessed he is still here with us.”

     “I can’t thank UC Davis Children’s Hospital enough. My son is doing so well,” Moran said. “It really is the best hospital and the people are amazing. They made us feel like family and kept us all smiling and full of hope.”

    Related Links:

    Constantly connected: A webcam for every NICU bed

    Being there when you can't

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    https://health.ucdavis.edu/health-news/children/multiple-surgeries-at-uc-davis-childrens-hospital-save-preemies-life/2020/09
    202009_pandemic-prompts-local-family-to-pay-it-forward Thu, 24 Sep 2020 07:00:00 GMT Pandemic prompts local family to pay it forward <p>The Martino's honor their son's memory with a donation to UC Davis Children's Hospital Child Life and Creative Arts Therapy Department.</p><p>&nbsp;</p> When COVID-19 shut down schools and businesses in March, Jodi Martino scrambled to help her four kids adjust to remote learning. Albeit challenging, Martino could not help but think of what other kids were facing. Not just students, but pediatric patients hospitalized at UC Davis Children's Hospital.

    “Our son, Matteo, died unexpectedly in his sleep at our home, with no prior health issues," Martino said. "At the time, I was working in marketing at Lucile Packard Children's Hospital, knee-deep in stories of children impacted by the child life and facility dog programs."

    When the pandemic hit, Martino knew there was no more important time than now for the social and mental health support child life specialists and canine team members provide. The Martinos wanted to support sick children facing life-threatening health challenges and give them comfort, especially since policy restrictions mean they are isolated in their rooms.

    That's when Jodi and her husband, Dan, turned to Matteo’s Dream Fund. Established in their son's memory more than a decade ago, thousands of dollars have been raised for children’s hospitals. 

    "Our hope was to make their hospital stay a little less scary and more comfortable, as we were living the flip side of shock, disbelief and grief,” Jodi Martino said.

    Now, with a bustling household and two loving canines, the family decided to make its final Dream Fund gift to the UC Davis Child Life and Creative Arts Therapy Department’s facility dog program. They recently delivered the donation to the child life team and its three resident dogs: Huggie, Paloma and Zeebee. 

    “We wish we would have had a chance to fight whatever it was that took Matteo's life and work with the amazing child life specialists. But we never had that chance," Martino said. "This was our way of paying it forward." 

    Canine Companions for Independence provides the facility dogs free of charge so the Martino family contribution will help the hospital provide for the facility dogs' care. The donation will help with the costs of medical visits, grooming, food, bedding and toys.  

    UC Davis Children's Hospital's facility dog program is a popular one with patients and families and is always in need of contributions to keep the dogs fit and healthy. To give directly, click here

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    https://health.ucdavis.edu/health-news/children/pandemic-prompts-local-family-to-pay-it-forward/2020/09
    202009_deftones-raises-funds-for-uc-davis-childrens-hospital-through-adopt-a-dot-campaign Wed, 23 Sep 2020 07:00:00 GMT Deftones raises funds for UC Davis Children’s Hospital through Adopt-a-Dot campaign <p>The Grammy Award-winning band Deftones has launched a philanthropic campaign called &lsquo;Adopt-a-Dot&rsquo; based on their forthcoming album, Ohms. All proceeds will benefit UC Davis Children&rsquo;s Hospital and Live Nation&rsquo;s &lsquo;Crew Nation,&rsquo; a global relief fund for live music crews who have been impacted by COVID-19. Donations can be made at Deftones.com/Adopt.</p> The Grammy Award-winning band Deftones has launched a philanthropic campaign called ‘Adopt-a-Dot’ based on their forthcoming album, Ohms. The cover art, created by Frank Maddocks, features thousands of pixelated dots, and fans can make a charitable donation for one, or multiple dots.

    All proceeds will benefit UC Davis Children’s Hospital and Live Nation’s ‘Crew Nation,’ a global relief fund for live music crews who have been impacted by COVID-19. Donations can be made at Deftones.com/Adopt.

    There are 12,995 dots available and each dot is $20. Once a donor adopts their dot(s), they can upload their photo to the site and be a part of the album cover for these two special causes. Ohms is set for release this Friday, Sept. 25, via Warner Records / Reprise.

    "Congrats to the Deftones, Sacramento’s band! We are honored and proud they have selected to support UC Davis Children’s Hospital, Sacramento’s only nationally ranked academic hospital for children. Money raised will fund music therapy for our hospitalized kids," said Judie Boehmer, executive director of patient care services at UC Davis Children's Hospital. 

    ‘Adopt a Dot’ comes on the heels of Deftones’ recently released song and video “Genesis” and  the previously released video for the title track to  “Ohms.” 

    ABOUT THE ART:

    "(The) Ohms album art is an iconic rendering of a suspended, chance moment in time. As with Deftones music and lyrics, the definitive meaning of the imagery invites and relies on interpretation from the viewer. From a dreamy gaze above, to sadness, hope, despair, optimism and a longing for connection, the emotions conveyed are endless and infinitely evolving." - Frank Maddocks, Creative Director, Deftones

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    https://health.ucdavis.edu/health-news/children/deftones-raises-funds-for-uc-davis-childrens-hospital-through-adopt-a-dot-campaign/2020/09
    202009_how-to-celebrate-halloween-safely-during-the-covid-19-pandemic Tue, 22 Sep 2020 07:00:00 GMT How to celebrate Halloween safely during the COVID-19 pandemic <p>Halloween can still be spooktacular with a little planning and imagination. UC Davis chief of pediatric infectious diseases Dean Blumberg offers families guidance and ideas that will keep the spirit of the season alive during the COVID-19 pandemic.</p>
    This video is best viewed in Chrome or Firefox.

    Halloween can still be spooktacular with a little planning and imagination. Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children's Hospital, offers families guidance and ideas that will keep the spirit of the season alive during the COVID-19 pandemic.

    What are the basic rules that families should follow to keep their kids safe during Halloween?

    The two most important things families can do to keep their kids safe is masking and social distancing. All families -  but especially individuals who are at increased risk for severe illness from COVID-19 - should stay home and avoid large gatherings. Other basic rules are as follows:

    • Continue washing hands regularly with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer with at least 60% alcohol. Remember to clean your hands before touching your eyes, nose and mouth.
    • Avoid sharing food or candy.
    • Please stay home if you have any symptoms of COVID-19, including fever, chills, cough, shortness of breath, headache, sore throat, fatigue, body aches, new loss of taste or smell, congestion, runny nose, nausea or vomiting, or diarrhea.
    • Cover your nose and mouth with your elbow "Dracula style" when coughing or sneezing.

     What are some safe ways that families can celebrate Halloween safely?


    Invite your child's friends to a virtual party with activities such as a costume contest, pumpkin carving and more.

    • The safest way is to have a virtual Halloween party! Invite your child's friends to a virtual party where you can even host activities such as a costume contest, dance party, pumpkin carving, or caramel apple decorating.
    • As pediatricians, we recommend eating candy in moderation. Instead of trick or treating, you can have a family game night or virtual game night with friends where your child can earn candy.
    • Alternatively, have your children go on a scavenger hunt for candy and other fun knick-knacks around the house or set up a glow-in-the-dark hunt in the backyard, by hiding glow bracelets inside small candy bags.
    • Instead of going to a crowded public haunted house, try creating one in your own home! Your kids can help you decorate the house with pumpkins, ghosts made of pillowcases, and witch hats made of paper. Use pipe cleaners and string to hang spiders around the house.
    • If your kids are older or love scary movies, kick back at home and watch Netflix or share ghost stories.
    • If you decide to go trick-or-treating, wear a mask outdoors or near people who do not live in your household. Travel in small groups and avoid large gatherings.
    • If you are providing candy to trick-or-treaters, avoid having a giant bowl that multiple kids reach into. It's safer to have an adult hand out the candy individually.
    • For trunk-or-treat events, make sure that the cars are parked more than six feet apart. Social distancing during these events is also key!
    • Talk with your neighbors about "reverse trick-or-treating": instead of having the kids go door to door, let the candy come to you! Kids can stand in their front yard showing off their cool costumes, while adults drive by and throw candy into their yard. 
    • Search your local area for some drive-through Halloween events like contactless haunted houses or drive-in movies.

    Will a costume mask keep my child safe from COVID-19?

    A mask that covers your child's nose and mouth and has two or more layers will provide the best protection from COVID-19. Masks with vents or other holes in them do not provide enough protection. Try decorating a cloth mask to match your child's costume.

    In addition to wearing a proper mask, it is important to stay at least six feet away from people who do not live in your household. Do NOT put a mask on children under 2 years old, someone who has difficulty breathing, or someone who cannot remove the mask themselves. Check out mask guidelines on the CDC website for more information.

    Related links

    CDC guidelines on Halloween 2020

    COVID-19 and Halloween safety tips - American Academy of Pediatrics 

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    https://health.ucdavis.edu/health-news/children/how-to-celebrate-halloween-safely-during-the-covid-19-pandemic/2020/09
    202009_wraparound-program-receives-966049-to-help-youth-injured-by-violence- Fri, 18 Sep 2020 07:00:00 GMT Wraparound program receives $966,049 to help youth injured by violence <p>The Board of State and Community Corrections (BSCC) has awarded UC Davis Health&rsquo;s Wraparound Violence Intervention Program $966,049 in funding to combat violence in the Sacramento area. The program is designed to support victims of violence and reduce the likelihood of subsequent violence involvement and re-injury through intensive, relationship-based, individualized community case management services.</p> The Board of State and Community Corrections (BSCC)  awarded UC Davis Health’s Wraparound Violence Intervention Program $966,049 in funding this month to combat violence in the Sacramento area. The program is designed to support victims of violence and reduce the likelihood of subsequent violence involvement and re-injury through intensive, relationship-based, individualized community case management services. 

    The award comes as the Wraparound program has seen a nearly 20% increase in violence-related injuries since May, compared with the same time period last year.

    The BSCC California Violence Intervention and Prevention (CalVIP) Grant is designed to help communities that are disproportionately impacted by violence through support programs that reduce and stop violence. The award is for a period of about three years, beginning next month.

    Since March 2018, the Wraparound program’s nationally certified violence intervention specialists have been providing evidence-based services to facilitate recovery for adolescent and young adult patients of UC Davis Health who have been injured by violence.

