Summer 2004, The Children's Sickle Center, San Antonio, Texas
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 From the Editor - Importance of Fluids

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Children with Sickle Cell Disease will always have a need for adequate fluids. These children demonstrate this by being thirsty more often than other children. During the summer, when temperatures soar and activities are often held outdoors, a loss of fluids can easily occur through increased sweating. To maintain normal body functioning, it is important to keep a balance of body fluids. Whenever there is a loss of body fluids, the child should drink more water and juices and eat such things as soup and ice chips.

Amount of Clear Fluids Your Child Needs Each Day

Child's Weight: 8 oz. cups per day
10 lbs. 2 cups
15 lbs. 3 cups
20 lbs. 4 cups
25 lbs. 5 cups
30 lbs. 5-6 cups
35 lbs. 6-7 cups
40 lbs. 7 cups
50 lbs. 8 cups
60 lbs. 9 cups
Over 60 lbs. 10 or more cups

Your child needs more fluid when:
  • He has a fever
  • He has pain
  • It is hot outside
  • He is very active

Signs of Dehydration:
pitcher of lemonade
  • Decreased urination
  • Dry skin and mouth
  • Increased heart rate
  • Thirst with loss of appetite
  • Pale skin
  • Weight loss


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Summertime Food Safety

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Summer is time for fun, food, travel and family. Food is a big part of our activities and social gatherings. With outside temperatures reaching above 100 degrees Fahrenheit, food safety should be a top priority. The Centers for Disease Control and Prevention estimates that each year 6 million people get sick, more than 300,000 are hospitalized, and 5,000 Americans die as a result of food-borne illnesses. Individuals that have an increased risk for food-borne illness are pregnant women, older adults, people with weakened immune systems and chronic illness such as diabetes, renal disease, HIV/AIDS and cancer patients.

Bacteria are present in raw food and widely present in humans. There is no such thing as sterile raw food. Bacteria multiply rapidly when provided WARMTH, NOURISHMENT and TIME. Food contamination occurs by many different methods. Human contact (improper food handling) is the most prevalent cause for food contamination. Washing hands more often when preparing and handling food is the single most preventative measure. Symptoms of food poisoning differ depending upon the infecting agent. Severe nausea, abdominal cramps, vomiting, diarrhea, headache, fever and chills are all symptoms of food-borne illness.

Foods that are especially susceptible to bacteria growth are those high in protein such as eggs, meats, dairy products and seafood. These foods are highly perishable and must be kept refrigerated properly and heated to the proper temperature when cooked.


Tips For Proper Food Handling

  1. Store perishable foods properly at 41 degrees or below.
  2. Cool foods to the proper temperature (more than 140 degrees).
  3. Cool foods quickly after serving - do not leave cooked food at room temperature.
  4. Reheat foods to a temperature of 165 degrees Fahrenheit.
  5. Use freezer ice packs to keep foods cold in ice chests.
  6. Wash your hands after handling raw foods.
  7. Don't handle ready to eat foods barehanded.

For more information on this topic, contact the American Dietetic Association and ConAgra web site,

Dion Turner
Director of Food Services, Morningside Manor


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Hot Tips for Keeping Children Cool

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During the hotter days of summer, children are at a higher risk for dehydration. Dehydration occurs when the body's fluid loss is greater than its fluid intake. Drinking enough fluids throughout the day is the best way to avoid dehydration.

Normally, children need six 8-ounce glasses of fluid per day, but that need can double with increased activity and length of exposure to high outdoor temperatures.

Because children are more susceptible to dehydration than adults, they should be observed for any signs of mild to moderate dehydration, such as a dry mouth, drowsiness, dizziness, disorientation, nausea, and decreased urination.

Parents should be aware of the symptoms of mild dehydration and monitor their children. If children do not receive replacement fluid, severe dehydration can occur, causing unconsciousness and other serious complications.

To protect children from dehydration, parents are encouraged t make water easily accessible to their children. Parents are suggested to:


  • Place children's cups and drinking glasses near the home's water cooler
  • Keep refrigerated water and water - abundant fruits (watermelon, cantaloupe, grapes)
  • Dilute fruit juice with water, or alternate offerings of full-strength juice with offerings of water
  • Avoid soft drinks and iced tea that include caffeine, which is a diuretic. A diuretic increases urine output, and this increases fluid loss, which increases the risk of dehydration
  • Plan ahead by bringing water bottles on outings, and reminding children to take water breaks during the day
  • Encourage children to drink before they go outside to play

Infants are at a greater risk for dehydration than older children because their smaller bodies tend to loose fluid faster, and they cannot clearly ask for something to drink. Parents of infants should be encouraged to monitor their baby's wet diapers. Several dry diapers in a row may indicate dehydration. If an infant needs more fluid than it has been receiving, the baby's body conserves its fluids by decreasing urine output. Monitoring diapers can provide an important warning of dehydration.

During hot weather, exclusively breastfed infants receive enough water from breast milk alone. When a breastfed baby starts eating solid foods or formula, it may be appropriate to offer about 4 to 8 ounces of water in hot or normal weather.

Formula-fed infants should be offered about 4 to 6 ounces of water per day during hot weather, and formula-fed babies already eating solid foods should be offered about 4 to 8 ounces of water each day.


