Wednesday, June 26, 2013

Water Safety ….. Importance Level: HIGH

by Richard Pass, RN,BS, Director, Save A Little Life, inc.

It is not unusual for us at Save A Little Life to get a call or email every so often by a parent who has actually had to try and revive a pediatric victim, for real. This, no doubt, is due to the fact that drowning events occur daily in the U.S. rating it the 5th leading cause of unintentional injury death.

Of even greater importance, drowning represents the second leading cause of accidental death in the pediatric population  -  second only to auto accidents. Parents & family members need to understand just how devastating these events can be so preparation for prevention can be improved and overall awareness heightened.

Highest Risk Individuals
Children between 1-4 years are the most vulnerable to drowning. Four out of five (a full 80%) of these children are male. In this group, the leading location for drowning is the family pool. African American children have an even higher rate of these lethal events compared to other ethnic groups. In particular, the rate of drowning for African American children between 5-14 years is nearly 3 times that of Anglo children of the same age range. Of the factors that seem to directly influence these rates, the following have been identified:

  • Lack of ability to swim
  • Inefficient barriers (fencing/ pool covers, etc.)
  • Poor adult supervision
  • Failure to wear life jackets
  • Alcohol use (in adolescence)
  • Children with seizure disorders
As we look at the higher risk issues it should become clearer as to what needs to be done to lower drowning risk in the pediatric population. 

What Does Drowning Look Like?
If you were to think of the image of someone in the process of drowning it is not unusual to anticipate someone screaming and wildly flailing about in a rather obvious way.  These images, which come from T.V. and film, are usually far from what actually occurs.  In fact, many of these are drowning events are quiet (or completely silent) with little or no noise made by the victim.  Children who have had swimming lessons can still become a victim.

In fact, one out of five of these events occurs in the presence of an adult or care provider and is not even realized until the victim is completely unresponsive. Without early recognition and quick reaction the chance of permanent brain damage or death increases.

As frightening as these images might be, the drowning victim still has a chance for survival, assuming two things occur: 1. The victim is not submerged for a prolonged period of time (no specific time frames have been provided but the quicker they are removed the better)  and 2. That CPR is initiated immediately upon removing them from the water.  In fact, this group of drowning victims has a reasonable chance of a full recovery if both of the above conditions are in effect.

Is CPR for the drowning infant or child different from dry land events?
The answer is no. Once removed from the water and deemed lifeless (no breathing or moving) we begin CPR just as we would on anyone else in that age group.  A very important concept here is that CPR for this victim is not about water extraction but rather an effort to move oxygenated blood to the victim’s brain.  This is done with immediate initiation of 30 chest compressions and 2 rescue breaths.

What about the water?
Typically, the majority of the water taken in is actually in the victim’s stomach.  Water that gets into the lungs does not come out but tends to be absorbed through the lungs into the chest cavity and dissipates from there.  If, however, there is prolonged submersion  -  and no CPR offered until paramedics arrive  -  the outcomes are almost always much worse.  Conversely, a victim who receives immediate CPR usually has a better outcome.

The water in the stomach is another issue.  It is normal for at least 80% of these victims to vomit water, even if they are otherwise lifeless.  At the instant we note vomiting, the victim must be turned on their side which will facilitate its removal.  You may swipe the mouth at that point to clear water or debris that is easily reachable.  Once this is done, turn the victim back onto their backs and, if no signs of life, resume the same 30 chest compression: 2 rescue breath format.  If spontaneous breathing or moving resumes, stop CPR and (if not yet done) call 9-1-1 immediately.

The 2 Minute Rule
Moments such as described can be emotionally devastating for the adult rescuer. As a result, judgment errors are not uncommon. We need to be very clear at this point with regard to our initial series of actions. If you are alone with a pediatric victim who appears lifeless, initiate CPR FIRST, instead of making the 9-1-1 call. Do CPR for UP TO 2 MINUTES (unless spontaneous breathing re-starts) BEFORE CALLING 9-1-1. If there is another person present, CPR and the 9-1-1 call can happen simultaneously.

