Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Vaccination Hesitancy: 4 Myths Explained

Vaccination hesitancy or concern about getting your child their shots isn’t new. But it has recently been gaining attention in the media. In February, Robert Kennedy Jr. offered a $100,000 reward for anyone who could turn up a study showing that it is safe to administer vaccines to children and pregnant women. Let me start by saying that there are countless studies and data in support of vaccination safety. So the offer and claim should be given/received over and over and over again.

I mean, COME ON.

However, with politicians using their platform to blast these fallacies and doubts about vaccination, I worry there is a new sense of unease growing among parents. This unease is causing pediatricians to worry about what’s to come in the coming years for families and their safety.

The below chart from the American Journal of Health Behavior and shared by the American Academy of Pediatrics (AAP) depicting the various types of parents and their responses to vaccinations helps frame up who we are. Even with all of the hoopla in the media, studies have found only 16% of parents are fence-sitters or worriers about immunizations. That means there’s a lot of distortion in the voices that are being heard in these conversations, which is causing “health advocates” and others to question if they should continue moving forward with vaccinating their children.

It’s my job as a pediatrician to make sure you hear the other 84%. The following are 4 of the most common myths that cause parents to worry about vaccinations, and most importantly, why they shouldn’t worry as much with real data to back it up.

Vaccinations Don’t Cause Learning Challenges and Autism

  • We don’t know what causes all of autism, but we do know that vaccines do not cause autism. We know that we pick up on communication challenges and concerns for autism spectrum disorders around the same time toddlers receive various vaccines — thus it’s natural that some have pointed to an erroneous connection. Research has shown this idea not to bear truth.
  • Truly? A select few vaccine villains literally created fear and hysteria that’s hard for many to forget. But let me be clear — this didn’t come from validated work. The idea that vaccinations cause autism gained international momentum after by Andrew Wakefield who authored a falsified report with a fraudulent claim. Since then he has lost his medical license (he’s not able to practice medicine) and the original report he authored has removed/retracted from publication. The study literally does not even exist anymore because it wasn’t fact-based.
  • There is a myth that thimerosal in the MMR shot causes causes autism. The truth? Thimerosal was NEVER an ingredient in the shot. Furthermore, the number of children with autism has continued to grow even after thimerosal was removed from childhood vaccines.
  • A 2011 report from The Institute of Medicine analyzed over 1,000 studies on adverse side effects from vaccines. They concluded, “the evidence shows there are no links between immunization and some serious conditions that have raised concerns, including Type 1 diabetes and autism.”

No Benefit In Delay of Immunizations Or Delayed Schedules

  • There is not a single scientific study in academic medicine showing that it’s safer to space out vaccinations. There isn’t a single study saying a delayed schedule provides any health benefit or reduction in side effects.
  • No matter when your child receives their vaccine there is the potential for side effects including rash or fever. Waiting does not decrease risk. Waiting only increases risk by leaving a child unprotected.
  • A 2016 AAP survey of pediatricians found that there is a growing number of pediatricians encountering parents who refuse vaccines (87% of pediatricians surveyed in 2013 compared to 75% in 2006). However, in both 2006 and 2013, pediatricians reported that they were able to convince approximately 30% of parents to vaccinate their children when they initially refused, after educational efforts. So partnering with your pediatrician for the facts helps.

Your Choice To Not Vaccinate Affects More Than Your Children

  • This is complicated (and controversial to some), but many parent’s believe vaccination decisions are their right and their liberty — to vaccinate their children is their decision. But not everyone agrees. Some believe vaccines are for individuals but also for communities. Vaccines are different from other medical decisions, in that making decisions about medicine or surgery only affect your child, but opting out of vaccinations changes the safety and risk of a population. Vaccinations give your child an army of defense to fight off illness decreasing the chances of them getting an illness. At the same time, it is also decreasing the chances of them becoming ill and sharing an illness with someone else. That’s where having everyone becomes a public health interest.
  • In Mississippi, West Virginia, and California there are no longer religious or philosophic exemption from vaccines for children that go to school. Rates of protected children in those states increased after exemptios were disallowed. Since getting rid of religious and philosophic exemptions in California in the past year, the number of children protected from vaccines is increasing in the state of California since this went into affect translating to a safer school systems for California children. Vaccination rates for California kindergartners have never been higher.

