Archive for September 2015

Monthly Archive

Flu Season, Pregnant Moms, And The GOP Debate

NFID T.F.

A selfie with Dr. Tom Frieden, Director of Centers for Disease Control (CDC)

It’s been a whirlwind this past week. Last week I flew to Washington D.C. as an invited speaker at the NFID Influenza News Conference at the National Press Club in Washington D.C. I joined thoughtful experts: Drs. Tom Frieden, Kathy Neuzil and Bill Schaffner to present the 2015/16 flu season recommendations and explain rationale for every-year flu vaccine. It’s an essential vaccine for children, especially as young children are at elevated risk for more serious or even deadly influenza infections. Timing auspiciously peaked interest in the news as the press conference was in the morning immediately after the presidential candidate debate where wild myths were shared on stage about vaccine science and safety. I was able to also share my refute of Trump’s false statements here on NBC Nightly News.

I got my flu vaccine at the event in front of the cameras. Thanks to the new jet-injected vaccines (truly a needleless “shot”) it didn’t even hurt! As expected, I was sore in my arm for a day or two thereafter.

Prepping for the press conference, I was a little underwhelmed to learn that only roughly 50% of pregnant women get the flu vaccine. If you’re expecting, here’s what you need to know about the flu vaccine. Quick 1-minute video below. SPOILER: it’s an essential and safe vaccine to get at any point of your pregnancy. Read full post »

Using Melatonin To Help Children Fall Asleep

When I recently shared this article on my Mama Doc Facebook about a “magic” children’s bedtime story promising to make the going-to-sleep process easier, many parents inquired about melatonin.

No question that supplemental melatonin has a role in children’s sleep dysfunction but also no question that parents are turning to melatonin out of a need for convenience. I’ve had COUNTLESS curbside consults from parents asking me if melatonin is safe to use in the short-term but also for years on end. The short answer is we don’t entirely know because studies just haven’t been done. Often when I get the story of how families are using melatonin, I end up advising changes in the sleep schedule more than a need for meds. What we do know: melatonin can help children fall asleep with sleep dysfunction, sleep dysfunction and inadequate sleep have serious health consequences, and although melatonin only helps with sleep initiation (falling asleep) it can be hugely beneficial for children who lie awake at night for hours at bedtime. The other thing we know: melatonin is not regulated like medicines (it’s overseen as a food supplement) that has been studied in very few pediatric populations so it’s difficult to generalize safety for children everywhere. Lots of definitions, dosing info, and pediatric sleep expertise below.

If your child can fall asleep in about 30 minutes after the lights are out (especially when you have made sure no screen time for 1-2 hours prior, no caffeine in afternoon) then melatonin is unnecessary.

If it were my child I’d use melatonin if sleep dysfunction at bedtime was getting in the way of necessary sleep, but I’d also do everything I could to get them off of it as soon as I could. Many children respond to the hypnotic effect of higher doses of melatonin, but many children are also given it for family convenience, too. In my experience, sometimes families use it to treat anxiety (those kids whose mind spins and spins and spins and worries) at bedtime. Although sometimes melatonin helps kids fall asleep, it’s just a band-aid.

Children are sleeping less than ever before and there are mounting impediments to a good night’s sleep (screens, early school start times, stimulants in the food source, busy school days and activities keeping kids up late). However inconvenient, I think sleep hygiene (routine bed time, no screens before bed, bed used only for sleeping) and consistency with what we do as parents may be the only magic wand to wave for sleep throughout childhood. Awakenings typically rise from all sorts of developmental milestones and changes as children grow. Overnight awakenings will always be normal although how our children get back to sleep on their own changes our night of sleep dramatically. When it comes to challenges falling asleep, sometimes melatonin can really help, especially in children with underlying autism spectrum disorder, attention deficit disorders, or children with shifted sleep schedules.

Only a few long-term studies have looked at prolonged use and associated effects, but most sleep specialists consider melatonin safe, particularly for occasional short-term use. The bigger question is why parents feel the need to give their child melatonin.  –Dr. Maida Chen

What is Melatonin?

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Another 20 Questions, Another School Year

last gasp of summerTime is so slippery. As we get older we feel the slip of time differently, having children pulls these time-space continuums to extremes. Nothing slower than a night with an infant who won’ t sleep and nothing seems faster than a school-age child flying through grade levels. As we prep for the beginning of the school year again this year I cannot help mentioning that it is clearly a delight to see our little humans head back into the classroom. But a little part of me whimpers inside, too. Tomorrow school really is supposed to start.

When O got up this morning and joined us at the breakfast table his first muttering was, “Why is it so dark?” I know some have been back in school for weeks but in the Seattle area many of us are just getting back to it.

There’s heartache and anxiety that comes with day one of school because the day is so emblematic for a year of what is to come. First day is packed of a blend of hopes and dreams, worries and insecurities, and pure unbridled excitement. For the last few years I’ve been asking the boys 20 standard questions just before they start. Here’s what they said this year:

20 Questions At School Start:

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More Teens Getting HPV Vaccine: Boys And Girls

The vaccine schedule is the same schedule for boys and for girls. The path to today’s human papilloma virus (HPV) vaccine has not been entirely straightforward for parents as recommendations have changed over time. Know this: the clear and simple message is that HPV vaccine is safe and effective for boys and girls. We know it works best when given earlier in the tween/teen years and we know the immunity it produces in our bodies is durable and lasting. HPV vaccines is an anti-cancer vaccine that works best when given to boys and girls at age 11. For me it’s a no-brainer to recommend this vaccine enthusiastically before children head off to 6th grade.

Earnestly, it’s not a “new” vaccine as pediatricians began giving the vaccine back in 2007 and it’s been given well over 50 million times. In the U.S. we starting giving the vaccine to girls first yet because human papilloma virus can infect boys and girls, men and women, HPV vaccine is also recommended for boys age 11 and older. Uptake by boys has been fast and steady since recommendations included them. Three different HPV vaccines are now available: a 2-HPV strain (protects against the viral strains that cause 70% of cervical cancer) or a 4-HPV strain vaccine (same 2 strains plus two more that protect against HPV strains causing warts) and now a 9-strain vaccine (expansion of strains causing warts), upping the number of different viruses that the vaccine protects teens against. The new options improve protection against HPV viruses that cause genital warts and also HPV viruses that can cause cancers of the cervix, mouth, throat, vagina and rarely, the penis.

HPV Vaccine Protecting Teens

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