The real scoop on teething and sleep

KC FB Profile logoThe Dr. Super Sleep Series is written in collaboration with KinderCare. KinderCare believes that early childhood education creates brighter futures. They are the largest provider of early childhood education in the nation and they are passionate about creating a world of learning, joy and adventure for more than 169,000 children every day. For more parenting resources, crafts, learning activities and family fun, visit their blog.

What’s the deal with teething and sleep difficulties? That’s the kind of thing you find yourself wondering about at 2 a.m. when your very cranky little one just can’t seem to settle down. Like with many baby conundrums, from mysterious low-grade fevers and runny noses, to weird poops or general grumpiness, it’s easy to decree teething as the culprit for bursts of bad sleep. But is it really fair to blame their budding chompers for your snoozing woes? We asked Dr. Elizabeth Super, pediatrician and children’s sleep specialist with the Pediatric Sleep Medicine program here at OHSU Doernbecher Children’s Hospital, for the straight scoop.

“Teething is a very long process that lasts through the first two or three years of life,” Dr. Super says. It can cause a bit of discomfort and even pain, but how much – and how it impacts sleep – depends on your individual baby: Some children have a lot of physical teething-related symptoms and some don’t; some teeth may cause a lot of symptoms (we’re looking at you, first-year molars) and others may not.

TeethingYeah, we know that’s sort of vague. So, what’s the sleepy parent of a sleepy – and possibly teething – baby to do?

First, decide if it’s her teeth. Teething can’t explain all sleep difficulties, so consider whether she’s been showing other symptoms during the day. Indeed, some children are more irritable or run a low fever. You might be able to see, or feel with a clean finger, a new tooth budding just under the gums. She may also have found teething toys or cool things – like wet washcloths from the fridge – comforting. If she isn’t displaying any teething symptoms (and she isn’t sick) then sticking to your usual sleep routine will help her learn to sleep better in the long run. Read more about the building blocks of a great sleep routine here.

Next, adjust your expectations. If yes to the above, then the imminent arrival of a new tooth just might be keeping him up – some babies might fuss over a dull ache, while others might cry or express pain. You can expect two to three days of sleep disruption as the tooth erupts, after which his sleep habits should return to normal.

Know that it’s fine to treat the pain. If it appears teething is painful enough to interfere with your child’s sleep, try giving her Infant Tylenol or, if she’s over six months old, Infant Ibuprofen (Motrin, Advil) at bedtime. “It helps parents to feel better that the pain has been addressed,” Dr. Super says, and it will hopefully help your child get comfortable enough to settle down. The American Academy of Pediatrics doesn’t recommend medicated teething gels that are rubbed on gums, notes Dr. Super, as they have been proven to be ineffective (baby’s drool is enough to wash them away) and can have side effects like numbing your baby’s throat and making it difficult for her to swallow.

Finally, stick (more or less) to the bedtime routine. Your response to sleep disturbances during teething can actually start to create new sleep patterns and routines – e.g., mama comes when I call and rocks me to sleep – that aren’t ideal for building your baby’s longer-term sleep skills. If teething is keeping you both up at night, trust your instincts and find a balance in your response. If a bit of extra soothing works for the few days it takes a tooth to erupt, go for it. But be mindful that the troublesome tooth should arrive in two to three days and when it does, gently steer your baby back to his usual routine. You’ll all sleep better in the long run.

Other posts in the Dr. Super sleep series:
What is your baby’s ‘sleep temperament?’
Six strategies to improve your baby’s sleep skills
Monsters under the bed: Banishing bedtime fears

Battle bad dreams, night terrors and things that go bump in the dark


Dr. Elizabeth SuperElizabeth Super, M.D.
Assistant Professor of Pediatrics
Doernbecher Pediatric Sleep Medicine Program
OHSU Doernbecher Children’s Hospital


Merry Heart: a camp with its own beat

Tim LaBarge serves on the board of Merry Heart Children’s Camp. He’s also a photographer in Portland. Below, he shares some special moments and memories from Merry Heart Children’s Camp.


Twenty-five children sat on log benches high above the Bull Run River and Mount Hood, towering in the distance, turned a shade of orange and then pink as the sun began to set. But hardly anyone noticed. All eyes were on cardiac surgeon Dr. Ashok Muralidaran as he answered these young campers’ questions about their hearts.

This is Merry Heart Children’s Camp.

After a full career in the pediatric cardiology department at OHSU Doernbecher Children’s Hospital, Dr. Mary Jo Rice knew what she wanted to do when she retired. She knew that no Oregon camp existed to welcome the kids she’d been treating for 30 years – it was up to her to start one. And so, with the help of her husband, Rob McDonald (a recently retired pediatric cardiac sonographer at OHSU Doernbecher), a newly-formed board of directors and many volunteers, Merry Heart Children’s Camp came to be.

On day three of camp, the campers, sitting on log benches, asked the surgeon hard questions about their bodies – the “whys,” “what ifs” and “what’s next” kind of questions. Dr. Muralidaran helped them understand his answers with a mixture of humor and transparency. 

After spending four days and three nights together, the campers formed friendships based not only on the similarity of their conditions and scars, but on their interests in books and sports and art.

“This is the first time I felt normal and not out of place,” said 13-year-old Ash of her time at Merry Heart. 

Laurie Robinson, a world-class archer from Portland, steadied Jacob’s elbow as he drew the arrow back and prepared to release. Her peaceful voice calmed the young archer. The bow rattled slightly and the arrow sped through the air, piercing the target.

“Archery was the best,” said 13-year-old Jacob, who was born with hypoplastic left heart and has had a Fontan procedure. “I’ve been wanting to learn archery for a long time.”

Each evening, the children gathered for movie night or singing or game night. As at any other camp, things got silly on more than one occasion. At least one of the campers was wrapped in blankets and in a deep sleep before the end of the movie – the result of a full day of activities. 

