Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Hot Days: Why Children Are At Particular Risk

Hiking on a hot dayEven here in the cool Pacific Northwest the summer months can send temperatures soaring into the 80’s, 90’s and 100’s. Hot for any average adult, but potentially even more dangerous for young children. Our country is currently experiencing rolling heat waves. Thing is, children heat up faster than adults (five times faster) because they have fewer sweat glands, their body-to-surface ratio is different (their sweating would never do as much good) and this combination makes it more difficult for children to regulate internal temperatures. Couple this physiology with children’s inability to tell us they’re HOT (infants/toddlers) or the instincts of a child or teen athlete (who may not know limits or want to regulate activity) and it can sometimes lead to overheating.

Heat is different for children than adults. They are at particular risk for two reasons: their dependency and their judgment.

Frankly, I worry most about children being left or trapped in hot cars this time of year. Ten children have already died this year in the U.S. after being trapped in a car that can heat up like a cooking oven. Yesterday, with millions of Americans on heat advisories, NBC national news showed footage of bystanders this week breaking glass to save a child left in a hot car. Even though everyone seems to believe it won’t happen to them, about 3 dozen children die each year (primarily during the summer) after getting forgotten or trapped in a car that heats up. If you think you’re too smart for it to happen to you or your family read this — a piece I’ve called the most devastating article around.

The majority of these children are 2 years old or younger. Children this young have very little control over their environment, so it’s up to us to ensure that they are safe  ~ Dr Tony Woodward, Pediatric Emergency Medicine Physician

Why Children Die Quickly In Hot Cars:

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3 More Things To Know About E-cigarettes


My goal here is to educate people about the risks and realities of e-cigarettes amid an environment full of popular misconceptions and half-truths. Talking about e-cigarette use in adults will NEVER be the same as talking about e-cigarette use and dangers for children and teens. Different groups, different realities, different risks, different use, and different vulnerabilities. Period.

E-cigarette use tripled among high school students last year alone. This is happening RIGHT NOW.

If we don’t get real about protecting children and teens from the availability, allure, and marketing of these e-cigs my fear is we’ll find ourselves rewinding progress made on nicotine addiction via declining teen use of tobacco cigarettes this past decade. In the past I’ve called e-cigs the gateway to the gateway drug which I still believe today. Nothing is currently better about e-cigs and liquid nicotine for teens today. There is no data to prove any benefit in having e-cigs around for teens and as time progresses liquid nicotine is still in arm’s reach for many children (one child has died from a toxic ingestion). Just this month the FDA has announced they will consider making changes to the packaging of liquid nicotine, but it will literally take congress and the FDA stepping up and prioritizing child safety to ensure in minimum liquid nicotine is sold in child-resistant packaging. Can you believe it’s this much of a challenge to protect children?

3 Things about E-cigarettes:

1. E-cigarettes Versus Typical Tobacco Cigarettes  Read full post »

Core Memories: Staggeringly Powerful

Sadness, Fear, Anger, Disgust, and Joy ... from Pixar's "Inside Out"

Sadness, Fear, Anger, Disgust, and Joy … from Pixar’s “Inside Out”

Over the weekend we saw the movie, Inside Out, with our boys. After reading previews of the film, I expected to be moved and somewhat thrilled by the look at mental health and emotions. But I walked away with a somewhat unexpected emotion: motivation.

Motivation for presence and for patience with my little boys. To me, the movie felt like a whisper, a gentle reminder in my ears to the power of each and every early experience our children take in. A prompt into the profound opportunity good — or even challenging — moments have to shape the foundation of a little developing human. Yes, we know this instinctively, but sometimes it takes a cartoon to jolt us back into focus. I’m motivated to remember that we can’t always carry the heavy load that EVERYTHING we do with our children matters all the time but it is nice to know some of these experiences really will stick forever. Read full post »

Storing Medicine Safely This Summer

How to Store Medicine More Safely

Storing medicines safely seems like a “no-duh,” I know, but it often isn’t…little mistakes here can have big consequences. Safe medication storage is an especially important topic in the summer when children are in their homes during more of the day and sometimes curiously exploring the house. Routines are shaken up and fortunately there’s more travel in the summer (yippeee!) which consequently leads to medicine in purses and travel bags, grandparents coming to visit (with their own medication), or families traveling to other homes where medicines might not be stored safely. This is not meant to be finger-waggy….I’ve just seen too many “if only I’d thought of that” moments after unintended medicine ingestion.

Do 2 things today quickly perhaps — make sure meds are up and out of reach in your own home and car (in a locked cabinet if toddlers around) AND have a designated place for summer guests to store their meds. This won’t take too long.

