Free Health Talk: Is this “normal?” Helping Children with Sensory Conditions

Loucresie Rupert, MD

Free Health Talk at the Playground in the Winona Mall, Monday, October 2, 2017

Sensory Integration is the ability to process information from the world around us. In typical development, this happens without having to think about it, but some children have difficulty. This can lead to a variety of challenging behaviors from intense negative reactions to certain things such as sensitivity to loud noises or needing to continuously move. What’s “normal,” and what may indicate a need for help?

Winona Health Child and Adolescent Psychiatrist Loucresie Rupert, MD, along with Occupational Therapists Kyann Brown and Emily Breunig will share information about how sensory processing can affect a child’s behavior and what can be done to help them at a Free Health Talk: Is this “normal?” Helping Children with Sensory Conditions, Monday, October 2, 5:30 to 6:30 p.m. at the Playground in the Winona Mall, 1213 Gilmore Avenue, Winona, Minn.

The program is free. RSVP is requested by Thursday, September 28.

RSVP here

or call 507.457.4161

Healthy Kids: VIP & Me Golf, August 1

Winona Health Healthy Kids and The Bridges have teamed up for a special event on Tuesday, August 1, 2017: VIP & Me Golf.

This fun, free event is for kids ages 5 through 12 accompanied by an adult, Tuesday, August 1, 2017 (rain date: August 8) from 10 a.m. until 6 p.m. at The Bridges Golf Course, 22852 County road 17 in Winona, Minn.

The driving range and putting green will be open, and kids can also sign up to play 2, 4 or 9 holes of golf. There will be games and contests both on and off course. Those who RSVP by Friday, July 28 also will receive a goody bag.

The event is free. Maximum of 2 children per adult.

Those who wish to play 2, 4 or 9 holes of golf must call The Bridges at 507.452.3535 to RSVP and reserve a tee time.

To RSVP for the driving range, putting green, games and contests only:

RSVP here!

RSVP online at or call 507.457.4161. RSVP by Friday, July 28.


About Healthy Kids:  Healthy Kids is a collaboration between Winona Health, Live Well Winona and other area organizations who share an interest in improving the health and wellbeing of children.

Vist our Healthy Kids Website


Immunization important in preventing measles

“Although we currently are not seeing cases of measles here in Winona, we know that parents are concerned,” said Sarah Lallaman, pediatrician and chief of Primary Care Services at Winona Health. “We have outstanding immunization rates in our community, and that is helpful in preventing the spread of disease.”

The Winona Health Pediatrics department shared the following information for parents who may be concerned about measles.

Measles Basics

  • Measles presents with fever, cough, runny nose and tearful eyes, which are fairly basic symptoms that can be similar in presentation with any other respiratory illness
  • The rash, when it develops, typically develops from the head downward
  • The illness is extremely contagious for unvaccinated individuals and can cause serious illness and hospitalization for symptom management


  • The MMR vaccine contains protection for measles and is routinely given at 12 months of age with a booster after age 4 and before kindergarten
  • The first vaccine provides a 93% effective protection, and the booster is thought to be 97% effective
  • The rest of the protection relies on herd immunity, or everyone else getting the vaccine to prevent outbreaks and high rates of disease
  • The vaccination series can be given quicker if needed, but that is only recommended for certain groups for certain risk factors

Winona Health’s Current Practice

  • Winona Health will continue to follow the recommendations of the MDH and CDC.
  • We will continue to offer the first MMR vaccine at 12 months of age, routinely given at the 12 month well check
  • We will continue to recommend the booster vaccine after age 4 unless there is reason to consider earlier administration or if the recommendations change throughout the current outbreak
  • We have no reason to recommend or administer the vaccine to anyone under 12 months of age, but if there is a particular concern for exposure, that should be discussed with the child’s health care provider

Winona Health highly encourages parents of any child over 12 months of age who has not received the MMR vaccine to consider immediate vaccination.

To schedule a well child check and immunizations, call the Winona Health Pediatrics department at 507.457.7607. Same-day appointments usually are available.




Jessica Nelson, CNP, joins Pediatric & Adolescent Medicine team

Jessica Nelson, CNP

Jessica Nelson, CNP (certified nurse practitioner), has joined the Winona Health Pediatric and Adolescent Medicine team.

