Parenting

All Articles in the Category ‘Parenting’

The Penis Podcast

This is a podcast episode about one thing…the penis. Guest on the podcast Dr. Rob Lehman, the co-founder of Great Conversations and leader of the For Boys Only classes at Seattle Children’s hospital joins me to discuss what’s “normal”  and all the examples of “normal but different.” We dive into what parents need to know about care of uncircumcised/circumcised penis, thoughts on erections (they begin in utero!), boys with their hands down their pants, appropriate touching and ways to help boys deal with a culture focus on size. I often say that when I’m in clinic, I get the most attention from parents when I’m talking to them about their child’s genitals and many families are nervous to ask about concerns. It’s something everyone wants to know about, but a lot of people are shy or embarrassed to bring it up — do hope this podcast helps. Don’t hesitate to ask concerns you have from the very beginning — most often you’ll likely get A LOT of reassurance.

I am a mom to two boys and like every other mom I know was surprised from the beginning with the amount of “hands down the pants” moments that start even in infancy. A treat to have Dr. Lehman provides great tips to normalize and set appropriate boundaries for touching and clear up ideas for better understandings of normal development.

Possible Allergy Protection From Thumb-Sucking And Nail-Biting

We do have to pick our battles at home. As a pediatrician I’ve never gotten too excited about advising parents to spend a lot of energy trying to rid your child of the thumb-sucking or nail biting habit. In general parents aren’t successful — peers are. Often it’s when friends or peers bring the habits up that children are motivated to stop. We can help support them by reminding them when hands are in their mouth or even having them place socks on their hands while watching television as that’s a common time for the behavior. Although many parents worry about their children sucking their thumbs and fingers, it’s a common habit, with some studies finding almost 25% of children do. Much time is spent thinking about ways to help our children quit, worrying whether germs on their hands will translate to illness and hoping it doesn’t affect their teeth. A new study today this week in Pediatrics highlights perhaps a positive effect of thumb sucking. It’s worth a mention.

Allergy Protection From Thumb-Sucking And Nail-Biting?

The study evaluated children between age 5 and 11 and their later diagnoses of hay fever, allergy skin prick testing and asthma. The premise of the study builds off the somewhat controversial concept of the hygiene hypothesis. The basic premise of the hypothesis is that germ exposure early in life can contribute to how our immune system responds as we grow and develop. We may build up tolerances and immunity that conform us into less allergic people if we have different bacteria and germs around. Basically, living in a sterile environment may not be “safer” as some believe lots of dirt, bacteria, and germs early and maybe not so many sensitivities later…

In the past theories for the hygiene hypothesis have supported a decrease risk of asthma (dirt and germs coming in from and on pets may decrease allergies or asthma later) and a small 2013 study a couple years back found those children who had parents who “cleaned” the pacifier with their own mouth may be less likely to develop allergies (theory was the bacteria transfer from mom/dad’s spit to baby changed their pattern of exposure to bacteria and possibly a tendency away from allergies and asthma later). So some researchers looked a the effects of children who have their hands in their mouths more to see if any protection comes of it — they evaluated data spanning from childhood to adulthood. Read full post »

Getting Your Children To Eat Vegetables

girl and vegetablesThis post is written in partnership with a Seattle Children’s parent, Beverly Emerson, who wanted to give back to our efforts. She’s a mom, food marketing, and R& D executive who has been thinking about how to get healthy food choices out to children for over 2 decades.

My two boys eat veggies pretty well. But that’s like saying Tuesdays are always good days. Sometimes it’s easy, sometimes it isn’t, of course because I’m raising humans on the planet and every day is something a little new. I think the reminders from Beverly may trigger some change in us. Beverly answers this:

“How can I get my child to eat two cups of vegetables a day?”

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According to government recommendations, our kids need between 1 and 3 cups per day depending on their age. Does it feel like that is a dream? Like one of those stretch-goals that will never be hit? There are some tricks to make it easier, and none of them involve hiding vegetables, but actually encourage kids to embrace the fresh flavors and textures of vegetables in their natural state. Yes, it really is possible!