Check out the Know Your OTC Safety Infographic (here on the left) for data support: children mainly discover household medications when misplaced or on the ground (27% of the time), in a purse (20%), on the nightstand (20%), or in the pillbox that’s in arm’s reach (15%). Who’s coming to your house this summer that may mess this up? Can you make a place to put those lovely purses and beach bags when people walk in that’s up and out of reach? A hook reserved for guests only?


What You Need to Know About Safely Storing Medicine
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Raising A Couple Of Eagles

eagle jumpOn July 4th my 8 year-old little eagle walked up a tall ladder, waltzed across a platform full of teenage girls waiting to leap, and like a veteran champion approached the edge of the platform and jumped off. Arms in the air, feet forward and hardly a beat of hesitation, he took flight. What a gamer move. Next came twenty feet of free fall and a dock full of screaming enthusiasts. It all happened really fast and I think I may not have been the only one with two feet planted whose stomach dropped. Without question I had serious physiologic and neurologic shifts in my body as he leapt and fell, my stomach in my toes by the time he hit the water. What a wonder to see our children step up, look right at their fear, and then just push forward. Talk about leaning in…courage really is one of the most beautiful emotions to see in our children as they grow.

Raising children takes all sort of courage, of course. The odds at times feel stacked against us (overnight relentless wake-ups, temper tantrums, health challenges, worries about mental health, worries about physical health, resource restraints, failures, failures, failures). But nothing is typically stacked against most of us like other species. All parents face big challenges.

If you look carefully in the image, just behind my little eagle in free fall is a Bald Eagle’s nest. We’ve been watching a family of eagles raise two of their own this spring and summer. And the crazy thing? Eagles have staggering odds stacked AGAINST them. Some studies suggest a mortality risk for the 1st year of life is near 72% and I’ve also been told the mortality rate for an eagle during its first flight (around 10-12 weeks after hatching) is nearly 50%. Imagine — a developmental milestone with a flip-of-the-coin chance at survival. Parenting anything is staggeringly terrifying. Although some children are born with these kinds of odds due to congenital malformations or inborn errors of metabolism, most children in the U.S. come out with remarkable odds for survival. Modern medicine has enhanced this: sanitation, vaccination, child-safety restraints, and perinatal medicine has done wonders for our children.

My sweet little eagle had hesitated the last couple summers when looking up at the platform. And this summer he decided to take flight. Just a quick reminder for me that the risks, coupled with a brew of courage and enthusiasm, are likely ubiquitous, shared traits for all species raising little ones. I suspect the thrill that comes with successful first leaps is too…

 

A Few Thoughts On The 4th Of July

We all know fireworks are dangerous, but outside the obvious hazards (burns, injuries, oh my!), there are other things to be aware of to stay safe this weekend. The 4th of July is a crazy-fun, chaotic day filled with friends and family. Lovely for the time and space to celebrate freedom and lovely for the holiday to celebrate each other. All easy ways to get distracted though, and take your eyes off your children who might be playing in circumstances not typical of your run-of-the mill Saturday. Enter fireworks (which the American Academy of Pediatrics urges families NOT to use) but also swimming, or driving, in ways changed by the holiday circumstances.

  • Distraction: it really is this decade’s issue in a profound new way. If supervising little swimmers or children using fireworks, perhaps stay off your cell or smartphones. While you’re distracted and typing a “Happy 4th of July” text, your child could be grabbing a hot (burning at over 1000 degrees Fahrenheit) sparkler. It’s true that 3rd-degree burns happen with (or without) distraction but we can minimize the chances. If you’re opting-in, be there fully. The National Fire Protection Association states that the risk of firework injury is highest for young people ages 0 to 4, followed by children 10 to 14. These little loves need your full attention; of anything parenting teaches us it’s that our children can do nutsy things when we least expect it.
  • Remind your teens and their friends about of risks associated with teens on the road for the holiday. Pull a parent move and remind them to wear their seat belt, avoid texting and driving, and ban the use of alcohol for those behind the wheel. The 4th of July ranks as the deadliest day all year for teen drivers according to AAA.
  • Too much of a smarty pants for a problem? If you think you’re too smart for injuries on the 4th of July, hold on a second. Recent research found that higher levels of education do not protect against firework-related injuries. Even if you’re part of Mensa, this is a day to make back up plans.
  • Heat: Temperatures around the U.S. are HOT this time of year. Keep in mind that infants and small children are not able to regulate their body temperature in the same way that adults do. If you’re planning on spending the 4th of July outdoors with your children, make sure you have sunscreen, water and most wonderful— shade — available to them. Never leave children or infants in a car, even if windows open and don’t ever hesitate to call 9-1-1 if you see a child left unattended in a car.
  • Water Happiness: If you’re lucky enough to enjoy cooling off in the pool or lake, keep in mind that drownings are most prevalent in the summer months. Children ages 1 to 4 have the highest drowning rates. If you plan on boating, keep your child in an appropriate size life jacket at all times. I’ve recently shared advice about what to do immediately if you think an infant, child or teen is drowning here.