“Game night and movie night were my favorites because I had never played BINGO with a spinner and movie night was fun because I enjoyed the movie that was shown,” said 9-year-old Lizzie.

Fourteen-year-old Gabe lives with a repair of an atrioventricular septal defect and a pacemaker. He helped lead the campers in pick-up volleyball games during free time and reeled in several fish at the pond.

“Being able to attend a heart camp in my state and meeting kids closer to my home with conditions like mine was a big plus for me,” he said. 

Prior to camp, many of the kids had never met another heart patient. Dr. Rice knew that these kids often lived isolated from each other and wanted to  help change that. Campers came from OHSU Doernbecher and Randall children’s hospitals. They traveled from Eugene, Pendleton, Salem, Vancouver, Scappoose and Portland to share their experiences – and make new memories together. 

“The camp was the best time of my life,” wrote 9-year-old Adrian in a thank-you letter decorated with a hand drawn hearts and a photograph. “I can’t wait for next year.”

Next year’s Merry Heart Children’s Camp takes place August 22-26 at a camp overlooking the Bull Run Watershed near Corbett, Ore. To help support the camp or to volunteer, please visit

Battle bad dreams, night terrors and things that go bump in the dark

KC FB Profile logoThe Dr. Super Sleep Series is written in collaboration with KinderCare. KinderCare believes that early childhood education creates brighter futures. They are the largest provider of early childhood education in the nation and they are passionate about creating a world of learning, joy and adventure for more than 169,000 children every day. For more parenting resources, crafts, learning activities and family fun, visit their blog.

It’s the wee hours of the morning and your child is standing at your bedside, tugging at your arm, wide awake and scared: She’s had a nightmare. While witnessing it can tug at your heartstrings, know that it’s also quite typical for children.Nightmare

“Dreams, even disturbing ones, are a part of normal development,” says Dr. Elizabeth Super, a pediatrician and children’s sleep specialist with the Pediatric Sleep Medicine program here at OHSU Doernbecher Children’s Hospital. “Nighttime fears are very common between ages 3 and 6 and often appear as children develop the ability to imagine.”


It’s not unusual for little ones to have one or two nightmares per week. The reason may be that children spend more time in REM sleep than adults (25 percent of a total night’s sleep versus 10-15 percent), the stage of sleep when nightmares (and all other dreams) occur. REM is an active sleep state during which our brainwaves are somewhat similar to a waking state. These REM periods get longer as the night progresses, which might explain why 2 a.m. seems to be the witching hour.

Have a freaked-out 5-year-old on your hands every few nights? Check out Dr. Super’s sensitive approach:

OfferNightmare 2 brief comfort. With most children who are developing typically, simple reassurance will likely be enough. If your child wakes up in the middle of the night, help her settle back down with a hug, a glass of water and kind words, and then lead her back to bed.

Give the fear a name. Younger children can have a difficult time describing what scared them, so asking your preschooler to explain the nightmare probably won’t help get him settled. Instead, provide reassuring words that describe and help him understand the scary experience: You’re safe; It was a bad dream. It wasn’t real; It was pretend. With time he will be able to use these words to calm himself.

Talk about it in the morning. Some children are able to describe bad dreams in the morning. The light of day is a great time to talk, especially if you suspect that the cause for her nightmare might be something in her waking life: scary movies, TV or books; a big transition, like starting a new school year; or a trauma, such as losing a pet. Ask her about what is bothering her – a simple discussion may help alleviate bad dreams.

Dream and discard. If your child is still rattled by his dream in the morning, invite him to draw it. Did the monster eat his dog? Help your child imagine another ending to the dream (the barking dog scares the monster away!) and draw it together. Discard the drawing and with it, hopefully, the nightmare.

Night terrors

Unlike a nightmare, which wakes a child and leaves her feeling fearful, night terrors happen while children continue to sleep. Children may even scream, cry out or become agitated without waking, and may not remember the incident in the morning.

Night terrors are a type of parasomnia, like sleep walking or talking. Unlike dreams, night terrors occur in deep sleep, during a stage called N3 – it’s the type of sleep where you can transfer your child from car seat to crib and she never stirs. Kids spend more time in N3 sleep than adults do, which may make them more likely to have night terrors. Longer stretches of N3 sleep typically happen in the first half of the night, which makes night terrors more likely at 11:30 p.m.

“If it offers a little comfort, know that night terrors are often scarier for the parents than they are for the child,” says Dr. Super. Here’s how to handle them:

Make sure your child is safe. A sharp cry in the middle of the night will send any parent racing into their child’s room. First things first, check that your sweetie is safely tucked in bed.

Decide if it’s a night terror. He may be breathing quickly, tossing and turning, or have a racing heartbeat. If he only briefly rouses and then quickly goes back to sleep, or never seems to wake up at all, then he could be having a night terror.

Minimal interaction. Because your child is still asleep, the simple reassurance that helps for nightmares can actually do more to agitate her. That said, you may want to wait out the episode by her side to reassure yourself that all is fine.

Review her sleep routine. Night terrors are more common if kids aren’t getting enough sleep, or if they’ve had a shift in their sleep schedule. If you suspect the latter, work on getting your child back to his normal routine, with an emphasis on plenty of quality sleep.

Speak to your doctor. If nighttime fears are starting to affect your child’s ability to fall asleep in the first place (he’s too scared of bad dreams to get into bed), if the terrors are persistent, or if you as a parent don’t feel that you are dealing adequately with the problem, speak to your child’s pediatrician.

Remember that this too will pass! This is a developmental stage that most children will grow through with your support and simple reassurance.

