Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

3 Shots: Protect Against Cancer

It’s 2014 and it’s a reality that you can protect a child, teen or young adult from a cancer-causing virus with a series of just three shots. About 79 million Americans are currently infected with Human Papillomavirus (HPV), a virus that can cause warts but also lead to cancer (anogenital and/or throat cancers). Most data find 14 million new people are infected with the virus every year. Most of the time, HPV enters our body and our immune system gets rid of it on its own, however sometimes HPV causes trouble at the cellular level. Fortunately there’s a safe and effective way to stop the spread of HPV, prevent some strains of the virus from ever causing cellular changes in our body and ultimately prevent the related cancers it triggers: the HPV vaccine.

HPV Vaccine Is Safe

The HPV vaccine isn’t really “new” anymore. Between June 2006-March 2014, approximately 67 million doses of HPV vaccines were distributed. The vaccine is made from one protein from the HPV virus, designed to trigger a protective immune response; the vaccine cannot cause HPV infection or cancer. A recent study by Pediatrics found the HPV vaccine to be not only effective, but long-lasting. The study followed vaccinated girls and boys for eight years and showed evidence of durability; the HPV-antibodies remained at high levels over the years after immunization. Read full post »

Ouchless Flu Vaccine In 2014-2015

Influenza spray finalIt’s Flu “shot” season but thankfully not every vaccine hurts going in. This year your child may be offered either the “flu shot” or the flu nasal spray vaccine (ouchless!). This year most nurses and docs will encourage young children to get a nasal flu spray over the shot as recent data has found the nasal flu vaccine protects younger children better. Every year the flu vaccine is created to protect against influenza viruses predicted to spread and circulate in North America. We need the shot every year for two main reasons:

  1. Typically, different influenza virus circulate around the world from year to year. Over 100 international centers maintain year-round surveillance to determine and predict which strain will cause human infections. The information is used to forecast the recipe for the vaccine here at home. This year the strains (types) of influenza in the shot and nasal spray are the same as last year (2013-2014).
  2. Protection Fades. When you get a flu vaccine you stimulate the immune system to create protection against the strains of the virus in the vaccine. That immunity (the antibodies that are created) tends to fade and wane in your bloodstream after about 6-12 months. Therefore, even if you got the flu vaccine last year you really want your family to have it again this year so it protects you through the winter influenza season which can continue late into the springtime but tends to peak in February or March.

The flu vaccine contains either three (trivalent) or four (quadrivalent) strains of influenza. There is no official recommendation for one over the other. Flu vaccine is recommended for all children over 6 months of age who have no contraindication to the vaccine.

Worth noting: If the thought of needles deters you from getting the vaccine for your child or your family, Live Attenuated Influenza Vaccine (LAIV), a nasal spray, is a great option for those age 2 to 49 years. In fact, there’s data to suggest the nasal flu vaccine is more effective in protecting children from influenza in young childhood. Recommendations this year include a push to have children between 2 and 8 years of age immunized with the nasal spray whenever possible. If the nasal isn’t available, the shot should be given — no reason to wait.

About 20,000 children younger than 5 years old are hospitalized from flu every year  — form CDC “Which Flu Vaccine Should Children 2 to 8 Years Old Get?”

Information about nasal flu spray from CDC, Healthy Children and my “Debunking 5 Myths about the Flu

Who Can Get The Nasal Flu Vaccine?

Read full post »

Digital Parenting: 5 Ways To Compartmentalize

26% of parents say they’ve used media as a distraction when with their children and we all certainly know our own smartphone use may be changing who we are as parents. No question I get cranky with my kids if I’m emailing on my phone and they interrupt me. Just one of many unfortunate realities of having work with us at all times. The more devices I use and the better they become at helping me enjoy life, the more imminent the need for getting serious about the daily calisthenics of doing things without our devices. Remember this article, Don’t Text While Parenting: It Could Make You Cranky ? It is becoming more and more uncomfortable for us to be away from our “phones” as we progressively depend upon them for daily living. I use my phone as a computer, a mail service, an organizer, a calendar, a video camera, an activity tracker, and a GPS every day. Of course I like when it’s around but there is also NO question that the best part of the last week of my life was time when my device wasn’t in arm’s reach…