    Wraparound’s unique position within the trauma center allows the program to serve as a point of entry for violently injured youth and young adults into a coordinated system of violence intervention and community-based recovery support services in Sacramento.

    “The CalVIP Grant gives us the ability to hire the additional staff needed to offer program services to all eligible patients, expand our provision of culturally affirming professional mental health support for violently injured youth, and rigorously evaluate program effectiveness,” said Christy Adams, trauma prevention and outreach coordinator.

    The BSCC received 74 proposals seeking $78 million. A total of $30 million was awarded to 18 cities and 14 community-based organizations, including the Wraparound program.

    The BSCC is a multi-disciplinary agency that offers technical support and training to local corrections departments and administers millions of dollars in rehabilitative grants.

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    https://health.ucdavis.edu/health-news/children/wraparound-program-receives-966049-to-help-youth-injured-by-violence-/2020/09
    202009_nicu-mom-becomes-nicu-nurse- Wed, 16 Sep 2020 07:00:00 GMT NICU mom becomes NICU nurse <p>After her daughter spent 80 days in the NICU, Jennifer Swenson decided to spend her life giving back to other families as a neonatal nurse.</p> Nursing was never on Jennifer Swenson’s radar. She came from a family of nurses but pursued a career as a corrections officer in Ohio. For more than 15 years, she moved up the ranks to the position of sergeant, working in a state prison with more than 600 inmates.

    She had just completed law school and passed the bar exam, with the hopes of becoming a corrections attorney, when she became pregnant with her first child. Life changed.

    Swenson started retaining water and began having puffiness in her face and hands. She soon gained 70 pounds of fluid and was diagnosed with preeclampsia and HELLP Syndrome, a life-threatening pregnancy complication that almost took her life. To save Swenson, doctors needed to deliver her daughter early.

    Baby Audrey was born at 28 weeks and two days. She was only 1 pound, 14 ounces.

    “It was very scary. I wasn’t a nurse and I hadn’t had babies before, but the nurses at the bedside in the NICU brought so much hope,” Swenson said. “I would call in the middle of the night when I couldn’t be there and talk to the nurse about how she was doing. The nurses gave us reassurance and explained everything in detail. They used terms we could wrap our heads around.”

    Audrey spent 80 days in the Neonatal Intensive Care Unit (NICU) in Ohio. During that time, Audrey had a bilateral brain hemorrhage and was told that she may have potential complications. She wasn’t producing her own red blood cells. Swenson leaned on the NICU team to help her through this unimaginable time.

    When her daughter was discharged from the hospital, Swenson started to think about giving back in some way.

    “I started to think that I needed to give back to what was given to us. I wanted to help other moms in the NICU,” Swenson said.

    A few years later, Swenson went back to college and completed an accelerated bachelor’s degree in nursing. The rest, as they say, is history.

    She has been a neonatal nurse for 10 years now and has been at UC Davis Children’s Hospital since January 2013. She was a NICU nurse and then was promoted to assistant NICU nurse manager in September 2013.

    “Going into the NICU … that is my passion. I just told a mom this morning, ‘I was you. I was a mom at the bedside, needing reassurance and feeling mommy guilt.’ I had to do this job. The NICU is a scary place and I love that I can give families a different perspective because of what I have been through,” said Swenson, whose daughter Audrey is now a 15-year-old high school sophomore who has had no lasting effects from having had a significant brain hemorrhage or from being born premature.

    Swenson’s average work day includes managing about 180 NICU nurses, ensuring they have all that they need to do their jobs, and organizing transfers of critically ill and preterm infants from other hospitals as well as the delivery room at UC Davis Medical Center.  

    But she also gets to know all the babies and the families within the unit and help them through this fragile time.

    “I had the chance to introduce a mom to her triplets for the first time recently. Those are the kinds of things that I love about my job. Being with families for those precious moments and sharing it with them is what warms my heart,” Swenson said. “This is my calling.”

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    https://health.ucdavis.edu/health-news/children/nicu-mom-becomes-nicu-nurse-/2020/09
    202009_comfort-commitment-helps-kids-better-cope-with-painful-procedures-in-the-hospital Fri, 11 Sep 2020 07:00:00 GMT Comfort Commitment helps kids better cope with painful procedures in the hospital <p>Comfort and pain management have always been paramount in UC Davis Children&rsquo;s Hospital&rsquo;s approach to care. A new hospital initiative called Comfort Commitment launched this month, which provides a standardized approach to help pediatric patients better cope with distressing procedures and decrease pain and anxiety.</p> Comfort and pain management have always been paramount in the child-centered approach to care at UC Davis Children’s Hospital. A new hospital initiative called Comfort Commitment launched this month, which provides a standardized approach to help pediatric patients better cope with distressing procedures and decrease pain and anxiety.

    It involves four steps to managing a patient’s comfort:

    • Ask the child and caregiver what they know and understand about the procedure
    • Share more about the procedure in simple terms using honest, age-appropriate language
    • Plan for the procedure, considering medicine and numbing options, refocusing techniques (toys, electronics, music), comfort positions (chest-to-chest for small children with their caregiver, swaddle for infants and young toddlers) and a calming environment (with lights, noises and words)
    • Follow the agreed-upon plan and ensure the child feels heard and modify comfort measures to meet the patient’s needs

    “Our ultimate goal is to establish an environment where hospital experiences can be growth-promoting for children and families,” said child life specialist Emily McDaniel. “Through individualizing procedural comfort plans with this collaborative four-step process, we are consistently able to provide coping support and empower the child to customize a plan that uniquely meets their specific needs.”

    The initiative was funded by a Children's Miracle Network at UC Davis grant. 

    For more information, visit https://ucdavis.health/comfort.

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    https://health.ucdavis.edu/health-news/children/comfort-commitment-helps-kids-better-cope-with-painful-procedures-in-the-hospital/2020/09
    202009_collaborative-care-for-justice-involved-youth-is-focus-of-aap-statement-by-uc-davis-doctor Wed, 09 Sep 2020 07:00:00 GMT Collaborative care for justice-involved youth is focus of AAP statement by UC Davis doctor <p>Youth involved in the justice system are more likely to have unmet medical, mental health and social needs, are more likely to be youth of color and are more likely to have been exposed to adverse childhood experiences (ACEs). This was outlined in the <a href="https://pediatrics.aappublications.org/content/146/1/e20201755">recently published policy statement</a> by the American Academy of Pediatrics, authored by UC Davis pediatrician Mikah Owen and University of Alabama at Birmingham adolescent medicine physician Stephenie Wallace.</p> Youth involved with the justice system are ­­­likely to have unmet medical, mental health and social needs, are more likely to be youth of color and are more likely to have been exposed to adverse childhood experiences (ACEs). This was outlined in the recently published policy statement by the American Academy of Pediatrics (AAP), authored by UC Davis pediatrician Mikah Owen and University of Alabama at Birmingham adolescent medicine physician Stephenie Wallace.

    Nearly 810,700 youth under the age of 18 were arrested in the United States in 2017. Pediatricians and other health care professionals play a critical role in promoting the health and well-being of these justice-involved youth. The AAP statement offers background of the juvenile justice system, discusses racial and ethnic bias within the juvenile justice system, reviews common medical and social issues facing justice-involved youth and identifies opportunities for pediatricians to engage in juvenile justice reform efforts.

    The statement addresses the deep inequities that impact these children and teens and makes recommendations for transforming the juvenile justice system so that it meets the unique needs of children and adolescents.

    The policy statement revises the 2011 policy “Health Care for Youth in the Juvenile Justice System.”

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    https://health.ucdavis.edu/health-news/children/collaborative-care-for-justice-involved-youth-is-focus-of-aap-statement-by-uc-davis-doctor/2020/09
    202009_bedwetting-solutions-expert-pediatrician-offers-help-for-kids Fri, 04 Sep 2020 07:00:00 GMT Bedwetting solutions: Expert pediatrician offers help for kids <p>We asked UC Davis pediatrician Lena van der List about causes, strategies and solutions that can help families beat the bedwetting blues.</p> Bedwetting, also known as nocturnal enuresis, is common in childhood and most children will grow out of it as they age. We asked UC Davis pediatrician Lena van der List about causes, strategies and solutions that can help families beat the bedwetting blues.

    What causes bedwetting?

    In the majority of young children who experience bedwetting, the main issue is sleep arousal. The brain is not signaling to awaken when the bladder is full, and, at times, doesn’t even signal the child to wake up when wet. Frequently, these kids are extremely heavy sleepers. Kids may also produce more urine than expected at night (which is called nocturnal polyuria) or have small bladder capacity (with frequent small urinations throughout the day and night), which may increase their risk for bedwetting.

    Other causes for bedwetting:

    • Constipation, which, if appropriately treated, can alleviate the problem. Constipation causes bedwetting because a large amount of stool may actually push up against the bladder and prevent the bladder from expanding all the way. Doctors may prescribe a medication to help “clean out” the stool and keep your child more regular. The most commonly used medication is a laxative, polyethylene glycol, with the brand name Miralax.
    • Urinary tract infections
    • Genetic predisposition. If one parent experienced problems with nocturnal enuresis, on average, half of their children also will. If both parents did, then three-quarters of their children will.
    • Sleep disorders like obstructive sleep apnea. It is estimated that 30% of kids with sleep apnea will also have nocturnal enuresis. A child with symptoms of sleep apnea may snore at night, have periods where they seem like they pause breathing or be excessively sleepy during the day - although some kids may exhibit more hyperactivity. Sleep apnea can be diagnosed with a sleep study (these are frequently performed by pulmonologists). If a child is found to have sleep apnea, the most common treatment is removing the tonsils and adenoids (tonsillectomy/adenoidectomy). This allows for a more open airway at night and resolves the apnea. One study from 2016 looked at kids with bedwetting before and after tonsillectomy/adenoidectomy were performed for obstructive sleep apnea. After the surgery, 76% showed complete resolution of bedwetting, however the studies have been mixed on this.
    • There are other more serious conditions including diabetes, spinal cord issues that prevent a normal functioning bladder, and metabolic issues. While these are extremely rare, they should be considered in older kids with persistent enuresis that does not respond to typical treatment.

    How can pediatricians help with bedwetting kids?

