Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Move The Clock: 30 Minutes For 3 Days

clock - daylight savingThe end of daylight saving time is upon us…in fact today is the day you want to think about it most if you have children in your house. Here’s why: prepping for the transition may save you some pain, and some sleep. Although a one-hour shift in time may not seem a big deal to adults, many of us with young children have learned the hard way that this transition isn’t as easy for toddlers and young children — often “falling back” doesn’t equate to an extra hour of sleep on Sunday morning. Some things in life are definitely NOT guaranteed during parenthood.

Dr. Maida Chen, director of the Pediatric Sleep Center here at Seattle Children’s says it perfectly. “The first thing to know is that younger children, especially, are not going to budge their ‘body clocks’ just because the time on the clock face changes.  As a parent, be prepared for an earlier morning start on Sunday and Monday.”

Can 30 Minutes Make A Difference?

Would cutting the difference help (i.e prepping for the 1-hour shift in advance)? Well, I think so, especially after consulting some sleep experts. Enter Dr. Maida Chen again, my friend and sleep expert (ahem, and Power Mama of 3) and Dr. Craig Canapari, a sleep expert, father and blogger out East. Dr. Canapari suggests cutting the difference and softening the change by moving your child’s sleep period later by 30 minutes for three days before “falling back.” That means today (Thursday) is the day to start thinking about it. This way you’ll get them 1/2 way to the time change and making going to bed at the “new time” easier. For example, if bedtime is 8pm now, move bedtime tonight and for the next three nights to 8:30pm (that’s the new 7:30 starting on Sunday).

4 Things To Remember When Changing The Clocks With Kids:

    1. Nighttime: Most kids adjust within a few days, but if you start today and prep them for the time change, Monday morning will potentially not be so painful. However, still be prepared for an early morning wake-up Sunday and Monday. Children don’t “sleep in” like we’d appreciate when we change the clock back.
    2. Daytime: Try to keep daytime schedules the same on Sunday. Dr. Chen suggests, “If lunch is usually eaten at noon, which on new clock time would be 11, try to push it out to 11:15, 11:30, etc. Meals are pretty big cues. Be prepared to distract your kids or have an activity planned so that the focus is not, “WHERE IS LUNCH?”
    3. Light: Use light to your advantage. Consider a timed nightlight or wake light and get outside every day (natural light from even cloudy days helps regulate circadian schedules) for the next 7 days.
    4. Smoke: Check the batteries in your smoke detectors, too! As a public health reminder, this is the perfect moment to make sure those batteries work and your family will be alerted all year long if there’s a fire in the home.

Does Your Child Need A Daily Multivitamin?

There’s a decent amount of confusion when it comes to the decision to give our children vitamins and supplements. Store shelves (real or virtual) are filled with tinctures and gummies marketed towards children. And you’ve likely heard that, in general, pediatricians don’t recommend vitamins for children who eat a “normal” diet. There are exceptions to every rule (see below, especially as it pertains to vitamin D) but the bottom line is that supplemental multi-vitamins are not an essential part of a child’s diet. If your child eats a rainbow of foods, it’s unlikely they need pile of additional minerals and vitamins in pill form.

4 Things To Know About Children And Vitamins

Read full post »

Perhaps Not Intuitive? Car Seat Use From Day One

car seatNew data presented at the recent American Academy of Pediatrics meeting found 93% of parents to newborns incorrectly positioned and buckled their infants into their car seat on their first trip home. A little more proof that perfectly buckling a car seat isn’t an innate early-parenting skill! Even Prince George’s royal family didn’t get it right. I’m certain I didn’t do this perfectly either on our maiden voyage home (I remember using a zip-in blanket in the seat) nearly 8 years ago. As The Car Seat Lady reminds, “products that have a layer that goes under the baby’s body can make the baby unsafe. This is true even if the product is designed with slots for the harness straps to fit through.” Most of us clearly mess this up and although the first trip is just one trip, it may be emblematic of our everyday use.

Car seats and booster seats are important for child safety; our habits for their use begin the moment we leave the hospital or birthing center. Although those “bucket” infant car seats are safest (we’d all be safer in the car facing the rear, and in a bucket) we move away from them when our infants are around 9-12 months of age. But do remember, with every graduation to a new seat, you decrease protection. For example, when you move from a a rear-facing infant seat —> rear-facing carseat—>forward-facing carseat—>booster seat—>seat belt—>front seat at age 13,  each time you advance the child safety seat, you’re decreasing protection you provide. Don’t rush the transition! Keep your child rear-facing until at least age 2 years and in a booster until they are at least 4 foot 9 inches (57 inches) tall.