5 Tips For Compartmentalizing Your Digital Life

  • On a Diet: We parents can model effective “media diets” to help children learn to be selective and thoughtful about compartmentalizing digital tools. I fail at this all the time, slipping into old habits or just “checking something quickly” online when unnecessary. Working on crafting a plan for what I consume and when I consume it, helps. Also thinking about what our children watch and play online/with devices and for how long, helps too. Yes, have movie night but also think about co-viewing programs with your children of any age and spend time discussing values and reactions you have to shows you watch and apps you play together. Be intentional showing your children the things you do to minimize technology interfering with things you love (keeping cell phones out of bedroom, putting cell phone in backseat of the car so you don’t text and drive).

Read full post »

Media Deprivation?

media deprivationMedia deprivation: do you think it exists? Although laughable at first glance I know I’m not the only parent who wonders if limiting screen time could change my child’s opportunity. Those of us who fiercely control screen/device time may have momentary lapses where we wonder if we’re doing things right. Even though I’m convinced there isn’t a study telling us that typically-developing children need media/apps/screen time to learn how to think and evolve into compassionate, successful, and happy adults, part of me wonders if my screen policing isn’t ideal.

Are You Screen-Phobic Parent?

There may be an inverse relationship worth noting: perhaps the more a parent loves technology, the more they see technology’s omnipotence and its invasive, devious elegance. Do those of us who adore technology consequently limit its use at home? Unsure there are data to back this up, however there are some nice anecdotes. Turns out Steve Jobs was a low-tech parent. “We limit how much technology our kids use at home,” he said. In addition, The New York Times reports that Chris Anderson, former editor of Wired Magazine and current CEO of a drone company draws hard lines:

This is rule No. 1: There are no screens in the bedroom. Period. Ever.

The American Academy of Pediatrics guides us that media should be limited (ideally to less than 2 hours daily) and advises us to protect the sanctity of the place our children sleep by keeping screens out. Pediatricians work heroically in the office trying to help families  get a sense of why moderation with media matters and the benefits for making media plans. You’ve probably heard about concocting a “media diet” and ways to reduce screen time, especially before bed. Some of us take it pretty far…our children may go days and weeks without screens while at home. Perhaps its my own technology enthusiasm and unending quest for balance with devices that has me locking up all the tablets and computers at home. In our home the phones, tablets and computer have taken the place of Drano — they’re up and out of reach. Read full post »

Spanking is Hitting Afterall

In my mind it’s no wonder the American Academy of Pediatrics has a statement against spanking. Spanking, in the simplest form, is the act of hitting a child, using physical force to try to get a different outcome. Thing is, spanking is an ineffective discipline tool in the long-run and research shows it’s damaging to a child’s mental health. Most parents don’t want to spank their children and may spank or strike a child while frustrated, making spanking more than just a tool for discipline, rather at times just another way to vent anger or frustration…

I’d say we spend countless hours teaching and modeling behaviors for our children in early childhood to ensure they do the opposite of spanking: we teach them to “use their words,” take “timeouts,” and to take deep breaths when frustrated or when throwing an enormous, inconvenient tantrum. We teach them to look for an adult for support if they need “back-up” during conflict resolution. When an adult turns around and uses physical force and strikes a child, they teach just the opposite. Spanking is hitting and hitting is always avoidable when enmeshed in a conflict.

If that doesn’t seem quite right to you consider it this way: under the US law, when angry or upset about the way things are going in your life the only person you can legally hit in our culture is a child. I’d suggest they are the most vulnerable and voiceless in this regard, the only members of our society with no capacity to change the law (vote). Just this winter lawmakers have argued to allow spanking at home and school that could leave a child bruised in the name of “parental rights.” In the US, you can’t punch or beat up your neighbor, your child’s teacher, your co-worker (assault), thankfully you can’t strike your partner/wife/husband (domestic abuse), and you can’t punch your other relatives (assault). But in many states in our nation, it’s legal to hit your child when they do something you didn’t want them to do. Of note, it’s still lawful to spank a child at school in up to 19 states.