Nelson, a Rollingstone native, has been a registered nurse at Winona Health since 2006. “I decided to take the next step and go back to school so I’d be able to care for people in my community on a different level,” she said. “Becoming a nurse practitioner has been a long-term goal.”

Nelson earned her Master of Science – Family Nurse Practitioner degree from Walden University, Baltimore, Maryland, and is certified by the American Association of Nurse Practitioners. Prior to becoming certificated as a Family Nurse Practitioner, she cared for patients as a registered nurse in the Family Birth Center for nearly 10 years and then for patients in the Dialysis department.

“After earning my certification, I chose to stay with Winona Health because I like being a part of this community and having the chance to develop relationships with people I’m caring for. We have a wonderful team of healthcare providers and a broad range of services for our patients.”

Nelson and her husband have four children and live in Rollingstone. In her free time, she enjoys spending family time on the river or just being outdoors fishing, hunting or hiking. In addition, Nelson volunteers as the director of the Rollingstone First Responders and president of the Rollingstone chapter of the Jaycees.

Nelson joins pediatricians Sarah Lallaman and Kelli Ostermann. Autumn Cole, CNP, and Laura Dubis, PA-C, in Winona Health’s Pediatric and Adolescent Medicine department. To schedule an appointment, call 507.457.7607. Winona Health has a provider designated for same-day appointments for children who are sick.

For information about healthcare providers at Winona Health, visit and click Find a Provider.


It’s free! Winona Health’s Healthy Kids – Healthy U, Sunday, January 29

Winona Health’s Healthy Kids Healthy U is a fun, free event for kids age 5 to 12 and their parents, grandparents or guardians. The event will be Sunday, January 29, from 1 to 3 p.m. at the Winona Middle School, 1570 Homer Road in Winona.

Kids and families can choose from a variety of fun programs and activities including:

  • WSU Nursing Club focusing on how the body works
  • Fun with SG Danceworkz and Fitness Studio
  • Crafts with Winona Public Library children’s department
  • Cross Country Skiing with staff from Ridgeway Community School (must bring warm outerwear including hat, mittens, warm socks and coat to participate in this activity)
  • Winona National Bank focus on finances for kids and parents
  • Winona Police Officer Barrientos and Neko the police dog
  • Winona Health Food & Nutrition with healthy snacks
  • Read to Rover
  • Paws4Independence therapy dogs
  • Happiness through random acts of kindness and more!

The event is free. Registration is requested for supply planning. RSVP by Friday, January 27. Call 507.457.4161.

RSVP here!



About Healthy KidsHealthy Kids is a collaboration between Winona Health, Live Well Winona and other area organizations who share an interest in improving the health and wellbeing of children.

Healthy Kids Zombie Crawl: Sunday, Sept 25. Free! RSVP

Winona Health and Live Well Winona invite all kids ages 5 to 12 and their families to RSVP for the Healthy Kids Zombie Crawl. The free event will be Sunday, September 25 from 1 to 3 p.m. at the Winona Middle School 1570 Homer Road in Winona.

Children attending the Zombie Crawl are encouraged to dress up like zombies for the event if they wish. Friendly zombies are welcome—nothing too scary please. The Zombie Crawl is a walk around the middle school with various stations for kids/parents to stop and explore. Each station represents one of the dimensions of wellness and features a fun challenge or activity. Activities include things like Zombie Zumba, Zombie Snacks, Brain Games, and Mask Making.

Winona Health’s Healthy Kids events are opportunities for children to have fun, be active and learn about the benefits of a healthy lifestyle.

Children must be accompanied by an adult. The event is free, but to help us plan, please, RSVP by Thursday, September 22.  RSVP HERE or call 507.457.4161.


About Healthy Kids: Winona Health’s Healthy Kids is designed to improve the health and wellbeing of children ages 5 to 12. To learn more about Healthy Kids, visit or call 507.457.4161.

Introducing: Live Well, Eat Well!

Live Well Winona and Winona Health launch Live Well, Eat Well program
Blooming Grounds first area restaurant to offer Live Well, Eat Well options

Live Well Winona, Winona Health and select area restaurants will make it easier for people to choose healthy food while dining out.

The new Live Well, Eat Well program is a collaborative effort to help area restaurants revise menu favorites. The foods will meet specific health criteria by cutting the amount of fat, sugar and calories—but not the appeal.