    When you visit your doctor with a bedwetting concern, they may ask you questions like how long has it been going on? What time does it occur most nights? How much fluid and what types of fluid does your child drink in a day? Has your child had any previous “dry” periods? How often do they stool and what is it like? Do they ever have continence issues during the day?

    Your child’s physician will perform an exam, which may include a genital exam and a neurologic exam. He or she may perform a urinalysis (where they ask your child to pee in a cup) to make sure there isn’t an infection or signs of diabetes, or extremely diluted urine.

    Some physicians may ask you to keep a diary documenting all elimination (stools, day and night-time urination), fluids consumed, or even at times the volume of urine to help pinpoint the problem.

    If the doctor doesn’t find a medical problem, how can parents help stop bedwetting?

    Well, the first criteria is that the child is motivated for it to stop. If the child is not bothered by the bedwetting, each of these proven methods is much less likely to work:

    • Limit their nighttime fluid intake. A good rule of thumb is for the child to consume two-thirds of their fluid goal before the end of the school day and then one-third of the fluid after school with no more drinking in the last one to two hours before bed.
    • Have a stable bedtime routine. Going pee before bed and first thing upon awakening should always be encouraged.
    • Consider stopping pull ups or diapers at night once they are reliably potty trained during the day. For some kids, these may be used as a crutch and could continue to trick their brains into thinking they don’t have to wake up to urinate.

    Do bedwetting alarms work?

    Bedwetting alarms are recommended by the International Children’s Continence Society. It is worn attached to the pajamas or underwear and will alert the child as soon as wetness or moisture is detected. At first, the alarm may not wake the child so parents need to play active roles in waking up their kid, walking him or her to the bathroom. Their child should help change the sheets before going back to bed.

    The alarm needs to be used nightly and may take two to three months to work, but it has been shown to be very successful in up to two-thirds of children. It also costs about $60 and is typically not covered by insurance so this can be a barrier for some families. It is recommended that parents and kids continue to use the alarm until two weeks of consecutive dry nights!

    Are there medications that can help?

    The most commonly used medication for bedwetting is called desmopressin. It reduces the amount of urine produced overnight so it may be more beneficial in those kids that produce more urine at night. Studies have shown a 20-30% response. One side effect of the medication can be low sodium, so parents need to be aware of the signs, including confusion, weakness and even seizures.

    One other bedwetting medication that is occasionally used is called imipramine. It belongs to a class of medications called tricyclics and is also used to treat depression. It is less frequently prescribed these days because if too much is taken, an overdose may occur. Before starting on this medication, the heart needs to be monitored with an EKG.

    There are a few other medications that have been used, but they have a higher likelihood of side effects and are therefore not routinely recommended as a first line of treatment in kids.

    What is dry bed training, and how do I do it?

    Dry bed training is a more hands-on, parent-led approach.

    • On the first night, awaken the child once every hour until 1 a.m., asking if he or she has to use the bathroom. At the 1 a.m. awakening, tell the child to try using the bathroom, even if he or she is dry.
    • The second night, wake him or her only once, three hours after falling asleep.
    • The third through fifth nights, wake the child once each night. Start at two-and-a-half hours after falling asleep, and keep diminishing the interval each night, so that on the fifth night, the child is awakened one hour after falling asleep.
    • On the sixth night, tell the child to self-awaken from then on.

    One older study reported a great than 90% success rate with this method.

    What do you recommend when a child has had a dry period for more than six months and then begins to wet the bed again?

    This is referred to as secondary nocturnal enuresis. This is often related to a psychological stressor like a divorce or the birth of a new sibling. Exploring what may be bothering your child is a good idea. But the above other medical diagnoses should also be considered.

    What’s the best way for parents to respond to bedwetting while still making sure they are being sensitive toward the child?

    As kids get older, typically closer to around 6-8 years old, they begin to get self-conscious and embarrassed by bedwetting. They may resist sleepovers. This can affect their self-esteem and friendships. It’s important that the child doesn’t feel like it’s their fault or something is wrong with them.

    They should not be shamed. For example, never say “I can’t believe you did this again” or “You are costing us a lot of money having to wash your dirty sheets every night.” It’s important that bedwetting is not discussed in front of the child’s siblings or friends. Parents should reassure the child that it’s normal for his or her age. Act as an ally to the child and show that you’re going to tackle this as a team.

    Parents may want to teach the child to do the laundry so they can wash their sheets and pajamas on their own. This should not be treated like a punishment; it is an opportunity for the child to have control over it and limit who knows about it. This also helps develop responsibility. If you approach it in this supportive and collaborative way, most kids will outgrow it.

    Resources

    Healthy Children Bedwetting
    Healthy Children Bedwetting in Children & Teens: Nocturnal Enuresis  
    Healthy Children Radio: Bedwetting  
    International Children’s Continence Society
    Enuresis alarms on Amazon  
    Kids Considered podcast episode: Bedwetting Basics

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    https://health.ucdavis.edu/health-news/children/bedwetting-solutions-expert-pediatrician-offers-help-for-kids/2020/09
    202009_duck-dash-goes-virtual-on-sept-26-to-raise-funds-for-uc-davis-child-life-and-creative-arts-therapy Thu, 03 Sep 2020 07:00:00 GMT Duck Dash goes virtual on Sept. 26 to raise funds for UC Davis Child Life and Creative Arts Therapy <p>The 8<sup>th</sup> annual <a href="http://theduckdash.com/">Duck Dash</a> will take place virtually on Saturday, Sept. 26 at 9 a.m. Proceeds will benefit the <a href="https://health.ucdavis.edu/children/clinical_services/child_life_program/">Child Life and Creative Arts Therapy Department</a> at UC Davis Children&rsquo;s Hospital.</p> The 8th annual Duck Dash will take place virtually on Saturday, Sept. 26 at 9 a.m. Proceeds will benefit the Child Life and Creative Arts Therapy Department at UC Davis Children’s Hospital.

    Every year, Sacramento area residents “adopt” rubber ducks for the chance to win prizes while supporting hospitalized children. The adopter of the winning duck receives a $1,000 Visa gift card. This year, winning ducks will be plucked from a pool by Canine Companions for Independence facility dogs, while fans watch the livestream. Thousands of ducks will be available for adoption.

    Those interested in adopting ducks can go to any of the 26 Sacramento area Quick Quack Car Wash locations between Sept. 15-25. The cost is one duck for $5 or three ducks for $10. 

     “We feel very fortunate to be included in this event,” said Diana Sundberg, Child Life and Creative Arts Therapy manager. “Funds raised by the Duck Dash will be used to help support children while they are in the hospital, including providing toys as well as art and music therapy supplies.”

    The Child Life and Creative Arts Therapy Department at UC Davis Children’s Hospital helps to minimize the anxiety of hospitalization, increase understanding and strengthen coping skills while helping children to continue their typical growth and development.

    Download the flyer.

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    https://health.ucdavis.edu/health-news/children/duck-dash-goes-virtual-on-sept-26-to-raise-funds-for-uc-davis-child-life-and-creative-arts-therapy/2020/09
    202009_7-year-olds-cancer-diagnosis-led-her-family-to-seek-out-uc-davis-childrens-hospital-and-lor-randall Wed, 02 Sep 2020 07:00:00 GMT 7-year-old’s cancer diagnosis led her family to seek out UC Davis Children’s Hospital and Lor Randall <p>Lydia Alwan&rsquo;s family wanted to save their daughter&rsquo;s leg and her life.</p> It was the spring of 2019 and the Alwan family had returned home from skiing when eldest daughter Lydia began complaining of leg pain. Likely a pulled muscle, they thought. But as the pain worsened, it began waking her up at night so her parents made an appointment to see her pediatrician.

    “We took Lydia in and had an exam and x-rays. When we got the news, it felt like the world just stopped,” said Lydia’s mom, Jessica Alwan. Lydia had osteosarcoma.

    Osteosarcoma is a type of bone cancer which tends to occur in teenagers and young adults but can also affect younger children.

    Treatment for osteosarcoma usually involves chemotherapy, surgery and sometimes radiation therapy. Doctors select treatment options based on the location, size, type and grade of the osteosarcoma and whether the cancer has spread beyond the bone.

    “Lydia’s cancer was in her mid-femur and there was no time to waste,” Alwan said. “We had to get up to speed quickly.”

    Alwan and her husband began their quest to get the best in surgical and oncological care for their daughter.

    “To save her leg, we needed an expert surgeon, but we also needed a great oncologist,” Alwan said. “We discovered both at UC Davis Children’s Hospital and were confident in her team to guide us in making some of the most important decisions of our lives.”

    Musculoskeletal surgical oncologist expert Lor Randall and pediatric oncologist Elysia Alvarez were the dream team the Alwans had hoped for. And they found them just down the hill from their home in Auburn.

    “Not only were these doctors the best, they were so close by,” Alwan said. “We knew Lydia’s chemotherapy treatments were going to be intense and would require her to be admitted to the hospital for days, if not weeks at a time. To not have to travel further was a gift. We also have two other children we had to take care of. The location made it easier to manage.”

    UC Davis Health Sarcoma Services is comprised of an integrated team of internationally recognized experts,” said R. Lor Randall, professor and chair of Sarcoma Services. “We knew we were poised to provide Lydia and her family with the very best care to be found anywhere. The team is very grateful for the trust that Lydia’s family placed in us.”

    The summer of 2019, Lydia underwent successful limb salvage surgery to remove and reconstruct the section of the femur affected by the tumor and subsequently endured 18 rounds of chemotherapy at the UC Davis Comprehensive Cancer Center, one of only 50 cancer centers in the country to be designated by the National Cancer Institute. Her last treatment was this past January and to date, Lydia’s scans have been clear.

    “We are huge fans of UC Davis. They did so much for Lydia and for our family,” Alwan said. “The doctors are amazing and the nurses are the kindest people on the planet. The care team did everything they could to support us and let us know we were not alone.”

    Now in monitoring mode with regular scans, Lydia started fourth grade online, with a full head of hair and the ability to walk without a walker. Just this week she was cleared for jogging and bike riding as well.

    “The strength that Lydia has shown is incredible,” Alwan said. “She doesn’t fear the future, but instead, truly appreciates the ‘right now’ … just as she did during treatment. Thanks to UC Davis Children’s Hospital, we have all learned how important it is to live in the moment.”