As of 2014, up to 38 countries around the world have banned spanking, outlawing corporal punishment in terms of human rights in a different way from The United States. During an NPR interview yesterday, Professor Elizabeth Gershoff highlighted this in historical context to American opinion on spanking stating, Read full post »

Calling The Shots

Tonight, after President Obama speaks, PBS airs a NOVA documentary about vaccine science and safety. Vaccines: Calling The Shots. It’s told through the parent, pediatrician, and community lens. If you’ve ever wondered about vaccines in America, it’s time to tune in. I’ve been in touch with the team producing this documentary. Seriously excited to hear this story unfold tonight.

(update Sept 11: watch Calling The Shots online)

I think this is a big deal. This is an investigation on the science of vaccines.

The less the disease exists, the safer I am.

It’s a balancing act. The risks happen to be minuscule… the benefits are enormous

If inclined, follow a team of parents, pediatricians, and communities tonight on Twitter while it airs:  #vaccinesNOVA

Enterovirus D68 And Some Old Reminders

girl in mask (1)Widespread news coverage over the last 24 hours has heightened concerns by many parents about a severe-symptom viral infection causing respiratory illness in children, predominately in the Midwest. Over the last month there has been a dramatic up-spike in children hospitalized with severe cold symptoms and wheezing. The virus isn’t new, but its effect on children seems to be. The Centers for Disease Control (CDC) has confirmed tests on children both in Kansas City and Chicago pinpointing the triggering virus as enterovirus D68. The biggest burden of illness has been in the Kansas City and Chicago areas where dozens of children were hospitalized daily, but there are reports of infections documented in about 10 additional states to date. The CDC report issued yesterday detailed data from their investigations

Of the tested and confirmed cases from Kansas City, their ages ranged from 6 weeks to 16 years, with a median of 4 years. Nearly 70 percent of patients had a previous history of asthma or wheezing. Of the Chicago group, ages ranged from 20 months to 15 years with a median of 5 years. Nearly three-quarters had a history of asthma or wheezing.

No question the illness has taken many by surprise as it’s an unusual time of year to see huge numbers of children with cold symptoms with severe wheezing. In areas where the infections started to pop up, schools been in session for a month or more so kids have been doing what they do best, playing in close contact and exchanging germs… Read full post »

Can’t Stop Time

photo (58)I take solace sometimes knowing I can’t stop time. When I look to the clock and trade panic for solace it’s a way to distance myself from the reality that as time marches on in its infinite human construction, I don’t have to think about moments with the boys lost. Every parent hears over and over again that, “it just goes so fast.” I find that advice never helps. Just makes us feel like time with our beloved little humans is slipping through our fingers and I can’t imagine a parent who feels good about that.

My little boy is no longer allowed to be entirely in my grasp as the doors of that big schoolhouse open forever next week. My 5 year-old starts Kindergarten and it’s pretty clear to me that from here forward there will be many forces facilitating his gradual exploration of the world away from our cozy nest.

The solace I mention is real though and it helps me. At moments I can feel the space and peace that comes in knowing I have literally no control over his aging and what it provides — like giving into the wind I can lean into this space and know what a privilege it is to witness this wild ride. It certainly helps that he clearly loves the speed with which life is hurling at him. I see it in moments where he looks at the Kindergarten class list and in the moments where he sticks his right foot out while standing next to his bike and poses as if he’s ready to take a big stage and I feel his thrill as he looks over to his older brother and realizes he finally belongs at the same school. Growing up really is quite a thing to behold.

Being a part of something bigger is a huge part of being human and school is an essential first (or second) step

And although that solace I just mentioned is real I can’t help but tell you that there is certainly a part of me that suffers in these waning summer days. I feel the excitement yes, I lean into the solace yes, but as a working mom I can’t help wonder, “did I do this all right?” Were the last 5 and 1/2 years exactly what I imagined for his time at home preparing for the onslaught of schooling? Was I present, available, ready, and everything I wanted to be? Well, surely not. It’s clear my iPhone got in the way, as did my job, and my ambition to improve children’s health. Thankfully there are ways he shows me he knows he’s got my attention but I can’t help but trip (and fall) sometimes knowing there are infinite ways to raise a child and I do look at those other paths with curiosity.