Live Well, Eat Well partners are committed to sharing the ingredients and nutritional information, so diners can make an informed choice,” says Winona Health dietitian Anna Hudson. “That’s how we make the healthy choice the easy choice.”

The first restaurant to implement the Live Well, Eat Well program is Blooming Grounds, a local coffee house and eatery with locations downtown and in the Winona Mall. Blooming Grounds will introduce their Live Well, Eat Well menu on Saturday, May 14 to coincide with Winona’s Play Streets and Touch a Truck event sponsored by Winona Health Healthy Kids, Live Well Winona and Winona Main Street. All Eat Well, Live Well menu options will be $1 off Saturday and Sunday, May 14 and 15.

“We decided to be a Live Well, Eat Well partner because this is another way we can give customers what they want,” says Amy Jo Marks, Blooming Grounds owner. “I think there is a shift with people wanting to know more about what they’re eating. We want to be transparent with nutrition information to help people make healthier choices.”

The details:

Live Well, Eat Well options focus on healthy ingredients, delicious food and satisfying portions. Menu items are reviewed by a Winona Health dietitian. The Live Well, Eat Well logo next to menu items ensures that the selection meets the following criteria:

  • 600 calories or fewer
  • 35 percent or fewer calories from fat (or fewer than 15 grams of fat)
  • 10 percent or fewer calories from saturated fat
  • 100 mg or less cholesterol
  • 800 mg or less of sodium
  • 3 g or more of fiber

“If it’s not delicious, people won’t order it,” adds Marks. “So our customers can be sure that menu items are staff tested and approved.”

Janneke Sobeck, Live Well Winona community wellness director, is looking forward to helping other area restaurants become Live Well, Eat Well partners. “Working with Winona Health’s nutrition experts, we make it as easy as possible to learn how to alter entrees to maintain the flavor while meeting the health criteria. Or, we can also offer options for new entrees to give customers more choices.”

Live Well, Eat Well restaurants will display the Live Well, Eat Well logo and indicate which of their menu items fit the specific nutrition criteria.

Look for the Live Well, Eat Well logo in participating restaurants. For more information about Live Well, Eat Well or about becoming a Live Well, Eat Well partner:

Live Well, Eat Well




Family fun – Saturday, May 14!

Touch a Truck & Play Streets event with Winona Health Healthy Kids

On Saturday, May 14, 2016 from 10 a.m. until 1 p.m. the Winona Main Street Program, Live Well Winona and Winona Health Healthy Kids will host a Touch a Truck and bike-and-walk-friendly Play Streets event in downtown Winona.

This fun, family-oriented and hands-on event provides a safe and engaging atmosphere for learning, play, active discovery and physical activity.

Touch a Truck gives kids of all ages an opportunity to explore vehicles, learn about trucks, and discover how they benefit our community. It’s also a fun photo opportunity!

Play Streets transforms streets into safe places where families and individuals can walk, bike, play and connect with neighbors. Activities include a bike rodeo (bring your bike and helmet!), crafts, face painting, treasure hunt, puppet show, tennis, fitness classes and more!

Winona Health Healthy Kids offers free events to help improve the health and wellbeing of children ages 5 to 12 and their families. The Play Streets event features the screamer slide, a bounce house, a Velcro wall, art projects, and chalk on the streets. A Winona Health Pit Stop area will be on site for a brief rest, information, and a private place to care for an infant’s needs.

This event will close Center Street between 2nd and 4th street, and 3rd Street between Center Street and Lafayette Street to motorized vehicle traffic and open those streets to people, offering three blocks filled with activities designed for fun and to promote health and wellness.

This event is FREE to the public and no registration is required. Participants are encouraged to bring canned food items for the local food shelf. Food and beverages will be available for purchase during the event which will take place rain or shine.

For more information about the event, call 507.452.2272 or visit Live Well Winona’s website.

Autumn Cole, CNP, joins Pediatrics team

Autumn Leigh Cole, CNP

Autumn Leigh Cole, CNP

Autumn Leigh Cole, CNP (certified nurse practitioner), joined the Winona Health Pediatrics team.

“Working with Kids and their families has always been a passion of mine,” said Cole. “I started my nursing career in Pediatrics and knew that my dream job would be working with kids as a nurse practitioner.”