Prevention remains our primary focus and should remain so.  Yet we must be ready in case these efforts fail.  Taking a current CPR course is an essential part of parental readiness.  If you have not taken a course in the last 12 months, we strongly urge you to do so.  Again, we can be reached at and/or 818 344-1442
We are expecting a long and hot summer with little ones in and out of the water in a wide variety of settings. Let’s do everything we can to reduce the risk for drowning.

Have a safe summer,

Richard Pass, RN,BS
Director, Save A Little Life, inc.

Richard is an RN with over 30 years of experience in Emergency and critical care nursing. He is currently on staff at Cedars-Sinai Medical Center and is a part-time instructor of nursing at California State University, Northridge. Richard has been a basic and advanced life support instructor with the Heart Association for more than 20 years. He also teaches Infant CPR at The Pump Station Locations and at Rosie Pope Maternity in Santa Monica.

The Truth about Swim Readiness and The Most Important Facts to know about your child and their abilities.

by Lisa Cook is the Founder and CEO of KidSwim Inc.
For many years, the American Pediatrics Association and American Red Cross determined that the best age to begin swim lessons was 4. These days, they, along with most other organizations, have revised their statement saying that it is almost never too early to begin swim lessons and learn to swim.

However, I want to clarify both of those statements and explain why it was one and now its the other and what it really means to ‘begin swim lessons in infancy.’

The reason why age 4 is ideal (and frankly it is ideal) to begin lessons is because cognitively, physically and emotionally, your children have solidly moved out of the toddler stage and are firmly entrenched in the preschool stage. Physically, their core development is at its strongest since birth, their coordination is more sophisticated, they are able to grasp and process a multitude of complicated instructions and their endurance level is much higher than in previous stages. Additionally, they are more rational characters, less prone to tantrums, succumbing to hunger and exhaustion, and their fears are often tempered. I have found that when starting lessons with a four year old child - who up until that point, may never have had lessons at all previously - they learn extremely quickly and move through the stages at an accelerated rate.

For children that have begun lessons two or even three years prior and as of yet have had little movement forward, right around age 4, everything seems to click and the child can often be found swimming by themselves on their first or second lesson of that particular season. This is why age 4 is what I call the ‘ideal age.’

In terms of beginning lessons earlier than age 4, I do highly recommend it, even as young as 6 months of age - however - and this is a very big stipulation - it is unreasonable to embark on the experience with any expectations about what your child should be doing. 

Prior to age 4, your child may or may not swim. One is not better than the other. Trust me on this. I have seen children forced to learn the physicality of swimming at age 2, but they did not learn inherently on their own and so they are often confused, puzzled, awkward and unsure. They, in a sense, learned before they were ready to learn.

I have also seen children as young as 18 months or 2 years take to the water as if they were born into it and learn to swim so happily and fearlessly that I, as the fortunate instructor, almost cannot take any of the credit. It is obvious that many children instinctively relax in new situations and embrace the experience of being in water without hesitation. We obviously want to take advantage of that and continue to keep them swimming so they don’t forget what they learn from season to season.
Here's the dirty little secret: very young children do forget any new skills learned if there is a gap of several months between practicing skills. It is all well and good to take an 18 month old and ‘teach them to swim’ but if they are not around pools and water for six months, I can guarantee that they will need to be reintroduced to it as though they had never had lessons before.

I firmly believe that the developmental approach works because it gives each child the time to explore the environment peacefully and respectfully, without forcing the child to comply with a generic checklist of what he/she should be doing. It takes into account each child’s character, temperament, age, stage, emotional and physical maturity.

Another thing to know - and this is perhaps the single most important part of learning to swim is that your child will NOT be water safe, no matter how well they learn to swim, by age 3,4,5 or in most cases even 6. 

Water safety is a multi-layered and complex state of being. A child's level of swim readiness depends upon both experience and maturity. A lot of children can be called water savvy and can appear highly skilled in very controlled situations (being the only child in the pool at their own house, a pool they are very familiar with, parent sitting right on the side of the pool watching closely, etc..). They can look like they are water safe. But if you add in any new variables or change the location, you cannot guarantee that your child will know how to react and will be able to anticipate potential problems - this is why claiming a very young child is ‘water safe’ is so dangerous. We as parents need to be as vigilant as possible around our children when they are around the water. Any indication that our children are ‘safe’ means instinctively we can relax and quite frankly, that is the most dangerous component of all.

