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New Pap Guidelines: Is The Annual Exam Gone?

2012-04-09T11:15:15-07:00

Cervical cancer was once the leading cause of cancer-related deaths in American women. In the 1930s, more American women died of cervical cancer than any other kind of cancer, including breast or lung. But in 1943, a new method for cervical screening was introduced. The Babeș-Papanicolaou test (named after physicians who pioneered the method), also called a “Pap smear” or “Pap test,” became the most successful cancer screening in history. Today, according to the American Cancer Society, there are fewer than 4,000 annual deaths due to cervical cancer, mostly among women who have never been screened.

Until now, physicians recommended that women receive an annual pap test, starting sometime in the teens. So when the U.S. Preventive Services Task Force issued a set of new guidelines for cervical cancer screening on March 15, 2012, it introduced a significant change to women’s health care routines. Now, the guidelines suggest screening should begin no earlier than age 21, and for most women over the age of 30, the tests can be safely spaced three years apart. Similar guidelines released by the American Cancer Society on March 14 support that approach.

Overscreening Causes Harm

“In the case of pap tests, it turns out that more was not better,” explains Lily Tsai, MD, a Scripps gynecologist. “In recent years, as we have come to understand the natural history of HPV infection, we’ve seen convincing evidence that over-screening can cause harm to patients, both physical and psychological.”

Nearly all cervical cancers are the result of infection with the human papillomavirus (HPV)—a fact that was not established until recently. But not all HPV infections will cause cervical cancer. “It turns out that most people fight off HPV infections naturally without intervention,” Dr. Tsai says. “So annual Paps were identifying abnormal cells at a very early stage of infection or were non-diagnostic, leading anxious patients and providers to treat them more aggressively than was necessary.”

The most common diagnostic procedure for suspicious pap results is a colposcopy, or magnified examination of the cervix. If abnormal areas are visualized, additional studies such as cervical biopsy or endocervical curettage may be performed and examined in the lab for precancerous changes. A confirmed high level abnormality often leads to a cone biopsy of the cervix to remove affected tissue.

“Treatments are not always benign. An unnecessary cone biopsy, for example, may increase one’s chance of a weaker cervix, potentially leading to problems in pregnancy” says Dr. Tsai. Plus the anxiety caused by an abnormal pap test is also significant.

The American College of Obstetricians and Gynecologists recommended spacing these screenings for appropriate women three years apart in 2009, and the American Society for Colposcopy and Cervical Pathology (ASCCP) issued similar guidelines in 2006. The recently released guidelines are now in alignment with those developed by experts in the specialty.

Women Should Not Skip Annual Pelvic Exams

This does not mean, however, that women can skip their annual gynecological examination. “Pap tests are not the only reason to have an annual exam,” Dr. Tsai emphasizes. “Women still need to be examined yearly, either by their gynecologist or their primary care physician, for the remainder of the pelvic exam and breast exam.

The new guidelines suggest:

For women with no other risk factors, pap tests should start at age 21.
Between the ages of 21 and 30, cervical cell screening should take place at three-year intervals, with no screening for HPV.
After age 30, women should have a combined cervical smear and HPV test every five years or pap test alone every 3 years.
After the age of 65, women who have had previous normal results may discontinue pap tests.
If a woman has had serious cervical pre-cancer, she should continue being screened for 20 years after that diagnosis, even if she is past 65.
Women with additional risk factors (including previous abnormal Pap tests, exposure to diethylstilbestrol [DES] in utero, or a compromised immune system), pap tests should be more frequent.
If a woman has had a hysterectomy with removal of the cervix for benign reasons, there is no need for a Pap test.

Find an OB-GYN

If you need to find a gynecologist for regular pelvic exams, Scripps can help. Call 1-800-SCRIPPS (1-800-727-4777) to get a physician referral from a member of our call center or visit our doctor finder.

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How to Get Your Child Back Into a Booster

2012-02-07T09:43:34-08:00

On January 1, 2012, the California law regarding child restraints in vehicles changed, and suddenly, 6- and 7-year-olds who thought they had “graduated” from their car seats were sent right back into them.

The new law states that children under the age of 8 must be secured in a car seat or booster seat in the backseat. Children under the age of 8 who are 4’ 9” or taller may be secured by a safety belt in the backseat.

The law is intended to make children safer. In fact, the California Highway Patrol (CHP) says the risk injury is reduced by 33 percent when children move to the backseat. Despite the facts, parents may have difficulties getting older kids to understand why they’re being forced back into to their car seats and boosters.