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    https://health.ucdavis.edu/health-news/children/7-year-olds-cancer-diagnosis-led-her-family-to-seek-out-uc-davis-childrens-hospital-and-lor-randall/2020/09
    202008_covid-19-labor-day-playbook-keep-it-small-wear-masks-hold-at-6-feet-dont-give-in Mon, 31 Aug 2020 07:00:00 GMT COVID-19 Labor Day playbook: Keep it small. Wear masks. Hold at 6 feet. Don’t give in. <p>UC Davis experts urge you to help stop another explosion of COVID-19 this Labor Day weekend &ndash; which could be a crossroads in the fight against the coronavirus &ndash; and they offer tips to stay safe.</p> The last hoorah for a very strange summer is coming this Labor Day weekend and UC Davis Health infectious disease and public health leaders are offering a combo of praise and warning: We’re making progress on COVID-19 — don’t blow it.

    Infection rates are generally trending down slightly in California, but other holidays this summer have fueled explosions of coronavirus transmissions. We are at a critical crossroads in the fight against COVID-19.

    The nationwide summer surge began with careless Memorial Day gatherings. What happens this weekend could determine the path COVID-19 takes for months — and how open or closed communities might be the rest of the year.

    “Right now, this epidemic is driven by behavior,” said Brad Pollock, chair of the UC Davis Health Department of Public Health Sciences. “It’s not a lack of tests or therapeutics. It’s behavior. We can slow COVID-19 if we all work together.”

    The progress against the coronavirus is fragile. For example, he said, look at the infections that erupted at many college campuses — fueled in big part by parties and large gatherings — just a few days after they started full in-person classes. Some of the many examples:

    • The University of Alabama in Tuscaloosa reported more than 1,000 cases.
    • The University of North Carolina at Chapel Hill switched to online classes one week into the semester. Its dashboard reported more than 800 cases and a positive test rate above 31%.
    • The University of Iowa reported more than 600 cases and the University of Kansas reported nearly 500 infections.
    • More than 300 cases were found at the University of Missouri in Columbia with a positive test rate of more than 44%.
    • Michigan State, North Carolina State and others went back to online classes for the fall, while Notre Dame stopped in-person classes for at least two weeks.
    “It can spread so fast. We can’t let ourselves reverse the progress … This is not a time to say, ‘Things are better.’ This is a time to be better. Wear a mask. Stay 6 feet apart. All of us can help each other and our communities by keeping up the cautions.”

    – Brad Pollock

    (UC Davis is waiting for guidance from public health officials to decide if it will be able to offer even a small number of in-person classes in the fall quarter.)

    “It can spread so fast,” Pollock said. “We can’t let ourselves reverse the progress. We’re turning the corner. We can’t repeat Memorial Day weekend. A new surge means closing things down, maybe until the end of the year, and it means many people will get sick and some will die.”

    Pollock said he is hopeful most people understand the critical importance of tamping down their Labor Day doings.

    “This is not a time to say, ‘Things are better,’” he said. “This is a time to be better. Wear a mask. Stay 6 feet apart. All of us can help each other and our communities by keeping up the cautions.”

    How to enjoy the weekend: Keep it outside and keep it small.

    “If you want to get together, do it responsibly,” said Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital. “That means keep your 6-foot distance, wear a mask, stay outside and just gather with a couple people. None of this is new, but it is more important than ever. This is a national holiday. Let’s take care of each other.”

    The value of staying outside

    “Being outside helps because the air flow dilutes the virus,” Blumberg said. “That’s why it’s so important to social distance. It will provide a great deal of protection outside.”


    Staying outdoors helps keep you safe because the air flow dilutes the coronavirus.

    On the other hand, if the party wanders indoors, everyone is at risk, partly because it is much more difficult to maintain that social distancing inside and because there is much less air flow to dilute the virus, even with windows open.

    “There is a much larger volume of air outdoors,” Blumberg said. “We saw the value of that with the recent protests. I’m not aware there were outbreaks related to the protests, but there were big spikes from bars and social events in people’s homes.”

    Why size matters

    The obvious reason is that small gatherings allow room to physically distance. Less obviously, small gatherings also make it harder for people to forget to distance.

    “It’s just human nature to move closer to friends and family at a party,” said Natascha Tuznik, assistant clinical professor of infectious diseases. “And if you’ve been hanging out a while, eating and drinking, you just forget to be careful. So, try to prevent any problems ahead of time.”

    It’s largely unnoticed, but California still bans all private gatherings in Sacramento County for people not living in the same household. County officials have said they understand friends and family will still gather, but they urge everyone to keep it to very small groups — like four or six people maximum.

    “Give yourself plenty of room to keep people at least 6 feet apart,” Tuznik said. “If you plan it right, you can remove temptations for people to get too close and you won’t have to worry about them forgetting to distance.”

    How to remove temptations to get too close

    • Mark off 6-foot distances for tables or zones for each household to put their chairs, if they’re bringing their own.
    • Set up tables for each household with clean plates and utensils.
    • Set a few “visitors chairs” 6 feet from each table so people can mingle.
    • Don’t have communal appetizer or condiment stations.
    • Give every table small bags of chips or nuts or some other party munchies. And give each table their own dips, salsas or condiments.
    • Put masks on each table as party favors, and in case someone did not bring one.

    Tips for food

    “There is no evidence that food transmits the virus,” Blumberg said. “The risk comes from people getting too close when they serve or eat it.”

    One easy solution is to have people bring their own food. But if you want to cook, here is a way to do it safely:

    • Have one person with thoroughly washed hands prepare the food.
    • Put the helping for one household on a serving plate or bowl and place it 6 feet from everyone. Then, that household can pick up their food and bring it back to their physically distanced table.
    • Repeat for the next household/table.

    “If you want to get together, do it responsibly. None of this is new, but it is more important than ever. This is a national holiday. Let’s take care of each other.”

    – Dean Blumberg

    “It’s not the fun of gathering around the grill,” Tuznik said. “But there won’t be utensils or serving bowls handled by multiple people, and everyone can maintain their physical distance.”

    BYOB?

    “It’s definitely safer if everyone brings their own beverage,” Tuznik said. “But whatever you do, avoid any community pouring like pitchers, shared bottles or kegs.”

    However, there is a way to have a distanced-but-shared pour. Person A puts her empty glass on a table and backs away 6 feet. Person B pours wine or some beverage, then moves away. Person A retrieves her glass.

    The restroom conundrum

    “This is a sticking point for anything we do now,” Tuznik said. “If people are not wearing masks, ask them to put one on before they go inside.”

    Other tips:

    • If you have two bathrooms, dedicate one for guests.
    • Put out liquid soap and paper towels — with strips pre-separated.
    • Create a hand sanitizer station for people to clean their hands before they come inside.
    • Limit guests to one person in the house at a time.
    • Space out guest restroom visits with a few minutes between them.

    Safest of all: Wait until next year

    “My birthday is close to Labor Day,” Pollock said. “I really like to have big parties. It’s a nice day to get together. Almost everyone is off work and we still have some summer. I really enjoy those parties — but not this year. I’m looking forward to the party we’ll have next Labor Day.”

    Pollock said think about it this way: Not having a party is doing a good deed for friends, family and the people in your community.

    The Centers for Disease Control and Prevention said two-thirds of COVID-19 infections come from people not showing symptoms – either because they’re asymptomatic or the symptoms haven’t developed yet. That means you can’t know if a friend &mdash or you &mdash could be transmitting the coronavirus.

    “Any one of us can make things much worse if we’re not careful,” Pollock said. “But each of us can help make things better.”

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    https://health.ucdavis.edu/health-news/children/covid-19-labor-day-playbook-keep-it-small-wear-masks-hold-at-6-feet-dont-give-in/2020/08
    202008_once-a-nicu-baby-haley-nagle-gives-back-as-a-nicu-nurse Thu, 27 Aug 2020 07:00:00 GMT Once a NICU baby, Haley Nagle gives back as a NICU nurse <p>Born at 36 weeks and at 3 pounds, Haley Nagle spent her first three weeks of life in the Neonatal Intensive Care Unit (NICU). Now she is a nurse in the UC Davis NICU, providing care to families during their babies&rsquo; first days of life.</p> Born at 36 weeks and weighing just 3 pounds, Haley Nagle spent her first three weeks of life in the Neonatal Intensive Care Unit (NICU).

    It was an emotional time that her parents will never forget. It also cemented her desire to give back as a NICU nurse.

    At 3 years old, she remembers taking care of her babysitter who was sick, giving her grapes and trying to help her feel better.

    At the age of 13, her best friend had cancer and she watched her battle the disease.

    “I would visit her in the hospital, and I remember how her nurses would treat her like a teenage girl, not like a diagnosis,” Nagle said.     

    Nagel, who grew up in the Sacramento area, graduated from nursing school at the University of Portland and landed her first job as a home health worker for medically fragile children. 

    NICU nurse Haley Nagle with patient Juniper Crawford who was born at 23 weeks gestation. Photo was taken in 2019.

    “I loved it. I’m so glad that they gave me that opportunity as a 22-year-old. I was a nurse in a family’s home. You learn that it’s not just a job. The families depend on you and have that trust in you,” Nagle said.

    But her dream of becoming a NICU nurse beckoned her back to the Sacramento area. For the past six years, Haley Nagle has called Davis 5, the UC Davis NICU, home.

    “Every day I’m thankful to be working with these babies and these parents who are going through the unimaginable and my coworkers, who are so smart,” Nagle said. “Being a NICU nurse is the profession that never stops giving. It’s very rewarding to feel that you’re making a true difference.”

    Her day typically involves checking and double-checking patients’ orders, running safety checks on emergency equipment and teaching parents how to feed their baby for the first time or how to give their baby a bath. It’s those special milestones that families never forget.

    “When I was growing up, my mom would talk about how those NICU nurses made her feel like I was a human, not a premature baby,” Nagle said. “The nurses gave me Cabbage Patch Kids doll’s clothing that I could wear. My parents still have those clothes 28 years later. It meant something to them.”

    These days, Haley says she finds herself going to the linen room and finding baby clothes or a special blanket to give to NICU parents.

    “It’s now come full circle,” Nagle said.