The No-Duh Importance Of Car Seats

  • Car crashes are the leading cause of death for children in the US. Creating safe habits from day one matters…don’t blow off importance of car seat safety as helicopter parenting. Using the child car seat well every time is an easy way to layer protection and channel your bursting baby love.
  • Infant car seats, rear-facing seats and boosters all hold equal import. Only two states require car or booster seats until age 8 (WA is not one of them) even though children should be in booster seats until they are both 4 foot 9 inches and between age 8 and 12 years.
  •  Car seats reduce risk of death by 71% for infants and 54% for toddlers if used properly: “Results of several studies have indicated that misused child safety seats may increase a child’s risk of serious injury in a crash.” (Page 9)

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On Being Mortal At 40

Screen Shot 2014-10-24 at 10.13.56 AMI felt very much alive reading Dr. Atul Gawande’s new book, Being Mortal. Not because I have a sense of youthful immortality, but because stuck here in the sandwich generation I’m feeling a bit caught in-between — feeling simultaneously mortal and then very alive. In my mind this has a little bit to do with turning 40, a bit to do with the gift of raising young children, and a whole lot more to do with a year of losing people I love. Over the last 11 months I feel like my soul has aged by a decade as people I’ve loved and held onto have passed away. When dealing with death some hours can feel far more centurion than any others we can remember.

Gawande’s words granted some space to reflect on both my profession and my role as a parent, wife, daughter, sister, relative and friend. There’s a balanced vulnerability woven throughout the book that facilitates our joining into his stories as peers. And although the book begins notably academic, it accelerates into a rich narrative of love, endurance, small failures and singular courage. In its essence, Being Mortal is about one man’s journey loving his family, caring for patients, discovering inadequacies in his profession and interrogating the options afforded us all in living our lives with intention.

As a true “middle-ager,” sitting with these words felt to me a bit like peering over a vast, newly frozen Great Lake. Imagine letting your eyes move from left to right, looking out at the cracks in the ice and swirling snow as you capture the enormity of the expanse and what lies in front of you. But remember that this Great Lake is enormous, as big as the potential space of the lives in front of us. The words in Being Mortal can feel like a nudge. It’s as if while looking out from the shores of that frozen lake you hear someone whisper, “ Why, yes, it’s only been frozen overnight, but please just get up and run across it, Girl.” And you will, never knowing just when you’ll fall in. Read full post »

Becoming an Impatient Optimist, One Mother’s Words

Alok post photo


Today’s post is written by Dr Alok Patel, a third year resident at Seattle Children’s. I met him last year as he immersed himself in training. Since then we’ve been syncing up, learning together about ways he can use his voice, his teeming passion, and his media channels to improve the health of populations everywhere. He’s peppered with ideas, brimming with ent
husiasm (it’s possible he speaks faster than I do) and diligently working to carve out his path as a public advocate, storyteller, and pediatrician. He’s a self-described, “wannabe medical journalist [working] to bridge the gap between public health and everyday.” He’ll finish his training this summer and begin his career officially; I suspect we’ll hear lots from him. In the past year we’ve both attended powerful social media summits at The Gates Foundation. And we’ve both stepped away inspired to do more. Dr Patel is starting to tell his stories publicly. Take a peek at his story below – the final quote left me slightly breathless… 

Turn on the news these days and it’s easy to feel like the world is falling apart. Globally, people are suffering from different diseases and even though public health officials are making great strides internationally, I often find my self wondering “what can I do to help?” And then I get overwhelmed by the idea of where to start.

Last month I had the opportunity to attend the Gates Social on Science Innovation, a workshop that unites people with two common interests, a love for social media and desire to enhance global health. Surrounded by “impatient optimists,” a software engineer, film director, marine biologist and elementary school teacher I was struck by the fact that we all have innovative ideas… and we all need help getting them off the ground.

I can’t speak for the other attendees, but my “awakening” of sorts took place during a presentation of New York Times Columnist, Nicholas Kristof. He was discussing the variety of stories he’s told, from the harsh realities of child prostitution, to the innovative games that are teaching anti-parasite practices on your phone. Then he said something that really resonated with me. Read full post »

Marijuana Mixer: Teen Use, Child Ingestion

Washington Poison Center http://www.wapc.org/wp-content/uploads/WAPC-Toxic-Trends-Report-Cannabis-September.pdf

Washington Poison Center http://bit.ly/1xT8PeJ

The 2nd recreational pot store opened in Washington State recently while store #3 opens later this week. Pace will quicken with several more stores expected to open by year-end. This puts parents and pediatricians in our state in a unique situation (shared only with Colorado) as we’re tasked to explain to children and teens the dangers of legalized drugs used by adults. However, the complexity extends even to those of us with young children. Growing concern (and evidence) finds accidental ingestion of pot among children, often in the form of edibles, is also accelerating. Online in social channels I’ve heard some argue that marijuana legalization is to be thought of like alcohol but the packaging and delivery of the drug really are far different.

Marijuana Use By Teens Still Illegal Yet Common

  • Nearly half of all teens have tried pot by the time they finish high school while almost 1/4 of all high school students report having used marijuana in the past month. That’s pretty common.
  • 35 different marijuana-infused food & beverages have been approved by WSLCB  (cookies, trail mix, peanut brittle, gummy bears, and chocolate bars for example). Often the packaging for these products looks as attractive as a fruit roll-up or delicious candy bar typically marketed to children.
  • There have been 68 pediatric marijuana exposures voluntarily reported to Washington State poison control already this year. Because reporting isn’t mandatory this is potentially an underestimate of the number of children exposed to marijuana accidentally.