  • Keep infants in the shade, avoiding long exposures to direct sunlight.
  • Dress infants in light clothing and keep their heads covered.

To make it a safer summer for everyone, remind parents about the dangers of dehydration through bulletin boards, individual counseling sessions, and nutrition education classes.

Bethany Zimbicki
Nutrition Intern
(Reprinted with permission from Texas WIC News, August 1998)


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Summer Safety Tips

- From the American Academy of Pediatrics

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Fun in the Sun


  • Babies under 6-months-old should be kept out of direct sunlight. Move your baby to the shade or under a tree, umbrella, or stroller canopy.
  • Dress babies in lightweight clothing that covers the arms and legs and use brimmed hats.
  • Apply sunscreen at least 30 minutes before going outside and use it even on cloudy days. The SPF should be at least 15.
  • Sunblock is not recommended for infants under 6 months of age.

Pool Safety


  • Never leave children alone in or near the pool - even for a moment.
  • Make sure the pool is surrounded on all four sides with a sturdy 5-foot fence. The gates should self-close and self-latch at a height children cannot reach.
  • Whenever infants or toddlers are in or around water, an adult should be within an arm's length providing "touch supervision."

Travel Safety

car seat

  • Buckle up car seats and seat belts, including your own. Children will model their behavior after yours.
  • The harness system holds your child in the car seat and the seat belts hold the seat in the car. Attach both snugly to protect your child.
  • Put your child in the back seat. It is the safest place in the car because it is the farthest away from head-on crash.


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Cool Summer Delights

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Banana Ice Cream

8 bananas


  • Peel bananas and freeze in plastic bags until frozen
  • Puree frozen bananas in a food processor or blender to achieve an ice cream-like consistency
  • Serve immediately. Serves 8

Hints: Top with nuts, coconut, nutmeg and cinnamon. You may substitute strawberries (1/2 cup frozen strawberries or 1/2 cup frozen blackberries) for bananas.

Lemon Lime Sorbet

limes 1 1/2 cup sugar
1 cup lemon juice
1 cup boiling water
1/2 cup lime juice
6 fresh lemon curds for garnish (optional)


  • Combine sugar and boiling water in a medium-size mixing bowl. Stir until sugar is dissolved. Cool for 20 minutes.
  • Pour juices through a strainer into cooled sugar water. Mix well. Transfer mixture to a metal 9" x 13" pan. Freeze 6 hours.
  • Before serving, break into chunks with a fork and process in a processor until smooth. Return to freezer for 15 minutes.


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Support Group

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Why Do Parents and Families Need A Support Group?

According to the U.S. Department of Health and Human Services, support groups provide emotional support in times of illness, stress, and crisis. Many families of patients with a chronic illness fell isolated and helpless. There are no easy solutions, but families find emotional support in groups dedicated to "helping people help themselves."

"The African American community plays an active and vital part in self help groups," continues the Department of Health and Human Services. "This is evident in the number of sickle cell mutual help groups located across the United States. Within these groups, members are finding support and learning how to cope with an inherited disease that primarily affects the African American community."

Together, We Can Conquer Sickle Cell Disease!

Are you interested in forming a support group of parents and other family members of children with Sickle Cell Disease? Such a support group would give us the opportunity to come together and enjoy such things as: social activities, becoming better informed about sickle cell disease, and discussing family and school issues that we encounter on a daily basis. If you are interested, please call Rosario at 210/704-3454.


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Your World

by Georgia Douglas Johnson

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Your world is as big as you make it.
I know, for I used to abide
In the narrowest next in a corner,
My wings pressing close to my side.

But I sighted the distant horizon
Where the skyline encircled the sea
And I throbbed with a burning desire
To travel this immensity.

I battered the cordons around me
And cradled my wings on the breeze
Then soared to the uttermost reaches
With rapture, with power, with ease!

(From American Negro Poetry by Anna Bontemps)


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united way logo CHRISTUS SANTA ROSA
Children's Hospital

The Children's Sickle Cell Center
519 West Houston Street
San Antonio, Texas 78307-3198
(210) 704-2187 (800) 227-3618
(After hours, call 704-2011 and ask for Hematologist on call.)

Anne-Marie Langevin, MD
Chief, Division of Pediatric Hematology/Oncology-UTHSC-SA
Howard A Britton, MD, FAAP
Medical Director, Pediatric Hematologist/Oncologist
Reginald Moore, MD
Associate Medical Director, Pediatric Hematologist/Oncologist
Javier R. Kane, MD
Pediatric Hematologist/Oncologist
Anthony Infante, MD, PhD
Pediatric Hematologist/Oncologist Immunologist
Paul J. Thomas, MD, FAAP
Director, Pediatric Oncology Clinical Services
Shafqat Shah, MD
Pediatric Hematologist/Oncologist
Leanne Embry, PhD
Psychology Fellow/Assistant Professor
Elisa Ornelas, LSW
Sickle Cell Social Worker
Yvonne Shannon, RN, MSN
Sickle Cell Disease Nurse Coordinator
Editor of the Sickle Cell Rapper
(210) 704-3110

Rosario Ocampo
Administrative Assistant

Newborn Screening Sickle Cell Disease Email



Last updated November 12, 2010