Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Driving Under The Influence of Electronics: The New Law

Getting a DUI just got easier. Driving Under The Influence of Electronics (E-DUI) is real and will cost you as Washington State gets serious about reducing deaths from car accidents caused by distraction. The reason is clear: we know distraction from cell phone use increases risks of accidents over 20-fold and we know the habit of using a device has quickly become the norm. Here’s to hoping the new law helps us think of our cars as the sanctuaries they can be for those we cart around and for those we love. Of anything I’ve learned from researchers about vehicle safety and distraction it’s the reality that finger-wagging and telling-us-to-change type advice won’t affect our habits — we have to be motivated to change the culture of our car. We have to want to connect there or we have to be fearful of being fined. Since I made the podcast with Dr. Beth Ebel (embedded below), whenever I get in the car with my boys I think of it more like I think of time at the dinner table. And I love thinking about the car in that way. It’s so much easier to make sure I won’t pick up the phone…

The New E-DUI Law In Washington:

Tomorrow a new law signed by Governor Inslee bans holding hand-held devices, like cell phones, while driving (and even when you’re stopped at an intersection). The law makes it so drivers can only use their phones to call 911 or by using one finger to trigger a voice-activated application on bluetooth. In addition to a $136 ticket for your first offense and $234 for the second within 5 years, these citations will be reported to insurance companies. Learn more about the law on Washington’s Target Zero website. The reason is pretty clear — just as we were seeing the death rate fall from good seatbelt use and clamping down on DUIs, there has been a rise in accidents and deaths. Many believe this is in part due to the rapid rise of device distraction.

Under the new law you can’t even look at your phone at stop lights. Reason is, you lose awareness of situations around you and many accidents occur when pedestrians are struck by distracted drivers in intersections.

Data Driving The New DUI Laws:

  • Fatalities from distracted driving increased 32 percent from 2014 to 2015 in Washington.
  • 71 percent of distracted drivers engage in the most dangerous distraction, cell phone use behind the wheel
  • One out of four crashes involves cell phone use just prior to the crash.
  • At any given time, 2013 research has found that about 10% of people driving are actually using a device and half are texting! Anecdotally it only seems to be getting worse. I mean we look around and constantly we see people flying down the highway while trying to send messages.

The law is a big step in the right direction for avoiding injuries and death from distracted driving. We know that it’s hard for us all (!!) to keep the phone off or in the backseat. And we know the fear of tickets — the ones that take away money but the ones that also increase insurance premiums — may change behavior. And that’s the goal. Public service announcements scaring us about risk clearly are not enough and are clearly ineffective as use of devices in cars rages on.

Other Distractions When Driving:

All sorts of things can distract us while driving, of course (hello, screaming children in the back). And tickets will be given for other infractions (grooming, eating, reading or smoking) if it gets in the way of safe driving. Oddly, the tickets for those distractions are only $99. In addition, just how we think can put us at risk, too. So those with a diagnosis of ADHD who take medicine to focus should continue to be careful to drive only when taking prescribed medications. The distractions associated with ADHD (Attention Deficit Hyperactivity Disorder) can be dangerous on the road. This may be especially true for our teens who are already at risk of getting in a car crash. In fact, driving is the most dangerous during the first six months that a driver is behind the wheel. For the majority of new drivers, 15 to 20 year-olds, they make up 10% of all motor vehicle traffic deaths and 14% of all police-reported crashes that result in injuries. So thinking carefully about devices, distractions, underlying risks, and experience behind the wheel all will matter.

Recent Study Findings on ADHD, Driving, And Distraction

A new study from JAMA Psychiatry of more than 2.3M US patients with ADHD found:

  • Untreated ADHD patients had the highest risk of a car crash
  • Men with ADHD were 38% less likely to have a car crash event when taking medication
  • Women with ADHD were 42% less likely to have a car crash even when taking medication

To better understand distracted driving, it’s important to know the three types of distraction that occur with smartphone use and each additional distraction increases risks and danger:

  • Visual (eye aversion)
  • Manual (hand preoccupation)
  • Cognitive (thought wandering)

Know the Risks

  • Car crashes result in approx. 33,000 deaths and 2.8 million injuries per year
  • Adolescents are 4x more likely to be involved in a car crash than drivers older than 20 years of age
  • Performance of a secondary task can increase the risk of a crash because it is cognitively demanding (texting is known to increase the risk of a crash by as much as 23-fold increase)!

The risks are everywhere. Let’s do our best to treat our cars like sanctuaries. Let’s travel as best we can without picking up our smartphones. And let’s welcome the law to help ensure we change our behaviors. For more from safety expert and pediatrician, Dr Beth Ebel, listen to the podcast below! She is so smart, so passionate, and so fair in working to find ways to make this better and safer for us all.

