Feeding a toddler is hard work because of all sorts of normal shifts that happen after the first birthday. But new data out this past month (see below) reminds us how pre-packaged toddler food isn’t the best food source, despite package claims. Whole food, the food your family eats, and the fresh stuff is the way to go.
Infant hunger matches their rapid growth; we’re used to our babies ravenous and near consistent basis from day one yet as infancy progresses feedings space out and form meals. By a year of age most children go 4 hours or more between eating. Toddlerhood is a completely different story; growth slows after a year of age and toddlers start to test limits in profound ways. Food is no exception. It can be tempting to reach for whatever’s convenient that you know your kid will eat (fish crackers, anyone?) but in the long run making good nutritional choices for whole food regularly will exceed the nutritional detriments of pre-packaged “toddler” food. In fact, a new policy statement released by the AAP this month is urging parents (and schools, daycares etc.) to take a “whole diet” approach to kids’ nutrition, namely focusing on a mix of foods from the five food groups and avoiding highly processed foods. Read more about the policy here from my friend Dr Claire McCarthy. These “fresh is best” ideas aren’t new to you I suspect but the data about food being marketed to us (and our children) is: Read full post »
As 2015 gets earnestly underway, many of us are working to keep resolutions we made to better ourselves and our family as the new year continues to unfold. In case health is a part of your resolution or focus, here are a couple very quick reminders for check-ups and interactions at the doctor’s or practitioner’s office (3 tips below). I’m going to sound very much like a pediatrician here: wellness visits and check-ups add great value to preventing things. So much better than having to do the hard work of reversing problematic changes. This isn’t just about vitamins (which children don’t really need) and shots (which children wildly benefit from). This is about communication.
Well-Child Visits And Check-ups
Courtesy of CDC
Wellness visits often get forgotten when things are going well (hurrah!) yet they serve a grand purpose on tracking health and wellness by working to create prompts and services that prevent illness. The numbers (from vision, hearing, height, weight, body mass index, and vital signs –blood pressure, temperature, respirations and pulse) help track trends and provide alerts. They help reduce bias in our thinking as parents and pediatricians. As parents we can have a tendency to both unintentionally ignore warning signs of health risks or over-analyze perfectly normal developmental phases. Case in point: half of parents of overweight/obese children underestimate their child’s weight. On the other end of the spectrum, 1 in 7 parents believe their normal-weight child is too skinny. As a reminder, reading a growth grid has a lot less to do with numbers than it does trends. The import lies in following lines; is your child tracking, are they growing at the right rate, do they deviate or “fall-off” the curve? Here’s a quick video where I explain how to interpret the growth grid if you want to learn more.
Importantly, these visits also facilitate a place to bring up the questions that nag at you. Often those things are about habits, sleep, anxiety, body size/shape, school work or mood — or just how a child sees the world. Use the prevention visit to squelch anxiety of your own. What parent doesn’t have something pulling on their sleeve of worry while raising another human? The task of parenting is always somewhat monumental and the job description is always shifting as our children grow. The stakes are high when a child’s life is guided by another. Read full post »
We all hope our children will get along with each other. Most of us also just want them to get the chance to be a kid amid a world of increased access, evolving speed, and constant digital communication. Immersed in the rigors of growing up right next to someone else, siblings can forge deep connection and of course deep divides. The connection part is gold…especially when it’s analog.
To foster this connection we can read Siblings Without Rivalry but we can also absorb the examples laid out by sibling units in our focus and in our own periphery.
Thankfully every once and a while something easy and authentic pops on YouTube in that periphery. For me, this week it’s the brother and sister, Nathan and Eva Leach, viral video from 2013. When I first watched it earlier this week it had 1M views, now it’s nearing 5M. Something works here. A set of siblings partnering to throw out a duet to the world. I mean in it they just LOOK like siblings! A regular kitchen in a regular life with glances to each other like everyday, regular kin. In typical YouTube form the familiarity, authenticity, and surprisingly beautiful strike is overwhelmingly refreshing in an over-marketed world. My favorite moment comes with the surprise about 2 minutes 45 seconds in and when Eva sings the line:
Baby I need some protection. I’m a kid like everyone else.
We’re all always hoping for a little harmony between our children, The Leach children hit it out of the park here. Although I am reminded this is just a tiny sliver into their lives, I’m thankful for its lesson and its reminders today. Happy Friday.
