Archive for 2017

I’m Not Eating Meat Raised With Antibiotics Anymore

A lot of people don’t eat meat for all sorts of reasons. You know why: their health, the environment, they don’t want to eat animals, just doin’ the right thing for the planet. I’ve gone through times in my life where I didn’t eat meat. Now I do again. The more I learn about health care, the more certain I am that as I go forward eating meat and preparing it for my family, I can use science to guide me to do it in smarter ways.

Being smarter about how we eat meat makes sense. This includes not consuming nitrates (cancer risk) and preservatives when we don’t have to, but also choosing meat raised without unnecessary antibiotics. Smarter meat-eating involves creating a demand for meat that’s safer for us and the population. Antibiotics used to raise animals for meat production aren’t always in our best interest, health-wise.

Animal agriculture uses 4x the amount of antibiotics as human medicine, so buying meat not raised with antibiotics is without a doubt a way towards a safer world where antibiotics can be reserved for use in helping us. Antibiotics aren’t used when raising farm animals to make the meat on your kitchen counter safer — raw or undercooked meat is still a biohazard, even if raised with lots of antibiotics — you can still get an infection from meat raised with antibiotics. Antibiotics are often used to raise animals in crowded or less ideal conditions to help prevent them from getting infections. The more antibiotics we use anywhere, the the more we’ll see resistant bacteria everywhere. So reducing demand for meat/animals raised in conditions demanding more antibiotics is a good thing. Moving forward, I’m raising my hand to eat meat (whenever possible) not raised with unnecessary antibiotics.*


Over the weekend I was at a large whole-sale store and I bought this meat. I think this is the kind to buy. Help me make sure I did this right, leave me comments below.

Resources

*This sentence was edited on 11.16.17 for clarity to reflect my intention based on comments I’ve received. I am doing a deeper dive on manufacturing and antibiotic-free labeling practices.

When Joy & Science Meet In Parenthood

I gave this little talk at Children’s recently about where joy and science meet– a lunchtime chat about life and balance and work and loving up our children. Ultimately, it was a sincere privilege to think of sharing a little bit of science and a lot of stories from my own tightrope walk as a mom to boys. I spoke about about how we get this done while bearing witness to our children and their enormity, while also working on our careers. In my mind it’s a messy palette of colors we use when watercoloring our lives as our children grow and make themselves into adults. We have big chewy highs and bits of beauty all the time. We also feel miserable when we don’t live up to what we’d hope for ourselves as parents. We all worry. It can be a little ugly. We all house doubt about who we are as parents. But joy is abundant in this lifetime with children and teens and little tips may help us connect with it more often…

There was a lot in this talk not included in the slides and images in the above Prezi, but hopefully you can enjoy a few of the lessons if you click on through it. Even Will Ferrell makes an appearance. I hope they invite me back even though I might have used a swear word or something.

  1. Mindfulness is just a devout attention to the moment as it happens. Without judgment for how we feel we can just feel and absorb time, anytime. It can bring on a little bit more peace in our soul. I shared a little that I’ve learned from experts at children’s and a series on the podcast I’ve done with guided mindfulness journeys. They are so good and can be shared with children. We can practice mindfulness anywhere — even in a terrible meeting just by refocusing our attention to our senses.
  2. Self-care is critical. Prioritize it. Only you know if you’re not living up to what you’d like to in this regard. Sometimes self-care is just sleep. Sometimes it’s being alone. Sometimes it’s seriously just a bowl of pho. Sometimes it’s just creating an empty pocket on your calendar.
  3. Everyone in the family needs sleep, you included. The focus cannot solely be on your children’s sleep. This may cause you all a little more suffering. Quick links included on some sleep blog posts and ideas that may help you prioritize your own shut-eye.
  4. The Flu vaccine is a safe, essential, every-year vaccine to protect you and your family from 4 strains (in WA state all childhood flu vaccines are quadrivalent) of influenza. Get one ASAP for yourself and everyone in your family 6 months of age and up, if you haven’t already. 10 reasons why included in the presentation..
  5. The HPV vaccine is an anti-cancer vaccine. It’s a BOOMER of a vaccine in that regard — I mean!?!?!? Over 90% of HPV disease could be prevented through the vaccine and about 80% of us will get HPV during our lifetime. The vaccine can be given after age 9 years and if your child starts the series anytime before their 15th birthday (when it works even better to create protection) they only need 2 doses in total! WIN.
  6. Let your children play lots of sports until age 16. Don’t think that having them focus intensely on one sport will do them any good. The data is clear on this. Sports specialization does not lead them to be better athletes, in fact, it leads to burn out & overuse injuries if it happens before puberty. Have your children take a month off every 3 months from each sport and make sure there is always a day off every week!
  7. Fill you children’s plates with 50% fruits and veggies. Your job is is to provide great options, their job is to decide what and how much they eat. I reviewed the famed “Division of Responsibility,” in the talk. But food may be poetry and poetry, in any form, may be life’s most generous nourishment. When I started putting poetry into my boys’ lunch boxes this year I started to feel JOY making them. A favorite video clip from Dead Poet’s Society in included up there to drive my point home…