Cole said she’s looking forward to, “meeting kids and their families. There is something that is so wonderful about working with families to ensure that their kids are growing up healthy and safe. Being around kids, listening to their questions (about everything) and helping them understand how to take care of their minds and bodies makes me love what I do!”

Prior to joining the Pediatric & Adolescent Medicine team, Cole cared for hospitalized patients at Winona Health. She joined the organization in November 2014. She said, “I love it here, the people, the patients, the staff that I work with on a daily basis—they all make me look forward to coming to work. It’s a fantastic place to have a career!”

Cole said she originally chose Winona Health because, “it is such a forward-moving organization; I wanted to be a part of that. I’ve been at other organizations and there is a much different feeling at Winona Health. From the moment you walk in, there is an energy and people seem happy to be here.”

Cole is certified by the American Association of Nurse Practitioners. She earned her Master of Science in Nursing-Family Nurse Practitioner from the University of Wisconsin- Eau Claire and her Bachelor of Science in nursing from Winona State University in Winona, Minn. Cole’s experience includes a decade of healthcare experience including caring for pediatric patients in an Intensive Care setting, and providing hospital and palliative care to patients of all ages.

Cole joins pediatricians Sarah Lallaman and Kelli Ostermann in the Pediatric and Adolescent Medicine department. To schedule an appointment, call 507.457.7607.

For information about healthcare providers at Winona Health, visit and click Find a Provider, or call 507.454.3650.

To test or not to test. Strep is the question.

By Pediatrician Sarah Lallaman, DO

Lallaman_small_RGBIf you are one of the many who feel that you or your family have been trounced with a strep infection or four, you are not alone. For an illness that is well known and so common, it seems that testing and treatment protocols would be more straightforward. However, when all details are considered, it’s not so simple. We receive many questions about strep testing, and I hope to clear up some confusion.

Strep throat is most common in school-aged children (5 years -15 years) during the colder months from fall to spring. The presence of specific symptoms helps us rule out strep from other possible causes. Along with a sore throat, a fever of over 101 degrees is usually present along with a lack of other cold-like symptoms, such as cough or congestion. Other common symptoms associated with strep throat include headache, stomachaches, vomiting and rash. A young child may have some respiratory symptoms, but these are generally mild and do not necessarily mandate treatment.

Strep throat can occur in other age groups, but the younger the patient, the more careful we all should be. Medical research has shown that children under age 2 years can be natural carriers and harbor strep over 25 percent of the time without it being a problem. Additionally, while toddlers are more likely to carry strep (and test positive), they are also less likely to have the strep be the cause of their illness. Young children are less frequently affected because they have fewer receptor cells in their throat to allow strep to be an active problem. For the same reason, toddlers and infants have a near negligible risk for some of the more severe complications of strep.

When strep is truly the culprit causing the problems, it is important that it be identified. Treatment is indicated to help decrease the severity and duration of symptoms, prevent the spread to others and to prevent serious complications, such as acute rheumatic fever and rare heart disease. Acute rheumatic fever resulting in heart disease has life-long complications.

It is quite reasonable to check a school-aged child or even adult, if the symptoms do seem to fit for strep throat. A common misconception is that if a child has tested positive for strep, household members should also be tested. Medically, only patients who have symptoms should be tested unless other circumstances arise. Testing and treatment is not recommended for family members or close contacts unless they are ill.

Occasionally, a situation will arise of a patient getting recurrent strep throat infections. While we try to convey the importance of hygiene to prevent repeat infections, it can be tricky for sure. Changing to a new toothbrush while on antibiotic therapy and cleaning or discarding anything else that routinely goes in the mouth is recommended. Household contacts can sometimes be a reason for a person to have multiple episodes of strep. There is debate whether testing and treating everyone in the house is worthwhile and effective – especially knowing that it is harder to rid a person who is a carrier of strep than one who has an acute infection from strep.

In some cases, Winona Health allows for walk-in strep testing, but only under the right circumstances. Given the low frequency of an active strep infection and low risk for strep complications, we don’t routinely do walk-in strep tests for children under age 2 years. We’ll ask a series of questions to determine whether a visit with a healthcare provider is necessary. If an appointment is needed, we do our best to accommodate people as soon as possible.

Pediatric & Adolescent Medicine