Trieva Scanlan, MD, a Scripps pediatrician, thinks the best approach to getting reluctant children to accept the new law is straightforward honesty. “Children who are between 6 and 8 are old enough to understand reason. So parents need to tell them there are two very good reasons to get into the booster seat,” she says. “First, it will keep them safe if something bad should happen while mom or dad is driving, because they could get hurt if there were and accident without the booster seat. And second, it would cost a lot of money if a police officer saw them in the front seat or out of a booster seat and their parents got a ticket.”

Dr. Scanlan doesn’t think bribery is not a good approach to gain compliance. “Be firm, be consistent, be logical and don’t engage in argument,” she advises.

While the new law applies to most cars and children, there are a few exceptions. According to the CHP, children may continue to ride in a front seat if:

A vehicle has no rear seats
The only available rear seats are side-facing jump seats
A child restraint system cannot be installed properly in the rear seat
Children under the age of 12 occupy all rear seats

Find out if your car seat is installed correctly

The National Highway Traffic Safety Association estimates that nationwide, 82 percent of car seats are installed incorrectly. If you have questions about whether your car seat or booster seat is as secure as it should be, visit one of several free car seat inspection sites run by police and highway patrol personnel.

Get a regular dose of health news and information from Scripps

Sign up to have health-related information from Scripps delivered to your inbox, including our monthly email newsletter. Designed to help you and your family get healthy and stay well, the publication contains timely and relevant consumer health news along with notices about classes, events and exclusive offers.

Summer 2011 Health and Wellness Classes

2011-06-27T15:27:41-07:00

See our quarterly Health Connections calendar for a list of health-related classes, screenings and events.

Events range from support groups to general health seminars to special training. Topics include:

Heart healthy nutrition and lifestyle
Driving safety
Pelvic floor conditions
Diabetes prevention
Health care reform, and what it means for you
CPR classes
Weight management and nutrition
Parenting

For more information, or to sign up for a class, call 1-800-SCRIPPS (1-800-727-4777).

You can also visit our online classes and screenings listing to search for classes, and register online.

Health Information Library

Read articles on hundreds of health conditions and wellness topics in our health information library.

North County OB-GYN Joins Scripps Clinic

2011-06-02T12:01:37-07:00

Scripps Health has acquired North County OB-GYN Medical Group in an agreement completed today. The acquisition creates the eleventh Scripps Clinic location in San Diego County.

The seven obstetrics and gynecology physicians have joined Scripps Clinic Medical Group, which includes more than 400 physicians practicing in more than 50 areas of medicine and surgery. Scripps Health contracts for the exclusive services of the Scripps Clinic Medical Group physicians through the Scripps Medical Foundation.

The group includes Kirstin Lee, MD; Allan Silver, MD; Tracy Ruymann, MD; Kelly Harkey, MD, MPH; Elizabeth Silverman, MD; Renee Nelson, MD; Kimberly Washkowiak, MD and Azar Bastanfar, CNP. Each of the physicians is board certified by the American Board of Obstetrics and Gynecology, and the practice’s ultrasound program is accredited by the American Institute of Ultrasound Medicine.

“We are pleased to provide excellent patient care under the Scripps name,” said Dr. Lee. “Our practice has served the San Diego community for more than 40 years, and our patients can expect the same high-quality service they have always received.”

Scripps Health has acquired the assets of North County OB-GYN Medical Group, located in the XiMED building on the campus of Scripps Memorial Hospital La Jolla, and the practice’s employees are now employed by Scripps Health.

“The physicians and staff are highly respected members of the San Diego medical community,” said Robert Sarnoff, MD, president of Scripps Clinic Medical Group. “As members of Scripps Clinic, they will now have greater access to the Scripps Health network to further their commitment to provide the best care for their patients.”

Current patients should experience no change in their care. The group has a long-standing relationship with Scripps Health. All of the physicians currently practice at Scripps Memorial Hospital La Jolla and have delivered more than 730 babies there in 2010.

This is Scripps Health’s fifth medical group acquisition since 2008. Previous acquisitions include Sharp Mission Park Medical Group, Penn Elm Medical Group, Del Mar Medical Clinic and North Coast Women’s Care.

Parent Connection Offers Networking for San Diego Parents

2010-10-15T16:26:21-07:00

The Parent Connection, sponsored by Scripps, offers parents throughout San Diego a chance to connect and share ideas. Featured on San Diego’s KSWB, the news clip offers advice for parents on how to get involved in parenting groups.