    Related links

    Haley Nagle - Year of the Nurse

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    202008_triple-the-joy-how-uc-davis-health-handled-a-very-special-delivery- Wed, 26 Aug 2020 07:00:00 GMT Triple the joy: How UC Davis Health handled a very special delivery <p>When Mali-born singer-songwriter Awa Sangho and her husband Ernest Moreno found out she was pregnant with triplets, she turned to UC Davis Health.&nbsp;</p> Mali-born singer-songwriter Awa Sangho has been a rising star on the global music scene. But when she and her husband Ernest Moreno found out she was pregnant with triplets, she turned to UC Davis Health. 

    UC Davis maternal-fetal medicine physician Véronique Taché saw Awa for weekly checkups during her pregnancy. Taché and Sangho both speak fluent French so Awa’s appointments were conducted in French.

    “Carrying multiple babies can increase your risk for a range of conditions including preterm labor,” Taché said. “We wanted to make sure that she and the babies were growing and developing as they should.” 

    At 31 weeks, Awa had high blood pressure during a routine appointment. More tests revealed a preeclampsia diagnosis, which can be life-threatening for both babies and mother. The health care team decided to schedule a caesarean section (C-section) the next day.

    Awa’s two sons, Ikai and Ubirajara, and one daughter, Korotimi, were born on July 1.

    Ikai and Ubijara weighed more than 3 pounds. Korotimi weighed 2 pounds 8 ounces.

    “I was so happy. They were so beautiful and healthy,” Sangho said.

    The triplets spent about a month in the UC Davis Neonatal Intensive Care Unit, Sacramento’s only nationally ranked level IV nursery.

    The Ronald McDonald House Charities, Northern California became a home away from home for Sangho and Moreno, while the babies were in the NICU.

    The triplets learned to eat and grew bigger. Korotimi, Sangho’s daughter, fought an infection, but thanks to the care from her NICU team led by Donald Null, she was discharged on Aug. 5, six days after her brothers left the NICU.

    As for Sangho, she also battled an abscess at her C-section site and was hospitalized at UC Davis Medical Center for nearly a week, requiring a drain to remove the infected fluid.

    “I’m glad that I’m doing better now. I was in good hands. My babies were in good hands. We are thankful to the whole UC Davis Health team,” Sangho said.

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    202008_uc-davis-childrens-hospital-helps-local-boy-with-kidney-disease-hold-onto-hope-- Tue, 25 Aug 2020 07:00:00 GMT UC Davis Children’s Hospital helps local boy with kidney disease hold onto hope <p>Justin Ramirez continues to look forward despite his failing kidney.</p> Meliza Ramirez was eagerly anticipating the arrival of her second child. The ultrasound was fine. There were no warning signs about what was going to be a lifelong struggle.

    When her baby boy, Justin, arrived early at 32 weeks gestation, that was a surprise. Then she got another one: Justin only had one kidney.

    “I figured it would be something we had to monitor, but I could not have imagined what we would go through,” Ramirez said.

    Although most people born without a kidney or with only one working kidney lead normal, healthy lives, that was not the case for Justin. He required a kidney transplant as a baby. A family member was a match and Justin’s surgery took place at UC Davis Children’s Hospital when he was just a year old.   

    UC Davis Children’s Hospital has a world-class reputation for kidney transplants in children, ranking #25 in the nation in pediatric nephrology by U.S. News & World Report.

    “The surgery went well and we were so relieved,” Ramirez said. “We thought the worst was over.”

    The new kidney lasted seven years, but then Justin landed in the hospital with serious lung issues in 2017. He had to be placed in an induced coma, which ultimately led to his body rejecting the transplant.

    “They had to take Justin off his anti-rejection drugs so he could fight through his lung issues on his own,” Ramirez said. “From there on, we had to start over and take it day by day. It’s been a rough road.”

    The quest for a kidney began again. All the while, Justin’s condition worsened. By March 2018, dialysis became a must, as did constant trips to the pediatric nephrology clinic at the Glassrock Building, spending hours getting treatment and checking on Justin’s condition which has since progressed to Stage 5 chronic kidney disease.

    Thanks to the outpatient peritoneal dialysis program, Justin now does dialysis at home for 10 hours each day. UC Davis Children’s Hospital is the only hospital in inland Northern California to offer outpatient peritoneal dialysis for patients under 10 years of age or 44 pounds.

    Many people who know Justin’s story have been tested to see if they’re a match. To date, there hasn’t been a suitable donor, but Justin takes it all in stride as he and his mom look forward to his 11th birthday next month.   

    “Justin’s a fighter and I know with UC Davis Children’s Hospital on our side, he has the best chance,” Ramirez said. “I am so thankful for the care we have received and the people who continue to help us. You all give us the strength to carry on.”

    The UC Davis Transplant Team contributes to the 15,000 kidney transplants performed each year in the United States – of which more than 40 percent come from living donors. Often described as "The Gift of Life," living donation gives recipients freedom from dialysis and allows them to enjoy a longer life, full of energy and productivity. Contact the UC Davis Health Transplant Center at (916) 734-2111 or (800) 821-9912 if you are interested in learning more about the living

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    202008_costco-to-raise-funds-for-uc-davis-childrens-hospital-during-annual-miracle-balloon-campaign Mon, 24 Aug 2020 07:00:00 GMT Costco to raise funds for UC Davis Children’s Hospital during annual Miracle Balloon Campaign <p>CMN&rsquo;s long-time partner doesn&rsquo;t let COVID-19 stop the giving.</p> Beginning Sept. 1, Children’s Miracle Network Hospital’s biggest partner in hope will once again give shoppers the opportunity to purchase a Miracle Balloon in support of children treated at UC Davis Children’s Hospital. May is typically the month for miracles at Costco, but the COVID-19 pandemic forced the Children’s Miracle Network campaign to be postponed to September.

    All month long, shoppers will be invited to donate at checkout. A total of 19 Costco locations from Redding to Tracy will raise money in support of UC Davis Children’s Hospital. All funds raised locally stay local to support a full range of children's services including research, education and clinical care.

    Each of the Miracle Balloons purchased will be displayed at the front of the warehouse during September. In addition to the small Miracle Balloons, individual and corporate members can purchase a six-foot Miracle Balloon for $250, $500 or more that will feature an individual’s name or business name. Other creative fundraising activities increase the fundraising total.

    “We are so grateful to Costco for moving forward with this campaign,” said Jacquelyn Miller, executive director of development at UC Davis Children’s Hospital. “Even with the pandemic, this amazing partner remains committed to our pediatric patients because they know kids can’t wait. Not for a vaccine. Not for a cure. Not for the economy to rebound. Kids need life-saving treatment now. The Costco campaign plays a huge role in ensuring our patients continue to get the care they need.”

    Costco participates in a month-long Miracle Balloon Campaign at all warehouses in the United States and Canada. The annual Miracle Balloon Campaign is the primary source of the fundraising effort made by Costco and its partnership with Children's Miracle Network Hospitals. Costco Wholesale has raised more than $240 million for Children's Miracle Network Hospitals since 1988. Currently, more than 600 Costco locations participate in this fundraising campaign for their local Children's Miracle Network Hospital.

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    https://health.ucdavis.edu/health-news/children/costco-to-raise-funds-for-uc-davis-childrens-hospital-during-annual-miracle-balloon-campaign/2020/08
    202008_what-you-need-to-know-about-breastfeeding-during-the-covid-19-pandemic- Mon, 24 Aug 2020 07:00:00 GMT What you need to know about breastfeeding during the COVID-19 pandemic <p>Laura Kair, medical director of Well Newborn Care at UC Davis Children&rsquo;s Hospital, addresses some frequently asked questions about breastfeeding, especially during the COVID-19 pandemic.</p> August is national breastfeeding month and we asked Laura Kair, medical director of Well Newborn Care at UC Davis Children’s Hospital, some frequently asked questions about breastfeeding.

    Can babies get COVID-19 from breastmilk?

    Spread of the virus from mother to infant through breast milk does not appear to be a major concern. Women with COVID-19 who are feeling well enough to do so are recommended to breastfeed. In fact, breast milk helps protect babies from viral infections, so it is likely that immune components in the breast milk of a mother with COVID-19 may help her baby fight infection.

    Should a mom continue breastfeeding if she has COVID-19?

    Yes! We recommend mothers wash their hands and any skin that will be touching baby, wear a mask to prevent the baby from contacting the mother’s respiratory droplets and breastfeed! If a mother is too ill to be around her baby, she should wash her hands, clean her breast and pump supplies, and pump breast milk to be given to the baby.

    Does breastmilk help fight against diseases?

    Yes! For infants, breast milk helps protect against gut, lung and ear infections, allergic diseases and leukemia. It also is beneficial for optimal neurodevelopment. For women, breastfeeding helps protect against breast, ovarian and endometrial cancer, along with heart disease and diabetes.

    How much breastmilk does a baby typically get in a feeding?

    For the first week of life, this changes day by day. On the first day, this is as little as 2-10 ml. (about a teaspoon) per feeding and this increases by about 15 ml. or ½ ounce at each feeding per day. By two weeks, babies take about 2.5 oz. per feeding, and by about a month, about 4 oz. per feeding. However, this varies by time of day and for different babies. If pumping and giving breast milk by bottle or freezing milk, it’s good to store in smaller, 2-ounce portions so it is easier to thaw and you can use it all once thawed. The best thing to watch is that baby is growing appropriately, making wet diapers and can be consoled between feeds. Your baby’s primary care provider or lactation consultant can help you come up with a plan if you are separated from baby and determining how much breast milk to put in each bottle and how often to pump.

    Is UC Davis a baby-friendly hospital?

    Yes! We were just designated in 2020.

    Why should a mom seek a lactation consultant?

    With your first baby, a lactation consultant can help teach some of the basics, see how baby is feeding and give you tips about a good latch and positioning. For women struggling with low milk production or oversupply, they can help you come up with a feeding plan that works in your life and support you along the way. Not every parent and baby needs to follow with a lactation consultant long-term, but some may find it helpful or find support groups led by a lactation consultant to be helpful.

    Can a tongue tie or lip tie create breastfeeding difficulties?

    Yes, a tongue tie especially can lead to some difficulties in the baby creating a vacuum in their mouth, staying at the breast, and successfully getting milk out without popping off or causing pain for the mother. Not every baby with a visible frenulum under their tongue has a problem though. It depends how well the baby can feed. A lip tie is a newer consideration and a bit more controversial, as there haven’t been randomized clinical trials looking at whether releasing them helps fix breastfeeding problems. If you have a concern about your baby’s latch or their tongue or lip tie, I recommend discussing it with your baby’s doctor and/or lactation consultant.