This talk was for The Seattle Children’s Hospital Parenting Network. One of the many amazing benefits of working at Children’s are the organizations and groups you can join and learn from. The Parenting Network’s goals are as follows:

  • LEARN more about child development and gain confidence in your parenting skills.
  • CONNECT with others experiencing the joys and challenges of raising children and/or working with patients and families.
  • BUILD your capacity to model and coach positive parenting skills in everyday encounters.
  • MAKE Seattle Children’s a great place for parents to work.

Online Interventions Improve Vaccination Rates

The flu season is upon us and I hate to be so prescriptive, but when it comes to avoiding influenza, I feel like I have to be. I get the flu vaccine each year as does my entire family — I think you should, too. I’m passionate about vaccines and have had the luxury of blogging and deploying vaccine science education to the world since I began the Seattle Mama Doc blog in 2009. I’ve been particularly vocal about the flu shot and have leveraged traditional, digital and social media tools ever since I began. I’ve used my blog, book, Instagram, Facebook, Twitter, and my podcast to share information about recommendations and rationale for why a flu shot makes sense for every infant over 6 months, child, teen, and adult. Of anything I’ve learned over the years, it’s this: building public insight into why this annual flu vaccine recommendation makes sense, is a marathon…it’s not a little sprint. Influenza can be a nasty virus with life-threatening and life-ending complications and it’s an ongoing obligation to ensure everyone in this country understands ways to decrease risk.

Data is on our side that online efforts in social media are worthwhile for spreading valuable research, expertise, and education. Every parent wants their child to stay healthy and live long into adulthood. Those who decline/defer vaccinations or don’t get the flu vaccine are clearly no different in that regard when compared to parents who do immunize with flu vaccine. But levels of trust and understanding for the science of safety in vaccinations between the groups may differ.

Thankfully, new research shows these online efforts by doctors like me may help families understand rationale for immunizations, especially if moms were educated even before the baby was born. A study published this morning in Pediatrics leaves those of us sharing information online validated in our efforts.

US Study Finds Blogs And Social Media Influence Infant Vaccine Status:

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6 Tips To Help A Child With Autism Eat Better

There are ways to support picky eaters and children who refuse new foods. I’m back with Dr. Dolezal further discussing feeding challenges for children with Autism Spectrum Disorders (ASD). The first post explored why children with Autism have challenges with eating (almost 90% do). I often say that a typically developing child will not starve with a full refrigerator, but this advice just doesn’t hold up with ASD children. I love Ellyn Satter’s advice and mission in helping adults and children be joyful and confident with eating. Her resource and guidance inspires a “division of responsibility” that basically a parent’s role is most simply to provide great healthy food and a child’s job is to choose what and how much of it to eat. But we have to acknowledge that parents to children with ASD need more information about challenges and often far more support. Here are Dr. Dolezal’s 6 tips to help a child with autism, or any child who choses to eat only a few, certain foods, eat better.

Children who graze are really not open to trying new things. — Dr. Dolezal

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Why Children With Autism Struggle With Eating

If you’re a parent to a child on the autism spectrum, take some comfort in knowing that up to about 90% of children with autism struggle with significant eating challenges. You are NOT alone in this. The challenges can range from picky eating to dependence upon PediaSure or g-tube for caloric intake. We know that children thrive in an expected world. But children with autism can take that to the margin where a preoccupation with sameness can drive them to eat only the same thing every day. Despite these staggering numbers, there are evidenced-based treatments and models of care that can help improve the lives of children and families from a nutritional and quality of life perspective. I had the pleasure of having Dr. Danielle Dolezal on the podcast to discuss this topic. The first podcast here is an overview of why children with Autism Spectrum disorders have these challenges with eating.

