Bronchiolitis and RSV

Bronchiolitis and RSVWinter is right around the corner, and with it cold and flu season. One of the most common conditions we see in the winter is called “Bronchiolitis.” It is an infection of the lower respiratory tract characterized by cough, congestion, and wheezing, and is very common in children.

The infection causes cells lining the small airways to die and can clog those airways causing difficulty breathing. Bronchiolitis is most commonly caused by a viral infection, so antibiotics do not help. The virus most frequently associated with bronchiolitis is called RSV which usually circulates between November and April, with most infections and hospitalizations occurring in January and February. Almost all children have been infected by age 3, but most do not need to be hospitalized.

Children most likely to require hospitalization include:

  • Infants under 6 months old
  • Infants with underlying lung disease
  • Infants born before 35 weeks gestation
  • Infants and children with congenital heart disease
  • Children with compromised immune systems
  • Children with asthma and/or exposure to second hand smoke

RSV and other infections that cause bronchiolitis are spread through secretions from the nose and mouth, prevention includes minimizing exposure to those secretions as well as other airway irritants.

Preventative steps include:

  • Minimizing exposure to tobacco and other smoke
  • Keeping high risk infants out of daycare if possible
  • Ensuring good hand washing, especially among siblings
  • Practicing good cough hygiene-coughing into elbow or tissue and washing hands after cough or sneeze

When a child does need to be hospitalized for bronchiolitis, the majority of treatment is supportive

  • If the child has a history of asthma, or there is a  family history, he or she may get a breathing treatment with asthma medication to relieve any asthma component to their increased work of breathing
  • If the child is unable to drink enough to stay hydrated, fluids through the IV
  • And if the child is unable to get enough oxygen from the room air,  supplemental oxygen through a mask or tubes in the nose may be given

Bronchiolitis is a self-limited illness that usually resolves within 2 weeks from the first symptoms. The most severe symptoms usually occur on days 5-7 of illness, but the cough can last up to 2-3 more weeks.

For more information:

Bronchiolitis and RSV
About Daniele Gusland, MD
Dr. Gusland is a pediatric resident at the University of Wisconsin Pediatric Residency Program.

View all posts by Daniele Gusland, MD
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Guide to Mindful Eating

Mindfulness is often described as an awareness of reality, or the present moment. Mindful eating begins with quieting the environment at meals and snacks and tuning into what is going on inside the body and mind. The following is guide to pursuing a mindful meal during the holidays, or anytime of the year.

  • Take a moment to relax. Breathe deeply in through your nose and out through your mouth. Allow your belly to rise when you breathe in and fall as you breathe out. Ask yourself where you feel hungry; Mind? Belly? Anywhere else? Rate your hunger using the following scale:
  1. Starved with severe hunger pangs that are present on and off for greater than 30 minutes. You may also have a headache, or feel fatigued or irritable.
  2. Very hungry with hunger pangs on and off for at least 15 minutes. You may also have constant thoughts about food with increased sense of taste and smell.
  3. Hungry and notice that the stomach is growling with an increased sense of taste and smell.
  4. Somewhat hungry and may first experience feelings of true hunger. Make a plan to eat in the next 30 minutes.
  5. Neutral and feel neither hungry nor full.
  6. Somewhat satisfied and starting to feel food in the stomach but do not feel ready to stop eating.
  7. Satisfied and could most likely go at least 2 hours without feeling hunger.
  8. Starting to feel full and could go 3-4 hours without feeling hunger.
  9. Very full with some discomfort and desire to sit and rest or nap.
  10. Stuffed with painful pressure inside the stomach is painful and feeling of sleepiness.
  • Imagine what type of food would satisfy the hunger
    • Texture: crunchy, smooth, chewy
    • Temperature: cold, warm, cool
    • Density: heavy, light
    • Taste: sweet, salty, spicy, sour
  • Prepare and portion the food.
  • Choose a peaceful place to eat. Try to eat most of the meals seated at a table where the food is prepared, such as the kitchen or the dining room. Limit distractions such as TV, computer, phone, radio, books or magazines.
  • Eat slowly and savor every bite. Notice all that you can when eating, such as what the food tastes, smells and feels like. Chew the food slowly and take a moment to rest between bites. Try to make meals and snacks last at least 20 minutes.
  • Do a check-in. Stop after you have eaten about 10 bites to assess your level of hunger or satisfaction using the scale above. Continue to eat and evaluate every few bites. Stop eating when you would rate yourself as a 7 or 8 on the scale above.