Watch the video

Media Contact: Lisa Ohmstede
Phone: 858-626-7142
E-mail: ohmstede.lisa@scrippshealth.org

Parent Connection Swap Meet Attracts Local Families

2010-09-29T13:54:54-07:00

Five t-shirts, three pairs of shorts, Lincoln logs, two Sesame Street DVDs, and a stroller to carry them off—all for $20. That’s the kind of deal that makes the bi-yearly Parent Connection Swap Meet a highly anticipated Fall events.

Parents looking for bargains will converge on Canyon Crest Academy Sunday, Oct. 3, 2010, from 9 a.m. to 1 p.m. to save on everything they need for their newborns, infants and young children.

More than 300 vendor families will be selling used furniture, clothing, strollers, toys and books. In many cases some of the items will have been worn once or never removed from the box.

“One family’s jumble is another’s jewel,” says Pam Nagata, Parent Connection coordinator. “It’s a win-win for local families. For example, a new parent can find some terrific deals on infant clothes and toys, while the seller family is able to clear out those items and stock up on toddler gear.”

The Parent Connection Swap Meet
Sunday, Oct. 3, 2010
9 a.m. to 1 p.m.
Canyon Crest Academy
5951 Village Center Loop Road
San Diego, CA 92130

Admission is $2/person; children under 12 years old are free. Proceeds from the Swap Meet benefit Parent Connection families in crisis.

The Parent Connection is a nonprofit parenting support network sponsored by Scripps Health that provides support in the form of parenting classes, playgroups, special events and an active online network. Since its inception in 1980, local families have relied on the Parent Connection to guide them through the maze of parenthood. Membership in the Parent Connection is open to all San Diego families.

Learn more about the Parent Connection

Media Contact: Lisa Ohmstede
Phone: 858-626-7142
E-mail: ohmstede.lisa@scrippshealth.org

Keep Your Kids Swimming Safely

2010-05-21T09:00:14-07:00

By Pam Nagata, Scripps Memorial Hospital La Jolla

With longer days, warmer weather and rising ocean temperatures, it won’t be long until San Diego’s beaches and pools are spilling over with kids. While summer fun should be enjoyable for the whole family, swimming can present risks, especially for young children. By taking a few simple precautions, you can help ensure your kids are splashing and swimming safely.

Stay Safe in the Pool

According to the U.S. Consumer Product Safety Commission, nearly 300 children under the age of five drown in residential and community pools and spas each year, and thousands more require medical treatment for serious injuries. These tragedies occur far more often in backyard swimming pools than at community or recreational centers.

The most important factor in preventing such incidents is constant adult supervision any time children are in or near a pool. In some cases, adults mistakenly think that someone else is watching a child playing in a pool, and doesn’t realize that the child needs help until it is too late. Make it a point to assign an adult to “pool duty” any time there are children in the water, and make sure the designated adult is able to give the children his or her full attention; in other words, no talking on the phone, doing yard work or multitasking. Keep lifesaving equipment by the pool, and always ensure a phone is easily within reach in case of an emergency.

Make sure children know where the deep end is and how far they can safely go in the pool and still touch bottom. If your children can’t swim well, stay within reach of them and be ready to help if they need it. “Water wings” and other toys that help children stay afloat are fine to use, but never depend solely on them to keep children safe. Allow your kids to dive only in designated areas where the water is at least nine feet deep.

Pool and spa drains can pose the risk of entrapment if not properly installed or protected. Entrapment can occur when the powerful suction of a pool or spa drain keeps a child from escaping the drain, or when a child’s arm, leg, hair or clothing gets stuck in a faulty drain cover. If the child cannot break free and get to the surface, drowning or serious injury can result. In 2008, Congress enacted the Virginia Graeme Baker Pool and Spa Safety Act to prevent the tragic and hidden hazard of drain entrapments in pools and spas; under the law, all public pools and spas must have approved drain covers installed and, in some cases, must add a second drain. However, don’t assume that every pool or spa is in compliance with the law. Teach children to stay away from pool and spa drains, and tie up long hair and loose swimsuit ties to help prevent entanglement. If you notice a loose or broken drain cover, notify the pool’s owner immediately.

When you’re not using the pool at home, make sure you take proper safety measures to keep children out of the area, including installing fencing, door and pool alarms, and automatic pool covers. California safety laws require fencing around residential swimming pools.