Other posts in the Dr. Super sleep series:
What is your baby’s ‘sleep temperament?’
Six strategies to improve your baby’s sleep skills
Monsters under the bed: Banishing bedtime fears
The real scoop on teething and sleep


Dr. Elizabeth SuperElizabeth Super, M.D.
Assistant Professor of Pediatrics
Doernbecher Pediatric Sleep Medicine Program
OHSU Doernbecher Children’s Hospital





“Inside Out:” A mindful movie for family film night

Pixar’s “Inside Out” provides an amazing look inside the mind of an 11-year-old girl. Child & Adolescent Psychiatry Training Program Director, Dr. Craigan Usher and Gabe Edwards, a fourth-year OHSU medical student planning to go into psychiatry, sat down to talk about the film.

They enjoyed “Inside Out” so much, they decided to document their conversation. We hope it sparks some thoughts for you and your family at your next movie night!

Animator Walt Disney once said that “movies can and do have tremendous influence in shaping young lives in the realm of entertainment towards the ideals and objectives of normal adulthood.” The word “entertainment” comes from the Latin word inter (between) and tenere (to hold). Many times, entertainment can be seen as simply keeping the viewer occupied – a temporary respite from life’s stresses. Yet, Disney’s quote challenges movie-makers, parents and kids to hope for something more – that instead, films could build bridges that take young people’s minds to a place that is unanticipated, rich and transformative. Pixar’s “inside Out” steps up to the challenge.

In fact, it seems to us that “Inside Out” uses bridging as a central theme, telling the story of a young girl named Riley who transitions geographically, moving from Minnesota to California, chronologically, shifting from childhood to preadolescence, and relationship-wise, with Riley’s interaction with her parents and mind growing more honest, mature and open to mixed-emotions.

“Inside Out” is a story that mainly takes place inside Riley’s mind, and it features fictionalized parts of the brain. There are various memory systems, a great imaginary friend (from when Riley was three years old) and five main emotions: Joy, Anger, Sadness, Fear, and Disgust. These “characters” interact and develop together in a way that deepens our insight about the human psyche. Their struggles demonstrate how emotion regulation is a process of continual refinement, with the mind constantly restructuring itself. The film’s ability to do so under the guise of “just being an animated movie” is part of its genius.

One of the main themes emphasized by “Inside Out” is mentalizing. Mentalizing, also called “mind-mindedness,” is the ability to reflect upon the thoughts, feelings, and motivations of one’s self and others. When people are mentalizing, they are concerned not just with external behaviors, but with the internal world—ideas and emotions that compel others to act the way they do.

We see a great example of poor mentalizing in one scene where Riley finds herself sad after a tough first day at her new school. At the dinner table, Riley’s parents ask a few questions. What they get in return is little detail and great sarcasm. Riley’s father registers this as Riley being snarky – in fact, his own Fear character announces: “Sir, reporting high levels of sass!” So he responds to what he sees as primarily oppositional behavior by “putting his foot down.” In doing so, he fails to take to mentalize, to consider Riley’s internal struggles – her despair at having left her life in Minnesota behind. So, she stomps away from the table. It’s an opportunity lost.

Another example of mentalizing gone awry appears when the animators turn their lens to the mind of a pre-teen boy, who is clearly attracted to Riley. The boy is simply dumbfounded, his brain repeating: “girl, girl, girl.”

The wonderful thing about this film is that it invites viewers to mentalize. It asks and answers: What might be inside the mind of someone whose life is uprooted? What happens to the machinery of the mind, to the very ability not just to experience joy, but also to draw upon memories, make new memories, and think clearly when a child becomes depressed?

An additional psychologically rich aspect of the film is how it demonstrates that each stage of development – thoughts, feelings and experiences – helps build toward the next. For example, in one scene Riley’s imaginary friend, Bing Bong, gives Riley’s emotions a boost. Sadly, this character ultimately had to be forgotten. This demonstrates how something like an imaginary friend helps provide support and a bridge. An imaginary friend allows a young child not to feel so alone or be afraid to be alone – and is then usually sacrificed once the child gains a new sense of confidence. They simply don’t need him or her or it anymore.

“Inside Out” also demonstrates to children and adults ambivalence: that more than one emotion can exist at a time. There is a scene where Riley is able to tell her parents just how much she misses her old home and friends and how sad she is. As her parents hug her tightly, we see Joy and Sadness both reach for Riley’s mental control panel – and begin working together. Rather than stalling at an antagonistic standstill, Riley’s mind seems to recognize the situation she is in as an opportunity for heartache and happiness to work together to help her move forward.

The British pediatrician and psychoanalyst Donald Winnicott once said that “a sign of health in the mind is the ability of one individual to enter imaginatively and accurately into the thoughts and feelings and hopes and fears of another person; also to allow the other person to do the same to us…”. We are so glad that filmmakers took it upon themselves to imaginatively consider the mind of Riley. We hope this film inspires children, adolescents and adults to mentalize, to consider their own minds and those of others and to support the process of growth – especially during tough times.

Craigan Usher, M.D.
Clinical Associate Professor of Psychiatry
Program Director, Child & Adolescent Psychiatry Training

Gabriel Edwards
Fourth-Year Student
OHSU School of Medicine

Getting home safely

After finishing up clinic on a Monday evening at about 5:30, I headed over to the pharmacy to pick up a prescription. As I passed through the drop-off circle on the way to the Physician’s Pavilion, I noted a new family wrestling with their car safety seat – the father pulling straps while the mother sat in the back with their newborn. I could see the frustration on both of their faces, exhausted from the ordeal of birth and the hectic post-partum period. I thought about stopping to help, but I needed to get home to cook dinner for my family, so I walked on.

Twenty minutes later, I left the pharmacy to walk back to my car. As I approached the circle, I saw the new family was still there, still wrestling with their car safety seat, and clearly at the end of their rope. I stopped.