Chemicals In Macaroni And Cheese Explained

If you’re a parent whose child loves macaroni and cheese (and truly, it’s the rare child who doesn’t), you’ve most likely seen the NYT media blitz on chemicals found in popular, boxed mac-n-cheese brands sold in grocery stores. I’m going to break it down quick and simple. Here we go….

  1. The chemical detected in the mac and cheese were are called phthalates. Phthalates aren’t an added ingredient that companies are purposely using in their products. This isn’t an artificial ingredient, per se. It also isn’t something you avoid in your food when buying organic foods.
  2. Phthalates are chemical toxins that are used to make rigid plastics more flexible and less breakable. These plastics are used in processing plants and conveyor systems that our food and other ingredients travel THROUGH while being preserved and packaged. The phthalates can then leak from the plastics (tubing, conveyor belts, machinery) INTO our food or ingredients.
  3. Research links phthalates to possible genital abnormalities at birth and disruption of hormones, learning disabilities, and behavioral problems. Phthalate exposures during pregnancy can cause changes in estrogen and testosterone levels in fetuses. There isn’t a known “safe” amount of phthalates for our diets. So when we can reduce our exposure to them, we should.
  4. Almost all dairy products you consume contain phthalates. So it’s not just the mac-n-cheese that’s exposing us to phthalates. Milk, cheese, cottage cheese, string cheese, ice cream and other foods…any milk product contains them. Phthalates piggyback into our food and are stored in fat. That’s one of the reasons it’s smarter to drink low-fat dairy products over high-fat ones.
  5. We don’t know yet which brands the report surveyed and this work wasn’t published in a peer-reviewed journal. Some media outlets are reporting Kraft was included but I was unable to unearth which brands and what levels were found. To be safe, I’d assume most macaroni and cheese prepared products contain some level of phthalates because they all require processing.
  6. Buying organic mac-n-cheese isn’t saving you from phthalate exposure. Remember anything that’s been processed through tubing or machinery can have phthalates. Phthalates can also leave plastic products in our house (plastic food containers, plastic dishware, plastic surfaces) and enter our food, especially when heated. So the less we use plastic to store or transport our food the better!
  7. We don’t actually know what level of phthalates are safe for consumption so as the science and understanding of the risks evolve it’s best to think on diminishing exposures.

Also, read more about the other challenges (high fat, low fiber, too many nitrates, high sugar, high salt) of processed foods in this piece in JAMA Pediatrics: Processed Food-The Experiment That Failed. I love this quote, “Given these outcomes, the conclusion is clear: processed food is an experiment that failed. Processed food is high in sugar and low in fiber. There’s only one recourse—real food, which is low in sugar and high in fiber. Real food is what the world ate for millennia without risk of long-term disease. But that’s not what the 10 biggest food corporations are selling.”  I’m also including a rebuttal to this opinion piece published this week here, too (it’s about motherhood and practical advice).

My bottom line: enjoy everything in moderation & offer your children lots of fresh fruits, vegetables and whole foods. We gotta eat real food! Eat low-fat dairy products over high-fat ones. Don’t heat food in plastic containers. Here’s a podcast where Dr Sheela Sathyanarayna’s explains more:

I agree with the New York Times suggestions, created with Dr. Sheela Sathyanarayna’s advice:

If you’re pregnant or planning a pregnancy, have young children or want to reduce your family’s exposure to phthalates for other reasons, here are some suggestions:

■ Eat more whole fresh and frozen fruits and vegetables, and minimize the amount of processed food you eat. “Avoid anything you find in a box that could sit around for many years,” said Dr. Sathyanarayana. “There are so many steps to get to that boxed product, and every step along the way, there’s usually plastic involved.”

■ Choose low-fat dairy products such as skim milk and low fat cheeses, and avoid high-fat foods such as cream, whole milk and fatty meats. “We know these more toxic phthalates accumulate in fat,” Dr. Sathyanarayana said.

■ Use glass, stainless steel, ceramic or wood to hold and store food instead of plastics, Dr. Sathyanarayana suggested, and if you are using sippy cups and baby bottles made from hard polycarbonate plastics, don’t put hot liquids in them.

■ Wash your hands frequently, and take your shoes off at home to avoid household dust that may be contaminated with chemical traces. Vacuum and wet dust frequently.
■ Food isn’t the only source of exposure. Many fragrances contain phthalates, Dr. Patisaul said, so choose unscented personal care products, from cleansers, moisturizers and cosmetics to shampoo and detergents as well.

