Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

A mom, a pediatrician, and her insights about keeping your kids healthy.

Pride: The Wellness Effect of Same-Sex Marriage Laws

Seattle’s Pride Parade is tomorrow, Sunday, June 25, and it has a great theme — Indivisible. Take the meaning of the theme as you like, but if there’s one thing that is true for Pride in Washington, it’s that there is an abundance of support. The majority of our people here, it seems to me, are building a community and will not be divided more. I feel so thankful to live in a community that is on its way to continuing to make all feel welcome, safe, and grounded in a sense of belonging.

As we come upon the 5th year since Washington State legalized same-sex marriage (woohoo!) it’s important to highlight the importance of what laws like this can do within the community. The legal changes here have had lasting impact on thousands and thousands: there were approximately 15,750 same-sex marriages in Washington between 2012 and 2015.

These laws not only increase liberty and resources for families with same-sex couples, the laws may increase our community’s health and they may earnestly decrease suffering.

A study published by JAMA Pediatrics found that states with same-sex marriage policies had a 7% reduction in adolescent suicide attempts. The study analyzed data from 762,678 adolescents in 47 states between 1999 and 2015. Of the states included in the study, 32 permitted same-sex marriage and 15 states did not.

Evidence from nationally representative 2015 Youth Risk Behavior Surveillance System (YRBSS) data indicates that more than 29% of gay, lesbian, and bisexual high school students reported attempting suicide within the past 12 months, relative to 6% of heterosexual students.

Teen and Young Adult Suicide

Suicide is the second leading cause of death among adolescents between the ages of 15 and 24 years (CDC data). When focusing more specifically at adolescents who identify as LGBTQ, teens unfortunately carry disproportionate suffering and anguish with elevated rates of suicide attempts (data finds teens identifying as LGBTQ may have 4-fold risk in acting on wanting to end their life). As a pediatrician and mom I am been struck by this horrific disparity for teens who identify as LGBTQ.

Messages of non-belonging are everywhere (hate crimes, prejudice, homophobia, bullying) but thankfully legalization of same-sex marriage has been accompanied by media attention that may increase not only rights and services, but a sense of progress and belonging. The local and national attention on legalization of marriage have been shown to increased social support for the rights of the LGBTQ community. This is one reason I cover this issue a lot.

JAMA Pediatrics Study Findings

  • Same-sex marriage policies are associated with a 7% reduction in all high school students reporting a suicide attempt within the past year. Suicide is the 2nd leading cause of death for teens age 15 to 24 years of age. Although not perfectly clear why rates of thinking of ending a life is so much higher in LGBTQ teens, researchers explain, “Although it is unclear what drives greater rates of suicide attempts among adolescents who are sexual minorities, prior evidence suggests several potential mechanisms, including stigma. Link and Phelan defined stigma as the confluence of labeling, stereotyping, differentiation from the norm, status loss, and discrimination in the context of differential power. Stigma based on sexual orientation is associated with mental distress, anxiety and depression, and greater rates of suicide attempts.”
  • Approximately 134,446 fewer adolescents reported an attempted suicide each year. (wow)
  • The effects of legalized same-sex marriage persisted for at least 2 years after legalization.

What Does This All Mean?

  • Laws help shape culture. Culture helps shape belonging. Belonging helps shape our mental health. Implementation of same-sex marriage policies reduces adolescent suicide attempts in addition to increasing opportunities for families to have health care, pooled resources and legal support.
  • The hope is these expanding laws around same-sex marriage will continue to improve mental health outcomes and a sense of belonging for all teens and couples across the nation. The bigger hope is less teens think on or attempt ending their life and LGBTQ teen rates of suicide continue to diminish and diminish.

Resources

Just ASK About Firearms

It’s national selfie day (??? an excuse for my millennial behavior) and it’s also Just ASK day (smart stuff), hence the image I snapped this morning. I spent the morning today at KING5 news making some TV segments encouraging us all to ask about firearms when we drop our children and teens off for playdates, sleepovers, camps, and fun. Although it seems awkward at first blush to ask how a firearm is stored at a home of someone you love or someone you hardly know for that matter, I’m convinced it’s time to make it the norm. Weird, I suppose, to ask something that may feel imposing especially when someone is graciously taking in your little rugrat for dinner or soccer or a sleepover or a trip to the beach…the reality is this: 9 out of 10 parents don’t mind being asked about firearms. And ensuring that our children can’t get their hands on firearms at the wrong time is something we all work on.