At dinner tonight we had breakfast for dinner (genius meal when you’re stumped by an unending need to create something “new”). At the end of the meal we were all discussing our love for bacon. Without a beat this came from the 6 year-old in our midst:
“Mama, could I live a long time and still have a piece of bacon everyday?”
I thought about it. Yes, it seems, yes. Yes, every day with bacon!
“Yes, I said, “I think you can have bacon but only if you exercise everyday and if you have really great friends. The kind of friends that make you feel alive.”
I launched into some sort of summary of the art of moderation with bacon, pouring out facts about fats, cholesterol, and diverse food choices – the essential need to balance bacon with things that grow in the ground. As I waxed on with a macronutrient-level discussion the 6 year-old in front of me just kept moving with his idea. Turned out he wanted concrete responses for his life with bacon. He pushed into the friendship part.
A long life with bacon goes something like this: of course you need to eat a lot of other goodnesses with your bacon. We can borrow wisdom from the Mediterranean diet and reduce the red meat we eat, put fish on the table twice a week, eat lots of seeds and nuts and ensure fruits and veggies show up on every plate we serve. Debates will wage on about the magic foods we eat, today it was the complexities to the value of an orange over OJ so we always have to put food advice in the context of life. I told my 6 year-old tonight he’d have to exercise every day and get outside, twirl around without a ceiling, take a lot of steps, and be connected with nature.
But perhaps most essential to living a long life (with bacon), I repeated, is solid choices with whom he chooses to live his precious life. If you’re going to eat bacon every day you have to make great friends and forge partnerships with those who make the world feel possible. In my mind you need soul-fetching friends — the ones who literally make you feel like you can fly. We have to spend time with those who let us unpeel ourselves without judgment and urge us to take risks, help us take our time, and lend support to shelter whatever we consider dear. Read full post »
Influenza is hitting hard this year thanks to a drifted influenza strain (H3N2) causing a more serious illness and one that is not included in our annual vaccine. Because of the hard hit, public health officials are reminding us to get high-risk patients into see physicians early if they have symptoms of “the flu” or influenza infections. Reason being, those at high-risk for complications may benefit from a prescription anti-viral medicine that can lessen the burden of illness and decrease risk for complications. Over-the-counter medicines you buy don’t fight influenza.
What Is “The Flu” And What Is Influenza
In general, in healthcare we use the term “the flu” when discussing an infection with influenza, a virus that causes widespread body aches, high fever, cough/cold symptoms, headache or even leg aches. Some children vomit with influenza infections as well (incidentally many patients with lab-confirmed influenza that I’ve seen this winter have also been vomiting) although in general influenza infections are upper and lower respiratory infections, and not the “stomach flu.” We worry about influenza as it’s in the list of top ten causes of death in the US and because it can cause severe symptoms, even in children. Infants and young children are at particular risk for serious infections as their bodies and their immune systems haven’t fought off influenza before.
High risk patients:
Children 2 years & younger (their immune system not as robust and not as much “memory” to fight off severe influenza infections).
Adults age 65 year & older (their immune system is aging and not as robust fighting off severe influenza infections).
People with underlying health problems (including asthma) or other lung problems, other chronic health conditions (like diabetes, heart disease).
Pregnant moms or newly postpartum moms.
Those people immunosuppressed.
The Numbers So Far
According to the CDC, widespread influenza activity is being reported in 46 states. The most common strain is that drifted virus H3N2, accounting for over 90% of the more than 5,000 reported influenza-positive tests recorded last week (ending January 10). It’s still too soon to tell whether we’ve reached the peak of flu season, however there are early signs that the virus is lessening in parts of the country. So far, this year the influenza vaccine is estimated to be about 23% effective, clearly not as effective as usual but still providing some protection.
What Over-The-Counter Medicines Can Help With Influenza?
It’s important to remember that over-the-counter (OTC) medications cannot cure “the flu” nor shorten your suffering with symptoms. They’re designed simply to help you get through the illness and should be taken within the proper guidelines. In general children under 4 should not be given OTC cough and cold medicines.