Ingredients In Immunizations Do Not Hurt Children

  • The CDC and FDA take many steps to make sure vaccines are very safe. Vaccines go through rigorous testing and monitoring – we know more about vaccines than we do food safety and medicine safety!
  • There’s a misunderstanding why and how much ingredients are in vaccines.
    • Thimerosal – Thimerosal is only found in multi-dose flu vaccinations for older children and adults. Research finds thimerosal does not cause autism or other developmental challenges.
    • Formaldehyde – Commonly thought of as a preservative, formaldehyde actually makes vaccines safer. Formaldehyde acts to protect the individual so the virus and particles of that dead flu virus used in the vaccine doesn’t cause the flu. Additionally, the amount of this ingredient found in vaccines is minuscule compared to the amount in the foods you eat.
    • Aluminum – Similarly, the amount of aluminum found in vaccines is minuscule compared to amount your child gets when playing in the dirt on Planet Earth or eating some foods.
    • Mercury – The amount of mercury in vaccines so small that is is cleared from the body in 1-2 weeks. It doesn’t stick around.

No matter where you land in the above chart, never worry about talking to your pediatrician about your concerns – ask them your questions and share what worries you. Pediatricians and family doctors, nurse practitioners and school nurses want to be your partner and support as you raise your child. Also, go get that $100,000! You deserve it.

Resources:

Mindfulness With Children And Teens

Cultivating mindfulness is clearly a concept all of us want to improve while parenting. Good news is there are ways to incorporate strategies that are mindful in every day activities; being mindful might be easier than it seems and it’s less “way out there” and voo-doo than it seems at first glance, as well. The practice of mindfulness isn’t just for the kale-eating-uber-natural-super-zen families — this, in fact, is for us all.

Mindfulness: paying attention in this moment, non-judgmentally.

Honing focus and taking in the luxuries of raising children is a daily treasure. But living mindfully, intentionally, and without judgment — right in the present moment — is a simple concept and yet hard to practice every day. Luckily, I had Dr. Hilary Mead, a child clinical psychologist in Outpatient Psychiatry and Behavioral Medicine at Seattle Children’s Hospital talk through what we know about mindfulness in pediatrics and in children, how we use it specifically to boost mental health, and when it can be implemented easily into our everyday lives. She’s a pro at supporting children and teens, and their parents, in incorporating mindful practices into life.

There isn’t really failing at mindfulness — Dr. Hilary Mead

This podcast is really good. Really….I suggest you listen to Dr. Mead….I just loved what she taught me and how she guides mindfulness.

What Is Being Mindful?

  • Being in the moment you’re in, aware, accepting and non-judgmental of yourself and relationships. So even if you’re in a moment you don’t like, you stay in the moment with your mind and thoughts.
  • Being mindful can be observing when you’re having a thought that’s moving you away from the present and re-directing your thinking back to what you’re doing, who you are with, what you’re working on – Dr. Mead describes these as “anchors to the present moment.” We expect your mind to move about — you’re not failing when you do. Being aware of what’s happening is key.
  • Being mindful can also be a freedom to express in a non-judgmental manner both positive and negative experiences and emotion. Mindfulness isn’t oppressing one idea for another but it’s also not critical, per se. It’s continually accepting. Think of it this way: if you’re thinking on a hard day filled with sadness you can feel akin to, “being sad is awful” — and this is a judgement. However, reframing this into presence and into a mindful practice you can move to, “I don’t like feeling sad” can help acknowledge where you are. Dr. Mead coaches that just doing more of this is being mindful.