Resources:

What To Do With Bug Bites and Itchiness

It’s July so we’re officially in summertime, thank goodness. My prescription: warm and outdoor adventures for us all! Obviously if we take the Rx seriously, we’ll all be more likely to get bit. When it comes to bug bites, the most important thing to know for your child (and yourself) is how they will react. Some children get bit all over and hardly react while others will have enormous, and tremendously ITCHY welts all over their body. There truly are children who are mosquito-bite sensitive and children who are not. Some get bit and hardly react while others of us end up with welts in minutes.

In general, bug bites cause a mild irritation to the skin. However, sometimes a more allergic reaction results and persists, even for days causing real discomfort. In these scenarios, it’s safe to use anti-allergy medications (diphenhydramine, etc) for itchiness from bites. It’s also safe to use over-the-counter (OTC) hydrocortisone cream or ointment on bites that aren’t scratched open or raw.

Some tips on how you can help keep your children bug bite free or help them when they do get bit: Read full post »

Pride: The Wellness Effect of Same-Sex Marriage Laws

Seattle’s Pride Parade is tomorrow, Sunday, June 25, and it has a great theme — Indivisible. Take the meaning of the theme as you like, but if there’s one thing that is true for Pride in Washington, it’s that there is an abundance of support. The majority of our people here, it seems to me, are building a community and will not be divided more. I feel so thankful to live in a community that is on its way to continuing to make all feel welcome, safe, and grounded in a sense of belonging.

As we come upon the 5th year since Washington State legalized same-sex marriage (woohoo!) it’s important to highlight the importance of what laws like this can do within the community. The legal changes here have had a lasting impact on thousands and thousands: there were approximately 15,750 same-sex marriages in Washington between 2012 and 2015.

These laws not only increase liberty and resources for families with same-sex couples, the laws may increase our community’s health and they may earnestly decrease suffering.

A study published by JAMA Pediatrics found that states with same-sex marriage policies had a 7% reduction in adolescent suicide attempts. The study analyzed data from 762,678 adolescents in 47 states between 1999 and 2015. Of the states included in the study, 32 permitted same-sex marriage and 15 states did not.

Evidence from nationally representative 2015 Youth Risk Behavior Surveillance System (YRBSS) data indicates that more than 29% of gay, lesbian, and bisexual high school students reported attempting suicide within the past 12 months, relative to 6% of heterosexual students.

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Just ASK About Firearms

It’s national selfie day (??? an excuse for my millennial behavior) and it’s also Just ASK day (smart stuff), hence the image I snapped this morning. I spent the morning today at KING5 news making some TV segments encouraging us all to ask about firearms when we drop our children and teens off for playdates, sleepovers, camps, and fun. Although it seems awkward at first blush to ask how a firearm is stored at a home of someone you love or someone you hardly know for that matter, I’m convinced it’s time to make it the norm. Weird, I suppose, to ask something that may feel imposing especially when someone is graciously taking in your little rugrat for dinner or soccer or a sleepover or a trip to the beach…the reality is this: 9 out of 10 parents don’t mind being asked about firearms. And ensuring that our children can’t get their hands on firearms at the wrong time is something we all work on.

Just ASK about firearms in the home. Every time. Make sure if firearms are in the home they are stored unloaded and are separate from ammunition. Ideally, firearms should be in lock boxes and/or have trigger locks

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Avoiding Shame When Talking About Weight With Your Teen

Figuring out what to say to a child or teen about being overweight can be perplexing. We want out children to love to eat. We want our children to love their bodies. We want our children to be of healthy weight. We want to avoid ever making our children feel shameful about how and what they eat.

It can be a challenge to figure out what to say when we worry our children may be overweight or at risk for being overweight. How do we talk with them about eating well without making them feel any frustration/shame/overwhelm about their body? There are roughly 7 million children and teens younger than 19 years old in the US that are of unhealthy weight or obese. In Washington, 23% of 10th graders (15 to 16 years old) are overweight or obese. That’s nearly one-quarter of teens who are at one of their most vulnerable ages. So lots of parents may find themselves wanting to support different choices with eating and activity and not know quite how.

Adolescent expert Dr. Cora Breuner is a specialist who works with teens who need extra help getting to a healthy weight. She recently joined me on a podcast to discuss talking about the difficult topic with your teen. Specifically, Dr. Breuner shared tips on how to approach conversations with your teen about their weight, and common confusions and excuses for overeating.