I introduced myself as a pediatrician and certified child passenger safety technician and offered to help. I spent the next 25 minutes teaching them to correctly use their car safety seat. We removed an insert in the seat that pushed the baby’s head too far forward, and lowered the harness straps to properly fit the baby in the seat. We tightened the harness straps to ensure a correctly snug fit. We adjusted the angle of the seat’s recline so the baby’s head would not flop forward, occluding his airway. We pushed the car seat into the cushion of the vehicle seat and tightened the lower anchor to ensure an appropriately tight installation. We rolled up receiving blankets to correctly position the infant’s head in the seat.

When we were finished, everything was perfect – and the parents could replicate everything we had done together. They shook my hand and graciously thanked me. My family ended up eating dinner pretty late that night, but that family left our hospital with their son protected as safely as possible.

During the 40-plus hours of that infant’s stay at OHSU, he had his vital signs (including his temperature) taken at least every eight hours. As a general pediatrician for more than 20 years, I cannot remember a single case where the temperature of a well newborn, with no risk factors for infection or other previously identified concerns, was abnormal. I know it happens, but I have never experienced it. Some of the reasoning behind taking an infant’s temperature at least once every nursing shift has to do with hospital policies and protocols, but nurses and medical assistants have told me it’s to ensure that the babies are “safe.”

Every single infant who is traveling home in a private vehicle is required by law to ride in an approved car safety seat. The newborn care team routinely asks families if they have a car safety seat. If families don’t have one, they’re instructed to get one, as a requirement for discharge. The pediatric team hands each family a sheet of paper with some basics of newborn care and safety, including the guidance to use their car safety seat facing the rear of the vehicle until the child is at least 2 years old. This is the generally the extent of the guidance and assistance that families get regarding safe travel.

According to data from the U.S. Centers for Disease Control and Prevention, 134 infants younger than 1 year of age died in motor vehicle crashes in the U.S. in 2013. Approximately 500 more infants were hospitalized and more than 8,000 were treated in emergency departments for serious injuries sustained in crashes. Twenty-three percent of the babies who died were unrestrained at the time of their death; 77 percent were in a car safety seat. Between ages 1 and 15, motor vehicle crashes remain by far the leading cause of death for children.

Anyone who’s ever installed a car safety seat will tell you it’s generally neither fun nor easy. Data from the National Highway Traffic Safety Administration has shown that approximately 3 out of 4 car safety seats are used incorrectly, with misuse errors that are likely to significantly increase the risk of injury to the child passengers.

My own experience as a CPS (child passenger safety) technician who has worked with more than 8,000 families since 1997 tells me that those misuse statistics are likely an underestimation of the problem. In 2014, with help from colleagues at the OHSU Doernbecher Tom Sargent Safety Center, we studied how families with well newborns at OHSU used their car safety seats. What we found was truly disturbing: Out of 292 families with well newborns, 93 percent made serious errors in how the infants were harnessed in their seat, and in how the seat was installed in their vehicle. The average family committed more than five serious mistakes.

How many families suffer the experience I encountered on that Monday evening? What might have occurred had I not stopped? At best, the child would have gone home at an increased risk for injury in the event of a crash. At worst, the exasperated parents may have given up and carried the infant in their arms. While this may seem difficult to believe, a full 10 percent of the infants injured or killed in crashes in 2013 were completely unrestrained – it happens.

The Tom Sargent Safety Center at OHSU Doernbecher currently employs a dedicated staff of certified CPS technicians. We can provide inpatient consultation for children who have suffered injuries, who have special transportation needs or who are in need of a car safety seat, collaborating as part of the care team to ensure a safe transition home.

We staff a community car seat fitting station at OHSU Doernbecher, generously funded by Kohl’s Cares, by appointment only, and work with more than 2,000 families in the Portland area each year. The demand for this service is so great that we routinely have a 3-week wait list. The Safety Center provides guidance and education to thousands of families each year and sells discounted home safety equipment (including bike helmets, stair gates, window guards, smoke detectors and cabinet locks) to many thousands more.

Here’s the thing: As hard as we work at the Safety Center and as much as we do, we simply do not have staff or resources to provide assistance to families with newborns. We know that each and every day, approximately 6-7 newborn babies will leave OHSU, and that almost all of them will be unsafe. We know that families will struggle, and that infants are being endangered, and we cannot unknow that. We also know that we need to change this.

A world-class health system should ask first and foremost “What is best for patients?”, and endeavor to do just that. So while you are reading this, you can be certain that every single infant born at OHSU today will have their temperatures carefully measured each nursing shift for the remote possibility of detecting an unsuspected fever. Perhaps an abnormal reading will lead to an intervention that will protect the baby.

You can also be certain that virtually every infant born today will travel home in a car safety seat that has been critically misused. You can be certain that families will try to do the best thing for their baby, as did the lovely family on that Monday evening. You can be certain that we will have very little to offer them.

I have a problem with that, and it’s time for us to change it. I have no problem with eating dinner late; I will be late forever if it means doing what’s best for kids. Is it best for kids to ignore their needs, to pretend we do not know what we know about how to best protect them? We owe it to our patients – to our community – to provide the best possible care. That is, indeed, what a world-class health system should do. Should that not include ensuring that each and every infant can get home safely?

Ben Hoffman, M.D.
Medical Director, Tom Sargent Children’s Safety Center
Professor of Pediatrics
OHSU Doernbecher Children’s Hospital

Fall safety tips from OHSU Doernbecher and the Oregon Poison Center

As colorful leaves fall from the trees and the air turns cool and crisp, it’s important to remember that the fall season can pose some safety risks. We asked the Oregon Poison Center at Oregon Health & Science University and the Doernbecher Tom Sargent Children’s Safety Center for tips to keep you and your loved ones safe this autumn.