Mindfulness For Children And Teen Health:

  • Learning mindfulness techniques can enhance the tools children and teens have to cope with pain-related conditions or emotional, behavioral or mental conditions. This includes depression, panic disorders or trauma. Children can be trained by psychologists on using mindfulness to boost mood and improve coping. And gain a sense of control over their experiences with mental challenges.
  • Teaching children and teens to observe their feelings and thoughts to try and help them slow down their feelings by observing their urges and thinking about them instead of immediately acting on them.

In preparing for this podcast, I reviewed the 2016 American Academy of Pediatrics (AAP) report on mindfulness and fell in love with the idea that:

Children are very capable of engaging in self-care skills such as mind-body therapies, and there are many mind-body skills that kids and adolescents can learn and apply throughout life.

4 Quick Ideas For Mindfulness In Everyday Life:

  • Formal Practice: The most popular/known are meditation and yoga. There’s also mindful eating (paying attention to what you’re eating when you’re eating it), mindful walking, mindfully playing with your child, even paying attention to your feet while waiting in line at grocery store. Plenty of apps and classes to join to help with this and I’d love if you’d share your recommendations in the comments.
  • Meditation: Consider trying the app Zen Friend or Headspace and thinking on introducing meditation to your children. Length of time and frequency of meditating can vary for different people and different practices. But, pediatricians typically recommend:
    • Preschool children: A few minutes per day.
    • School-age children: 3-10 minutes twice a day.
    • Teens and adults: 5-45 minutes per day or more based on preference.
  • Label emotions you and your children and teen feel – research shows that being aware of how you’re feeling and acknowledging it, ideally without judgment, (like saying “I’m feeling sad”) helps in acceptance of the emotion and moving past it.
  • Don’t judge your judgments. Start with that. Ohhhhh, how hard it is to avoid this!

I highly recommend taking some time to fully participate in listening to the podcast and practicing mindfulness with us. Then share it with your children and teens. Even if your mind wanders (mine did and DOES), Dr. Mead says it’s ok and that “wandering is a part of it. Mindfulness is knowing it happened.” There’s no failing when it comes to being mindful. How refreshing is that?

Dr. Mead Is Coming Back For More! We asked her to come back and record more on mindfulness and guided practices. Stay tuned (and follow the Seattle Mama Doc podcast so you don’t miss it) as there will be more from Dr. Mead in May! We’re planning a 5-day quick mindfulness series I’ll share here on the blog and in the podcast.

If you work at Seattle Children’s or live in Seattle, we’ll be highlighting some of the resources on mindfulness and behavioral health (I’ll be there!) at the Seattle Children’s Mental Wellness Fair:

  • When: Thursday, May 4 from 11:30 a.m. to 1:00 p.m.
  • Where: Seattle Children’s Hospital – 4800 Sand Point Way NE in the Ocean Cafeteria (Level 7)
  • What: FREE event bringing the community together to tackle the stigma of mental health and learn about the importance of mental wellness. More information.

Mindfulness Resources

Getting Out Of Town With Children: Anchors of Happiness

Spring has sprung (hurrah!) and summertime is oddly just a couple of months off. A co-worker reminded me this week that school is out in 2 months. What?

As the rituals of summer near I’m reminded of the power and value in creating memories that break the mold of routine. Trips, time away, adventure, and creating a sense that the world is truly as big as it is. This starts and gains value right from home at the kitchen counter…

Recently, I’ve seen a series of online parenting articles about how family vacations throughout childhood are “anchors of happiness.” That they make and enhance a child’s life. At first glance it seems like pressure. It’s just been Spring Break, or is this week for you, and the pressures of watching families on Facebook fly off to Aruba are real… But I think there is something more essential to talk about here. Not the need or want to plan a luxury vacation, but the pristine opportunity to think on and prioritize exploration with our children. Clearly children notice and in my heart I know it’s meaningful.

The simple exercise of moving around our city or county or state or country or continent to different places with our children, during breaks from school and work, is magic. From planning a trip with your children to taking an actual vacation, there are a lot of data driven benefits – enjoyment (joy!), memory-making, cultural exposure and simple protected time away from school and work together to reflect on what matters.