    What are your thoughts on using lecithin to prevent clogged ducts?

    There is not a great deal of scientific evidence to guide an answer to this. Anecdotally, several of my breastfeeding-medicine colleagues at times prescribe sunflower lecithin, given as a powder for women with nipple blebs (also known as milk blisters) or plugged ducts. There are a few reports of this practice in the scientific literature and how to dose it, but currently there isn’t enough evidence from trials for me to specifically recommend it. I do recommend that women with plugged ducts feed directly at the breast, rather than by pump if possible, and talk with their doctors for the latest evidence.  

    How do you start weaning?

    There’s the how and then there’s the why and when. The American Academy of Pediatrics (AAP) and World Health Organization (WHO) recommend exclusive breastfeeding for the first six months. The AAP then recommends the addition of complementary foods with continued breastfeeding for at least the next six months, when baby turns a year old. WHO recommends a minimum of two years of ongoing breastfeeding plus complementary foods.

     As toddlers get bigger and eat more table food, they naturally take less and less breast milk. For women who have a reason to want to speed up weaning, I recommend working together with their doctors or lactation specialists. Milk production is all about demand, so the less milk you empty from the breasts, the less your body will make. For women who are pumping, this can mean gradually decreasing the number of pumping sessions per day.

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    https://health.ucdavis.edu/health-news/children/what-you-need-to-know-about-breastfeeding-during-the-covid-19-pandemic-/2020/08
    202008_childrens-miracle-network-awards-grants-to-uc-davis-childrens-hospital-for-2020-2022 Wed, 19 Aug 2020 07:00:00 GMT Children’s Miracle Network awards grants to UC Davis Children’s Hospital for 2020-2022 <p>More than $260,000 in CMN donations will support the work of pediatric clinicians and researchers.</p> Thirteen grants totaling $261,307 have been awarded by Children’s Miracle Network (CMN) at UC Davis to clinicians and researchers at UC Davis Children’s HospitalGrants in the amount of $113,729 will enhance the clinical care of children, while $147,578 was awarded for research directly improving the health and welfare of children.

    Each fiscal year, applications are accepted by Children’s Miracle Network (CMN) for both clinical services and research grants. Each application must demonstrate how the project or research contributes to UC Davis Health Strategic Goals and/or UC Davis Medical Center Institutional Goals. The amount of funds awarded each year is determined by the CMN Executive Committee and chief executive officer of UC Davis Medical Center.

    Clinical services grants funded for fiscal years 2020-2022 for pediatrics are as follows:

    Pediatric neurology room enhancement project – Cassandra Ingemansson 

    Ultrasound equipment for pediatric vascular access by bedside nurses – Jonathan Trask 

    Pediatric type 1 diabetes (T1DM) Spanish language support groups – Diana Arellano 

    Promoting early childhood literacy & resilience to discrimination – Ivan Marquez 

    In-room cell phone chargers – Sandie Dial 

    Educational materials for pediatric hematology/oncology – Melinda Beckham 

    Improving newborn hearing screening follow-up and early intervention – Jamie Funamura 

     

    Clinical services grants funded for fiscal years 2020-2022 for the Child Life & Creative Arts Therapy Department are as follows:

    300 Sib Sacs – Jessica Vroman 

    The Medikin Doll: A child-friendly spin on preparation – Mackenzi Lee 

    Welcome to UC Davis Children's Surgery Center: A video tour – Ginger Rounds

     

    Research grants funded for fiscal years 2020-2022 for pediatrics are as follows:

    Pilot study of remote glucose monitoring among pediatric patients with type 1 diabetes – Stephanie Crossen 

    Cardiovascular effects of prenatal methamphetamine exposure – Deepika Sankaran 

    Optimal epinephrine dose in perinatal arrest in extremely preterm lambs – Payam Vali
     

    Special consideration was given to junior faculty members and junior investigators. Faculty mentors reviewed the proposals prior to submission and included a letter of support and a current National Institutes of Health (NIH) biosketch, as applicable.

     

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    https://health.ucdavis.edu/health-news/children/childrens-miracle-network-awards-grants-to-uc-davis-childrens-hospital-for-2020-2022/2020/08
    202008_advice-about-kids-and-covid-19-from-uc-davis-health-expert Tue, 18 Aug 2020 07:00:00 GMT Advice about kids and COVID-19 from UC Davis Health expert <p>More and more evidence shows that coronavirus infections among children are increasing, and that kids can also get seriously ill. Children&amp;rsquo;s infectious disease expert Dean Blumberg offers help.</p> Researchers are finding a growing number of coronavirus infections among kids, although younger children remain a small percentage of COVID-19 cases in Sacramento and throughout the country. But there is no guarantee that won’t change.

    “COVID-19 is something we need to take seriously with children,” said Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital. “We’ve heard a lot about how it’s milder in children than adults, but it’s important to know that kids get sick, too. Kids get pneumonia, too. Children have died from this, and we’ve had children in the ICU because of this. It can still be severe and scary for them.”

    With some schools already starting classes, and new research coming out, both researchers and parents are focusing more and more on the impacts and risks of COVID-19 to children.

    National data shows COVID-19 cases among children are increasing.

    An August report from the Centers for Disease Control and Prevention that detailed hospitalization rates for children put it bluntly: “Children are at risk for severe COVID-19,” the CDC said.

    The report said one in three kids hospitalized with the coronavirus end up in intensive care.

    A recent report from the American Academy of Pediatrics and the Children’s Hospital Association said more than 97,000 U.S. children tested positive for the coronavirus in the last two weeks of July. That’s more than a quarter of all COVID-19 infections among U.S. kids since March.

    "It's important not to open schools too early. Even if children are not the primary drivers of transmission, gathering them in classrooms is going to increase the number of cases among children, and they will spread COVID-19 to their families who could then bring it into the community."

    Researchers say there may be a number of reasons for the spike – including the spike in COVID-19 cases throughout the U.S. population overall and the likelihood that children are spending more time playing together or in summer activities.

    “We also think children may be getting infected from their families more,” Blumberg said. “Their parents are likely out in the community more, whether at work or somewhere else, and they’re bringing it home.”

    Children under 10 appear to be less likely to transmit COVID-19 than older kids, teens and adults, partly because they often have less severe symptoms. That means they don’t do some of the things that spread the virus quickly, like cough and sneeze. But less risk doesn’t mean no risk.

    “Children can certainly spread the virus to other people, including their families and older adults,” Blumberg said. “So, it’s important, even for parents of young children, not to bring COVID-19 into the household, and to help their children protect themselves with social distancing and with masks.”

    Black and Latinx children are disproportionately getting COVID-19

    Just as Black and Latinx adults have higher percentages of COVID-19 infections and more serious cases, their children are also disproportionately getting infected and battling more severe COVID-19 illnesses, according to the CDC report on children’s hospitalization rates.

    “The differences are pretty dramatic and pretty frightening,” Blumberg said.

    According to the report, Black children are five times more likely than white children to have serious cases of COVID-19 that require them to be hospitalized. Hispanic children are eight times more likely.

    “Many of these children and their families have less access to care,” Blumberg said. “We think the parents of these kids are more likely to be essential workers in high-risk jobs. They could be working in the food industry, meat packing plants or agriculture where they’re often in crowded conditions with minimal airflow and may not have masks available.”

    Where do we stand with back-to-school?

    “It’s important not to open schools too early,” Blumberg said. “Even if children are not the primary drivers of transmission, gathering them in classrooms is going to increase the number of cases among children, and they will spread COVID-19 to their families who could then bring it into the community.”

    He said before any communities consider in-person classes, the rates of COVID-19 must be low enough in the region to make the risks of getting back into schools manageable.

    “California is not there, yet,” Blumberg said. “But it’s important to have these discussions, because if communities practice COVID-19 safety, we might get there in a couple months.”

    He also said school officials should be aware of the danger to teachers.

    “Those are adults who have a higher risk, in some cases a much higher risk, of both getting sick and having severe cases. Do we want to do that to teachers?” Blumberg said. “There is a danger to whole communities, because outbreaks may be amplified in schools, as we’re seeing in some states now.”

    Advice for the time when in-person classes resume

    “When the outbreaks are controlled, we need to do this in a rational manner,” Blumberg said. His advice:

    • Keep classes small. “This might mean having a morning session and a separate afternoon session,” Blumberg said.
    • Keep children isolated in small groups and have them stay in one classroom.
    • Prevent those small groups of students from mingling with other kids at recess or in the cafeteria. Each group should have separate recess and mealtimes or arrangements.
    • Be sure to instruct students, and everyone at the school, on the proper use of masks.
    • Be flexible and prepared to shut down if there is an outbreak.

    “I would hope schools would be able to social distance and enforce universal masking for everyone – teachers, administrators, staff and children,” Blumberg said. “Once we can get schools open, that’s the only way they can stay open.”

    Home schooling pods not likely to reduce risk

    Some families have grouped together for at-home learning and other events with their kids. Blumberg warns they may be giving themselves a false sense of safety.

    “I don’t think it’s possible for groups of parents to create their own bubbles. I don’t think it’s realistic,” he said. “Most of the time people are fooling themselves when they’re in a pod.”

    "Children need to wear masks just as much as anyone else. Kids will wear a mask if they are told to wear a mask."

    He said a group would have to be extremely strict about 6-foot-distancing and wearing masks in public, but it’s still very unlikely that everyone in a pod will have no interaction with anyone outside that group.

    “Not everyone has the same values, so they will make exceptions for different reasons,” Blumberg said. “People will have contact with people outside the pod, and eventually, every pod will get connected to every other pod. In the real world, creating a bubble is just not possible.”

    Kids and masks

    “Children need to wear masks just as much as anyone else,” Blumberg said. “Kids will wear a mask if they are told to wear a mask.”

    CDC guidelines say any child over age 2 should be wearing a mask in public, unless they have a health reason.

    “Part of the issue is that some kids have been allowed to avoid masks for no real reason,” Blumberg said. “If a parent says, ‘Oh, my kid won’t wear a mask,’ then they won’t. If we expect them to wear masks, they’ll do it.”