Have a safe Halloween

  • DCH HalloweenTalk to your child about the difference between reality and make-believe. The scarier aspects of Halloween can frighten preschool-aged children.
  • When choosing or making a costume, look for fire-resistant material and bright colors. If you choose a dark color, add reflective tape so drivers can see your trick-or-treater. Be sure that the costume is not a tripping hazard.
  • Avoid sharp objects or accessories and opt for make-up or face paint instead of a mask, if possible. To help eliminate skin irritation, choose face paint with the following labels: “made with U.S.-approved colored additives,” “laboratory tested,” “non-toxic” or “meets federal standards for cosmetics.”
  • While cosmetic, decorative or colored contact lenses may be the perfect complement to a costume, the OHSU Elks Children’s Eye Clinic recommends against them due to safety concerns including blurred vision and injury to the eyes.
  • Be sure children have adult supervision while trick-or-treating – and carry a flashlight. If older children are going with a group, review safety rules, including street safety, with them in advance. Know the route they plan to take, set a curfew and provide a cell phone, if necessary. Verify that children know their last name and phone number in case they get separated from their chaperone; consider attaching this information to the child’s costume.
  • Colorful glow sticks are becoming increasingly popular. Overall, these products are safer than candles, but they are easily broken. While considered nontoxic, the contents may cause irritation or nausea if they come in contact with skin or eyes.
  • Use battery-powered candles rather than candles with a real flame. If you do use a real candle in a jack-o-lantern, place the pumpkin a safe distance away from where trick-or-treaters will be walking or standing. Be sure your home is well lit for trick-or-treaters, and clear steps and lawns of tripping hazards.
  • Instruct children not to eat any treats until an adult has checked them. With the recent legalization of recreational marijuana in Oregon, these rules are even more important as some marijuana edibles may look like everyday candy and holiday treats. Dispose of any candy that has loose or open wrappers. Wash and cut up all fruit to inspect it before eating.
  • Don’t forget your pets! Remember that some treats — especially chocolate — can be poisonous to our furry or feathered friends.

Prevent carbon monoxide poisoning in cold weather

  • Be aware of increased exposure to carbon monoxide, a colorless, odorless and tasteless gas that can be fatal if inhaled in large quantities. The risk of carbon monoxide poisoning increases when the weather turns cold as heating devices are used and closed windows decrease fresh air circulation.
  • Know what can cause increased exposure, such as a leaking car muffler, improperly functioning home heating furnaces, woodstoves used in poorly ventilated rooms or burning charcoal indoors.
  • Ensure proper ventilation in your home or vehicle, and get fresh air immediately if symptoms such as headache, nausea, sleepiness or vomiting occur.
  • Install carbon monoxide detectors on every level of your home; use detectors that are approved by Underwriters Laboratories (these products will have the statement ‘UL-approved’ on the packaging).
  • Check heating appliances annually and before you first use them in cold weather.

Keep antifreeze and windshield washing fluid away from children and pets.

  • Prevent exposure to antifreeze products and windshield-washing fluid, which contain toxic chemicals that can cause severe illness or blindness if ingested; large amounts can be fatal.
  • Store these and other car care products in locked cabinets and never store them in old food containers.
  • Rinse empty containers thoroughly and recap before discarding.

Plan for fun and safe holiday celebrations

  • Take a few minutes to poison-proof your home in anticipation of visiting holiday guests and the altered household routine that inevitably accompanies the holiday season.
  • Handle decorations and lights with care.
  • Keep poisonous plants, décor and gifts away from children and pets; lock medicines away and out of reach.
  • Be sure that houseguests store medication safely away from children.
  • Traveling for the holidays? Have your child’s car seat checked. Call the Doernbecher Tom Sargent Children’s Safety Center at OHSU for more information: 503 494-3735.
  • Post the Oregon Poison Center’s number (1 800-222-1222) by home phones and save to cell phones.

This post originally appeared on the OHSU News and Events site

Monsters under the bed: Banishing bedtime fears

KC FB Profile logoThe Dr. Super Sleep Series is written in collaboration with KinderCare. KinderCare believes that early childhood education creates brighter futures. They are the largest provider of early childhood education in the nation and they are passionate about creating a world of learning, joy and adventure for more than 169,000 children every day. For more parenting resources, crafts, learning activities and family fun, visit their blog.

While it’s wonderful that children’s imaginations can make the ordinary magical (that cardboard box is definitely a rocket ship!), imagination can sometimes make the ordinary scary for a small child – think about that dark closet, which, come bedtime, is suddenly full of monsters.

Monsters under the bed“Nighttime fears are very common between ages 3 and 6 and often appear as children develop the ability to imagine,” says Dr. Elizabeth Super, a pediatrician and children’s sleep specialist with the Pediatric Sleep Medicine program here at OHSU Doernbecher Children’s Hospital.

Bedtime fears (as opposed to nightmares or bad dreams) arise during waking hours, as your child prepares to fall asleep. “It might feel like a stalling tactic – and sometimes it can be,” Dr. Super says. “Regardless, help your child address her fears by being really validating and reassuring, even as you stick to your sleep routine. Keeping on track will make her more confident and comfortable in the long run.”

Facing bedtime fears at your house? Try Dr. Super’s practical approaches to help put them to rest:

Scared of the dark? Turn on just enough light to allow your child to fall asleep. While a lot of light can inhibit a good night’s sleep, a bit of light will help your child move past her fears and fall asleep on her own – after all, there’s no good sleep if she can’t get to sleep. A special night light – one she gets to choose and then turn on herself – could help keep her fears at bay.

Monsters under the bed (or somewhere else)? Don’t dismiss his fears or reason them away, instead encourage your child to get in on the solution. For example, whip up a batch of monster repellent: Mix a little lavender oil (it has a calming aroma) with water and put the potion in a clean spray bottle. Have your little hero squirt it under the bed, in the closet, etc. and then check together to make sure his room is all clear. He’ll feel more in control – and his room will smell lovely.