Just ASK about firearms in the home. Every time. Make sure if firearms are in the home they are stored unloaded and are separate from ammunition. Ideally, firearms should be in lock boxes and/or have trigger locks

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Avoiding Shame When Talking About Weight With Your Teen

Figuring out what to say to a child or teen about being overweight can be perplexing. We want out children to love to eat. We want our children to love their bodies. We want our children to be of healthy weight. We want to avoid ever making our children feel shameful about how and what they eat.

It can be a challenge to figure out what to say when we worry our children may be overweight or at risk for being overweight. How do we talk with them about eating well without making them feel any frustration/shame/overwhelm about their body? There are roughly 7 million children and teens younger than 19 years old in the US that are of unhealthy weight or obese. In Washington, 23% of 10th graders (15 to 16 years old) are overweight or obese. That’s nearly one-quarter of teens who are at one of their most vulnerable ages. So lots of parents may find themselves wanting to support different choices with eating and activity and not know quite how.

Adolescent expert Dr. Cora Breuner is a specialist who works with teens who need extra help getting to a healthy weight. She recently joined me on a podcast to discuss talking about the difficult topic with your teen. Specifically, Dr. Breuner shared tips on how to approach conversations with your teen about their weight, and common confusions and excuses for overeating.

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Reducing BPA and Phthalates in Your Everyday Life

Chemicals are a part of our environment in the modern world, of course, thanks to the conveniences afforded to us by farming, manufacturing, and industry. Every parent wants to reduce exposures for their children as they grow. No question that developing babies and children may be more vulnerable to the effects of toxins as their bodies and organs and minds form. There are 80,000 chemicals in commerce (yikes!) with 3,000 being high volume meaning they can be found ubiquitously in some of our lives. There is no way to completely avoid them, but there are ways to reduce exposure to specific chemicals you’ve likely heard about, like bisphenol A (BPA) and phthalates and other pesticides and toxins found around your community.

Four quick tips for reducing toxins in your home below.

My colleague (from way back in residency), Dr. Sheela Sathyanarayana is an expert in understanding the effects of chemicals on developing and growing babies and children. She joined me for two podcasts to discuss chemical exposure, what the effects are and how you can reduce your family’s exposure. Dr. Sathyanarayana is a pediatrician at Seattle Children’s Hospital and a pediatric environmental health scientist at Seattle Children’s Research Institute. Her research focuses on exposures to endocrine disrupting chemicals such as phthalates and BPA and their impact on reproductive development.

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Limit The Juice: None for Babies, Only Ounces For Kids

Not news that pediatricians recommend against juice. But the news this week is clearer: no juice for babies, only tiny bits for toddlers, and less than a cup a day for the rest of us. Fruit juice is widely thought of as a healthy and natural source of vitamins and hydration. And although I won’t vilify having juice in the diet of an older child, I can’t endorse it’s ever good for a child. Pediatric recommendations for juice got stricter this week. Juice is never really recommended in an a child’s diet past ounces to a cup a day but now it’s recommended as a NEVER during infancy.

Although whole fruit (i.e. an apple or an entire avocado or apricot) is one of the main focus foods in the Dietary Guidelines of Americans, fruit juice may feel a thoughtful substitute, but it’s not. In fact, even 100% fruit juice offers no real nutritional benefit and it’s never needed. The short list for why?

  • Juice is just a bunch of water and simple sugars (naturally occurring sugar is sugar) and lacks fiber or protein.
  • When you obtain calories from juice you take them in at a faster rate than is ideal. Juice is known to contribute to overweight and excess energy imbalance in children. We don’t need to drink these calories.
  • Whole fruit has the advantage of containing quality fiber that’s good for us.

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A Few Recommended Rules For Fidget Spinners

Fidget spinners are everywhere. The photo here was captured this morning on the way into school. That little blue wonder spinner showed up in our home without us even knowing it last week. My 8 year-old got it at the 2nd-grade market our school put on! And I’ve even heard about a set of savvy middle-school students in the midwest using a 3-D printer to make their own. Hello, New World of Toys and Toy-Making. This just a reminder that these fidget toys are often cheap and easy to get ahold of so parents may not even know when one’s safely tucked in a backpack of a school-aged child or teen.

