Author Archive

What About You? The Value Of Sleep

The minute we become parents we immediately start to hone in on the value of our children’s sleep. Their growth, their feeding, their development and their sometimes labile temperament quickly illustrate the import of real rest in our lives. Many parents advertise their commitment to their child’s sleep as a huge parenting win. Those of us who struggle with it, we often admit defeat. It’s clear, pretty early in infancy, that sleep transforms who we are, how we think and how we live from day one. Our babies are savvy professors in this regard.

Modern parenting conversations are teasing out the value of child sleep versus the value of adult sleep in multiple ways. In some cases, it’s the tug-o-war and battle-of-minds while discussing data and beliefs around when to let a baby cry-it-out. Working parents often report on their inability to sleep in the early working/baby years. In the U.S. we constantly revere those who don’t sleep a lot  — productivity seems to trump wellness in the hierarchy: there are politicians, profressional athletes and successful business people who brag about their capacity and earnest commitment to their craft via the lens of accomplishing greatness on minimum sleep. All this, despite the mounds of research that find health and performance benefit from a good night’s rest.

No question it’s culturally acceptable (if not culturally desirable) to sacrifice our own sleep for our children’s. I’m uncertain there are hard and fast rules here about which is more important but I speak with sleep expert, Dr. Maida Chen about the value of sleep routinely. We decided to share some perspectives on sleep (see the video) because I wonder:

What about you? What about your sleep?

Just this morning someone commented on the intensity with which I work and suggested (like so many do) that I must not sleep. I was happy to report that I’m all in for improving things, but that I also have spent a good deal of energy these past years making great time to sleep at night, while also carving out time to love-up those in my life who consume my heart. I think there is a better way to care for ourselves and it may start with 7 or 8 hours a night with our eyes closed.

Support For The Value of Sleep

In the video we mention a bit of data. Read more here:

Allergies Run In The Family


It’s a gorgeous time of year when things are abloom. Many of us suffer from irritation and allergies to these months as pollens and particles float around and trigger allergic response.  Not so beautiful when our families (over)react to pollen. Thing is, there’s also the fact that cold season isn’t quite over and the exact cause of that runny nose your child is dealing with may be hard to decipher. One hint that it’s allergies and not a cold: do you, your spouse or any of your other children suffer from seasonal allergies? Unfortunately if so, there’s a 25% chance your child will too. That said, the likelihood more than doubles when both parents deal with allergies on a seasonal basis. Watch the video above for tips on telling the difference between hay fever & the common cold and when to be on the lookout for the former.

5-13 allergies

Allergies Or A Cold This Time Of Year

  • This is common: 1 in 5 Americans have allergies at some point in their life so allergies and over-reacting immune systems are a part of many families. Hay fever is the most common allergy in America and can easily be treated with avoidance to allergens (avoid parks when irritating pollens around and/or take a shower when you get home from the park and wipe those pollen allergens off!), OTC medications, and sometimes additional prescription medications. Most children with hay fever only need allergy medicines during seasonal bursts but some children benefit from year-long treatment because of allergies to multiple things. Here’s more on OTC medications used to treat allergies.
  • Often allergy symptoms change with age; allergy symptoms can accelerate during young childhood but then often subside and diminish as you age into adulthood. Talk with your child’s nurse, PA, or physician if you’re concerned about their symptoms or their trend in symptoms as they age.
  • Read medication labels for ingredients in allergy medications. Use the lowest dose possible to treat symptoms and talk with your child’s clinician if any questions about dosing. If your child is under age 6, check in at the physician’s office before doing a trial of an OTC antihistamine. If over-the-counter medications don’t improve symptoms or suffering, don’t panic — if the cause of symptoms are allergic there are prescriptions and many environmental changes you can make to improve your child’s discomfort.

5-13 know your OTCsThis post was written in partnership with knowyourOTCs.org. In exchange for our ongoing partnership helping families understand how to use (and dispose of!) OTC (over-the-counter) medicines safely they have made a contribution to Digital Health at Seattle Children’s for our work in innovation. I like the Know Your OTCs tagline, “Take your healthcare personally.” You can follow @KnowYourOTCs #KnowYourOTCs for more info on health and wellness. 