Pause after eating to enjoy the satisfaction.

December Recipe: Chewy Oatmeal Cookie Bars

Chewy Oatmeal Cookie BarsIngredients

  • 2 Tbsp light butter, room temperature
  • ¼ cup prune puree
  • 1 Tbsp flaxseed, ground mixed with 2 T Water
  • 1 tsp vVanilla extract
  • ½ cup white sugar
  • ¼ cup + 2 Tbsp splenda® brown sugar
  • 1 cup whole wheat flour
  • 1 tsp baking powder
  • ½ tsp baking soda
  • ½ tsp salt
  • ½ tsp ground cinnamon
  • 2 cup oats
  • ½ cup raisins (optional)
  • ½ cup walnuts (optional)

Preheat oven to 375°F. Grease a 11 x 14 baking dish.

In a medium bowl, whisk together flour, baking powder, baking soda, salt, and cinnamon.

In a large bowl, cream together the butter and the white and brown sugars; Add the egg, prune puree and vanilla extract.

Stir in the wet mixture into the flour mixture.

Add the oats and raisins and mix until combined.

Pour mixture into baking dish and smooth with rubber spatula.

Bake for about 9 to 12 minutes, or until the edges are light brown and pull away.

Guide to Mindful Eating
About Cassie Vanderwall, MS, RD, CD, CDE, CPT
Cassie Vanderwall is a registered dietitian, certified personal trainer and certified diabetes educator at the UW Health Pediatric Fitness Clinic and Pediatric Diabetes Clinic. Cassie is passionate about empowering families by equipping them with the tools they need to achieve a healthier life.

View all posts by Cassie Vanderwall, MS, RD, CD, CDE, CPT
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The Darker Side of Cough Medication

The Darker Side of Cough SyrupParents of students attending a local middle school got a surprise recently when they received a letter informing them that students had been caught using cough medication for recreational purposes. What would possess anyone to chug awful-tasting medication if not having hacking coughing fits? The answer is simple: cough medicine affords a cheap and easy high. And obtaining it may require no more effort than strolling to the family’s medicine cabinet.

Dextromethorphan, a common ingredient in cough medication, acts on the same brain receptors as drugs like PCP or ketamine. This can cause dissociation (out-of-body experiences) and hallucinations.  Coricidin HBP Cough & Cold capsules (street name Triple Cs or skittles, a popular choice among recreational users) contain Dextromethorphan. Another cough suppressant, codeine, acts on the same receptors targeted by opioids like heroin. Consuming more than the therapeutic dose of codeine cough syrup can produce euphoria similar to that produced by other opioid drugs.

Recreational use of cough medicine is not new. When I was in high school (just a few years ago…wink, wink), students drinking Robitussin between class was not unheard of. In 2013, 4% of the nation’s 8th, 10th, and 12th graders used over the counter cough and cold medications to get high, making cough medicine more popular than heroin, cocaine, or ecstasy.

Sometimes the medications are consumed on their own; sometimes they are used in mixtures containing other ingredients, like soft drinks or alcohol. These concoctions have a variety of names: purple drank, sizzurp, lean. There are multiple pop culture references to these mixes, as well as famous arrests (like former Green Bay Packer, Johnny Jolly).

Like any drug, cough medications have side effects. They can cause loss of coordination, numbness, heart rate changes (either a really fast rate or really slow rate, depending on the medication), blood pressure changes, even death (especially in infants). These medications may also contain other drugs, such as antihistamines (like diphenhydramine, the main ingredient of Benadryl), which is also dangerous at high doses. Deaths from diphenhydramine are rare, but possible. In fact, earlier this year a teenager from Waukesha died from overdose of this ingredient.