Today let me tell you this: I’ll hold onto the solace every single moment I see it and I’ll let it mix up with the suffering. I can gently mute the parts of pain that comes with aging and losing the intimacy found between mother and son during toddlerhood and the preschool years. I’ll find that solace when I feel the thrill from peering over the edge of this great big world ahead of him. One thing I know for certain is I’ll enjoy the first moments of Kindergarten next week, too. This little boy of mine is growing up to be a thoughtful, curious, kind, and happy little man. It’s his excitement for the next giant step that will tug me along into September…

Shifting To An Ideal Bedtime For School

We know children are sleeping less now than they did 30 years ago. Our children are unfortunately more tired and can suffer side effects in life because of it. Studies show that school-age children who create a sleep debt (chronic sleep deprivation) and are chronically tired have a more difficult time completing school work, they don’t score as well on tests, they may be more distractible, they can have difficulty maintaining attention, and they may be at higher risk for having an unhealthy weight. Even if your kids have already started school, you can provide a boost for your child’s attention, mood, and health by focusing in on sleep.

Starting out the year with better habits can help everyone at home (ahem, wouldn’t it be nice to avoid late evening battles?). If you’re not already there, think about moving to ideal bedtimes during the next couple of weeks.

How Much Sleep Do Children Need?

Sleep debt is created when we don’t sleep enough — it causes kids to crave “catch-up” sleep like those after-school naps, sleeping in until noon on the weekends, or falling asleep in the carpool on the way home. That being said, each child’s sleep need can be a bit different but in general children need:

  1. sleep needsPreschoolers: 11-12 hours of total sleep
  2. School-age children: 10-11 hours total sleep
  3. 12 year-old to teens: 8 1/2-10 hours total sleep

5 Ways To Support Good Sleep

  • Keep to an 8pm bedtime for young children. Move bedtime back slowly (move it by 30 minutes every 3-5 days) to prime your child for success and avoid battles!
  • 10pm bedtime for children age 12 & up is age-appropriate. More info here.
  • Habits: No screens 1-2 hours prior to bed, no caffeine after school, no food right before bed.
  • Exercise or move 30-60 minutes a day to help kids sleep easier
  • No sleeping with cell phones (create a docking station in the kitchen)
  • Don’t use OTC medications (cough & cold, for example) to knock your kids out and get them to sleep. Using medications that have a side effect of drowsiness can cause sleepiness to extend into daytime which can negatively affect school and sports performance.

Read full post »

Let Them Sleep, Start School Later

Over the past decade mounting evidence finds that teens are chronically sleep deprived and subsequently suffering significant health effects. Chronic sleep deprivation is becoming the norm for our high schoolers and is known to cause both mental and physical health challenges. In fact The National Sleep Foundation found that over 85% of high schoolers aren’t getting the 8-10 hours of sleep they need while over 50% of middle school students are already falling behind in their zzzzz’s.

The evidence is in: teens who don’t get enough sleep can have academic challenges, an increase risk for sleepiness-caused car accidents, inattention, risk for overweight, risk for anxiety, greater use of stimulants like caffeine or prescription medications, and mood disorders.

This is a biology thing not a laziness thing. That teenager who can’t get out of bed until 11am on the weekends is just tired and trying to catch up! Puberty changes all sorts of things in our life, one major biologic shift occurs in the brain as children morph into adults. Around the age of 12, instead of naturally falling asleep at 8 o’clock like children in middle childhood, tweens and teens’ sleep cycle shifts about 2 to 3 hours making it a real challenge to fall asleep prior to 10 or 11pm. That means those teens up and awake until 11pm are really just acting their age.

The causes of sleep loss for teens are complex. Early school start times, use of electronics, smartphones, and tablets interfere with sleep as do homework, extra-curricular activities, and sports. But so do misperceptions — the same research that found over 85% of HS students weren’t getting enough sleep also noted that >70% of parents to those tired teens felt their child was getting enough sleep! We have to make sleep a priority in our homes. Read full post »