 

 

Good News & Bad News: Whooping Cough

Two new Pediatrics studies are out this week teaching us more about the effectiveness of the whooping cough vaccine. Lots to learn about how we protect babies and reminders here why we’re immunizing moms during EVERY pregnancy:

  • First, the good news: traditionally we have been trained to tell parents that the first shots we give during infancy aren’t fully protective for infants but rather the beginning of creating immunity against the diseases they prevent. However, a study conducted by researchers at the CDC looked back at cases of infants with pertussis from 1991-2008 and they found evidence that babies who received their whooping cough shot as early as they could, at the age of 6 weeks, were less likely to be hospitalized and/or die from the infection. Wonderful news! The first evidence out there that even that first shot, when given as early as possible, helps protect very young infants who are most at risk from whooping cough. New parents can increase protection, even during outbreaks like we’re having right now, by getting their babies immunized on-time and as early as possible.
  • The not so good (but important) news: the effectiveness of the Tdap shot given to young teens (explained more below) doesn’t always provide long-lasting protection and wanes significantly in the years after the 11-year-old booster dose is given. New research out found after 1 year, about 70% of teens are still protected from the booster, but by 4 years after the shot only about a 1/3 of them are. More:

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You’re Not Kate Middleton, Here’s What To Do

5-4 Kate Middleton

Photo credit: Ben Stansall/AFP/Getty

On Saturday evening, the newest member of the royal family was introduced to the world. Princess Charlotte Elizabeth Diana made her public debut at 6:12 PM Saturday evening, a mere 10 hours old. But what caught the attention of royal-enthusiasts and moms everywhere was new mother-of-two Kate Middleton’s appearance. That blown-out hair! That perfectly made-up face! The heels! She gave birth to a healthy, term baby girl that same day and looked as if she stepped from the cover of a magazine. And some moms around the world thought, “How does she look like that so soon after having a baby?”

I think this just brings light to the variant experiences we have with childbirth and the differential circumstances that we bring children into the world. I certainly wasn’t ready for heels a 1/2 day after giving birth but that may have to do with complications I endured and the C-section I had to undergo. Many women labor for days are are thoroughly exhausted by the time they start skin-to-skin and feeding their newborn. Many of us would have no interest in being in front of the world’s cameras 1 day after child birth. Some of us would, of course…

All this: a reminder that some women have wild support systems and elastic rebounds after childbirth while some take time to heal, recover and transition to the extraordinary privilege of being a mom. Some women deliver babies alone and without support, some have royal birthing suites. You can only imagine the team of people who helped support the Duchess’ worldwide unveiling. Kate’s appearance caught on camera reminds us ever so gently again that as parents we’re happiest when we don’t compare ourselves to others. When we focus on where we are with our own children and the gifts and challenges we often find coming our way, we typically can poetically enjoy this wild ride with such increased joy. In my opinion, competitive parenting abounds — comparing ourselves to the Duchess will always lead us astray.

As Mother’s Day beckons, we can put the hesitancies we may feel about our own circumstances in perspective and gift moms and women here and around the world. Perhaps consider giving a donation to One By One (a group providing support and cure to women with postpartum fistulas) or Women’s Opportunity Network (a group supporting women with micro-financing to start their own businesses and support their families around the world). If you want to honor your own mom and support children and their mothers here at Seattle Children’s, please consider doing that too! You give away $5 to another mother and all of the sudden Kate’s gorgeous yellow dress fades into the background…

Disneyland Success Story During Measles Outbreak

baby-O-e13075541951481There’s a beautiful story of success tucked away in the recent measles outbreak in the United States. Sometimes we forget to talk about it. When measles popped up at Disneyland in December 2014, it made headlines as the public remained thirsty for the media’s support in understanding who was at risk and why. I spoke to dozens of media outlets about the outbreak, under-vaccinated populations, the MMR vaccine, and how to protect those most vulnerable during an outbreak. We all emphasized those at biggest risk: infants too young to be immunized, those who were unvaccinated, or those too ill to be vaccinated. Measles is an illness I would be terrified to get — and I don’t like that people who aren’t protected are at risk for both catching the disease and spreading it. I think the public gets this in new ways although I hate that it takes outbreaks to capture attention and drive this education and understanding.