Open Water Safety

Children need to understand that swimming in a lake, ocean or other open water is much different than in a pool. Uneven surfaces, sudden drop-offs, waves, currents and sea life each pose their own risks. Allow children to swim only in designated swimming areas patrolled by lifeguards, and assign an adult to watch them as well.

Teach Your Child to Swim

It’s a good idea to teach your child to swim as soon as he or she is ready. A number of swimming schools offer lessons for children as young as three months to teach them to be comfortable in the water. In addition to learning to swim, knowing how to tread water and float can help a child feel more in control in the water, and enjoy it more as a result.

Look for a professional, certified swim school that caters to families with children. Instructors should assess each child’s ability and comfort level in order to develop an individualized program that the child will enjoy. Taking lessons year-round can help children become strong, confident swimmers. And who knows, you might discover the next Michael Phelps!

It’s important to remember that no matter how well your child can swim or how well-supervised they are, accidents can happen. Learn infant and child CPR and keep a phone nearby.

Pam Nagata is the coordinator of The Parent Connection at Scripps Health, a parenting network serving San Diego County (www.sandiegoparent.org). For more information, call 1-800-SCRIPPS.

Media Contact: Lisa Ohmstede
Phone: 858-626-7142
E-mail: ohmstede.lisa@scrippshealth.org

Parent Connection Swap Meet Attracts Local Families

2010-04-16T13:53:02-07:00

Five t-shirts, three pairs of shorts, Lincoln logs, two Sesame Street DVDs, and a stroller to carry them off all for $20. That’s the kind of deal that makes the biyearly Parent Connection Swap Meet one of the hottest spring events. Parents looking for bargains will converge on Canyon Crest Academy Sunday, April 18, 2010, from 9 a.m. to 1 p.m. to save on everything they need for their newborns, infants and young children.

More than 300 vendor families will be selling used furniture, clothing, strollers, toys and books. In many cases some of the items will have been worn once or never removed from the box. “One family’s jumble is another’s jewel,” says Pam Nagata, Parent Connection coordinator. “It’s a win-win for local families. For example, a new parent can find some terrific deals on infant clothes and toys, while the seller family is able to clear out those items and stock up on toddler gear.”

The Parent Connection Swap Meet will be held on Sunday, April 18, 2010, from 9 a.m. to 1 p.m. at Canyon Crest Academy, 5951 Village Center Loop Road, San Diego, CA 92130, located in Carmel Valley. Admission is $2 per person; children under 12 years old are free. Proceeds from the Swap Meet benefit Parent Connection families in crisis.

Learn more about the Parent Connection

Media Contact: Lisa Ohmstede
Phone: 858-626-7142
E-mail: ohmstede.lisa@scrippshealth.org

Young Mother Receives Lifesaving Care During Son’s Birth

2011-05-02T13:58:10-07:00

Miranda and Bryce Klassen have been married four years. As they stand in a small garden with family and friends, they share a toast to celebrate their wedding anniversary. There are smiles and hugs from the group of well wishers — and on this special occasion, there are even a few tears. Their four-month-old boy Van, not to be ignored, with big blue eyes and platinum blond hair, gurgles and his face lights up when his mother kisses his cheek.

The Klassens are in the healing garden at Scripps Memorial Hospital Encinitas. Their friends and family — as Miranda refers to them — are, in fact, some of the physicians, nurses and clinical staff who mobilized in a matter of minutes to save her and her son’s life, during the delivery just months ago. “Thank you for allowing us to have a four-year anniversary,” says Miranda to the entire group. “I don’t know what else to say, but simply, thank you for saving my life.”

Carolyn Eoff, a labor and delivery nurse, who is among those in the garden, remembers that spring morning in 2008, when Van was born. Miranda had been admitted the night before, and Carolyn took over her care the following morning. She had been thoroughly briefed by the nurse who worked the previous shift, and Carolyn spent her first hour on-duty getting to know Miranda.

“Miranda was anxious about the delivery, so I wanted her to feel safe and supported,” says Carolyn. “She was such a kind, friendly lady, and this was her first child, so I stayed by her side.” Miranda had been given an epidural. Carolyn says that when she checked Miranda’s contractions and dilation, she noticed there was some bleeding. The nurse went to find Miranda’s obstetrician Dane Shipp, M.D., and during an exam, the physician noted that the baby’s heart rate was dropping, and so was Miranda’s blood pressure.