Basically, you can sum all that information up this way:

  1. Prior to age 4, children should be exposed to water as early as is comfortable and accessible to families. Even a parent/child class is wonderful and beneficial in forming a benevolent association to aquatic experiences. 
  2. Children should begin real instructional swim lessons at approximately 2.5 years of age (this is a general rule obviously) and ideally private lessons at this stage are the best bet for a calm, focused, safe and controlled environment.
  3. It is best not to force children to swim EVER and especially not at ages younger than 4 years. Children have their own mechanisms for protecting themselves in new and unfamiliar situations.  Overriding this by force (even gentle coercion to comply is still force) is extremely disrespectful and sends a message to your child that their instincts are not to be trusted.
  4. By age 4 most children who’ve had benevolent experiences around water or little experience, WILL learn to swim easily, unless there are underlying issues not identified.
  5. A very young child (18 months - 2 years) who obviously seems comfortable and natural in the water should be encouraged to swim and in the best case scenario, to limit regression, keep them exposed to and swimming year round.
  6. A child who was swimming at a very young age and seems to have forgotten everything, will quickly re-adapt and surpass their previous season’s skill levels, so do not worry if it looks like they have slid back into becoming a non-swimmer. It is only temporary.
  7. and lastly and most importantly - never ever classify a child under the age of 7 as water safe, no matter how well they swim.

Lisa Cook is the Founder and CEO of KidSwim Inc., a developmental swim school that teaches children and adults to love the water. As an educator, Lisa obtained her teaching credential from LMU, and has worked with children and adults in aquatic instruction for more than twenty years. Kidswim was founded in 2001 and now services the greater Los Angeles area, the San Fernando Valley, the Southbay, Orange County, Glendale/Pasadena and Calabasas.  KidSwim offers parent/child programs, one-on-one lessons for ages 2-and up, and pre-swim team training, as well as Mommy and me water fitness classes. Lisa Cook continues to conduct water safety seminars nationally, offering valuable information for everything parents need to know to keep children safe in the water.

Lisa Cook | KidSwim Inc.
Phone: 888-579-SWIM (7946)


Friday, June 21, 2013

Help Your Child Learn How to Sleep at Baby Sleep School

Dear Exhausted Parent,   

We have the deepest empathy for what it feels like to stand in your shoes.  You are so tired that you can't function or think straight - but you love your child and would do anything to make sure she knows it, including feeding or rocking her to sleep, lying down with her in bed, or rushing to her side whenever she cries at night.

And yet, your child's poor sleep is wreaking havoc on your whole family.  Desperate for answers, you've talked to anyone who will listen and scoured the Internet for solutions.  But there is so much conflicting information out there on sleep, and it can be incredibly overwhelming to decide on a method that's right for you.

At Sleepy Planet, our mission is to take the guesswork out of sleep for tired parents who know things need to change but feel uncertain about how to move forward.  We aim to make the road to peaceful sleep as smooth, simple and swift as possible, standing by your side every step of the way.

That's why we created Baby Sleep School! Baby Sleep School is a brand-new, personalized and affordable way to help your little one sleep through the night and take great naps! This class offers everything you would normally receive in a personalized consultation (value $395), for a fraction of the cost. Designed for parents of babies 4 to 18 months, this three-hour class with Jennifer and Jill will offer in-depth assistance to help your baby settle on her own, sleep through the night, and take predictable, good-quality naps. Each class will include:
  • A thorough assessment of your child's current sleep habits, and feeding, and developmental needs 
  • Detailed information about wind-down routines, scheduling, and the sleep environment appropriate for your child 
  • Guidance on creating a customized, step-by-step sleep plan for your child, taking into consideration your family's needs and preferences  
  • Plenty of Q&A about the sleep-learning process   
  • A companion workbook and audio CD  
  • Optional follow-up support to ensure that your plan goes smoothly (additional fees will apply) 
Saturday from 1-4pm in Santa Monica. Call 310-998-1981 for next class date.

