Author Archive

Let The Teens Sleep

As teens nestle into their deep, unrestricted summer sleep, let’s think clearly about setting them up for success in the upcoming school years. Today there is a pressing need for our attention and our action. An opportunity to improve the lives of teens exists this upcoming week here in Seattle and I suspect, in ways, the outcome will inform the nation. The School Board is revisiting their commitment to do an analysis of feasibility & community engagement in 2015 around start times and will discuss this next week. They’ll vote July 2nd.

Nationally, there is mounting pressure to move school start times later for middle and high-schoolers due to a known health impediment: teens don’t naturally fall asleep until around 10pm and yet need 8 1/2 to 10 hours of sleep for good health. If you do the math and consider a need to eat in the morning and commute, if school starts prior to 8am it’s unlikely teens are set-up to get the rest they need.

The far majority of high schools in the US may make it impossible for teens to get necessary sleep with an average start time prior to 8am. The CDC’s Youth Risk Behavior Survey in 2011 showed that 69% of U.S. high school students get fewer than 8 hours of sleep on school nights, and 40% get 6 or fewer hours.

I touched base with Dr Maida Chen, a sleep expert about why this movement matters so much. “I have to start by saying that it is impossible to place a ‘price’ on the health, safety and achievement of a child,” she told me. She mentioned she’d spent significant time this week documenting the evolving data and cost-effectiveness of moving school start times. She’s written, “Rational start times, which align with students’ fundamental sleep needs, are a cost-effective and scientifically robust approach to improve equity, opportunity gap, and academic achievement on a large-scale with the greatest positive impact on students at the most disadvantage.”  Translation: this makes sense and will affect a large amount of teens.

We should always be driven to do what is best for the child, and not what is convenient for society.  And ultimately, there’s no money that will take back the life of a child who has died in a sleepy driver related accident – a known consequence of early start times ~Dr Maida Chen
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3 Reminders For Summer Sleep

Bed as throneOur house is teeming with excitement about the impending reality: it’s almost summer break. As the hard-core school, sports and carpool coordination chaos eases up, you wanna know one thing I’m really hoping for this summer break? A bit more sleep. I do a great job protecting my children’s sleep and a mediocre job protecting my own. I work on sleeping with my cell phone off and away from while getting 7 to 8 hours of sleep but reality is my phone has a tendency to creep back up next to the bed and I am often up early to start working. Clearly I’m not unusual in this way. Parenting and sleeping a lot don’t necessarily go hand in hand. Studies find 14% of grade school children are still getting their parents up. The news is grim when it comes to sleeping with our phones, even 4 out of 5 teens say they sleep with their phone (on or near the bed). It’s becoming clear that quality sleep is one of the most undervalued power solutions to preserving wellness in our families. The more data I review, the more I know we have to get the word out on the value of sleep and the way that we protect it as we raise our children. Culturally, this is a swim upstream; we’re bred to revere those who do so much during the day they are left with limited sleep at night. Some new data, a funky article ending, and a 4-minute TED talk lay the foundation for my 3 quick reminders: Read full post »

On hand-holding

handholdingThe boys still eagerly hold my hand when we go out and about. And it’s not just when we cross the street. I find that, my 5 year-old in particular, will just show up alongside me while we’re walking and all of the sudden his hand will be in mine. Divinity. This little hand doesn’t go unnoticed and I suspect although it won’t always come so frequently or so eagerly or so spontaneously, I’ll get to hold my son’s hands throughout my life if I ask. I really do treasure that hand in mine.

There is nothing of more value than this love of family we find as our children grow. Nothing more striking really than the intimacy that can exist between a family totally in love.

When we’re walking hand-in-hand my mind often slips to a stunning obituary I read last summer. In it, Jane Catherine Lotter (who wrote her own obituary) details her life’s achievements, her love for family, her gratitude and wisdom, and her memories. As she’s closing the piece she says, “At any rate, I am at peace. And on that upbeat note, I take my mortal leave of this rollicking, revolving world-this sun, that moon, that walk around Green Lake, that stroll through the Pike Place Market, the memory of a child’s hand in mine.”

There’s wisdom in clarity and it seems to me Jane had it and was generous enough to share it. One distillation of life’s joy being a child’s hand in her own. When you hold onto that hand today perhaps take notice of the extraordinary thing it is to have it curled up inside your own. I mean, wow.

Is It Allergies Or Is It “A Cold?”

Screenshot 2014-05-13 22.58.02It’s the time of year for seasonal allergies. It’s also still, unfortunately, the time of year for “colds.” Although it may be intuitive for many parents to decipher the causes of symptoms in their child during the month of May, some of us have a hard time determining what’s causing our children to wipe their nose!