During this time of year where upper respiratory infections, the common cold, and influenza are prominent, beware of the dangers in your medicine cabinet. Pay attention to the types and quantities of medications in the house. If you have any questions or concerns about the possibility of your teenager using cough medication inappropriately, talk to his or her primary care provider, or call the Poison Center at 1-800-222-1222.


The Darker Side of Cough Medication
About Paula Cody, MD, MPH
Dr. Paula Cody is fellowship trained in adolescent medicine and is a pediatrician at the UW Health John Stephenson Teenage and Young Adult Clinic.

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Baby Gabriel’s Story

GabrielHave you read Gabriel’s story? He is an amazing little guy who was born in July of this year. Although his mother’s pregnancy was uneventful, within moments of being born it was clear Gabriel was in trouble. He was transported to American Family Children’s Hospital’s new Level IV Neonatal Intensive Care Unit (NICU) where physicians from multiple specialties filled his room to try and determine what was wrong.

At only hours old, it was clear that Gabriel would need surgery for a twisted bowel and cardiac catheterization to more precisely image an anomaly in his heart. Time was not on Gabriel’s side. Normally, these multiple procedures would mean transporting a patient to different locations throughout the hospital. But, earlier this year a new facility opened at American Family Children’s Hospital that allowed Gabriel to undergo both the surgery and imaging in a single place. It’s the only facility of its kind in North America.

Gabriel’s story is full of harrowing moments, yet he is alive and thriving due to the medical care he was able to receive at American Family Children’s Hospital and due to the generosity of donors. You see, the facility where Gabriel underwent multiple procedures and the NICU were made possible through donations.

In my position as development program director I see the power of philanthropy every day. Health insurance only covers so much. But the incredible facility we have here at the Children’s Hospital and the programs to help make the experience less stressful for kids, like Child Life, are made possible through contributions. These donors, donors like you, continue to have a tremendous impact on the lives of the children and families for whom we care.

If you are considering a gift at the end of the year, we encourage you to consider American Family Children’s Hospital. Your support directly changes lives. Make a donation.


Baby Gabriel’s Story
About Tom Young
Tom Young is the Development Program Director at American Family Children’s Hospital.

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Posted in Philanthropy | Tagged , , ,

How to Help this Holiday Season

Four Ways to Help American Family Children's HospitalMany families use the holiday season to teach their children about generosity and giving back to the community. Here are four simple ways your family can make a difference in the lives of the children and families at American Family Children’s Hospital.

 In-Kind Donations

In-kind donations (also known as the Child Life Wish List) are welcome at American Family Children’s Hospital all year long. Donated toys and gifts can provide distraction during a procedure or a clinic waiting area. They are also used to restock our playrooms, celebrate a birthday spent in the hospital or a completion of a treatment.

Choose an item from our wish list and drop it off at our Guest Depot or order from our online gift registries.

Here are a few items that we can always use:

  • Bubbles
  • Crayola crayons, markers and colored pencils
  • Distraction items
  • Rattles (all plastic)
  • Gift cards ($5 and $10 increments to Target, Walmart, Best Buy)
  • Glad Press’n Seal
  • Newer release DVDs
    • Patients love Disney/Pixar/Dreamworks
    • PG-13 movies are great for our teen patients
  • Play-Doh
  • Reusable wall decals for all ages

 Donate to the Greatest Need Fund

Donations to support the Greatest Need Fund will provide an immediate resource for American Family Children’s Hospital administrators to support emerging needs. A few examples of how the Greatest Need Fund has made a difference include improving laundry facilities for families and providing free family meals for families. Gifts to this fund allow us to be flexible and respond to changing circumstances, and can have the greatest impact.

Kids Helping Kids

The Kids Helping Kids program celebrates and empowers kids, tweens and teens interested in helping patients and families at American Family Children’s Hospital. You can host a Change Challenge, organize a Caps Day at your school or try a hop-a-thon.

 Family Meals

When a child has to remain in the hospital, families are often faced with the burden of paying for regular meals as they try to remain by the bedside. Each month approximately 16 free meals are provided to help alleviate some of the stress families face.

If you’re interested in donating a family meal, please contact:

Julie Auenson
(608) 890-8095


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