Spooked by the TV? If your child is suddenly scared to get into bed, consider what she’s been watching. Did she see something that spooked her? Sometimes what’s frightening to a child isn’t immediately apparent to an adult (like those flying monkeys from The Wizard of Oz…), so ask her. If you stop watching the scary show, or reading the spooky book, it might help her settle down. And if the movie made a lasting impression? Remind her that it’s pretend and together, imagine a different ending to the story. In your version, maybe those flying monkeys are busy delivering gumballs to all their monkey friends.

Worried about something? The world is a pretty big, confusing place and growing up is a lot of work. Setting aside a regular 5 to 10 minutes of “worry time” every day can be really helpful for older children, starting around age 5. At this time he is likely able to express his feelings more clearly, so talking to him about whatever is bothering him can help ease his fears. Just pick a time to chat that’s not immediately before bed.

Remember that this too will pass! Most children will grow past their bedtime fears with your support and reassurance.

Other posts in the Dr. Super sleep series:
What is your baby’s ‘sleep temperament?’
Six strategies to improve your baby’s sleep skills
Battle bad dreams, night terrors and things that go ‘bump’ in the dark
The real scoop on teething and sleep

Dr. Elizabeth SuperElizabeth Super, M.D.
Assistant Professor of Pediatrics
Doernbecher Pediatric Sleep Medicine Program
OHSU Doernbecher Children’s Hospital



Behind the scenes: Doernbecher Freestyle XII

Being nominated and selected to work on the Doernbecher Freestyle collection is a once-in-a-lifetime experience – both for our patient-designers and for the Nike employees chosen to be involved in the program. We sat down with some of folks who helped make this year’s collection magic happen to see what their experience has been like thus far.


Interviewees and patient designers

  • Andrew Winfield, John’s Nike team
  • China Hamilton, Jacob’s Nike team
  • Hingyi Khong, Lizzy’s Nike team
  • Jonathan Johnsongriffin, Kian’s Nike team
  • Megan Collins, Emory’s Nike team

On being selected:

“I was ecstatic [when I found out I had been nominated]. It’s probably been one of the best experiences I’ve had so far. I’m from the area, so I’m familiar with Doernbecher and I was really excited to be able to work with a program that benefits the hospital. What they do is amazing – this is the highlight of my year.”
–Megan Collins

“I had heard about the program beforehand, and I was so excited!”
–Jonathan Johnsongriffin

On working with the patient-designers:

“For this project, it was all about John and what he wanted. He already had his ideas – he was excited and knew what he liked, so it was easy for us as a team to grab material and get this whole project together. His message is ‘stomping out Crohn’s Disease,’ so that was a big part of the messaging behind the shoe. When we showed him the initial sample, he had a big smile on his face – that was really gratifying for me and for our team. John has been a real trouper; he has a quiet strength to him and I learned a lot about him from how he dealt with this whole process.”
–Andrew Winfield

“It’s been amazing working with Lizzy. I guess the word I would use to describe Lizzy is ‘particular.’ She’s confident, very sure of herself – she knows who she is and what she likes. It’s been great to see self confidence in someone so young. I was lucky enough to go out to The Dalles to hang out and watch Lizzy’s dance recital, where I saw her perform with girls a year older who practice three times as much as her. She was holding her own – she’s obviously a real talent! Seeing the context of her inspiration was really helpful for this project.”
–Hingyi Khong

“Emory was great! When we were briefed on her design inspiration, we knew we’d never have a chance to do something like that again. She’s such a sweetheart and she has such a fire inside of her. She’s just amazing. Seeing that smile – that makes it all worth it.”
–Megan Collins

“Jacob is such an inspiring kid; I felt very fortunate to be paired with him. He has really amazing taste and sense of style – it was a dream to work with him. He kept asking our team, “Why are you guys so awesome?” Giving us the motivational speech! He’s the sweetest kid, and he’s super smart. He has a very bright future in front of him.”
–China Hamilton

“Kian kept us on our toes! He really loves shoes, and he picks up on every little detail. Every time I come see him, I make sure I wear something cool – he’s like a little sneaker head. He knows so much about shoes and was naturally curious about the design process – his curiosity made me more excited to work on the project. We were able to bring his story to the shoe, and getting that story out of him was really interesting. Throughout the process you can see how hard he’s had to fight. Hopefully this project and this shoe will inspire people to win the day, every day.”
–Jonathan Johnsongriffin

Why the Doernbecher Freestyle program is so special:

“Overall it’s a project we can really connect to that’s different from our everyday tasks. It’s kind of a different feeling than just creating a product – you create connections with the family. The program is something you can really get behind, something you’re proud of (in an entirely different way) when it’s finished.”
–Hingyi Khong

Learn more about our incredible Doernbecher Freestyle patient-designers here, and read a blog post by Nike graphic designer Carson Brown, who worked with Isaiah, here. We hope we’ll see you at this year’s collection reveal and auction on October 23!

Isaiah’s Doernbecher story

Last year, Isaiah’s Neumayer-Grubb’s family discovered that he had a brain tumor that would need to be surgically removed. We sat down with his mom, Melissa, to learn more about Isaiah and his Doernbecher story.

How would you describe Isaiah?
He’s a charismatic little guy who makes friends wherever he goes. He shines at everything he does and loves to stay active. Isaiah walks into a room and you can feel his presence – he has this wild sense of humor that makes you want to be around him all the time, just to see what he’ll say next. He fills your soul with happiness.

When did you know something was wrong?
Isaiah was getting headaches that were becoming more frequent – about three a week. His primary care provider referred him to a neurologist, who thought it was just childhood migraines and didn’t seem super concerned since Isaiah was otherwise very healthy and still taking part in sports, in dance and in school.

Just in case, though, the neurologist recommended an MRI. We went in on a Friday and were told Isaiah would be in and out in 45 minutes. He was back there for about two hours. We knew that day that something was wrong, but didn’t hear back until the following Monday that he had a lesion on his brain.

