Archive for June 2011

Monthly Archive

Speak Up, Share Your Values About The Vaccine Schedule

Ever wonder how the CDC makes the vaccine schedule? For example, how they decide when to start a dosing series (at birth versus a year of age versus age 11) or why pediatricians and other clinicians recommend the number of shots that we do?

Ever want to let them know your thoughts about how the schedule feels to you and what values you feel should contribute to changes?

This is your moment. For real. Read full post »

If It Were My Child: No Television In The Bedroom

This morning as I was getting ready for the day, my 2 1/2 year old was watching Sesame Street. In the show, the segments change every few minutes or so and seem to weave old-school 1970′s content (familiar to me) with newly created vignettes that have a modern feel and construction. I like it nearly as much as the boys. One of the stories this morning was about tooth fairies. An animated group of fairies were detailing how they got to the tooth under a child’s pillow (lifting up the child) to replace it with a golden coin. Mind you, I was coming and going from the room and didn’t view the whole story. However at one point, the fairies accidentally turn on the child’s TV and worry it might wake the child, ultimately uncovering their work and secret magic.

A TV in the child’s bedroom? No way, Sesame. Read full post »

Seattle Mama Doc 101: What is the Choking Game?

http://www.gaspinfo.com/en/home.html

http://www.gaspinfo.com/en/flash_vid.html

Portable Pools: Real Responsibility, Real Risk

I’ve got 2 boys under the age of 5. While reading a Pediatrics article just now my stomach flipped. It’s because I read:

Children younger than 5 years, especially boys, are at greatest risk from drowning in swimming pools.

The words startled me as pediatrician but as Mama, too. Three thousand children under the age of 5 were treated in the ER each year between 2006-2008 for injuries associated with submersions. Private pools were the riskiest pools of all. Over half of the children who drowned and died (129/209) did so at their own home. Wrong, terrible, traumatic.

94% of the fatal and nonfatal downing injuries in portable, above-ground pools in the US between 2001 and 2009 were in children younger than 5 years. If you have, or entertain, or care for, or ever have the responsibility for a child under age 5 near water, think about safety ahead of time. That pool you buy at Target for $11.99 comes with real responsibility. That pool you buy at Target for $11.99 comes with real risk. Don’t believe because of a portable or above-ground pool’s size, cost, or convenience, it’s any safer than the ginormous pool at the YMCA. The article this week would suggest it may be alarmingly deceptive from a danger stand-point. Those plastic blow up pools just look so benign… Read full post »

Home

Home is difficult to describe. At any point in our lives, home is something that has a feeling, a near tactile truth, a definitive smell. A smell that becomes so familiar, so woven into who we are, we’re unable to recognize it. Only those who enter infrequently can–they’re simply far enough away. This week I was reminded again that home has very little to do with the structures built by hand. More with the hands that hold it together.
I had the fortune of seeing one of my nieces. Earlier this week I asked her a question; I was thinking concretely about an expected answer. I was limited in what I was looking for. She and her family have recently moved to a new home in a sunny part of California. I asked, “How’s the new house?”
She told me all about it:
The neighbors. Their dog. Their year in school, the three year-old brother, the sports they play, and the proximity of new friends to her porch. To my 8 year-old niece, this is her new home. The people.

I’m left knowing nothing about the paint, the color, the number of bedrooms, the faucets, or the kitchen.  And this is perfect, it feels like home.

Seattle Mama Doc 101: When is a Child Ready for a Cellphone?

On May 16, 2011 Reader Jenny asked: ” What is the developmentally appropriate time to allow kids to have cell phones?”

Thank you Jenny for your suggestion. If you have a question or topic suggestion for the Seattle Mama Doc 101 video series please leave a comment here.

If It Were My Child: A Pediatric ER When Possible

A joint statement published in 2009 by the American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Emergency Physicians Pediatric Committee, and Emergency Nurses Association Pediatric Committee spelled out the need for reform in emergency care when it comes to caring for children.

The bottom line is this: if your child has an emergency and you have the luxury of time and choice of where to go, go to an ER at a Children’s Hospital or a pediatrician-staffed emergency room. Collect $200 and pass go. Learn from my mistakes.

Driving the joint statement was concern from both pediatricians and ER physicians about inconsistent care for children in Emergency Departments (EDs) that do not normally specialize in the care of children. The statement outlines strategies to prepare EDs around the country to care for children based on some sobering statistics… Read full post »

Forever My Baby

Being a parent is entirely overwhelming. Yes I know, we hold it together about 99.9% of the time, but there are these little windows where our fractures are evident. Or where our Mama/Papa-Achilles is wide open, taught and stretched. Or the beats of time where we get to let our knees buckle beneath the weight of our world. Where we give into the love we feel, the desperation of certain moments, the lack of control over things, and the slipping moments that occur each and every day as our children grow–where we feel we lose parts of them, and then simultaneously gain bits and pieces of who they become.

A pediatric partner of mine once told me that she felt the toddler and preschool years were the most intimate time of parenthood. I think about it all the time. It actually haunts me on some level, as if I’ll lose this proximity with my boys as time marches forward. That I won’t have this utter closeness. That the kisses at the cubby really will come to an end.

Last night, I buckled a little bit. I was also reminded that my pediatrician partner may be wrong.

Before bed, O (he’s 2 1/2 now) and I somehow migrated into his bedroom alone. Usually we read books together with his brother, but last night it was just the two of us while the husband read to F. He reached for a dreaded book and handed it to me. I wanted to shake my head. It was clear: he insisted. Of course I consented to read it but as I opened the cover, my stomach flipped. I knew I was in for a doozy. It had been a tiring day and I was weak in the knees with love for my boys. The book: Read full post »

5 Things We Shouldn’t Do

I really want you to trust your child’s doctor. I really want them to trust you, too. Partnership is key to any relationship. Recently an article was published in the Archives of Internal Medicine entitled The “Top 5″ Lists in Primary Care. It sounded more like a blog post than an article. In media summaries, reporters wrote about less being more. Not surprisingly, it was right up my alley. Like I’ve said many times before, in medicine, less is often more. Partnering with your child’s doctor is essential in assuring that when nothing needs to happen, nothing does.

This list is a reminder for us all.

The group authoring the article is part of the “The Good Stewardship Working Group” and represents 22,000 physicians for the National Physicians Alliance. Their intentions: to find 5 things “not-to-do” in primary care. For pediatrics, the committee used evidence (Cochrane reviews, AAP/AAFP Guidelines, The FDA, NAEPP), experience in the office, and field testers (pediatricians) to generate a list of what to avoid/what not to do, to avoid harm. The goal is to improve health, reduce burdens both financially and physically, and ultimately to empower patients, parents, and pediatricians to avoid unnecessary testing and intervention. I’m sharing them here because good care is partnered care. Being a strong, informed parent is likely the best asset your child will ever have in a health system. Parents need to know this list. If I could tattoo it on your arm, I would. You’re the strongest and most motivated person to advocate for your child. You’re also the most likely to help avoid unnecessary and dangerous intervention alongside the doctor or nurse caring for your child. The “don’t” list according to this group: Read full post »

Seattle Mama Doc 101: Teen Texting when Driving