Rigidity and sameness contributes greatly to feeding picture. Eating is one of the most sensory experiences you can have.” ~Dr. Dolezal

Dr. Dolezal is the Clinical Supervisor of the Pediatric Feeding Program at Seattle Children’s Autism Center. She’s super smartypants and created the highly sought after (nearly 500 families on the wait list, unfortunately) interdisciplinary team model and program at the Autism Center. That means patients that have multiple factors contributing to feeding issues (medical, skill, motor, physiologic, and psychology) get to see a variety of team members under 1 roof. She started off her career with a masters in special education with special emphasis in early childhood and children who struggle with severe challenging behavior. She then got her PhD in child psychology with further emphasis in behavior analysis specializing in feeding disorders and severe challenging behavior. So needless to say….she knows her stuff. Her podcast is so good. Insistence on sameness is a common theme and can be horribly challenging for families who worry about their child’s nutrition.

A Few Quick Tips:

  • Try to not let your child slip into patterns of grazing, which is very common and leads to disrupted hunger/satiety patterns. This makes it difficult for them to try new foods because they graze to take the edge of the hunger all day long and are never really sitting down to eat a full meal at set meal times. They will be more apt and ready to try new foods if you keep to a set schedule. They don’t have to stay seated in a seat. They can stand up. But the food stays at the table.
  • Try celebrating and reinforce flexibility with something the child is already doing. So if they are eating dry/crunchy textures, try branching out to ANY type of cracker. Go from white cheddar Cheez-It to regular Cheez-It. Celebrate that as a new learning experience and new demonstration of flexibility.

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Alternating Acetaminophen And Ibuprofen For Fever

Lessening a fever in your baby or child, with multiple medicines, can be tricky. And it may not always be necessary. Many pediatricians urge avoiding “fever phobia” and allowing a fever to stick around, especially if your child is acting well. See this recent piece, “The Case For Letting Fevers Run Their Course,” by Dr. Paul Offit, an infectious disease expert on this take, the data behind it, and why fevers can sometimes help children fight infection.

Lots of families consider alternating medications like acetaminophen and ibuprofen at home to treat pain and fever, but I’m unconvinced that this leads to better outcomes for kids and/or improved fever control. It’s not my recommendation that you try alternating medications, and this post is not here to endorse this approach, rather if you choose to, I’m hopeful that this will help you do it more safely.

It’s important to note that the dosing amount for one medicine AND the duration of time between doses for medicines can be different from one medicine to another. So it can get confusing, FAST. However, armed with a plan, alternating medicines can be a good way to feel in control of supporting your child with medicines that relieve fever, improving your child’s behavior and comfort.

First….and I know I said this but I gotta say it again: it’s not necessary to treat every fever. And it’s certainly not ideal to treat the numbers on the thermometer. What always matters most is how your child looks to you and how they appear. Fever is a natural response of the immune system — it’s a response to illness, not illness itself. Fever ultimately can be productive and may assist your child’s body in fighting off infection. There may be no reason to make a fever disappear if your child is otherwise acting well, playful, and staying hydrated.

Second…there are some fevers that do require a visit with the pediatricians. It’s important to seek care when fever persists after 3 days in infants and children, any fever in a baby 3 month old or less, and if fever is over 104 degrees it’s wise to get support. Talk to your doctor before giving a pain reliever or fever reducer containing ibuprofen if your baby is younger than 6 months. Talk to your doctor before giving acetaminophen to a child younger than 2 years to obtain the proper dosing instructions, or see charts below.
Before giving your child any medicines, make sure you know your child’s weight. Dosing is always based on a child’s weight, not age.

Last… trust your instincts! If your child looks unwell in the face of fever and doesn’t seem to be improving as you would expect, call your pediatrician for help! If the fever is unexpected in a way, consider calling in to get support and education.

Ok…now that we’ve got all that out of the way, here is one way you can alternate between medicines (acetaminophen and ibuprofen) every 3-4 hours: Read full post »

After The Vegas Shooting: What To Do Now And How To Talk To Children About Firearms

In the wake of the recent Las Vegas shooting, I went on the Seattle NBC affiliate, KING5 News, to discuss how to talk to your children about guns and violence. Frankly, it’s not the first time I’ve covered this topic and as horrifying as it is, it probably won’t be last. I’m upset and sad that these shootings are becoming a part of American culture and I’m committed to doing my best to learn and translate what the experts advise us to do to decrease deaths from firearms.

I have lost people I love dearly to firearms so like so many of you, this is personal.

No question that we can feel helpless after horrific events. Focus on what you can do and share that with your children. If there is a gun in your home, keep it locked, unloaded & separate from ammunition. Remember that exposure to violent media and violent video games will change your child’s relationship with firearms – the “weapon effect” is real – so think carefully about what video and media your children use. Common Sense Media is a great site to help you sort out your choices.

Guns And Violent Media – A Toxic Mix With An Available Antidote. <— read this, it’s amazing. Basically the gist: violent media changes what children think of and may do with firearms and firearm safe storage reduces firearm suicide and accidental shootings by 75%. Seventy-five percent reduction of suicide deaths and accidents from firearms just with storage. Talk about it, do it.