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Reducing BPA and Phthalates in Your Everyday Life

Chemicals are a part of our environment in the modern world, of course, thanks to the conveniences afforded to us by farming, manufacturing, and industry. Every parent wants to reduce exposures for their children as they grow. No question that developing babies and children may be more vulnerable to the effects of toxins as their bodies and organs and minds form. There are 80,000 chemicals in commerce (yikes!) with 3,000 being high volume meaning they can be found ubiquitously in some of our lives. There is no way to completely avoid them, but there are ways to reduce exposure to specific chemicals you’ve likely heard about, like bisphenol A (BPA) and phthalates and other pesticides and toxins found around your community.

Four quick tips for reducing toxins in your home below.

My colleague (from way back in residency), Dr. Sheela Sathyanarayana is an expert in understanding the effects of chemicals on developing and growing babies and children. She joined me for two podcasts to discuss chemical exposure, what the effects are and how you can reduce your family’s exposure. Dr. Sathyanarayana is a pediatrician at Seattle Children’s Hospital and a pediatric environmental health scientist at Seattle Children’s Research Institute. Her research focuses on exposures to endocrine disrupting chemicals such as phthalates and BPA and their impact on reproductive development.

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Limit The Juice: None for Babies, Only Ounces For Kids

Not news that pediatricians recommend against juice. But the news this week is clearer: no juice for babies, only tiny bits for toddlers, and less than a cup a day for the rest of us. Fruit juice is widely thought of as a healthy and natural source of vitamins and hydration. And although I won’t vilify having juice in the diet of an older child, I can’t endorse it’s ever good for a child. Pediatric recommendations for juice got stricter this week. Juice is never really recommended in an a child’s diet past ounces to a cup a day but now it’s recommended as a NEVER during infancy.

Although whole fruit (i.e. an apple or an entire avocado or apricot) is one of the main focus foods in the Dietary Guidelines of Americans, fruit juice may feel a thoughtful substitute, but it’s not. In fact, even 100% fruit juice offers no real nutritional benefit and it’s never needed. The short list for why?

  • Juice is just a bunch of water and simple sugars (naturally occurring sugar is sugar) and lacks fiber or protein.
  • When you obtain calories from juice you take them in at a faster rate than is ideal. Juice is known to contribute to overweight and excess energy imbalance in children. We don’t need to drink these calories.
  • Whole fruit has the advantage of containing quality fiber that’s good for us.

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A Few Recommended Rules For Fidget Spinners

Fidget spinners are everywhere. The photo here was captured this morning on the way into school. That little blue wonder spinner showed up in our home without us even knowing it last week. My 8 year-old got it at the 2nd-grade market our school put on! And I’ve even heard about a set of savvy middle-school students in the midwest using a 3-D printer to make their own. Hello, New World of Toys and Toy-Making. This just a reminder that these fidget toys are often cheap and easy to get ahold of so parents may not even know when one’s safely tucked in a backpack of a school-aged child or teen.

I played with one for the first time this morning and lemme say this: I get the draw.

Spinners are here to stay, at least for the rest of this school year, and teachers/parents/schools are making up the rules as we go. But yesterday when I interviewed with TODAY.com about potential choking risks after a 10 year-old needed surgery to remove a piece of a similar spinner from her esophagus, and I later learned the (now, not confirmed story — urban legend aka “fake news?”) tale that a teacher sustained a serious eye injury when one spinner went flying and fell apart. Although the injury is likely theoretic I got to thinking about what to know and how we can parent with the latest craze. The Facebook shares on this story have gone viral with over 700,000 shares and 75,000 comments in the past few days (*update 5/22/17: Facebook link has since been taken down). Clearly, spinners are on many of our minds.

The choking events will hopefully be exceedingly rare, as will the injuries from fidget spinners, but we can think clearly about how to enjoy these silly little objects and not go bananas or have anyone get hurt. Read full post »

Tips for Reducing Hearing Loss From Earbuds And Earphones

I’ve started to use earbuds a lot. Like a lot a lot…like every day. Just like so many other people you see on the street, and many teens, I use earbuds daily to make phone calls, listen to music or podcasts or engage while I stream videos. On the plane, always. And on a bad day or a sad day, no question I love to turn the music way up when I go for a run.

Turns out I’ve got to make some changes. The 60/60 rule has gotta start soon (keeping volume no more than 60%, listening for no more than 60 minutes at a time).

I’m not alone. We’re seeing more and more adults and teens with hearing-loss related to earbud use and loud sounds from digital devices. This problem is growing. Data on how using earphones and earbuds, in particular, they change what we hear, how we hear it, and how the placement of a speaker deeper into your ear can contribute to irreversible hearing loss is worth our attention. Hearing loss from loud sounds isn’t recoverable  — meaning once you damage the little hair cells deep in your ear they don’t grow back — that hearing is lost for good. When it comes to our hearing, we do therefore really matters at any time in our life.

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