In one article I read about family-vacationing, I saw this:

  • Only 25% of kids say they talk to their parents about something of great importance to them in a weeks time

Ohhhhhh, no! I decided to vet the above data with my 10 year-old. Puffed up with great pride that just in the last week I’d brought up the temperature of space, talked about the implications of a recent political scandal, worked on his school project together and generally been a stimulating conversation partner and “master mom” I said, “do you think we talk about things of great importance every week?” He paused and said, “No, I don’t think so.”

OH, no. Gotta get out of Dodge… Read full post »

I Like The Film Alike, A lot

Many of us struggle knowing which pitch or tenor to take in balancing the responsibilities, rigors and rule-following of regular school and work-life with the need to extend boundaries to live with our children in poetic, artful ways. How and when to comply, and how and when and why we sometimes don’t want to. It’s ultimately tricky and nuanced, yet the opportunity to live in color is just so profound.

Life is precious and unpredictable.

Thing is, sometimes we just miss the moment with our children. Sometimes we really are too demanding, too rigid, perhaps too purposeful. At least I know I am and can be. When I realize I’ve been blunted or on-task in ways that separate me from my children’s mindfulness or creativity or I’ve stunted my children in any way, it can feel a tiny bit like despair. Like a big, juicy #momfail.

I must say, I like Alike, a lot. This sweet film embodies the pulse of the challenge in living mindfully and playfully with children and the immensity of its import in daily life. There is a moment in this film that feels as tremendous as the love we feel for our children in real life. I cried witnessing it.

Everyone is born creative. Creativity can be especially fluid and accessible during childhood (some experts and parents and teachers and artists, of course, worry we work creativity “out” of children as they grow with our schooling structure and rigidity). Thankfully, children often get to live days that make space for the creative process and the exploration and silliness so wonderful in being alive that we stop making space for as we “grow up.”

Although this beautiful short film doesn’t offer any answers it moved me immensely.

I’ve been reflecting on mistakes I’ve made (ohhhhhhh, parenting is so tough!) but it also brewed a sense of optimism in me. I saw a glimpse of the big huge opportunity illuminated in each new day that unfolds. Enjoy, enjoy!

 

New Data On Preventing The Flu And Whooping Cough

Many of us have probably experienced influenza (the flu) at some point. Sometimes we really know it, sometimes we don’t. Previous data has even found that in a typical influenza season (winter) as many as 10-40% of all children get exposed or actually get influenza in a given year.

Sometimes the infection from influenza is mild (“just a cold”) but sometimes it’s a horrific long-lasting-high-fever-achy-pneumonia-hospital-causing infection. Sometimes it’s worse. Hard to predict why we all don’t experience the same virus the same way each time we’re exposed.

Those under age 5 and those over 65 years of age are at highest risk from influenza. The reason: young children have an unexposed, immature immune system that doesn’t work as well fighting against influenza as a 12 year-old where as the elderly have a tired immune system that just doesn’t work as well as it did during young adulthood. Each year children die from the flu that could have been prevented. The flu vaccine isn’t perfect in protection, and this year it’s got about a 50% chance of totally protecting you — far better than 0% when you don’t get it at all!

New data out proves that flu vaccine helps prevent death in children. News any mom or parent or pediatrician wants to hear and share.

For infants and elders, the flu can be deadly. For new babies, pertussis (whooping cough) can be, too. The good news is that these illnesses are vaccine-preventable. This post is just a reminder of the power of vaccines to prevent pain and suffering and new data that continues to support our use of whooping cough shots during pregnancy for moms and babies and flu vaccines for children every year.