That being said, there are four types of medications that can make getting through the flu a little more bearable. Read full post »
Our children will never be the sole judge of our job as parents of course. We are likely our own closest and most fastidious critic. And really it’s just us (and our partners) that can truthfully reflect and evaluate how it goes as we raise our children — what our hopes were when we started on the journey of raising another and where we find ourselves. And so, however radiant the peaks and successes seem, the anxiety of our choices in this high-stakes job will likely dominate. The angst with how this all goes as our children mature ties our feet together at times, and can feel a little like stuffing big rocks into our pocket as we jump off the dock into the lakes of our lives. We’re hard on ourselves. Sometimes this is good and motivating, centering or stabilizing, and at times it can even be useful when sorting priorities. But sometimes, it’s simply unkind. Some of the best advice I was given after my boys were born was this: Read full post »
It’s that time of year again. The season of snot and mucus and colds….if you’re a parent you may even call this “sick season.” Typical cold viruses are getting readily exchanged as recirculated air in crowded malls, classrooms and daycares facilitate exchange of the germs. It’s more than inevitable that one of your kids will come down with something. Those 6-10 colds that children get on average, every year, have arrived which means there’s a good chance you’ll be up late one night with a feverish or coughing child reaching for an over-the-counter (OTC) medicine . Data proves we’re all at risk for making a dosing error. Remarkable how easy it is to do. As a pediatrician I always have to check (and double check) the label when I’m home dosing my kids. The bottles and doses are all so different.
A new study in Pediatrics found that every eight minutes a child under the age of 6 experiences a medication error (outside the doctor’s office or hospital). Over the course of ten years (2002-2012) 696,937 children experienced medication errors. Young children (under age 1) had the highest rate of errors making up more than 25% of the total number. For parents these may be easy mistakes to make as containers and dosing devices aren’t always clear (nor are they consistent) even after FDA rule changes were made a few years back.
It’s important to note that the study referencing dosing errors (above) found dosing errors from cough & cold medicine are thankfully going down while dosing errors around other meds are actually rising. It’s also of import to say that most pediatricians don’t recommend OTC cough and cold meds for children under age 6 anyway as they provide little benefit and put children at risk for side effects and dosing errors. Read full post »
I recently listened to an interview on This American Life that stuck with me. The show was entitled “It’s Not The Product, It’s The Person” and went through a series of examples uncovering the reality that great business (or great work) is more a product of the who than the what. Who people are, how much grit, tenacity, raw or natural talent, passion, or skill really matters when doing whatever it is that that they do. Far more perhaps than what they actually create, sell or even perform. And although this isn’t the point I mean to make (you’ll see) it’s worth noting that the show opens with details of a young entrepreneur, like really young (age 11 years) and demonstrates how her talents, bravado, and finesse allow her to sell things and attract attention that others can’t. The show rounds out as the narrator showcases the varying pitfalls in his own quest for success as an ex-NPR radio producer turned start-up entrepreneur. The story was somewhat lighthearted, of course, but one point stuck. As he was gleaning information from an established, successful venture capital investor he was asked a potent question. The investor was interrogating how this fledgling entrepreneur could get funding; assisting him in creating his “pitch” for the money people. He asked, “What’s your unfair advantage?”
Think about it, what’s your unfair advantage?
It stuck with me because it was so relevant for success in an often random, senseless world of building ideas and companies but also in parenting “like a pro.” An unfair advantage sometimes facilitates success and I would suggest nearly all of us have something in our pocket that we know makes it work. You can think of this unfair advantage in terms of celebrity or early success for some (Kate Hudson’s mom is Goldie Hawn after all, and it certainly seems easier to get a bedroom in The White House if your last name is Bush or Kennedy or Clinton for that matter). Yet we all also know that success isn’t only built of “unfair advantages,” that it does take advantage wed to sheer passion, purpose or intent. But clearly those unfair advantages help people get their ideas and skills discovered.