Read full post »

Malala, Malala, Malala! A Child Wins The Nobel Peace Prize

Photo: Claude Truong-Ngoc/Wikimedia Commons

Photo: Claude Truong-Ngoc/Wikimedia Commons

Malala, Malala, Malala – this is a historic day! A child has just won the Nobel Peace Prize! Our heroine, Malala Yousafzai, has been awarded the Nobel Peace Prize. She shares the prize with Kailash Satyarthi. Children and parents everywhere on planet earth have a perfect bedtime story. The youngest ever recipient of the prize goes to a girl born and raised in Pakistan who was denied equal access to her education. I mean, really, whenever you think your child’s potential is bounded or someone in the community minimizes the importance of your child’s ideas or implies that their potential is truncated by their age, limited by their perspective, or premature because of their experience, we have a new story to tell. We have an extraordinary antidote to those who treat children as lesser citizens of the world.

Malala Yousafzai.

Malala, you amaze us and you open up doors for little girls and little boys everywhere. Parents and pediatricians can and will share the news with young children and teens who falter.

First off, don’t let her globe-trotting-book-writing-media-circus attention fool you into thinking she’s an adult. She found out about her Nobel while in class, a place where all the other 17 year-olds in our country get the opportunity to sit…

Malala has leveraged her skills as a brilliant communicator and wed it to the courage of a champion to change the world’s understandings and opportunities. We are all so lucky.

Quick Facts For Your Family About Malala Yousafzai:

  • Malala and her father report that part of her success is based on the reality that her “wings were not clipped.” More from her dad in this popular TEDtalk.
  • Malala is a world leader. Read Amy Davidson’s New Yorker article from earlier today as a reminder of her influence — note Davidson saying, “It is past time to stop seeing Malala as simply the girl who survived, as a symbol. (The Times called her a ‘global emblem.’) She is a girl who leads: who addressed the United Nations on her sixteenth birthday; who amazes Jon Stewart and asks Barack Obama about drones.”  Watch her interview on Jon Stewart for examples of her unflappable courage and determination.

Age-Appropriate Malala Bedtime Stories:

Age 2-5: There once was a little girl loved to go to school. But one day the rules changed where she lived and she was unable to Read full post »

Teens And Medicine Abuse, A Bad Rap?

OTC med abuse

infographic from OTCsafety

I’ve been lucky enough to interact with teens on a regular basis for my entire career. As a previous middle and junior high school teacher, people often express pity when they hear I taught middle-school, as if teens are “too” tough, histrionic, and irresponsible to have wanted the job. I really did want the job. I love the drama and rate of change during adolescence. In my experience I see teens take on huge responsibility, make good choices, care deeply about their family and friends, and work diligently to improve their world. Their interest and work on evolving into an ideal self is captivating. Most teens are highly motivated. Many are over-extended because they are so committed. Lazy teens just aren’t the norm…

Sometimes teens get a bad rap. Sometimes they make choices without thinking of the consequences too. That’s normal when you’re still developing. Those mistakes pave the road of opportunity for us to give teens information that keeps them safe.

October is a lot of things (more on that this month) but know it’s National Medicine Abuse Awareness Month and there’s a big push to both educate parents on signs of over-the-counter (OTC) medicine abuse and encourage parents to talk with teens about the risks of using medications as recreational drugs.

Thing is, approximately 1 in 25 teens reports abusing excessive amounts of Dextromethorphan (DXM) to get high. DXM is a safe ingredient found in more than 100 OTC medicines. It’s typically found in cough suppressants or medicines for cough and colds. Because it’s a stimulant, when DXM is consumed in excess it can cause a rapid heart beat, vomiting, stomach pain, hallucinations, confusion, and loss of motor control. It also can induce a high — hence why teens experiment with it.

1 in 3 teens know someone who has abused OTC cough medicine to get high. Consider asking at home what your kids know. Read full post »

Deliberate Ambiguity

Deliberate ambiguity

I was at Back-To-School night this week at my boys’ school. Heard something I’m still thinking on. One of the teachers talked about how students are introduced to technology in the school house. She detailed how her philosophies helped shape their evolving understanding of, skills with, and opportunities with computers, code, and digital tools. She discussed her opacity with instructions as just one way to help develop grit. She said,

 

 

 

I use deliberate ambiguity. I want to make it a bit of mystery getting from point A to point B…

In ways, this is our job as parents in rearing independent children. Strike through childhood with deliberate ambiguity and provide a sense of mystery each day. With it, we can prime opportunity for our children to discover and stumble upon a sense of mastery. We can vilify technology in our children’s lives or we can facilitate our children’s use of new tools for expression and creativity. But deliberate ambiguity? That’s genius that we can apply in all sorts of places in our children’s lives.

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 »