I remember trying to write down the word ‘lesion’ on a piece of paper, but in that moment I couldn’t spell it – I just couldn’t wrap my head around it.

The space in between getting this news and going to the hospital was the scariest, really. We were Googling “lesion on brain” and getting search results ranging from “it’s nothing” to “he could die.” That was the last time I Googled anything.

Meeting Dr. Nate Selden
Our neurologist referred us to Dr. Selden, whom he called the “best of the best.” My husband and I were super nervous – you don’t really know what to expect when you’re talking to a neurosurgeon. But the moment we walked into Dr. Selden’s office, we felt like we already knew him. It wasn’t what I expected at all – we felt instant comfort and instant safety. He really is incredible.

At this first meeting, he told us he believed Isaiah’s tumor wasn’t cancerous and didn’t want to jump into surgery right away. He said he wanted to take it to the tumor board so eight other experts could weigh in.

In the meantime, a sleep-deprived EEG showed Isaiah had been having absent action seizures. At the time, it just seemed like Isaiah would space out and ignore us for 30 seconds to a minute. Once we found out, Isaiah started anti-seizure meds and we made some life changes almost immediately. We went from having a perfectly normal 7-year-old to having a child we had to keep an eye on at all times. He couldn’t ride a bike by himself or even get in the bath by himself. It was very, very surreal.

A week later, we got a call from Dr. Selden’s office that the tumor board was recommending surgery – the tumor was large enough that he and his team needed to determine what it was. I felt like someone was kicking me in the stomach. He explained all of the factors that went into the recommendation and the associated risks and benefits.

Dr. Selden told us he’d be putting together the best team possible for Isaiah’s surgery. They would practice ahead of time on a 3-D model constructed using scans from his MRI.

Brain surgery isn’t without risks – we had to consider possible impacts to Isaiah’s speech and movement of his legs, and we also had to consider the possibility of paralysis and death. We didn’t know what our son’s future would look like with surgery, but we didn’t know what it would look like without it, either. The hardest part for us was that it was ultimately our decision.

The one thing Dr. Selden said that still stands out to me was, “I believe I can do this surgery. I know I can.” I just remember the way his eyes looked when he said that – it was genuine, not cocky. I’m a pretty intuitive person and I had no doubt that he could do it.

We decided to go ahead with the surgery.

We scheduled the surgery for October 27, which meant we had about a month to wait. Our family took some time off work to go to the beach for five days, and I decided we were going to live life to the fullest for that month so that if I lost my son, he would go with peace and love, not with fear or uncertainty. We had no control over the situation, so we spent those weeks doing all of the things we could.

Jameson, Thomas and Isaiah. Isaiah is a huge Oregon Ducks fan, so we got tickets to a UO game. He always said he was going to play ball with Thomas Tyner someday, not realizing the age difference between him and Thomas. After a family friend told Thomas about Isaiah, he arranged to meet us before the game. He gave Isaiah a pair of his cleats and introduced him to Marcus Mariota. Thomas is truly a fantastic kid – he’s exactly what I want my boys to be like. I want to give his mom a hug and tell her she did a great job!

Our friends got together and planned a Halloween party for Isaiah since he would be missing it that year. More than 100 people came out to celebrate one of Isaiah’s favorite holidays with us.

People were amazing – AMAZING. I can’t put into words how much gratitude and humbleness I feel.

Batman was a way of escaping for Isaiah – if Batman could overcome anything, he could, too. On October 27, the day of Isaiah’s surgery, students and staff at his school all wore Batman gear, and the kids in his class wore black and yellow bracelets with Isaiah’s name on it. A lot of our friends and family flew in for the surgery, and they were all wearing Batman shirts. Isaiah was wearing his Batman shirt before he went into surgery. There were probably 30 people waiting with us at the hospital. It was absolutely amazing.Isaiah Batman family

I didn’t realize how terrified I was until they called to say the surgery was complete. I grabbed my purse and backpack to head upstairs and I cried in a way that I’d never felt before – I didn’t know if my son could talk or walk, but I knew he was alive. It was almost like a release of all of this pain and fear.

Upstairs, Dr. Selden came out and said the surgery went great and his team was able to remove more of the mass than they’d anticipated. We were crying and hugging him – even my husband, who’s not a hugger!

Isaiah after surgery 2We knew the first 12 hours would be touch and go with a lot of neuro checks. Isaiah woke up yelling, so we knew that, despite being really scared, he had the ability to talk.

As a mother, I can see that our time at Doernbecher was incredible. Isaiah just remembers being very angry and confused – he went into surgery feeling fine but no matter how much information we gave him prior to it, he wasn’t prepared for how he would feel afterward. He couldn’t fully grasp it – none of us could.

Isaiah didn’t want to eat or walk. Dr. Selden said if he did, he could go home. He walked around that ICU unit, and people were clapping and cheering. He was still so mad! I’m sure if he knew any bad words, he would have been saying them. Dr. Selden released him to go home that same day, just two days after his surgery.

A brother’s love
Isaiah and Jameson sleeping copyWe wanted to prepare our younger son, Jameson, for Isaiah’s arrival – he was 3 at the time. Isaiah had two swollen, black eyes and the cut on his head, plus he just generally looked pretty frail. My brother Tommy told Jameson that the doctors had to fix Isaiah up, and he would be fine – Jameson pushed himself out of Tommy’s arms and followed us back. He jumped up on the bed to lie next to Isaiah. My two crazy, hyper, ridiculously energetic boys were lying there together, holding hands and not saying a word. It was amazing. I could see the color come back into Isaiah’s face.