Miranda was given medications through the epidural to help stabilize both her and the baby. Carolyn remembers turning Miranda from side to side and giving her oxygen for her shortness of breath, but says she was not progressing the way she had hoped.

Just that week Carolyn had been recognized as Scripps Encinitas’ Nurse of the Year for her dedication to patient care and nursing excellence. Carolyn says her 23 years of experience helped her remain calm as she explained to Miranda all the steps that were being taken for her and the baby.

“When I called Dr. Shipp, the anesthesiologist and the respiratory therapist back to the room, Miranda looked up at me and asked, ‘Am I going to die?’ I told her to be strong, take control of her thoughts, and stay with me,” recalls Carolyn, with a slight catch in her voice as she remembers the moment — and what happened next.

Because the baby was in distress, Dr. Shipp needed to perform a caesarean section. The operating room in the Leichtag Family Birth Pavilion was already in use, so a team was quickly assembled in the hospital’s main operating rooms (O.R.).

“En route to the O.R. Miranda had lost consciousness and had a seizure,” says Dane Shipp, M.D. “We knew this delivery had to be well orchestrated; there was a room open between cases in the O.R., and there were additional staff available to assist. Everyone
had a job for the survival of both the mother and baby.”

When Miranda reached the O.R. she was in cardiac arrest, which caused a temporary lack of blood flow to the baby because of her lack of oxygen. “While I was at the foot of the table performing the caesarean section, there was staff at the head of the table performing chest compressions on Miranda,” adds Dr. Shipp. “Everything was moving fast. It took only a matter of minutes from when we left labor and delivery to when the baby was delivered in the O.R.”

The baby was immediately taken to the hospital’s neonatal intensive care unit (NICU). Miranda still was not responding well; her blood wasn’t clotting and she continued to rapidly bleed. During her care, she had 45 different medications, including clotting drugs, delivered through IVs to her fragile body, and received 25 pints of blood to keep her alive. Now, in the intensive care unit (ICU) she was placed in a paralytic coma, through the use of medications, to help her body heal.

Bryce and Miranda’s parents were told the news. What was expected to be the happiest day of their lives was now one of their young family’s toughest. “I don’t think I slept for days,” says Bryce. “Carolyn took us to a private waiting room where the ICU doctors and nurses provided us with updates. Miranda meant everything to me, and I had to be strong for her and the baby. I prayed — and waited.”

Scott Eisman, M.D., was Miranda’s physician in the ICU: “We were assessing the situation moment by moment. Her body was in shock; she was on a ventilator; she was anemic; and we had to get oxygen to her tissues. It was a coordinated effort between our physicians and nurses, laboratory staff and the respiratory therapy team in the ICU to care for her.”

By her second day in the ICU, Miranda’s medications were gradually lessened to see if she would regain consciousness. Dr. Eisman says no one knew how she would respond, and if, because of the cardiac arrest and lack of oxygen to her body, she would ever function at the same level.

Miranda did wake up. Bryce remembers walking into her room not knowing what to expect, but being hopeful. “She used sign language to tell me ‘I love you,’ and I knew she was going to be okay.”

Drs. Shipp and Eisman, and the multitude of staff that cared for Miranda, soon had a name for the mysterious condition that affected her. As a healthy, 32-year-old mother with no medical history of disease, and no signs or symptoms during her pregnancy to indicate that she would have such life-threatening complications during her baby’s birth, Dr. Shipp soon diagnosed the cause. Miranda had suffered an amniotic fluid embolism.

An extremely rare obstetric emergency, an amniotic fluid embolism occurs when amniotic fluid enters a mother’s blood stream and triggers an allergic reaction that can cause cardiorespiratory (heart and lung) collapse and excessive bleeding. There is no known cause of the condition. Most physicians will never encounter a case in their careers; and 80 percent of the women who experience an amniotic fluid embolism
do not survive.

“I don’t remember much about the experience,” says Miranda. “I do know that I felt well taken care of while I was at the hospital. Most of my memories are created from my husband’s recollections or accounts from my family, friends and doctors.”

One thing that Miranda will never forget is meeting her son, Van, for the first time. “I was taken in a wheelchair from the ICU to see Van in the NICU. When I got to hold him, I experienced such great love and unbelievable happiness,” she says.

Miranda spent a total of eight days in the hospital — and Van was at Scripps Encinitas a few days longer. Today, she continues to have her progress monitored through neurological and cardiac assessments, and takes medication to shrink the blood clots that later developed in her lungs.