We look forward to helping you restore balance and harmony to your lives, and to helping you finally get some much-deserved shut-eye!   

With love, 
Jill and Jennifer 

Friday, June 14, 2013

Postpartum Challenges: Very Common and So Treatable!

By Tiffany Howsam, MFT
I remember when one of my best friends told me that she had suffered from postpartum depression (PPD) after having her first child.  She didn’t tell me this until several years later.  I had no idea she was suffering.  It wasn’t until after I had my first child that I felt the weight of her experience.  Although I felt ready to be a mother and felt tremendous love for my baby, the transition to motherhood was difficult enough without the burden of anxiety and or depression.  I knew then that I wanted to help women and families adjust to life with a baby.  What could be more important than the health of moms and babies! For this reason, I’m very happy to announce that I will be leading a new support group at The Pump Station™ to help moms with these challenges. 

As a licensed Marriage and Family Therapist, I focused my private practice on pregnancy and postpartum related issues. I attended conferences, professional trainings and read all that I could about postpartum depression and anxiety. What surprised me most was learning that Postpartum Depression and Anxiety is the number one complication of childbirth, yet no one was talking about it!

At the time, there wasn’t a lot of media exposure and there was still a lot of shame and judgment around PPD. About a year later, Brooke Shields came out with her memoir, “Down Came the Rain,” an excellent book describing her experience with Postpartum Depression.  She really normalized the experience so many moms have gone through but weren’t able to talk about. Her book opened the door for moms to be able to discuss difficult feelings related to being a mother; the book let moms know that they are not alone and there is help. What I find so inspiring is that she had the courage to ask for help, she recovered, and she went on to have another child despite her traumatic experiences. 

I have been counseling moms individually, with their partners, and in support groups for eight years now. I love what I do. PPD is so treatable. With the right support and help, moms do feel better. I love seeing moms get through these challenges and really start to enjoy motherhood.

So what is Postpartum Depression and how does it differ from the baby blues? The baby blues usually occur within the 1st two weeks after giving birth and disappear within a week or two.

 Baby Blues: what you can expect:
  • Mood changes
  • Weepiness
  • Sadness
  • Irritability
  • Frustration
  • Anxiety
  • Difficulty concentrating

If these feelings persist beyond 3 weeks, you may be experiencing some form of postpartum depression or anxiety.

Postpartum Anxiety/Depression
1 in 5 women experience postpartum depression and/or anxiety. It can occur during pregnancy and up to one year after giving birth.
Symptoms can include:
  • Sad mood
  • Guilt, shame and inadequacy
  • Excessive worry
  • Lack of energy
  • Disinterest in your baby
  • Feeling worthless or hopeless
  • Irritability, anxiety, feeling on edge
  • Feeling like you are not yourself
  • Feeling like you are not a good mother
  • Feeling overwhelmed, as if you are drowning
  • Loss of interest or pleasure in life
  • Unable to sleep, even at night when your baby is sleeping
  • Having thoughts of hurting yourself or your baby
  • No energy or motivation
  • Thoughts of suicide

Anyone can experience PPD, however, there are several risk factors.  The three risk factors that seem to have the greatest impact are personal/family history of anxiety/depression, marital difficulties, and lack of social support. 

One of the ways to help moms through this adjustment is by getting the needed support. Once a child is born, so much focus goes towards the baby that little attention is given to what the mother might need. This is where the Postpartum Challenges Support Group comes in.  Here you have a chance to talk about motherhood as it really is, including the difficulties, the stresses, the worries, and the joy.  You also have the opportunity to make connections with other moms having similar experiences.

This support group focuses on moms and ways to take care of yourself so that you can take care of your baby. I heard one person say it this way: when you get on an airplane with your child, your instructions are to put your oxygen mask on first so that you can take care of your child.  I love that analogy because it’s so difficult to take care of someone else if you aren’t feeling your best and there is no one we want to care for more than our own children.

8-Week Group starts July 18th, 2013 in our Santa Monica Store
Thursdays from 12:45pm - 2:15pm
For registration please email or call 310-998-1981.