Here are three keys in getting kids to eat (and LIKE) their vegetables:

1. Start Early & Keep Going

Research shows that if a pregnant woman eats vegetables regularly in pregnancy, her infant will be more accepting of the flavors as well during the transition from milk-based diet to introduction of complementary foods. But acceptance begins to decrease as kids move into toddlerhood and preschool years. Humans are biologically wired to dislike bitter foods, and so we need to work at continuously exposing our children to the flavors.  Susan B. Roberts, a Tufts University nutritionist and co-author of the book “Feeding Your Child for Lifelong Health,” suggests putting a food on the table at least 15 times to see if a child will accept it. At our house, we use a “thank you bite” model. We insist that our children have one tiny “thank you” bite of a new food simply to expose them. I know that she won’t like it the first time, and maybe not the fifth time. But suddenly, she’s reaching for a full helping! Until that happens, you can prepare dishes that YOU will eat so you don’t feel like you’re wasting food. Read full post »

No Allergy Medication For Kids Under 2

Recent heartbreaking news reported about a baby who died due to a medication overdose by his babysitter/nanny has me reeling. And although this is a tragic, outlier type event, it can awaken us to everyday ways to improve our children’s safety with over-the-counter medicines.

The tragic story: a fussy baby was mistakenly given allergy medicine to calm him down and get him to sleep after a day of crankiness. Allegedly, the babysitter unfortunately gave an adult dose of an allergy medication. Sometimes medicine side effects can impair or stop breathing. Especially at elevated doses. The lesson from this horrific story is threefold:

  1. Medicines, even those sold over-the-counter have real effects and demand our serious attention. We need to make sure medication dose is the right one. The story of this tragedy is a nightmare to even think on, but it can remind us to make sure we are always a part of every dose our children are given of ANYTHING. Every parent should know it’s not “over-the-top” to have any caregiver review medication administration with you every time for safety.
  2. Kid medicines for kids not for the adults who care for them. Medicines should be used only when necessary and not for adult convenience. Fussiness in babies is exhausting for parents and caregivers. Read about fussiness and the period of PURPLE crying here especially in early infancy that’s considered normal. We need familial and community support for parents exhausted and overwhelmed by fussy babies. And we need back-up plans for respite for caregivers to babies, but we also need to remember that medicines given to a child for the benefit of a parent just isn’t the reason they were designed or licensed. As a pediatrician I just can’t recommend using allergy medicine to knock your kid out. Just doesn’t make sense. Proper and appropriate medication dosing is paramount but using medicines only when necessary is where you have to begin.
  3. Allergy medicines, even over-the-counter medicines are not recommended for use in babies under age 2 years.

Medication Rules For Parents Everywhere

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Each Hour Matters: How Much Children Should Sleep

The American Academy of Pediatrics (AAP) has issued a Statement of Endorsement supporting the American Academy of Sleep Medicine (AASM) guidelines outlining recommended sleep duration for children from infants to teens. Not exactly “news” but great reminders because of their import. The statement is pretty clear about it’s importance and perhaps this is why it will make headlines:

Sleeping the number of recommended hours on a regular basis is associated with better health outcomes
including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and
mental and physical health. ~Journal of Clinical Sleep Medicine

Melatonin Boy SleepingHard to beat the benefit. Nothing quite as powerful as this besides, in my mind, a feeling of belonging and getting outside and moving/exercising every day! I’m in full support of the guidelines. Bottom line, even with the phase shifting we’re doing with summer because of the glorious evening light we get, and with release of the noose of tight schedules during the school year, there’s no question each night of sleep is something worth preserving and protecting. If we think about sleep like we think about what we feed our families and how much we move and exercise, we’ll be keeping our wellness in check.

Little deficiencies in sleep matter. Sure, if you’re a great sleeper and get the recommended amounts of sleep nearly every night, one night here and there with a bit less sleep is tolerable. But children who consistently don’t get recommended sleep accumulate sleep deficiencies into an earnest sleep DEBT. That sleep debt has consequences like decreased attention, increased risk for challenges with weight, dangerous driving, bad mood (YUCK!), injuries, hypertension, diabetes and decreased performance at school. In teens insufficient sleep is associated with increased risk of suicidal thoughts, suicide attempts and self-harm. This is all real deal, powerful and important stuff. The National Sleep Foundation has found that 85% of teens don’t get adequate sleep leading researchers to call this The Great Sleep Recession. Badness for all of us. Knowing bad sleep habits can start early, we can address this actively and consistently.