Measles virus, and the vaccine we have to prevent it, form a unique pair because although measles is wildly infectious and can be life-threatening the immunization is wildly effective and life-saving (>99% of those immunized are protected for life). It is a safe vaccine with minimal side effects. What a fortune and a triumph in prevention medicine. A terrible disease, once thought to be eradicated in the U.S., is swiftly prevented by a vaccine that nearly everyone in the population can get after their 1st birthday.

The beautiful story from the outbreak is this: Read full post »

Pale4Prom: Indoor Tanning And A Hashtag

Image courtesy: @mdub686 (Original source found here)

Image courtesy: Melissa Walling (Original source found here)

It’s prom season and we all know it’s the season where teens feel pressure (and sometimes giddy delight) to prepare to look entirely fabulous for the night. Full of pressure or full of glee, this is without a doubt the time of year when teens I see in clinic talk most about tanning.

A 2014 JAMA study found 19% of teens (under the age of 19) have used a tanning bed, with 18% of them stating that they’ve used one in the last year. That’s in every teenagers still feeling that “bronzed is better” and a thing of youthful beauty regardless of the known consequences. We have to do a better job, both as parents and as doctors and health educators, explaining the unnecessary risks teens take on when changing the color of their skin. Recently, a hashtag surfaced on social media encouraging teens to be “#pale4prom.” Thoughtful critics have raised concerns about the racial implications this campaign could ignite, I do feel this campaign can do good for those teens exploring indoor tanning. We all want to feel beautiful in skin that is protected from the sun. In my mind, the easiest word to market the idea of skin without sun is pale. I’ve urged teens to enjoy the beauty of pale skin (sometimes unsuccessfully, in clinic and in my personal life) and hope the shift from bronze to pale is a trend that continues to grow as years unfold. There’s no question we can do a better job valuing what beautiful skin really is. 5 reasons why: Read full post »

Maybe This: “I Wish My Mommy And Daddy Knew”

I’ve watchedWish Mommy Knew the viral #Iwishmyteacherknew campaign with earnest intrigue. If you haven’t read about it or followed along this past week, know that the campaign started when Denver 3rd-grade teacher, Kyle Schwartz, honed listening and asked students directly what they wished she knew about them. They wrote out responses and she started to post them on social media with the above hashtag when she realized the goldmine she’d discovered. In my mind this has captured the nation’s attention because of the empathy we feel reading about perceived (and real) short-comings in children’s lives and because the raw power that third-grade words provide in understanding inequities for US children. As a previous inner-city middle and junior high school teacher I think this teacher’s tactic and insight-seeking is profound. Reminds me so much of Momastery’s post last year about a teacher who finished each week in the classroom asking children to write down who they’d like to sit next to in school. She asked not to stir up the seating chart, but to determine immediately which children were being left out. She honed listening to facilitate and build connection for children who may be silently struggling.

I’ve been snagged a number of times this past week thinking about the #Iwishmyteacherknew, thinking on asking my own children the same question. What do they wish I knew? Would they journal something they wouldn’t say? Would invited words, written out in silence on paper, protect our children from the inevitable judgment/worry/concern/disorganization they may feel in answering a question like this in real-time when something dear is at stake? Something as dear as the bond they feel?

I surveyed a couple of parents and friends in the last few days if I should do it and if they would ask their own children. Most parents I discussed it with had a similar feeling to my own. Immediately our faces wince. We cringe when we think of it, unsure we’re ready to face the reality of where our children may feel we’ve fallen short in listening or unsure we’re steady enough to not just tolerate what we hear but also change things in life to improve the circumstances.

Would you do it? You ready to ask your school-age children or even your teen what they wish you knew about them and allow them time and space and paper to write it down?

Pill Swallowing Sooner Than You Think

4-20 pill tongueAs adults, many of us take or swallow pills out of necessity to manage or prevent a chronic health condition. From a vitamin to even a life-sustaining medicine, you probably don’t hesitate or panic when swallowing the pill, even the biggies. But knowing how to swallow medicine isn’t something that just happens, often it’s a learned skill that may vary widely in regards to timing. During my education I was trained to think that once children hit double digits (age 10 years) it’s appropriate to think of them as “capable” of swallowing pills. But new findings published in Pediatrics cite research demonstrating that learning how to swallow a pill may be easier for younger children to master before they’re facing anxiety that can come from having to swallow something whole. Bottom line in the research: although many children struggle with swallowing pills, five studies reviewed find various techniques to support children with pills really do work! Mastery is possible here, but anxiousness about pill-taking spans childhood for some. Unease about pill taking can be a real barrier in treatment adherence both for children and teens with chronic health conditions.