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    https://health.ucdavis.edu/health-news/children/advice-about-kids-and-covid-19-from-uc-davis-health-expert/2020/08
    202008_strategies-for-supplementation-to-breastfed-newborns-vary-widely-among-us-hospitals Mon, 17 Aug 2020 07:00:00 GMT Strategies for supplementation to breastfed newborns vary widely among U.S. hospitals <p>A study led by UC Davis Health found considerable differences in the management of breastfed infants across U.S. hospitals, especially in terms of criteria for medically-indicated supplementation.</p> A study led by UC Davis Health researchers found considerable differences in the management of breastfed infants across U.S. hospitals. The study, published in Hospital Pediatrics, explored the hospitals’ criteria for medically-indicated supplementation of healthy breastfed infants, pumping recommendations and methods for delivering supplementation.

    There is no unified, specific criteria or guidelines for which breastfed newborns have a medical indication requiring supplemental feedings with donor human milk or formula.  With the absence of best practices and standard recommendations for supplementation, there was a need to identify current practices and procedures in U.S. hospitals.

    “We wanted to identify the practice patterns and provider perspectives on supplementation of healthy breastfeeding newborns across the U.S.,” said Laura Kair, associate professor of pediatrics.

    Kair led a survey of 71 U.S. hospitals who are members of the Better Outcomes through Research for Newborns (BORN) research network. These hospitals care for around 10% of newborns born in the U.S.

    The study examined criteria hospitals use for when and how to deliver supplemental feedings to breastfed infants and explored hospitals’ pumping recommendations. It found that the approaches used varied considerably across and within hospitals. It highlighted how frequently hospitals’ pumping recommendations were inconsistent with best practices.

    How do neonatal departments in U.S. hospitals approach supplementation?

    Breastfed infants have fewer ear, gut and respiratory infections, lower risk of leukemia, and improved neurodevelopment than infants who are not breastfed. Women who breastfeed have lower risk of heart disease and breast, endometrial and ovarian cancers. Therefore, identification of ways to best support postpartum women and infants to establish breastfeeding are important for optimal infant and maternal health.

    The first few days after birth are a critical time in the establishment of breastfeeding, as frequent feedings help ensure adequate breast milk production. Supplemental feedings, when necessary, can help prevent dehydration and neonatal jaundice requiring phototherapy; however unnecessary supplementation puts the mother and the infant at increased risk for low milk supply and early breastfeeding cessation.

    Many hospitals reported using infant weight loss as a criterion for supplementation. The most commonly reported weight loss threshold for initiating supplementation was baby’s weight loss of 10% or more compared to the birth weight. Other weight loss thresholds for supplementation reported by the participating hospitals include:

    • Any weight loss of 4% to 15%
    • Weight loss of 3% in a 24-hour period (mostly for late preterm newborns)
    • Weight loss exceeding the 75th percentile on the Newborn Weight Tool (NEWT) curves.

    “We didn’t expect to find such a wide variation in breastfeeding support practices, most pronounced for late preterm newborns,” Kair said.

    The study found that human donor milk availability is concentrated in hospitals with the highest prevalence of breastfeeding. Among hospitals with at least 81% breastfeeding initiation rate, 44% of them provided donor milk. This is compared to only 4% of hospitals with less than 80% breastfeeding initiation.

    The most commonly reported method for supplementation was bottle feeding (59%), followed by supplemental nursing systems (SNSs) (52%) and finger feeding with a syringe (58%).

    “To help improve maternal and child health and to narrow health inequities, there is a need to implement known best practices in hospitals across the U.S.,” Kair said. “Implementing evidence-based management of supplementation among U.S. hospitals has the potential to improve the care of newborns.”

    Lactation consultant availability and hand expression education were more consistent among hospitals.

    ###

    Co-authors are Carrie Phillipi of Oregon Health and Science University, Allison Lloyd-McLennan of Benioff Children’s Hospital, Kimberly Ngo of University of California, Davis, Heather Sipsma of Benedictine University, Beth King of Academic Pediatric Association and Valerie Flaherman of University of California, San Francisco.

    This study was funded by a Building Interdisciplinary Research Careers in Women’s Health award (K12 HD051958) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Office of Research on Women’s Health, Office of Dietary Supplements, and the National Institute on Aging (NIA). This work was also supported by the National Center for Advancing Translational Sciences (NCATS) and the National Institutes of Health (NIH) (UL1 TR001860).

    Article: Kair et. al. (2020). Supplementation Practices and Donor Milk Use in US Well-Newborn Nurseries, Hospital Pediatrics, DOI: https://doi.org/10.1542/hpeds.2020-0037

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    https://health.ucdavis.edu/health-news/children/strategies-for-supplementation-to-breastfed-newborns-vary-widely-among-us-hospitals/2020/08
    202008_during-the-covid-19-pandemic-mothers-can-still-safely-breastfeed-with-appropriate-precautions Thu, 13 Aug 2020 07:00:00 GMT During the COVID-19 pandemic, mothers can still safely breastfeed with appropriate precautions <p>Mothers with confirmed or suspected COVID-19 can safely breastfeed with appropriate precautions and the benefits of breastfeeding outweigh potential risks, according to a review article published in the American Journal of Perinatology.</p> Mothers with confirmed or suspected COVID-19 can safely breastfeed with appropriate precautions and the benefits of breastfeeding outweigh potential risks, according to a review article published in the American Journal of Perinatology.

    The article, published July 21, provides guidance to clinicians and families about breastfeeding during the coronavirus pandemic.

    “The benefits of breast milk have been well documented, but this current pandemic may cause mothers to limit breastfeeding efforts to protect their babies. This article reminds care providers and mothers, even those with confirmed or suspected COVID-19 infections, that it’s still an important time to continue to breastfeed,” said Ritu Cheema, first author of the article and health sciences clinical assistant professor in the UC Davis Division of Pediatric Infectious Diseases.

    Some of the article’s key points: 

    • There are very few case reports of COVID-19 being transmitted from a mother to her fetus or newborn. This appears to be a rare event.
    • No compelling evidence suggests the transmission of COVID-19 from mother to baby via breast milk.
    • Mother-baby separation has negative health and emotional consequences for both mother and baby.
    • Maintaining appropriate respiratory hygiene when in contact with the newborn baby is critical.
    • There may be an additional benefit of providing breast milk from a mother with COVID-19 to her baby for specific protection against COVID-19, assuming appropriate hygiene practices are followed.

    Based on this information, mothers with suspected or confirmed COVID-19 infections can and should breastfeed their newborns with appropriate precautions.  Mothers should wear a surgical mask and wash their hands and breasts with soap and water before breastfeeding. During intervals between feeds, it is recommended that the infant’s crib be placed at least six feet from the mother’s bed, preferably behind a physical barrier such as a curtain.

    These precautions should be continued until the confirmed COVID-19 positive mother demonstrates an improvement in her symptoms for at least 24 hours without the use of fever-reducing medications, and at least 10 days have passed since she had a fever and her COVID-19 symptoms appeared (or at least 20 days have passed if she had severe illness or is severely immunocompromised as the Centers for Disease Control and Prevention currently recommends).

    In an unfortunate scenario where the mother is very sick and cannot directly breastfeed, every effort should be made to feed the baby the expressed breast milk from her if possible. A healthy family member or nurse can feed the baby the expressed milk in a separate room. Breast pump tubing and container should be cleaned after every use and mother should have a dedicated breast pump. Strict hand hygiene must be followed.

    “Any mother with a  suspected or confirmed COVID-19 infection should not hesitate to breastfeed if she can do it safely and if her health allows,” Cheema said. “Given the potential risk of transmission of infection from anyone infected around the baby, the importance of observing appropriate precautions while handling the baby cannot be overemphasized at the same time.”

    Co-authors of this article are Elizabeth Partridge, Laura Kair, Kara Kuhn-Riordon, Angelique Silva, Caroline Chantry, Mark Underwood, Satyan Lakshminrusimha and Dean Blumberg of UC Davis Health, and Maria Bettinelli of the University of Milan.  

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    https://health.ucdavis.edu/health-news/children/during-the-covid-19-pandemic-mothers-can-still-safely-breastfeed-with-appropriate-precautions/2020/08
    202008_racial-socioeconomic-disparities-fuel-increased-infant-mortality-rates-in-california Tue, 11 Aug 2020 07:00:00 GMT Racial, socioeconomic disparities fuel increased infant mortality rates in California <p>While infant mortality rates (IMR) decreased overall from 2007 to 2015 in California, disparities in infant death rates have increased in some groups, including among obese mothers, those who smoke and African American women, according to a new study published in PLOS One.&nbsp;</p> While infant mortality rates (IMR) decreased overall from 2007 to 2015 in California, disparities in infant death rates have increased in some groups, including among obese mothers, those who smoke and African American women, according to a new study published in PLOS One.   

    The goal of this study was to better clarify the maternal and infant predictors of infant deaths in California. The study analyzed data from the Birth Statistical Master Files in California, compiled by the California Department of Public Health (CDPH). Files from a total of 4,503,197 single births, with 19,301 infant deaths, were reviewed.

    Key findings of the study include:

    • Children of African American women had almost twice the risk of infant mortality when compared with children of white women.
    • Infants of women with bachelor’s degrees or higher were 89% less likely to die, compared to women with less than a high school education.
    • Infants of mothers who smoked during the first and second trimester of pregnancy were 75% more likely to die than infants of nonsmokers.
    • Infants of women who were overweight and obese during pregnancy account for 55% of the infant mortalities in the study.
    • More than half of the infant deaths were to children of women with lower socioeconomic status.
    • Infants of mothers who participate in WIC, the Special Supplemental Nutrition Program for Women, Infants and Children, were 59% less likely to die than infants of non-WIC participants.
    • Infants with low birth weight and preterm birth were more than six times and almost four times more likely to die than infants who had normal births, respectively.
    • Infants born to mothers under the age of 20 represented 10.9% of infant deaths. Mothers over the age of 40 were associated with 5.6% of the total cases of infant deaths.
    • In rural San Joaquin Valley region, women were 51% more likely to experience infant deaths when compared to urban women living in the San Diego area. 

    Reducing disparities

    “Infant mortality is a widely-reported indicator of population health, which can potentially be reduced by addressing racial/ethnic and geographic disparities and morbidities of clinical significance,” said Anura Ratnasiri, first author and research scientist at the State of California’s Department of Health Care Services. “Our study showed that taking steps to reduce infant mortality is likely to have a spillover effect on improving the overall health of the population in generations to come.”