It was only recently that I realized my unfair advantage this past decade or so. Read full post »
Laundry detergent pods continue to cause trouble — increasing convenience yet posing risks to young children. New data out today confirms what we’ve seen since their introduction. These cute, colorful and entirely convenient laundry packets (typically called “pods”) were introduced in the U.S. in 2012 and quickly made measuring out laundry detergent a thing of the past. Unfortunately we’ve also seen that these pods grab the attention of young children. Beautiful design gone wrong. As you’ve likely heard, or witnessed yourself, young children can be drawn to the pods (often these packets of detergent look like a preschooler’s toy or a piece of candy) and because of young children’s unique method of exploration (infants/toddlers/preschools use their mouths as much as their eyes & hands to explore) they may be at risk for injuries if the detergent pods are in arm’s reach. New research out today from Pediatricsdocuments an ongoing onslaught of children exposed to laundry pods, more than 17,000 children in less than two years. Some in the media have translated the volume of calls to poison control — a call every hour in this country — secondary to exposures to these packets of concentrated detergent.
Single-Dose Detergent Concerns
The first warnings about the dangers of laundry pods came out in May of 2012. The American Association of Poison Control Centers (AAPCC) started getting calls about children getting in to the capsules and ABC news did a subsequent story warning parents about the risks. Several factors make the pods a serious risk for young children: they’re appealing to the eye (look how fun and colorful the Tide pods look in the photo above) and small in size. They also have a thin membrane (built to dissolve quickly in the wash) and are full of highly concentrated soap. It’s unclear exactly why this concentrated liquid causing so many new symptoms (vomiting, coughing, or rarely severe breathing problems and severe symptoms like changes in level of alertness or seizures). Dr. Suzan Mazor, an emergency physician at Seattle Children’s, adds she’s seen several eye abrasions, which happen when children accidentally squirt the pod contents in their eyes. She adds, “These ultimately heal just fine but can be painful and distressing to the children and parents.” The ingestions have been serious enough at times to send children to the ICU and need mechanical ventilation. With the beautiful curiosity of a toddler coupled to the lack of judgement, you have a recipe for this “pod” problem. Here’s a look at it by the recent study numbers:
17,230 – Children under the age of 6 exposed to laundry pods (between Feb. 2012 – Dec. 2013), the majority being ingestions. The AAPCC reports that 8,915 exposures have already been reported in 2014 (data through end of September, 2014)
645% -The increase in exposures to laundry packets between March 2012 – April 2013
74% – The percentage of children exposed to detergent packets who are under age 3 years. Clearly toddlers are the most vulnerable group when it comes to these packets of detergent
80% - The percentage of ingestion for the reported cases. This translates out that 8 of 10 children who have an exposure put these pods in their mouths. About 7% of children have injuries to their eyes, and the remaining 3% are a combination of skin injuries and damage caused by inhalation into the lungs
#1 – #1 household product ingested in Italy. This isn’t just a US problem. In Italy, where detergent pods have been available since 2010, the product is the number one most commonly ingested household product
56% – More than 1/3 of kids vomit after an ingestion. For overall exposures, 48% percent of children exposed to pods vomited, making it the most common side effect. After vomiting comes coughing or choking (13%), eye irritation or pain (11%), drowsiness or lethargy (7%), and eye redness (6%)
There may be a stereotype that women talk more than men; the language environment in which we’re raised, starting at day one, may have influence on this. Whether or not women are chattier than men is due largely in part to the context of the conversation. But a new study published in Pediatrics shows when it comes to parents talking to their babies, the term “Chatty Cathy” probably rings truer than “Chatty Carl.” And this has the potential to change the game with your child as they age. It’s well founded that the number of words your baby/child hears in the first few years of life has dramatic impact on their vocabulary, school success and education for a lifetime. Parent-talk has more impact on a child’s IQ and vocabulary than their education or socioeconomic status. Who we are as talkers really changes our babies’ lives.
Gender Differences In “Baby-Talk” And “Parent-Talk”
The Pediatrics study out this week evaluated the intersection of both baby-talk (comparing preterm and term baby boys and girls vocalizations for 16 hours at a time) and parent-talk (comparing Moms’ to Dads’ vocalizations to their infants) at birth, at about a month of age (based on original due date), and at 7 months of age. More than 1500 hours of recordings (derived from little devices worn on babies’ vests) were analyzed to compare family language interactions. Babies in families with a Mom and Dad at home were included (no same-sex couples). About ½ of the babies were late preemies (note: 1/4 of all the babies studied had a stay in the NICU) and 1/3 of families were raising children in a bilingual home. I found three key takeaways: Read full post »
Seattle Children’s provides healthcare for the special needs of children regardless of race, color, creed, national origin, religion, sex (gender), sexual orientation or disability. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.