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California Mandates Vaccines Like West Virginia And Mississippi

Illustration by David Rosenman

Illustration by David Rosenman

Yesterday California Governor Jerry Brown signed a childhood vaccination bill into law along with a letter stating, “The science is clear that vaccines dramatically protect children against a number of infectious and dangerous diseases. While it’s true that no medical intervention is without risk, the evidence shows that immunization powerfully benefits and protects the community.” The hash-tagged, much discussed bill (#SB277) was co-authored and proposed to lawmakers by Dr Richard Pan, a pediatrician and CA state senator in Sacramento. The law, SB 277, establishes one of the toughest mandatory vaccination requirements in the nation for school children and those in child-care centers. As imagined, the process of getting the bill into law was not for the faint of heart. Riding on realities of necessary community immunity unveiled during the 2014-2015 Disney measles outbreak, the idea of mandating vaccines for public health still ignited evocative and divisive bullying campaigns on social media.

We can’t forget that these outbreaks are dangerous (over 20 people were hospitalized for measles during the Disney outbreak and 5 children in Chicago got measles while at daycare). Remember that infants are more vulnerable to getting measles and they’re also at greater risk to die from it.

Testimony before the state senate was reported to be passionate, evocative, and compelling from both sides. The law passed the senate by a 24 – 14 vote and went to the governor. By signing the bill into law yesterday, Governor Brown acknowledges a tenet in public health and vaccination: vaccines are for individuals, yes, but they also serve to protect others — those especially vulnerable and not. Read full post »

Love Wins For Children

Orange denotes states where same-sex marriage is legal.

Orange denotes states where same-sex marriage is legal.

While I was out of the country last week there was remarkable progress when it comes to public health and the opportunity for children. It was wild to be so far away seeing the news unfold. First it was The Supreme Court Of The United States (SCOTUS) voting to allow subsidies for the Affordable Care Act (facilitating the federal government to provide nationwide tax subsidies to support poor and middle-class people when they buy health insurance). Then just a day later SCOTUS voted 5-4 in majority to make gay marriage legal in all 50 states. With the highest court in the land stating clearly that from here forward, “marriage is a right” we realize it changes the game. These laws are about dignity and rights and care but this is squarely also about families. As a mom and pediatrician this feels MOMENTOUS. Read full post »

Working With Babies Of Any Age

Illustration about what it feels like to go back to work by David Rosenman

Leaving anyone we love is fraught with duplicity. While we feel the tug of distance, we have the fortuitous lens to see two things at once: the treasure of the bond forged and the aching feeling of distance when it’s gone. This binocular into our lives inspires joy but it also occasionally does bear weight. I’ve often said that leaving my babies (now children, but let’s be honest they’re always my babies) and going to work feels a little like walking around without a limb or without a necessary body part. Without them around something essential is glaringly absent. At times thinking on them is wildly distracting, especially right at first.

Up there, look at that graph. Haven’t you had days like this?

The fortune in raising and loving children is that we’re continually reminded of these dual realities. Life after a baby is forever transformed; as parents we are never again simply singular. Or at least as I see it, we’re not entirely whole again when alone. When we meet our babies big real estate in the heart is rapidly taken up by our children and although wandering, working, traveling away, and seeking new experiences is essential to our personal evolution, we do always seem to notice the absence of our babies when we’re apart. I’m coming to know this is true at any age. Read full post »

School Is Out, Head Lice May Still Be Around

Head LiceThey’re a little gross, somewhat annoying and for most parents, inevitable. It also seems to me that for most of us they show up at the most inconvenient times. I’m talking about lice. With school coming to an end this month, you may think your child’s chances of picking up the little bugs will diminish. Unfortunately, according to the American Academy of Pediatrics (AAP) most cases of lice occur outside school. Between summer camp, sports and play dates there are still plenty of opportunities for lice to take shelter on the head of at least one family member. They’re certainly no picnic to deal with and they can also be unwittingly contagious during the school years. Clearly there’s nothing to be ashamed of when discovering lice but it doesn’t always feel that way. New guidelines from the AAP out last month offer some tips for getting your family lice-free as quickly as possible. Acting fast with a plan often diminishes all sorts of anxiety and discomfort for all. Read full post »