In general, it’s time unfolding that helps us know if our children are beginning to suffer from allergies as opposed to another cold. If steady,unwavering symptoms of runny nose, coughing, sneezing, and/or  itchy eyes persist longer than a week this time of year, allergies to pollens are likely be blame –with one caveat– if your child is a toddler seasonal allergies are far less likely. Although there are exceptions to every rule, most children don’t start to develop hay fever symptoms until around age 3 or 4 years of age after their bodies have been exposed to a few seasonal changes and pollen counts and their body starts to mount an over-reaction. Allergy symptoms are created when the body basically over-does-it to triggers (allergens) and starts an immune response to a normally harmless particle. Instead of having no response to a dandelion, for example, allergic people rapidly release a series of chemicals (including histamines) after encountering the flower that cause their eyes to itch and run, their mucus membranes to swell, and their airways sometimes to cough.  There’s no sure-fire, singular way to know at first glance if your child has seasonal allergies when they start sneezing in the spring (or fall) but in general children will suffer from a constellation of symptoms and a set of circumstances: Read full post »

20 Minutes

photo (43)When it comes to food allergies, expert parents are uniquely-positioned educators. They know the tricks of the trade and the ways to the oasis of safety in a culture that has yet to fully embrace supporting children with unique medical needs. Over the years in practice, it’s parent-food-allergy-experts that have taught me the greatest new lessons I now pass on routinely to patients. Marrying the life-threatening nature of food allergy to the concepts of strict avoidance to the use of medication to treat anaphylaxis will never be enough when supporting children, their families, and their schools. The essential advice may be locating the inspiration families need to be staunch, relentless, and tireless advocates for their children. Even when uncomfortable. It’s Food Allergy Awareness week and some just-in-time allergy info has arrived.

This post, this concept, this advocacy, this is Mom-to-Mom health care. Enjoy this post from the ever-brilliant mom and researcher, Susannah Fox (her bio below)

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Once a year, I give a high-stakes presentation in front of a single audience member: my son’s teacher. I have 20 minutes to teach her how to save his life.

I need to explain the science of food allergy, list all of his many allergens, accurately describe the symptoms of anaphylactic shock, instill an appropriate sense of urgency and responsibility with one or two frightening stories, but also build her confidence so she does not tune out or give up prematurely. Read full post »

The Power Of A Sugar Cube


There’s no question the challenge of unhealthy weight and rising obesity rates in America present a complex problem for children, their parents, and their doctors. No wonder I cycled through so many emotions while watching the new movie Fed Up. As Fed Up premiers all over the United States today it’s provoking a fiery, national conversation about the threats of obesity on our nation’s children. I loved the power behind the film.

Instead of pointing the finger at children for poor choices or limited activity, filmmakers Katie Couric and Laurie David take a deep dive into the mechanics of how food is being made in America, how food companies have contaminated our culture, and how with a changing food source we’re obligated to return to a menu of primarily fresh foods to heal our children.

This movie is guaranteed to cause you to re-evaluate the number of processed foods you bring into your home.

Fed Up is constructed out of powerful interviews and activist-like thinking as national experts illuminate the fallacy that eating less and exercising more will singularly improve the health of our nation and curb the obesity epidemic. It feels a little like a get-out-the-vote campaign blended with a whole new kind of math. In fact there’s lots of new thinking challenging the simplicity of previously held beliefs about energy gap. With overweight and obesity threatening our longevity and our national bank account, Fed Up assures us that we’ll have to take on one big sugar cube, the food industry, to lean-up our nation. Read full post »

Perhaps The World’s Most Perfect Sport?

world's greatest sportEvery runner who’s ever had a runner’s high knows it is one of the best sports in the world. It can be grueling and painful, yes, but the rewards we reap from running– especially once we’re in shape — pay big dividends. For those of us aging, ahem 40’s coming quick, and those of us trying to find ways to live longer, exercise is still likely the most influential thing we can do to promote the quality of our life and extend the years we get to witness our children grow. Nothing is a guarantee, of course, and I loved an article I read on Five Thirty Eight about the value of eating nuts for health and longevity that mentioned, “no matter how many nuts you eat, you’ll eventually die.” Yipes! Exercise is the good stuff, though. If you need pushing, be informed that recent data out of Canada shows that exercise may even improve the appearance of our skin and decrease wrinkling. Tah dah! It may be vanity that gets us out to pound the pavement.

