Archive for August 2010

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Wonderfully Un-Wired

I returned home from the mountains yesterday. We spent the majority of the weekend in a cabin with my brother’s family, my mom, and our dog Luna. There was sunshine. A bike. Lots of little boys. And loud wind in the trees. The best kind of noise…

The owners of the cabin had advertised WiFi in the cabin, so I made no preparations for my time away. I was gone Saturday noon until mid-day Monday. Not a long trip by normal human standards. Yet it felt like a huge voyage.

As fortune had it, the WiFi didn’t work. I got a signal on my phone for only a few minutes, twice, during the 48 hour respite. Not surprisingly, I was transformed. And rapidly. By Sunday morning, I’d tossed the iPhone in the corner, hid the computer, and stepped away from my responsibilities with work. This isn’t the norm for me since I started this blog back in November; I’ve been plugged in nearly every waking hour of every day. I haven’t taken a full day away from technology since last fall. Not requisite per se, but the way I’ve lived through the evolution of this blog and my time in social media. Part necessity to feel thorough, part insanity, and possibly part-addiction; social media can squeeze into any space. Maybe, a little like a bedbug. Read full post »

Spanking: 65% Of Parents Say “Yes.” Do You?

Life is a blur this week. But something stopped me in my tracks. A study published in Pediatrics on Monday found that 65% of parents to 3 year-olds said they had spanked their child within the last month. Sixty five percent? The number surprised me. If you’d asked me to guess, I would have said 20-25%. Talk about way off. Another reminder of how much I have to learn.

The study evaluated risk factors, including domestic violence and intimate partner aggression & violence, on spanking and corporal punishment. The researchers are trying to understand/describe that while most child advocacy groups condemn spanking, in the US, the reality remains that nearly 2/3 of families continue to use spanking as a form of discipline. They found that parents who experienced aggression and violence between each other were twice as likely to be in the group that spanked their children. Having been spanked as a child increased the odds, too. Not surprising.

But the 65%; that was surprising.

I don’t talk about spanking in clinic (I can’t think of a time I did); no one asks my opinion about it. I talk about setting limits, behavior, tantrums, obedience, discipline, but no one asks me about spanking. I wonder, do parents feel it’s taboo? Do they feel I would judge them?

My position on spanking may be irrelevant, really. What I say as one mother or pediatrician doesn’t change the reality that more than half of the parents in this study are spanking children. I’ve always thought of spanking as illogical. If I’m trying to model behavior against aggression, why would I hit my child modeling just the opposite? But I’ll tell you this: I was spanked as a child and I certainly remember it. Clarity in fear. Further, there have been moments of desperation (think: major-tantrum-melt-down-disaster-ness) where I thought about it, too. So, I think the instinct to spank (particularly when you’ve seen it, or experienced it) in a moment of utter overwhelm may be the norm when raising kids. But 1/3 of us choose not to spank,and about 2/3 of us choose to spank our children. Why?

What pediatricians ultimately need to figure out for families is how to help parents improve their lives with their children. We need to support families in times of frustrations. Groups like the AAP discourage using spanking or corporal punishment of any kind. But their statement may not make much of a difference.

So I wonder, does 65% surprise you? Do you spank your children? Do you think it works? Do you feel spanking is corporal punishment? If you don’t spank your child, why not? So curious. Please share, even anonymously if need be.

Don’t Let The Bed Bugs Bite

A friend called yesterday and asked if I thought her daughter had bed bugs. Her toddler had woken up with welts over her face, chest, back and trunk. She was itchy. Her mom was worried about bed bugs. I tried to reassure her, telling her what I knew about bed bugs &  how young children react to insect bites (not just bed bugs), I asked:

  • Does the bed have copper colored stains on it?
  • Is the mattress new or borrowed?
  • Any other babies or children nap in her crib recently?
  • Any one else at home with bites or itching?
  • Any travel to a hotel recently?

But I got to thinking, what do I know about bed bugs? Not that much, actually. A good friend of mine caught bed bugs from a famous San Francisco hotel about 3 years ago. I’d read up on it at that time to help her; she’d been diagnosed by a SF dermatologist while traveling for work. The hotel apologized, placed all her things (suitcase) in their walk-in freezer overnight and sent her home with some “points” to return to their hotels for free. She left with her frost encrusted “baggage.” She did just fine (easy for me to say), but I’ve certainly remembered the story and I’ll never stay at that hotel. There is something uber-creepy about the thought of bugs chewing on our toes while we sleep.

So I get the overwhelming response to media reports about bed bugs. When my mom mentioned a local NPR interview about bed bugs she heard yesterday, in combination with the phone call, I thought, “Oh no, people are starting to freak out.”  It ‘s all over the media. Then, I opened the NYT this morning and saw the cover article about bed bug infestations in New York City that ends likening bed bugs to the H1N1 scare. Closed movie theaters, infested dressing rooms, you name it.  Bed bugs appear to be teeming around the internet, and as we all start to scratch ourselves and wonder if it’s worth leaving the house (or if we’re surrounded at home), I did a little research: Read full post »

Only One Decision

When becoming a parent, we make a big choice. One enormous decision. Hello, understatement of the century. I remember my father-in-law saying, “There’s a freight train coming,” just before F was born. Yes, thunderous and steamy, I was ushered into a new world December of 2006, when my first freight train hit. And although I now may be billowing steam and coal, motherhood is the most astounding segment of my life thus far.

This weekend I read a blog post written by an OB I don’t know. She calls herself The Skeptical OB. We may hum on the same wavelength. She says that “Mothering is about choosing motherhood, and not about mothering choices.”