Sleep Recommendations For Children, Even In Summer

For optimal health, children should keep a consistent bedtime — helps with school days, attention and actually getting the sleep they need! Even if you shift bedtimes to later times this summer (Yeah!) keep thinking on these goals in hours.

sleep needed by age

In addition to these recommendations, the American Academy of Pediatrics suggests that all screens be turned off somewhere between 30 minutes and 1 to 2 hours before bedtime so as not to interfere with falling asleep. Data has found small screens (smartphones) are more disruptive to sleep that even TVs. And another thing pediatricians recommend (because we have the data to back it up) is that parents make sure no TV, computers, tablets or other screens be allowed in children’s bedrooms.

For infants and young children, establishing a bedtime routine is important to ensuring children get adequate sleep each night. Even if it’s about to shift, keeping it consistent from one night to the next can be the magic stuff of good dreams.

Teen Vaping Leads To Cigarette Use


Big news published today in Pediatrics; a new study reports that adolescents who vape are 6 TIMES more likely to smoke cigarettes in early adulthood. Researchers studied 11th and 12th graders during the transition from being US minors to legal adults when they have the right to buy traditional cigarettes (age 18 years) to see the effect using e-cigs had on smoking traditional, combustible tobacco cigarettes. It’s known that if you’re friends use e-cigs you’re more likely to use and it’s known that rates of e-cig experimentation are on a rocket ride for teens across the US. Because we know that more than 80% of all adult smokers begin smoking before the age of 18; and more than 90% do so before leaving their teens, when and why people get addicted to nicotine matters.

Over the last decade there has been great progress in helping teens stay away from tobacco cigarettes but the new vaping trend, e-cigs, hookahs, and chew-able tobacco is unfortunately changing the game and changing risk. Last week the CDC published new data,”Cigarette smoking among high school students dropped to the lowest levels since the National Youth Risk Behavior Survey (YRBS) began in 1991, but the use of electronic vapor products, including e-cigarettes, among students poses new challenges according to the 2015 survey results.” Read full post »

Seattle Mama Doc Podcast Is Live

Audio is having a moment and I’m hooked. I am so thrilled to announce the launch of my Seattle Mama Doc podcast! It’s a weekly, quick, 5-15 minute show to help guide you through the joys and the complications of parenting. I’ll share what I’ve learned throughout my career in pediatrics and years of parenting my own 2 children, but also really hope to get super smart people to share what they know out to the world! The podcasts will air each week and will include interviews with pediatric experts, researchers, and peers across the country who are committed to preventing illness and injury while raising children — but this will also be a show sharing wisdom into how to enjoy the immense and privileged task of raising our babies into adults. The goal here is to breakdown all the guilt we have, doubts we share, and give us a boost in knowing what we’re doing well. Parenting is high-stakes but we really do have this.

You can listen to a couple of the first few episodes below and you can download episodes on SoundCloud, iTunesGoogle Play Music & Stitcher. Please subscribe and let me know what you think!

I recorded several episodes on sleep with my good friend and the Director of the Seattle Children’s Pediatric Sleep Disorders Center, Dr. Maida Chen. She’s a mom to 3, pediatric pulmonologist and sleep science guru. She’s also just uber-articulate. Here’s a blog post we did together a few years about with more on why and when children dream.  More podcasts arriving weekly on Tuesdays.

Maida Recording

Cry-It-Out Improves Sleep And Reduces Mom Stress

Parents debating sleep training can rest (literally and figuratively) easy. New data out today in Pediatrics found that letting babies cry-it-out (CIO) or self-soothe does not increase signs of stress compared with babies who don’t. The study out of Australia tested two sleep training methods: “graduated extinction” (parents leave and return at increasing intervals of time, AKA one version of CIO) and “bedtime fading” where parents shifted bedtimes based on how long it took babies and young toddlers to fall asleep. The groups of babies and their moms were compared to those in a control group of babies and moms/dads who received only sleep education. The group in total was small, some 43 infants spanning 6 months to 16 months randomized into the three groups. I was fortunate to be able to discuss the study and what it means for parents on The TODAY Show this morning. In addition, I chatted about the study design, findings, and implications with Dr. Maida Chen, the Director of the Seattle Children’s Sleep Center. We were both excited as the study evaluated baby’s sleep, tracked their sleep with actigraphs (movement monitors), evaluated sleep by parental sleep diaries, measured morning and afternoon cortisol levels (a stress hormone) and tracked time to fall asleep, number of nighttime awakenings, total sleep time, mom’s stress, mom’s mood and long-term bonding. Even though the study may have some limitations (very small sample size and parents self-selected to the study with sleep concerns therefore it may be non-representative of parents at large who AREN’T worried about sleep) the randomization to the three groups and the measures studied boost the exciting results.