    The study speculates that the most effective health interventions may be social and public health initiatives that mitigate disparities in sociodemographic, economic and behavioral risks for mothers.

    Public education focusing on maternal obesity and smoking cessation may also make a positive impact on all aspects of infant mortality.  Empowering women to attain higher educational goals will likely also improve their socioeconomic status and employment opportunities, which are major indicators of health disparities.

    “These results clearly show that we need to focus on the well-being of African American mothers and mothers in the San Joaquin Valley and address issues such as maternal obesity to achieve improvement in IMR,” said Satyan Lakshminrusimha, a study author and physician-in-chief at UC Davis Children’s Hospital.

    IMR is a standardized measurement of deaths in the first year of life per thousand live births. It is a well-recognized indicator of the general health of the population and has been steadily declining in the United States. The IMR reflects broad socioeconomic conditions, the educational status of the population, maternal behaviors and the quality and accessibility of medical services.

    View the study.

    Other co-authors on the study are Ronald A. Dieckmann of UC San Francisco; Henry C. Lee and Jeffrey B. Gould of Stanford University;  Steven S. Parry and Ralph J. DiLibero of California Department of Health Care Services; and Vivi N. Arief, Ian H. DeLacy and Kaye E. Basford of The University of Queensland.

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    https://health.ucdavis.edu/health-news/children/racial-socioeconomic-disparities-fuel-increased-infant-mortality-rates-in-california/2020/08
    202008_fetal-interventions-help-baby-with-hydrops Fri, 07 Aug 2020 07:00:00 GMT Fetal interventions help baby with hydrops <p>Amanda Brazeal was pregnant for the second time. She expected an easy delivery. She could not have known that her baby would have hydrops, a life-threatening condition in which an abnormal amount of fluid builds up in the unborn child.</p> Amanda Brazeal was pregnant for the second time. She expected an easy delivery. She could not have known that her baby would have hydrops, a life-threatening condition in which an abnormal amount of fluid builds up in the unborn child.

    But Amanda’s 20-week ultrasound at the Prenatal Diagnostic Center in Stockton revealed a buildup of excess fluid in her unborn baby’s chest. Doctors told her it was bilateral pleural effusions. They also diagnosed her baby with cystic hygroma, a fluid-filled sac created by a blockage in the lymphatic system.

    “We weren’t sure what was going to happen. But we opted to have the doctors do what they could,” Amanda said.

    The doctors Amanda relied on were part of the team at the UC Davis Fetal Care and Treatment Center in Sacramento, the region’s first comprehensive, multidisciplinary fetal diagnosis and therapy center.

    The complications continued. Excess fluid in the unborn baby’s tissues brought the hydrops diagnosis. If left untreated, hydrops is usually fatal. It occurs in one out of every 1,000 pregnancies.

    Amanda had never heard of the condition. Doctors told her to treat it, they would insert a small needed into her baby’s chest to drain the fluid – all while in the womb.

    “I came back a couple of days later and the fluid came back,” Brazeal said.

    This time, the doctors tried a different procedure and placed a small tube called a shunt into the baby’s chest to help remove the excess fluid. After doing this twice, her health care team was hopeful.

    “Amanda came to UC Davis twice a week during the entire coronavirus pandemic so we could evaluate her baby. Initially we were very worried that we were going to have to deliver this baby very early and it was going to be very sick,” said pediatric surgeon Payam Saadai.

    But Amanda’s baby had other plans. Aria Quin Lee Riley was born at 37 weeks in June, weighing 9 pounds, 14 ounces. The newborn only spent a week in the UC Davis Neonatal Intensive Care Unit, a designated level IV nursery, and then was safely home. 

    “It was a stressful time, especially during COVID-19. But our experience has been really good with the team,” Brazeal said.

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    https://health.ucdavis.edu/health-news/children/fetal-interventions-help-baby-with-hydrops/2020/08
    202008_zulresso-brings-new-mother-back-from-postpartum-depression Wed, 05 Aug 2020 07:00:00 GMT Zulresso brings mother back from postpartum depression <p>The birth of her son should have been a happy time for this new mother. But for Bari, the first three months after she delivered her baby boy were dark. But after taking Zulresso, the first intravenous drug for the treatment of postpartum depression to be approved by the Food and Drug Administration (FDA), she is able to find joy in her life once more.&nbsp;</p> The birth of her son should have been a happy time for this new mother. But Bari battled with postpartum depression for the first three months after she delivered her baby boy.

    “I couldn’t see the light at the end of the tunnel. I was super anxious and rarely left the house,” said Bari, adding that she lost the will to eat and 30 pounds in a short amount of time.

    Her depression and generalized anxiety disorder, of which she had a history, also plummeted to new depths of despair postpartum. 

    When Bari learned about Zulresso, the first intravenous drug for the treatment of postpartum depression to be approved by the Food and Drug Administration (FDA), she and her doctor began researching where she could go to get treatment in Southern California, where she lives. Several locations offered the drug, but none was a hospital.

    “I didn’t feel comfortable about getting this treatment outside of a hospital. They told me that UC Davis Medical Center offered Zulresso. I thought that was a good option,” Bari said.

    Within a couple of weeks, she had a telehealth appointment with Shannon Clark from the UC Davis Maternal-Fetal Medicine Division, who assessed her and approved her for the treatment.

    “The nurses were incredible and Dr. Clark was amazing,” Bari said. “Dr. Clark has a background and familiarity with postpartum depression. It wasn’t just any doctor giving me the medicine. She understood and made me feel comfortable.”

    The 60-hour treatment, coupled with Bari’s existing anti-depression medication, provided the results she hoped for. Within a couple of days, she went to her first exercise class in months.

    “It was the first time I had the motivation to go out and do something like that for myself,” Bari said. 

    Not long after her treatment, the coronavirus pandemic hit and shelter-in-place took effect, an emotional time for so many. Bari admits she’s had some down days, but despite these challenges, she can tell that the treatment worked.  

    Today, her son Max is 8 months old. She connects with him like never before and appreciates these precious days as a mother.  

    “I’m in love with my son. I’m in such a good place,” Bari said.

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    https://health.ucdavis.edu/health-news/children/zulresso-brings-new-mother-back-from-postpartum-depression/2020/08
    202008_panda-cares-day-supports-uc-davis-childrens-hospital-patients- Wed, 05 Aug 2020 07:00:00 GMT Panda Cares Day supports UC Davis Children’s Hospital patients <p>On August 8, order online using <strong>PandaCaresDay</strong> promo code to help local kids.</p> Panda Express is hosting a one-day, virtual fundraiser to support Children’s Miracle Network Hospitals (CMN). This Saturday, August 8th, is Panda Cares Day and 28 percent of online sales will be donated when customers use the promo code PandaCaresDay. Place an order on the Panda Express mobile app - available at the App Store or Google Play Store - or on the website and all funds raised locally stay local to help kids treated at UC Davis Children’s Hospital.

    The philanthropic branch of the company, the Panda Cares Foundation, is behind year-round fundraising efforts at local Panda Express locations. The program’s purpose is to promote the spirit of giving within Panda Express by directly serving the health and education needs of underserved children. Panda Restaurant Group has been a proud CMN fundraising partner since 2007 and has raised $59M through their in-store donation boxes, Associate Giving campaign and annual golf invitationals. 

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    https://health.ucdavis.edu/health-news/children/panda-cares-day-supports-uc-davis-childrens-hospital-patients-/2020/08
    202008_uc-davis-childrens-hospital-is-named-gold-safe-sleep-champion-by-national-safe-sleep-hospital-certification-program Mon, 03 Aug 2020 07:00:00 GMT UC Davis Children's Hospital is named gold safe sleep champion by National Safe Sleep Hospital Certification Program <p>UC Davis Children&rsquo;s Hospital has been recognized by the National Safe Sleep Hospital Certification Program as a gold safe sleep champion for its commitment to best practices and education on infant safe sleep.</p> UC Davis Children’s Hospital has been recognized by the National Safe Sleep Hospital Certification Program as a gold safe sleep champion for its commitment to best practices and education on infant safe sleep. 

    The National Safe Sleep Hospital Certification Program was created by Cribs for Kids®, the only national infant safe sleep organization. Based in Pittsburgh, PA, Cribs for Kids is dedicated to preventing infant sleep-related deaths due to accidental suffocation. As a Nationally Certified Safe Sleep Hospital, UC Davis Children’s Hospital is recognized for following the safe sleep guidelines recommended by the American Academy of Pediatrics (AAP), and providing training programs for health care team members and family caregivers. 

    “Sleep-Related Death (SRD) results in the loss of more than 3,500 infants every year in the U.S.,” said Michael H. Goodstein, neonatologist and medical director of research at Cribs for Kids®. “We know that modeling safe infant sleep in the hospital and providing education to families has a significant effect on infant mortality. The Cribs for Kids Hospital Certification Program is designed to recognize those hospitals that are taking an active role in reducing these preventable deaths.” 

    A baby dies every other week within Sacramento County related to unsafe sleep environments. Half of these infants are African American.   

    “We are committed to preventing these tragedies and teaching safe sleep practices to all of our new mothers in our hospital,” said Judie Boehmer, executive director of patient care services at UC Davis Children’s Hospital. “Our team is proud to receive this new hospital certification.”

    The National Safe Sleep Hospital Certification Program was created in partnership with leading infant health and safety organizations such as All Baby & Child, The National Center for the Review & Prevention of Child Deaths, Association of SIDS and Infant Mortality Programs and numerous state American Academy of Pediatric chapters and health departments.

    “The certification program launched in 2015 in Pittsburgh, PA, home of the Cribs for Kids® national headquarters. Hundreds of hospitals across the US are certified. We welcome UC Davis Children’s Hospital to this expanding group of committed hospitals,” said Judith A. Bannon, executive director and founder of Cribs for Kids®.  “This will have a profound effect on  saving babies’ lives.”

    For more information on the Cribs for Kids® National Safe Sleep Hospital Certification program, visit https://cribsforkids.org/hospitalcertification/

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    https://health.ucdavis.edu/health-news/children/uc-davis-childrens-hospital-is-named-gold-safe-sleep-champion-by-national-safe-sleep-hospital-certification-program/2020/08