Parenting

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Spanking is Hitting Afterall

In my mind it’s no wonder the American Academy of Pediatrics has a statement against spanking. Spanking, in the simplest form, is the act of hitting a child, using physical force to try to get a different outcome. Thing is, spanking is an ineffective discipline tool in the long-run and research shows it’s damaging to a child’s mental health. Most parents don’t want to spank their children and may spank or strike a child while frustrated, making spanking more than just a tool for discipline, rather at times just another way to vent anger or frustration…

I’d say we spend countless hours teaching and modeling behaviors for our children in early childhood to ensure they do the opposite of spanking: we teach them to “use their words,” take “timeouts,” and to take deep breaths when frustrated or when throwing an enormous, inconvenient tantrum. We teach them to look for an adult for support if they need “back-up” during conflict resolution. When an adult turns around and uses physical force and strikes a child, they teach just the opposite. Spanking is hitting and hitting is always avoidable when enmeshed in a conflict.

If that doesn’t seem quite right to you consider it this way: under the US law, when angry or upset about the way things are going in your life the only person you can legally hit in our culture is a child. I’d suggest they are the most vulnerable and voiceless in this regard, the only members of our society with no capacity to change the law (vote). Just this winter lawmakers have argued to allow spanking at home and school that could leave a child bruised in the name of “parental rights.” In the US, you can’t punch or beat up your neighbor, your child’s teacher, your co-worker (assault), thankfully you can’t strike your partner/wife/husband (domestic abuse), and you can’t punch your other relatives (assault). But in many states in our nation, it’s legal to hit your child when they do something you didn’t want them to do. Of note, it’s still lawful to spank a child at school in up to 19 states.

As of 2014, up to 38 countries around the world have banned spanking, outlawing corporal punishment in terms of human rights in a different way from The United States. During an NPR interview yesterday, Professor Elizabeth Gershoff highlighted this in historical context to American opinion on spanking stating, Read full post »

Calling The Shots

Tonight, after President Obama speaks, PBS airs a NOVA documentary about vaccine science and safety. Vaccines: Calling The Shots. It’s told through the parent, pediatrician, and community lens. If you’ve ever wondered about vaccines in America, it’s time to tune in. I’ve been in touch with the team producing this documentary. Seriously excited to hear this story unfold tonight.

(update Sept 11: watch Calling The Shots online)

I think this is a big deal. This is an investigation on the science of vaccines.

The less the disease exists, the safer I am.

It’s a balancing act. The risks happen to be minuscule… the benefits are enormous

If inclined, follow a team of parents, pediatricians, and communities tonight on Twitter while it airs:  #vaccinesNOVA

This Will Not Change Pediatrician Resolve

Screen Shot 2014-07-28 at 3.50.30 PMFlorida politicians will not change pediatrician resolve to advocate for and protect children. There’s no question that a gag order cannot halt a passionate child advocate. I’d call the recent Florida ruling a dull tool taken to a very sharp crowd. Consider this post an open letter to Florida politicians…

I live as far away from Florida as any continental American (you do the math) yet Florida politics this past week affect pediatricians and families everywhere. In my opinion, every parent should tune in and follow this case. Florida just restricted physician free speech and hindered a physician’s ability to help your neighbors, your relatives, and your family create a safe environment for children.

Guns In Your Home? Do you ask about guns at playdate drop-off? Have you seen the Moms Demand Action For Gun Sense In America online presence (and progress) or follow their feed on Facebook?

Florida may have gotten this wrong thinking that restricting a pediatrician’s words and inquiry about safely storing firearms meant that pediatricians were trying to take away guns. Not so fast.

The Florida Physician Gag-Order Law:

Last Friday The 11th Circuit Court of Appeals in Florida upheld the “physician gag law” in Florida, a law that violates the First Amendment rights of pediatricians and family doctors and threatens their ability to counsel parents about how to protect children from unintentional injury and death. This started way back in 2011. Then the law was appealed. Now the appeal is overturned. This ping-ponging is just politics but the waste here is distraction from protecting children. In 2011 I explained the gag-order for pediatricians — basically it’s this: Florida says it’s illegal for pediatricians to ask about how families and guardians store firearms in their home even though we know about 4,000 American children die every year from firearm injuries. Read full post »

Fitbit Motivation, From Anecdote To Evidence

I wear both a FitBit and Shine Health Tracking Device on my wristOn Sunday night I left the house for a quick run. It was 9:20pm. It’s been years since I ran in the dark and likely a decade or more since running at night made any sense in my life. As every parent knows, we’re jailed in our houses around 8pm when the kids go to bed — if exercise hadn’t yet happened it gets pushed off until “tomorrow.”

Sunday night the Fitbit was 100% of the driving force behind me putting on my running shoes. I was about 500 steps shy of my 10,000 step goal and couldn’t go to bed, in good faith, that close to success (see image below).