How do you explain something like this to a 7 year old?
We always made a point to tell Isaiah the facts – what we knew for certain – about what was happening. My husband and I would try to process the information we were receiving before having a conversation with him. We wanted to first handle our emotions so we could focus on helping him handle his. At the initial appointment with Dr. Selden, Isaiah just knew we were there to get his headaches checked out.

There’s no sugarcoating with Isaiah – downplaying the news actually makes him nervous. He’s very intuitive, so you have to be straightforward with him. Dr. Selden picked up on that immediately. There was also talk of Isaiah getting an Xbox if he did indeed need to get surgery, which was looking unlikely at our initial appointment.

After finding out the tumor board had recommended surgery, we had another appointment with Dr. Selden. We sent Isaiah out of the room to ask the hard questions (this was something we learned early on: Always bring another adult to appointments with you so your child can leave the room when necessary).

Once we had made the decision to go ahead with the surgery, we sat Isaiah down and told him. Isaiah CHAPWe compared the lesion to a freckle on Isaiah’s brain, and said we’d heard that freckle was what gave Batman his superheroes. Isaiah had a lot of questions – Is Dr. Selden going to have to cut open my head? How big will it be? Will they shave my head? At this point, it dawned on him that he just might be getting that Xbox!

He seemed completely fine with the surgery at first, but four or five days later, the fear kicked in. We spent the next few weeks answering his questions (and writing down the ones whose answers we didn’t know so we could find out) and trying our hardest to be calm.

A lot of waiting areas at Doernbecher have arts and crafts areas, which was a lifesaver on so many different occasions. In fact, he and my 19-year-old daughter made a necklace together right before Isaiah went into his surgery.

What other advice do you have for other families facing serious health problems?
That’s a tough one, because I get to say this being on the other side. We’re very lucky. I think it changes you – you learn how to live in the moment. I faced the possibility that I could lose my kid, and I made a conscious decision not to think about that every day (though that’s not to say it didn’t go through my mind every day). You’re thinking about your child’s mortality and you’re watching him face it, too. As a parent, you think a lot about how you would want your child’s last moments to be if these are indeed to be his last moments.

Another piece of advice: No Google. That’s a big one! Google is scary.

At this point, we’re not planning on another surgery. We continue to monitor his seizures and our goal is to get him off of those meds at some point.

Freestyle XII IsaiahIsaiah is really comfortable talking about his experience. He went back to school a few weeks after surgery and answered everyone’s questions, even taking off his beanie so they could see his scar. One time someone unknowingly told him they thought he had something on his ear – he just answered, “Nope. I had brain surgery!”


Learn more about Isaiah and the rest of this year’s incredible Doernbecher Freestyle patient-designers here, and read a blog post by one of the Nike graphic designers who worked with Isaiah here. We hope we’ll see you at this year’s collection reveal and auction on October 23!

A letter from one ‘well child’ to another

A few weeks ago, pediatric resident Dr. Antwon Chavis wrote a blog post called “11 things your ‘well child’ wants you to know.” This week, he’s back with a letter for all the other ‘well children’ out there. 

Well Child Photo for TW

Hey there,

My name is Antwon. I heard you’re the sibling to a child with special needs, like I am. I wanted to write you a letter explaining why I think you’re amazing, and how lucky I think you are. I know your life seems harder than a lot of people that you know, but to be honest, you’ll be better off because of it.

I know you deal with more than kids your age should. Your parents spend a lot of time caring for your sibling and taking care of regular doctors appointments, hospital stays and phone calls. You see the love and patience they have when taking care of him or her. They never stop trying to get what your sibling needs, and they lose sleep so you and your sibling are well cared for. You’re going to learn so much from them! Believe it or not, your parents are teaching you how to be a good person and an amazing parent.

I know that this is hard to take into consideration, as you struggle with jealousy and worry for your sibling. You struggle with anger because you can’t go to every school or social activity you’d like. You struggle with embarrassment as your friends don’t always understand, and then guilt because you felt embarrassed. Or worse, guilt that you are healthy while one of your best friends is not. You know what? I get it! You totally have the right to feel like this sometimes. And its normal, and I’ve felt the same way. But it gets so much better as your and your sibling get older.

Do you know what’s awesome? Your sibling loves you in a way that most adults will never understand. They look at you and know how important they are to you, that you lose sleep crying for them, that you struggle with envy and guilt but that, regardless, you play with them like no one else can. You are their friend and protector. Even if they, like my brother, can’t speak, you both can carry out entire conversations that no one else understands. I bet you guys even have inside jokes. Friend, let me tell you – that is extremely cool!

Your parents see what you do for your sibling, and they are so very proud of you. And they don’t always know how to say it. They notice when you stop what you are doing to smile at them, to give them a hug or a kiss, or a hello. They see how softly you speak to them. They see how gently you play with them. They watch you go out of your way to include them in the things you do. They even know about that time you got in a fight with the kid next door to protect them. And they are so thankful for you. You are so helpful to your parents, even if you don’t know it. It takes a special person to do your job, and no one on earth could do it like you do.

Lastly, friend, promise me that you will remember something. In a very unique and indescribable way, you know love, you know heartache, and you know what is truly important. These lessons aren’t easy to learn, and they will eventually define who you are. They’ll cause you to mature much faster than your friends. They’ll cause a stranger to pull your parents aside and tell them how impressive you are. They’ll give you a weird sense of humor and ability to find joy in almost anything. You are an awesome person and even at your young age, you have changed the lives of others for the better. All because you are the sibling of a child with special needs. Enjoy your journey, friend!

With love and admiration,


Antwon Chavis, M.D.
Resident in Pediatrics
OHSU Doernbecher Children’s Hospital

Dr. Chavis has a wide array of interests, including working with teenagers, children with mental health concerns and children/adolescents with behavioral or developmental issues. He enjoys working with older children and their families because he gets the opportunity to educate the patient directly, as well as the family that cares for them.

Doernbecher Best in the Country U.S. News & World Report


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