Two studies from the American Academy of Pediatrics (AAP) highlight just this by establishing vaccine effectiveness for reducing death and serious infection. Take these as reminders of why we vaccinate our children and ourselves! Read full post »

How Genetic Technologies May Change How We Approach Parenthood

Seattle writer Bonnie Rochman has a new, smartypants book on genetic testing. It’s not a “how-to,” per se, rather a storytelling look and near confessional at how confusing it can feel when you’re pregnant (or plan to be) and faced with the marketplace of ideas and opportunities for knowing more from genetic testing. Simply put, she articulates the quandary nestled in the “to know” or “not to know” more about your expected baby, genetically speaking.

In the book (and the podcast and TV seg she joined me for —  included below) Bonnie talks of her own journey as a mom but also interviews researchers, geneticists, families, expecting parents, and ethicists along the way. It’s researched; the pages of notes and references at the end could overwhelm, if you let them. Thankfully, the book reads like a story and yet Bonnie doesn’t shy away from complex ethical spider webs like the implications (for some) in getting tested for fatal diseases and the option to enter the abortion debate. More than anything, Bonnie takes on the reality that when it comes to prenatal genetic testing, the tests themselves, the official guidance, and the technology itself is moving faster than our public and medical understanding…

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5 Things That Confirm You’re A Master Parent

After I published my book Mama Doc Medicine, I toyed around with the idea of writing tiny little books inspired by a favorite short story publication, One Story. Literally I was thinking that the way to consume ideas about parenthood was not in book form but in pamphlet-sized publications on parenthood, vaccines, & general tips for feeling awesome while raising children. I haven’t entirely tanked the idea (please weigh in if you think you’d read them!) but it’s not at the top of my to-do list. That being said, I realized after publishing years of blogs and a whole book of stories about my boys and science and parenting and the general overwhelm we all feel, that I could have perhaps just published 5 tips in 5 pamphlets! Sure would have saved time…

Thing is, in my opinion, if you do these 5 things, you’re wildly decreasing the likelihood of death for your child and pretty much preforming at the top 99%, parenthood-wise. All the rest is gravy. As a mom and pediatrician, I think if you do these things well you should feel like a ROCK STAR. The rest of what we all read about is a smattering of parenting “style” advice. There will continue to be books on grit and food selection and poop and sleep forever. And reading up on new ideas and new data can be great ways to bolster our confidence. But really, I’m saying, do these 5 things out of love and with ongoing daily respect for who your child is as an individual, and I think you’ll be a master.

This is the cousin to my recent “5 Things To Stop Worrying About” blog. In my mind, there are 5 non-negotiable pediatric parenting must-dos. If you can make these things a top priority, you’re pretty much nailing it. Congrats. Check this off on your life list as an awesome new start to spring. Listen to the podcast, please but little notes about it are below, too. Love up your children and love up yourself for doing all of this so well!

Read full post »

Tongue-Tie And Breastfeeding: What To Do For Babies With Tongue-Tie

Image c/o Mayo Clinic

Tongue-tie is a condition in which an unusually short, thick or tight band of tissue (frenulum) tethers the bottom of the tongue’s tip to the floor of the mouth. Often it goes unnoticed and causes no problems in life but rarely it can affect how a child eats and how they sound when they speak, and can sometimes interfere with breastfeeding because baby’s tongue may not have enough range of motion to attach to the breast, suck and swallow effectively. Sometimes tongue-tied babies can’t maintain a latch for long enough to take in a full feeding, and others remain attached to the breast for long periods of time without taking in enough milk. Sometimes babies with tight frenulums make it miserable for mom to feed because of the way they attach and latch. When a newborn has a tight frenulum breastfeeding moms may have nipple pain, mom may hear clicking sound while the baby feeds, or mom may feel it’s inefficient. Sometimes a parent will notice a heart shape to the tip of the tongue as the band of tissue pulls on the tongue where it’s attached.

What to do about tongue-tie can be controversial. Not all pediatricians, Ear, Nose and Throat surgeons, lactation consultants and occupational therapists always agree. However, every baby deserves the chance to be evaluated by both a physician and a board certified lactation consultant if there is concern! Awareness about a newborn’s challenges with breastfeeding increases diagnosis in the newborn period but decisions to clip a tongue-tie come about from a variety of factors. The American Academy of Pediatrics states: “surgery, called frenotomy, should be considered if the tongue-tie appears to restrict tongue movement, such as inability to latch on with breastfeeding. It is a simple, safe, and effective procedure—general anesthesia is not required.” It takes only a few seconds and many pediatricians can perform the clip in their office.