6 Take-Aways From The Baby Sleep Study

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All Dogs Bite


To the owner of the two black poodles who bit my husband last Saturday early morning while running at Magnuson park, this is for you. But also for all of us as a reminder to something I know both from the medical data and from life experience too well: all dogs bite. Even when an owner assures you they don’t or won’t.

For many, having a dog isn’t just having a pet, they are clearly part of our families. We invest, we believe, we protect, and we stand behind them. I’ve written about the love my family has for our sweet dog Luna who passed away a year ago this month. Many of us love our dogs for many reasons, and they even have been shown to boost humans’ health in psychosocial but also fundamental ways. A study published in JAMA Pediatrics back in 2015 found that exposure to dogs during a baby’s first year was linked to a 13% lower risk of asthma in school age children. Having a dog also helps teach children responsibility and can boost their self-esteem. But we do have to remember, dogs are animals and they act like it when provoked, frightened or activated. All dogs will bite given the right circumstance. Coincidental to a dog bite in my family, this week is National Dog Bite Prevention Week and I’m sharing some tips from the American Academy of Pediatrics (AAP) for keeping your family and children safe from dog bites.

Each year, more than 4.5 million people in the U.S. are bitten by dogs, and of the 800,000 Americans who receive medical attention for dog bites, at least half are children. Almost 1 in 5 people bitten by dogs require medical attention. Children are, by far, the most common victims of dog bites and are far more likely to be severely injured. Most dog bites affecting young children occur during everyday activities and while interacting with familiar dogs. Remember, as most dog bites involve familiar animals, prevention starts in your home.

Some species of dogs are more likely to bite unprovoked or when startled (Pit Bulls, Rotweillers, German Shepards, Huskies, etc). But this post really is intended to remind us that even when a sweet lamb-like doggy of ANY breed gets frightened or provoked by an unsuspecting human, toddler or child, they may bite without even THINKING of it. Some of this is just animal instinct.

7 Ways To Help Prevent Dog Bites:

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Moms, Benefit of Part-time Work, And Breastfeeding

pumpingA new study out confirms something that almost every working mom and dad already suspected — it can be a challenge to maintain breastfeeding goals when you return to work after only a few months with your newborn, especially when asked to return to working full time. The study out this week found that moms who worked about 1/2 time (19 hours or less) were able to continue breastfeeding similarly to those women who didn’t work.

Logical: the more hours a new mom works, the tougher it is for her to continue breast feeding. The amount of time we work may be more influential than the timing of our return to work. In this study, conducted in Australia, women who worked 19 or less hours in a week were much more likely to maintain breast feeding until their baby turned 6 months old, compared to moms who had returned to full-time employment. Additionally, women who work 19 hours or less only faced a 10% chance that they quit breast feeding altogether by the time their baby turned 6 months old. Your level of work place seniority will also affect your ability to continue breast feeding at 6 months, meaning those in managerial-type roles will have more success. Other factors that made it easier? Unsurprising it’s being older, higher education, better physical and mental health and being self-employed.

If we want moms to be successful with the recommended breastfeeding guidelines through infancy we should think on how we prime them for success. And how we support them.

It’s inconvenient but potentially important to acknowledge that it’s simply harder for moms to go back to the workforce, especially those who breastfeed, than it is for dads to newborns. In the first few months of life, the time it takes to nurse a baby is equivalent to a 8-9 hour work day for most women. Most babies will drain a breast in about 12-15 minutes if they are eager and actively feeding but babies often stay on the breast for up to 20 minutes or even 30 minutes at a time. Therefore, if you sit down, feed your baby on the right, feed you baby on the left, burp the baby and then change the inevitable diaper:  poof, one hour.  And, most newborns feed up to 8-10 times daily. 1+1+1+1+1+1+1+1+1. Math is easy when you do it this way.  Breastfeeding alone is a full time job for the first few months. The time spent with a baby nursing diminishes as the months unfold but it can still be a significant number of hours spent every day.

The take home for me here is that we may be more successful, culturally, supporting moms to return to work during the 1st 6 months after a baby is born if we give them options for part-time work. Especially if breastfeeding past 6 months is a goal. Read full post »