Crazy or perfect? I wear 2 devices now. This month I added a Fitbit to my wrist; I’d already been wearing my Shine for a year or so and had certainly had seem improvements in self-awareness, a better understanding of my sedentary days at work, and the rewards of having daily data about my movement. I exercise a lot more now compared with a year ago. The reasons are multi-factoral of course (turning 40, losing loved ones, craving exercise) but the device has unequivocally helped. Adding the Fitbit to my wrist was designed to help hone an understanding for the level of consistency 2 devices can have (on the same person). The other reason was Fitbit would allow me to “compete” and/or compare daily totals with my husband. This is 40, my friends.

Seattle Mama Doc Tweet

before and after runNo question that in short order the Fitbit has helped me understand the difference between my movement and my activity, something I’d not really spent time on previously. For example, Sunday was a day of housekeeping. I’d moved around all day doing errands, going to store to buy hangers, cleaning the closet, goofing around with the boys, but I hadn’t been out for a run or bike ride — my first glance my Fitbit was about to give me a false sense of security. I nearly got my goal (in steps) without any real, active “exercise.” Like almost 1/2 of American adults, I hadn’t gotten the 30-60 minutes of moderate-to-vigorous activity (walking briskly, running, cycling, swimming) we all crave and need. All the sudden it dawned on me — it wasn’t just the number of steps I’d had on Sunday that mattered it truly had to be about how I got them. I was 500 steps shy of my goal of 10,000 steps but the Fitbit also told me I’d only had 2 minutes, the whole day, of active time. YIPES! Read full post »

Summer Reading From Day One

boys readingThe boys and I read two extra books last night — we almost skipped it altogether as it was late and we were beat from a long day and yada, yada, yada…you know the drill. But reviewing this data changed me, yet again. I knew some of the value of reading to young children before I had kids because of my experiences being a teacher and my training in pediatrics but the refreshers provided this week only compound my interest in screaming the value of reading from the rooftops.

It’s NEVER too early to start reading to your baby. Reading aloud before bed is always the right thing to do.

This week The Clinton Foundation with Too Small To Fail, The American Academy of Pediatrics, Reach Out And Read, and Scholastic got serious about ensuring our country takes reading seriously right out of the gate. For the first time ever the groups have come together to proclaim that parents should start reading to children “as early as you can” after birth. The new policy and partnership emphasizes the need for early reading to all infants and children while also emphasizing the necessity that all pediatricians promote this healthy habit at birth and through all preschool doctor visits. Profound health disparities currently exist for US children and book time. I suspect the numbers will surprise you.

It’s a no-brainer to most parents I talk with that reading books enhances development, literacy, and school readiness. What may surprise you is that reading has also been found to enhance the relationship between a child and parent. Reading books (or even the newspaper) to your infant from day one can have profound effects on how they live, how they talk, and how they learn — the impact extends well into adulthood. From the very beginning, though, some children are missing out. Children from low-income families hear fewer words in early childhood and know fewer words by 3 years of age creating the “word gap” early in their lives. The more words a child hears during early, critical times for language development, the more they’ll know. And although reading books can be a great resource to introduce an expansive, enriched vocabulary, less than 1/2 of children are read aloud to in this country every day.

All families face issues of limited time, limited parental understanding of the key role of reading aloud, and competition for the child’s interest and attention from other sources of entertainment ~  The American Academy of Pediatrics Council on Communications And Media ( 2011)

Read full post »

You Mamas Taking Iodine?

A new policy statement from The American Academy of Pediatrics finds that many women, including up to 1/3 of pregnant women, may have low levels of iodine putting them at risk for iodine deficiency. The reason for the deficiency is the changing food source. Over the last 20-30 years our major source of salt has shifted away from table salt (supplemented with iodine) to salt from processed foods, sea salt or gourmet salts that have no supplemental iodine. This is especially important for breastfeeding and pregnant women as iodine is essential for thyroid function that supports fetal and newborn brain development.

This policy statement was news to me. I had no idea that the salt used to make most processed foods lacked iodine, that the majority of prenatal vitamins didn’t provide iodine, and the number of women who may have a deficiency. I’m not alone; when I polled my Mama Doc Facebook community most moms & many doctors also commented this was a newsflash. Here’s more:

Iodine Deficiencies– Shifting Sources Salt

  • WHY ARE WE DEFICIENT? Most processed foods made are with salt that is not iodized.  Since we get most of our salt from those foods we’re taking in less iodine than we used to.
  • TABLE SALT INTAKE: Table salt is iodized, many gourmet salts are not. Consider ensuring that when cooking in your home (ie putting salt in the pasta water or salting the veggies) you use iodized table salt so your intake of iodine goes back up. REMEMBER: this doesn’t mean you should eat MORE salt, just swap in the table salt for the fancy salts when you can.
  • WHY DO WE NEED IODINE? We need iodine for thyroid hormone synthesis as thyroid is essential in brain development and metabolism. The policy reminds us that even mild iodine deficincy can affect fetal and early childhood neurocognitive development stating, “adequate thyroid hormone production is critical in pregnant women and neonates because thyroid hormone is required for brain development in children.” The recommendations from AAP spelled out:

Read full post »

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 »

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 »

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 »