As individuals we obviously can’t prevent mass shootings by what we do in our homes today, but we can communicate openly and honestly in age-appropriate ways with our children, we can build a safer culture with our firearms in America, we can vote, and we can remind children all of the things we do to increase safety in their lives. We can make sure that those around us know how much we want to keep firearms out of children’s hands, too. This will help. Read full post »

10 Things To Know About 2017-2018 Flu Shots

The flu season is soon to be upon us and I hate to be so prescriptive but when it comes to influenza I feel like I have to be. I immunize my entire family and I think you should, too.

Hard to believe, but with our children going back to school and swapping snot around the classroom, it’s time to get fall flu immunizations on your radar. Last year during the 2016-17 season, more than 100 U.S. children died of the flu (influenza), and thousands more were hospitalized for severe illness or complications from the virus. Historically, more than 80% of children who died of influenza were not vaccinated. The flu shot is the best way to teach your own immune system to fight back if exposed to the virus. The flu vaccine “recipe” was changed this year (one different A strain compared with last year’s vaccine) to accommodate for predicted viral strains that will likely come and circulate around our neighborhoods.

The recommendations this year are the same as last year. Every child over 6 months of age should be immunized.

10 Things To Know About Flu Shots:

Here’s what you need to know based on my experience as a pediatrician, The Centers for Disease Control and American Academy of Pediatrics policies: Read full post »

1 Small Hack For Smarter Smartphone Parenthood

It’s the last official week of summertime around here. My babies love school and are eager about the beginning; it’s me nursing an increasingly bigger pit in my stomach as summer wanes and September nears. While my boys grow up I feel like I see more clearly the ways summertime affords juicy glimpses into the innocence of childhood. This summer I watched these little boys stay in their jammies past noon and watched as they dabbled in stories and books, make believe, competition, mindless daydreaming, Lego-building, risk-taking, and an earnest growing concern about safety in the world. To me the collection of those interests feels so earnest and utterly serene. Summertime is just slower.

I crave the de-clutter of long days without so much chaos. Without the stresses that the school schedule ushers in, the summertime-alarm-clock-free space lends priority to an actual circadian rhythm. We eat better, the days are less driven by rule following. I think we might laugh more. Less time spent rushing and shuttling from one thing to the next and more time listening. A lot more time goofing off. I mean my 8 year-old ran into my room first thing this morning in a cape! What life (with children) is ultimately about.

As this summer, in particular, wraps up I’m also recognizing with increasing fortitude the peril we’re under because of technology in our lives.

Nothing new or profound but I really feel it right now, more than ever. My work over the past years with The American Academy of Pediatrics Council on Communication and Media has shaped the study on device-use as a station in my work, but it’s my role as a mother that screams out louder in me right now. We could really mess this up. Not our kids, per se, I just mean how we all experience this precious gift. Read full post »

Tips And Facts For Families On The Solar Eclipse

I know, everyone is writing about the eclipse. I’ve got just a few messages. One is, this is gonna be cool. Two, the caution messages are real. The cool part is because when our world goes a little dark mid-day next week it will be fairly startling. Even the animals are expected to change up how they behave. And the cautionary messages just make sense. Our eyes and our vision are clearly worth protecting ferociously. Damage from the eclipse can be permanent so taking a few steps to understand how and why just makes sense. And for framing this whole thing up in life? Thank goodness many of us have children in our midst. Their enthusiasm about how BIG this event is can help scale how exciting it is when the sun disappears in the middle of the day. Children harbor amazing perspective of what matters. Monday is a great day to stop reading the news and stare up into the sky (carefully). Thank goodness.

Quick Summary Of The Total Solar Eclipse

On Monday, August 21, 2017, all of North America will be treated to at least a partial view of an eclipse of the sun. Anyone within the path of totality can see one of nature’s most awe inspiring sights (as I’m told) – a total solar eclipse, which has not happened in 99 years. This path, where the moon, the sun and the Earth all line up such that the moon completely blocks out the sun will stretch from Salem, Oregon to Charleston, South Carolina. The New York Times created the above video that captures the science and awe of this event. Even NASA created a website to provide a guide to viewers. Out West, people are talking of little else and Slate is reporting that Oregon is expecting 1 million tourists view the eclipse. People are changing up their weeks to view this. Two little girls from Seattle are getting real – they’re launching a weather balloon into space, in partnership with NASA, with live GPS tracking (and an Amelia Earhart LEGO) and some live video coverage links, too. I mean, it’s a big deal.

Can The Eclipse Hurt My Eyes?

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