When I read her post, I nearly held my breath. Then I re-read it again a few times. So much of what she says makes sense to me and hits on my recurring theme about parenting in the world of opinion–the reality that there is no manual, no right or correct way to parent. There is no needed judgment and guilt about our choices. Love and commitment to our children may be the only pre-requisites for success. I found Dr Amy Tuteur’s blog post about choosing parenting on a popular medical blog this past weekend.

I felt like she was channeling my thoughts.

At one point she says, “My fundamental objection to the philosophies of natural childbirth and attachment parenting is not the emphasis that they place on mothering; I object to the fact that they privilege specific mothering choices over others.”

Hallelujah. Read her entire post.

3 Things That Won’t Help Babies Sleep

There is a lot of information (and opinion) about how to get your infant to sleep through the night. Cry it out/don’t cry it out, rocking/no rocking, co-sleeping/crib sleeping, white noise/no noise, breastfeeding or bottle-feeding. Everyone has an idea about what works. Like I said earlier, there is very little data to support one technique over another.

Auspiciously, there is new data that may help us know what NOT to do. Researchers found 3 things to avoid while helping your baby learn to sleep through the night.

A study (summary in Journal Watch) refutes an urban legend: feeding rice cereal keeps babies asleep.

Read full post »

Stammina

That’s no typo. I meant Stammina.

Dr Stanley Stamm is retiring this month after a 57 year clinical practice at Seattle Children’s. F-i-f-t-y-s-e-v-e-n year career. His wonderful nurse, Marlene, is retiring, as well. They have been caring for children together for decades. Yesterday I had the privilege to attend one of their retirement parties. Lovely, inspiring, humbling. I was silenced by it all; I was among giants. Working in medicine has granted me a unique window to witness exceptionally compassionate people who devote their lives to care for children. Dr Stamm and Marlene exceed the margins as they shine brightly through the window panes.

Dr Stamm has done incredible things for children: Read full post »

If It Were My Child: No Feeding The Dog

“If it were my child: No kids feeding the dog.” Don’t allow kids to play, handle, or touch the dog bowls, dog treats, or supplements, either. You have to be vigilant and organized. I’m not always both, or either, for that matter. I have found my boys basically bathing in dog water, and dipping their hands/face/sippy cup into our dog food bin many times. News today informed me to change the rules around here.

Pet owners, be aware. Not, “beware.” I’m not trying to scare. A study published yesterday in Pediatrics found that a large number of salmonella infections between 2006-2008 were linked to contaminated dry dog/cat food.  Salmonella infections cause abdominal cramping, bloody stools, and in some (often the very young), more severe infections. I read about dog food as a possible cause of infection back in 2007 when my son (4 months at the time) came down with Salmonella gastroenteritis. Yes, it’s a real story. Bloody diarrhea, cramping pain, lots and lots of crying–poor little guy. I felt it was all my fault. He was an infant and I was controlling everything he ate, after all.

But F didn’t get Salmonella from dog food, he got it from a more predictable route. Read full post »

Parenting, As Seen On TV

I’ve had some recent indiscretions; I’ve been watching multiple episodes (near seasons) of Weeds and Mad Men on my computer. All in one sitting. It’s been a a perfect retreat. While others are off camping in the mountains, I’ve been holed up, late at night staring at a screen. I’m not a big TV person, but watching the torrid lives of fictional families is good for some little piece of me.

Because of my recent over-consumption, I’ve been a little skewed, off kilter, and stuck between TV and real life. Fact: last Tuesday, I opened the door to a patient’s room and jumped (as in startled) when I thought one of my patients was a character out of Weeds (crazy resemblance). True, and scary, I know…Too much TV.

The great thing about all of this time spent sedentary is that the worse the parenting model I observe, the better and more relaxed I feel about my real life. These shows puts the, “Well my children are good listeners” type comments from other parents in perspective, especially while your child tantrums. And yes, this is why we watch television. To be off the hook, off duty, non-eligible. This working-our-butts-off-to-parent -as-perfectly-as-possible-while-earning-wages-to-save-extra-money-for-kids’-college-while-also-cleaning-and-grocery-shopping life, is Ex-haust-ing.

So I have turned to the boob tube. And have focused on two women, in particular: Betty Draper (now Betty Francis) and Nancy Botwin. They are both remarkably flawed. And they make no apologies. It’s wonderful. Read full post »

Navel Gazing?

You want navel gazing? Read a Blog-ter-view of my experience working in social media and medicine.

If It Were My Child: No Tylenol Before Shots

Earlier this year there was a massive Tylenol recall. The recall included Infant Tylenol drops, Children’s Tylenol, as well as many other children’s medications. I’m not exaggerating when I say massive, but generic medications (liquid acetaminophen made by Walgreens or CVS, for example) were not included. The recall was a great reminder that generics are just as good as brand-name medications.

The recall also serves as a great reminder that giving medications to children is never risk-free. Recalls like this remind us to use medications only when absolutely necessary. There is always risk when you intervene.

Tylenol (acetaminophen) is a great medication. It has a place in our medicine cabinets and in keeping children comfortable in the face of fever or pain. Teething, viral infections, ear infections, and minor injuries are great times to use Tylenol. But prior to shots is not. Or afterward, as it turns out. After shots, Tylenol will help prevent fever, but may also prevent the desired immune response. There is new data to support this that has changed the way I think and counsel families about Tylenol. Now when parents ask, I say,“If it were my child, no Tylenol before shots.”

Fever is a “normal” immune response to a trigger (medical school and residency taught me this). But being a mom has certainly shown me that fevers in my babies don’t feel “normal.” When we pediatricians say it’s “normal,”we neglect to connect with the experience of parenting a feverish child. I understand why so many parents reach for the Tylenol. I did; after F’s 2 month shots, he developed a low-grade fever and cried his little face off. I gave him Tylenol twice that night. I wouldn’t have, had I known this: Read full post »