But finding time and keeping healthy enough to keep up a rigorous running schedule amidst the whirls of child rearing and work? I have found it an exceedingly large challenge. When I was in medical school, I ran over 4-5 miles every day. Now a 4-5 mile run would be a freaking miracle day. Things are just busy.

Thankfully a cure-all has arrived… Read full post »

What’s Your Strategy?

cocktail“What’s Your Strategy?” she asked. And although she wasn’t asking me directly, I must admit I was a bit startled by the question. What really is my strategy for keeping my kids alive in the car? Although I’m strict about boosters, about buckling, about ensuring the booster seats travel with my kids, and I repel when I hear parents joke about not using car seats perfectly, I’m unsure I’ve ironed out the strategy to ensure my kids never die at the hands of a drunk driver. I mean we make smart choices, but smart enough? “What’s Your Strategy?”

Dr Beth Ebel, Director of the Harborview Injury Prevention & Research Center, is a pediatrician and researcher who spends her days working to improve safety for children in the car. She studies the use of car seats, the effects of distraction on driving, and health disparities. In my experience, she’s an optimist. During our conversation she stated a couple of times that the last decade housed great success: there has been a 41% reduction in child passengers deaths involving alcohol-impaired drivers and a 44% reduction in death in child passenger deaths over all. In addition she reminds me that 97% of drivers and passengers wear their seat belts! Even though she’s proud of the declines in death and the huge number of seat-belt-wearers, she does account for the ongoing deaths and how that 3% of the population who is unrestrained account for a huge proportion of the near-fatal and fatal injuries in car accidents.

New numbers out today provide a chilling lens into the realities of how young children in the US die in the car. Car accidents remain the number one killer of children over age 4. Today’s report focuses on children under age 15 who died in the last decade as a result of a car accident. I’d suggest this is uncomfortable data and somewhat uninteresting to most people. It does seem like this is just going to happen to someone else’s kid, right? My concern is some of us may be wrong and while looking around we better look closely at those we know well who drive our children around. Read full post »

What’s Your Best Part Of Day?

Thanks for these clips (see above)! Practicing gratitude remains a highlight around here. Although ritualizing the sharing of the great parts of our family’s day bring us together at meals, helps us connect, and assists us in talking about our time apart at school or work, it also may be boosting our health.

Practicing gratitude has been found to improve overall wellbeing, assist in sleep, and help decrease anxiety and depression. People who practice gratitude also report better long-term satisfaction with life and demonstrate kinder behavior to others. Who wouldn’t want this for their kids?

Best Part of Day (BPOD) is a big deal in our house. Consider it for yours?

Thanks for answering our call for sharing BPODs from your life (captured in the video). Clearly we didn’t get to include everyone’s BPOD here. We’re hoping to have another composite video to share in a few months! Feel free to send in any more BPODs you’re excited to share.

Tips For Inspiring Gratitude

  • strawberry lemonade bpodBuild rituals into your day to share what you are thankful for every day, even the hard ones.
  • Write thank you notes to people for non-material things (i.e. a thank you  to a teacher for remembering something special or a thank you to a friend for showing up).
  • End the day at bedtime talking about what you’re looking forward to. Remember that some research finds we may get more enjoying/happiness planning a vacation than actually experiencing it! You have a summer camping trip planned? Involve your children in the planning, prep, and enthusiasm that goes into pulling it off — boost their happiness juice.
  • If it seems overwhelming, start with “gratitude light” –doing a BPOD every day (takes less than a minute) or incorporate tips here in New York Times summary of the research on gratitude.

The Link Between Vaccines And Optimism

Yesterday morning there was a public Freudian slip. It was perfect. During an interview on the Today Show about “hot button” health issues the team addressed concerns about myths related to the causes of autism. Autism spectrum disorder, now estimated in 1 of 68 children, is a brain condition causing challenges with how children communicate, behave and relate with others. Autism spectrum disorder is thought to be caused by a mix of genetic risk, potentially starting inutero, and potentially influenced by environmental factors. There is so much more research needed to understand causes (for cures). In the past some have pointed to vaccines as a cause of autism although that theory has been debunked, disproven, and refuted again and again. But here’s what happened on the show. The interviewer addressed the topic and said, “We hear a lot about it in the media, that is, vaccines causing optimism….”

Now it was a misspeak, which of course happens to us all, all the time. But it got me thinking, we need to share this real link  like wildfire — the link between vaccines and optimism. We moms, we dads, we pediatricians, we nurses, we family doctors, we community members, we must speak up. Share this incredible fortune, peer-to-peer, the reality that indeed living now in the 21st century that yes, vaccines are linked to optimism.

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