I played with one for the first time this morning and lemme say this: I get the draw.

Spinners are here to stay, at least for the rest of this school year, and teachers/parents/schools are making up the rules as we go. But yesterday when I interviewed with TODAY.com about potential choking risks after a 10 year-old needed surgery to remove a piece of a similar spinner from her esophagus, and I later learned the (now, not confirmed story — urban legend aka “fake news?”) tale that a teacher sustained a serious eye injury when one spinner went flying and fell apart. Although the injury is likely theoretic I got to thinking about what to know and how we can parent with the latest craze. The Facebook shares on this story have gone viral with over 700,000 shares and 75,000 comments in the past few days (*update 5/22/17: Facebook link has since been taken down). Clearly, spinners are on many of our minds.

The choking events will hopefully be exceedingly rare, as will the injuries from fidget spinners, but we can think clearly about how to enjoy these silly little objects and not go bananas or have anyone get hurt. Read full post »

Tips for Reducing Hearing Loss From Earbuds And Earphones

I’ve started to use earbuds a lot. Like a lot a lot…like every day. Just like so many other people you see on the street, and many teens, I use earbuds daily to make phone calls, listen to music or podcasts or engage while I stream videos. On the plane, always. And on a bad day or a sad day, no question I love to turn the music way up when I go for a run.

Turns out I’ve got to make some changes. The 60/60 rule has gotta start soon (keeping volume no more than 60%, listening for no more than 60 minutes at a time).

I’m not alone. We’re seeing more and more adults and teens with hearing-loss related to earbud use and loud sounds from digital devices. This problem is growing. Data on how using earphones and earbuds, in particular, they change what we hear, how we hear it, and how the placement of a speaker deeper into your ear can contribute to irreversible hearing loss is worth our attention. Hearing loss from loud sounds isn’t recoverable  — meaning once you damage the little hair cells deep in your ear they don’t grow back — that hearing is lost for good. When it comes to our hearing, we do therefore really matters at any time in our life.

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5 Days of Mindfulness: Day 5 – 3 Beautiful Guided Meditations

It is day five of our 5 Days of Mindfulness series with Dr. Hilary Mead, but remember, you can re-listen to any of these guided practices as many times as you need. Mindfulness is a great technique that can enhance how you, your children and teens cope with pain-related conditions or emotional, behavioral or mental conditions. By teaching them to observe their feelings and thoughts, mindfulness practices can help them slow down their feelings by observing their urges and thinking about them instead of immediately acting on them.

To finish off the week I’m sharing three new guided practices. As with the others, I invite you to do these with your family to help incorporate mindfulness into your everyday routine.

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5 Days of Mindfulness: Day 4 – Guided Meditation Waking Up as a Robot

If you haven’t been able to follow us this week, you’re coming in at a great time as we’re in the middle of a 5 Days of Mindfulness series with Dr. Hilary Mead. The guided meditation below is a paired guide for your mind and your body with movement, meaning you’ll not only be moving your body but you’ll be more conscious about how you’re doing that. This practice was originally developed by John Kabat-Zinn, but Dr. Mead added a twist of being a toy robot that has been on a shelf (think being stiff or the tin man from the Wizard of Oz that needs a little oil in his joints to get going).

This is a great mindfulness practice to do with your kids especially in the morning to help all of you wake up your body and imagination!

We’ll be finishing off our series tomorrow via the Seattle Mama Doc podcast and blog with three new guided imagery and meditation practices. My absolute favorite one (I got so lost in it I was a little transfixed) rounds out the series . There’s a water slide involved….

More from Dr. Mead about mindfulness:

5 Days of Mindfulness: Day 3 – Swinging Meditation

Welcome to day three of our 5 Days of Mindfulness series with Dr. Hilary Mead where she leads a guided imagery of swinging. She is a guru at helping children, teens and their families learn how to incorporate mindfulness and guided meditation into their everyday lives to help cope with the various difficulties of life. Today’s guided practice was created/adapted by Dr. Jim McKeever of Seattle Children’s to help listeners focus on their breathing by imagining they’re on a swing. While on the swing you’ll not only concentrate on each breath, but also on the pause between your inhale and exhale.

Invite your kids to join you as you enjoy your time on the swings!

Learn more about mindfulness from Dr. Mead:

Stay tuned for more podcasts and blog posts as we continue our 5 Days of Mindfulness series.