Pill-swallowing may not come “naturally” to your child. A 2008 survey found more than 50% of children, by parental report (children from birth to age 26), were unable to swallow a standard size pill at some point. This complexity in pill-swallowing or refusal of medicines can be a once-in-a-while battle or a daily barrier at home. Many important medications are taken orally and the illness experience for parent and child is much more stressful when this challenge pops up.

Interventions Do Help

Five interventions were reviewed in the research and all of them proved beneficial for children: Read full post »

Mindfulness In A High Stakes Job

4-17 mexicoWe’re just back this week from a vacation with our children. The 6 days we had together, the variant pace at which we were able to live for the week, and the challenges that bubbled up offered some reminders but also some fears for me. We’re always on quicksand while raising children. Parenting demands exceptional grace but also exquisite flexibility and immediate rapid-fire insight. Our job descriptions, as parents, are ever-evolving; we’re asked to shift what we know as we step from stone to stone and into something new as quickly as our children do. The minute we feel we’ve figured something out — whammo — a new challenge arises we never even thought to consider.

The stakes are high. Of anything that unites us all as parents it’s knowing that truth. Along the way we will fail, fail, fail and have wondrous little successes too, thank goodness. Yet the tasks involved in raising a child will never look just like they did last month. I loved a This American Life (#553) segment I listened to this past week where a mom discussed some of the complexities in the requisite shifts she faced raising a principled little 7 year-old boy named Elias who is vegetarian and very emotional about animal-eaters. He finds himself living amid a family who explores an occasional pepperoni pizza and turkey sandwich. As his parents upend the way they eat at home (they end up banning all meat at home because of their son’s feelings) narrator Ira Glass states,

“If you’re hearing all this and you are feeling judgey about these parents and I know you are, because that is a national pastime — judging other people’s parenting – I just want to say I totally felt that way until I heard Elias….just like she says. Hearing Elias made me realize ‘oh, right, she actually is in a really tough situation. Where she has these two kids and those both have really strong feelings about this and she doesn’t want to crush either one of them.’”

Judging others’ parenting is often just the malaise of parental insecurity. We all have our own shakiness at times, especially as we’re asked to rise to new heights each new day. It’s of course so easy to judge, and so much harder to elevate and emulate others. In my mind, the best we can do while parenting (failing or succeeding) is tease out others’ profound moments. Learn from them but also copy and try those things out ourselves and see how we can make them work in our own lives. Read full post »

When Recess Is The Favorite Subject

4-13 recessMost parents cringe in the office or at the park when their child reports to me that recess is their favorite subject. Thing is, I think they may want to celebrate. Some of our best thinking, our most inventive or creative solution generation, happens when moving around outside. Research has validated the merits of play and movement for learning during the past decade and educators and pediatricians have risen up to exalt the time our children spend twirling around between math and social studies. It’s time to get excited about recess before we lose focus that it’s not just healthy weight we’re fighting for — this is about promoting healthy minds, bountiful creativity, and skills for connection too.

Tips To Advocate For Protected Recess & Play

  • White Space: I think of recess as a part of the white space we serve up for our children in life. That time and space to dream, elaborate, and enjoy whimsy in our minds. We cannot forget the value that reflection and exercise has on the creative process. When talking with your school educators and when designing a day with children make sure there are “pockets of stillness” (see #4 here on Brain Pickers) but also white space for loud iteration. No question in my mind that movement aids learning. Think of all the things you discover while going for a walk, a run or even the epiphanies you discover while taking a shower.
  • Join Forces: PTA/Lunch & Recess Matter Group. Band together with like-minded parents and educators. In the Puget Sound area, for example, only the Tacoma School District mandates a certain amount of time for recess and play. Join forces with Lunch & Recess Matter Group to re-prioritize this play and learning if it’s not happening at your school.
  • Social and emotional well-being matter (more on this later this week): Although we all want our children to have an education that affords endless opportunity (we want our children ready to be brain surgeons, artists, stay at home parents, educators, or entrepreneurs), we must remember how the time spent while playing and relating with peers may be most essential to creating pluripotent opportunity.

 Data On Recess And Play

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