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International Women’s Day: Boys, Listen Up

Happy International Women’s Day!

I’m squarely in mid-life, 42 years old, a mom to two, no longer a “young” doctor or young entrepreneur or young voice. Perhaps because of that, I’m starting to see things differently when it comes to raising boys and girls to support equality.

I’m a feminist. I think that means I don’t want gender/sex to get in the way of any individual. I was raised with a mom and dad who didn’t present a world of possibilities different for me than the one they presented for my brother. At least not that I could see. I’ve been mentored, supported, encouraged, and nurtured as a woman in the workplace, and a mother in my community, by female mentors like my mom and my advisor in college (a professor of psychology who studies gender), current and past colleagues, advisors, employers and co-workers, and dear friends. But more than ever before I’m feeling the profound support I’ve had from men in my life to be an active, striving-for-equal opportunity physician and advocate. In some ways it’s easier for me because I have the fortune to work as a physician in pediatrics, a field of physicians with a majority of women. In fact, 3/4 of the pediatric resident physicians in the US are women. It’s complicated though, so if interest consider reading, “The Good and Bad Statistics On Women In Medicine.”

However, now more than ever,

I’m starting to feel it isn’t my voice that will make things better for equal rights at large as time unfolds, it’s the voice of my boys.

Obviously this isn’t only about women supporting women. My strongest and perhaps most loyal advisors during my medical school education and during my residency training were both men who have helped me see and also helped me strategically carve out ways to get work done while also having children. I’d describe my residency mentor as one of the biggest feminists I’ve ever known. His feminism and support for me persist in my work and life. Exhibit A: I posted a photo in my pink hat on the day of the Women’s March in January and he was the first to comment saying, “I’m with you, Wendy.” He’s 40 years my senior and carries with him an elegant view of different ways to contribute to pediatric health care and also enjoy raising children of my own. Circa 2005, I vividly remember him drawing out, on a napkin, the different kind of career trajectories one could have in pediatrics and public health, describing them in terms of typical gender norms and roles and stating that I could do this — this career and life — any way that fit with my ethos, energy, passion, and tempo. I could adapt a “male” trajectory or a historically “female” one but that all models could work for all people.

Boys and men in my life do show me also how much they include me. Of course, I’ve felt discrimination, too. But this post isn’t about that. It’s about the BIG opportunity of NOW. Read full post »

Perhaps The Most Marvelous Time To Be A Parent

This week I awoke to realize this may be a marvelous time to be a parent. I mean this time, the one where political divisions run rampant, where protests and rallies have become the norm, where known science is questioned, and where we seem to be facing threats to our inequalities and our justice head on.

My boys have their eyes wide open.

Early Thursday morning I flew home from a speaking event in Oregon. I was a little bit exhausted and only had about 15 minutes to swing through my house prior to heading to the hospital for some meetings and an afternoon of podcasting. When I walked into the kitchen I found a little tube waiting for me on the kitchen counter. Our poster had arrived! Thrill coursed through me as I uncurled it and ran to the front yard.

It’s the sign you see here now gracing our front yard. It’s the sign I picked out with my boys a couple weeks ago online after a friend shared the one she’d put up. It’s the one the boys and I selected because of the poetry we felt it held, but also the power that lifted from it. In this house we have no interest in hiding how we feel. The boys have watched the pink hats get knit, the signs being painted, and the work to continue to protect our neighbors, friends, immigrants, and family of the United States that we hold so dear.

And so it was not just the platter of ideas that embody respect, liberty, and truths on this little sign that I got excited about it. It’s my boys own insight that unfolded Thursday — without me — that has me sharing here. Their pledge to the world, too.

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