For Miranda, who is a commercial banker, her thoughts have now turned to helping others. Learning more about the mysterious causes of amniotic fluid embolisms, and trying to prevent any other woman from experiencing the same complications during the birth of a child, is providing her with a greater purpose.

“I am so blessed to have had the exceptional care that I received at Scripps Encinitas,” Miranda says passionately, “I have a mission. I don’t want any husband to live without his wife and any child to grow up without a mother.”

Watch a Video

See the Klassen family reunite with the Scripps Encinitas clinical staff who saved Miranda and newborn Van.

Klassen family reunite with Scripps Encinitas staff. Duration: 00:02:58.3

Grandparents Go Back to School for Modern Baby Care

2009-03-04T11:51:38-08:00

by Joan Quigley, RN, MSN, NP, Scripps Memorial Hospital La Jolla

Twenty or 30 years ago, it was considered safe for babies to sleep on their stomachs. Parents held infants in their arms when they rode in the car, and put them down to sleep at night in their cribs.

A lot has changed

Well, times have changed—and for many new grandparents, the new rules about childcare may be confusing. To help them navigate these changes, Scripps Memorial Hospital Community Health is offering a new class especially for grandparents. “Grandparenting Today” gives new grandparents an introduction to the role they will be playing in their grandchildren’s lives, and can help them adapt to the changes that have taken place since their own children were young.

Some of these changes apply even before the baby is born. Couples were not as educated as they are now; today, many take various classes in preparation for the birth. Ultrasounds were reserved for high-risk patients in the past, whereas today they are routine. It was unusual for fathers to be in the delivery room helping out during childbirth, much less recording the event on their digital cameras. (How many old movies show Dad nervously pacing in the hospital hallways, waiting for his baby to be born?)

Following delivery, newborns were taken to the nursery down the hall, because “rooming in” with their mothers was not a common practice. Today, all of these are quite customary, and the more grandparents understand about prenatal care and the modern labor and delivery process, the easier it will be to support their daughters or sons during the pregnancy and birth.

Safety and nutrition issues

Other changes become evident as soon as the baby leaves the hospital. Grandparents who always held their children on their laps in the car, with or without seatbelts, may find the new car safety laws daunting. In California, children are required to ride in a federally approved baby car seat or child booster seat until they are at least six years old or weigh at least 60 pounds.

Even some of the most basic aspects of baby care have changed. Breastfeeding is more popular now than it was thirty years ago, and more parents are concerned with feeding “natural” or “organic” foods when their babies are ready to eat solid foods.

Sleep safety

Sleeping can be a major issue. Years ago, it was considered safe to put babies to sleep on their stomachs, so that they would not choke if they spit up in their sleep. Today, stomach sleeping is considered dangerous. In fact, The National Institute of Child Health and Human Development, a division of the National Institutes of Health, has created an entire campaign devoted to spreading the word about putting babies to sleep on their backs.

According to the “Back to Sleep” campaign, babies who sleep on their stomachs have a higher risk of sudden infant death syndrome (SIDS). “Back to Sleep” applies not only to nighttime sleeping, but naps as well.

New grandparents also may be surprised to learn that in addition to sleeping on their backs, many babies are sleeping in the same bed as Mom. A number of young mothers prefer to have their babies sleep with them. This practice can make some grandparents uncomfortable, as they may believe that the baby is in danger of being smothered or injured should Mom roll over in her sleep.

Communication is essential to good relationships

Given all of these changes, it’s no surprise that conflicts may arise between grandparents who think their way is correct and parents who have learned otherwise.

This is where communication is key. “Grandparenting Today” offers tips for creating clear, positive communication between parents and grandparents, including suggestions about how and when to speak up and when to stay quiet. The class also serves as a “support group” for new grandparents, who share ideas and learn from one another.

Grandparents play an important and irreplaceable role in children’s lives. They are a link between the generations, passing on the culture and history of the family through stories, memories and photos. The more grandparents know about creating loving, nurturing and supportive relationships with their children and their children’s children, the stronger their bonds can be.

Joan Quigley RN, MSN, NP, is Lead Perinatal Educator with Scripps Community Health at Scripps Memorial Hospital La Jolla. For more information on grandparenting classes, please call 1-800-SCRIPPS.

Media Contact: Lisa Ohmstede
Phone: 858-626-7142
Email: ohmstede.lisa@scrippshealth.org