Parenting

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A Few Thoughts On The 4th Of July

We all know fireworks are dangerous, but outside the obvious hazards (burns, injuries, oh my!), there are other things to be aware of to stay safe this weekend. The 4th of July is a crazy-fun, chaotic day filled with friends and family. Lovely for the time and space to celebrate freedom and lovely for the holiday to celebrate each other. All easy ways to get distracted though, and take your eyes off your children who might be playing in circumstances not typical of your run-of-the mill Saturday. Enter fireworks (which the American Academy of Pediatrics urges families NOT to use) but also swimming, or driving, in ways changed by the holiday circumstances.

  • Distraction: it really is this decade’s issue in a profound new way. If supervising little swimmers or children using fireworks, perhaps stay off your cell or smartphones. While you’re distracted and typing a “Happy 4th of July” text, your child could be grabbing a hot (burning at over 1000 degrees Fahrenheit) sparkler. It’s true that 3rd-degree burns happen with (or without) distraction but we can minimize the chances. If you’re opting-in, be there fully. The National Fire Protection Association states that the risk of firework injury is highest for young people ages 0 to 4, followed by children 10 to 14. These little loves need your full attention; of anything parenting teaches us it’s that our children can do nutsy things when we least expect it.
  • Remind your teens and their friends about of risks associated with teens on the road for the holiday. Pull a parent move and remind them to wear their seat belt, avoid texting and driving, and ban the use of alcohol for those behind the wheel. The 4th of July ranks as the deadliest day all year for teen drivers according to AAA.
  • Too much of a smarty pants for a problem? If you think you’re too smart for injuries on the 4th of July, hold on a second. Recent research found that higher levels of education do not protect against firework-related injuries. Even if you’re part of Mensa, this is a day to make back up plans.
  • Heat: Temperatures around the U.S. are HOT this time of year. Keep in mind that infants and small children are not able to regulate their body temperature in the same way that adults do. If you’re planning on spending the 4th of July outdoors with your children, make sure you have sunscreen, water and most wonderful— shade — available to them. Never leave children or infants in a car, even if windows open and don’t ever hesitate to call 9-1-1 if you see a child left unattended in a car.
  • Water Happiness: If you’re lucky enough to enjoy cooling off in the pool or lake, keep in mind that drownings are most prevalent in the summer months. Children ages 1 to 4 have the highest drowning rates. If you plan on boating, keep your child in an appropriate size life jacket at all times. I’ve recently shared advice about what to do immediately if you think an infant, child or teen is drowning here.

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Love Wins For Children

Orange denotes states where same-sex marriage is legal.

Orange denotes states where same-sex marriage is legal.

While I was out of the country last week there was remarkable progress when it comes to public health and the opportunity for children. It was wild to be so far away seeing the news unfold. First it was The Supreme Court Of The United States (SCOTUS) voting to allow subsidies for the Affordable Care Act (facilitating the federal government to provide nationwide tax subsidies to support poor and middle-class people when they buy health insurance). Then just a day later SCOTUS voted 5-4 in majority to make gay marriage legal in all 50 states. With the highest court in the land stating clearly that from here forward, “marriage is a right” we realize it changes the game. These laws are about dignity and rights and care but this is squarely also about families. As a mom and pediatrician this feels MOMENTOUS. Read full post »

School Is Out, Head Lice May Still Be Around

Head LiceThey’re a little gross, somewhat annoying and for most parents, inevitable. It also seems to me that for most of us they show up at the most inconvenient times. I’m talking about lice. With school coming to an end this month, you may think your child’s chances of picking up the little bugs will diminish. Unfortunately, according to the American Academy of Pediatrics (AAP) most cases of lice occur outside school. Between summer camp, sports and play dates there are still plenty of opportunities for lice to take shelter on the head of at least one family member. They’re certainly no picnic to deal with and they can also be unwittingly contagious during the school years. Clearly there’s nothing to be ashamed of when discovering lice but it doesn’t always feel that way. New guidelines from the AAP out last month offer some tips for getting your family lice-free as quickly as possible. Acting fast with a plan often diminishes all sorts of anxiety and discomfort for all. Read full post »

What To Do If Your Child Is Drowning: School-Age & Teens

6-2 boy swimmingThis is part two of the “What To Do If Your Child Is Drowning” series. Read about infants/toddlers here.

The purpose of these posts is to find out what you should do if you realize your child is actually drowning or struggling in the water rather than repeat the warnings of how to prevent it. I want to put a couple thoughts and tools in your hands to know WHAT to do if faced with an emergency.

Dr. Linda Quan, an emergency attending physician and drowning expert at Seattle Children’s shares information on what to do if you come upon a school-age child or teenager who is drowning. Preparing for this can help boost awareness and response if ever you support or discover a child in need for rescue.

Keep Your Own Safety In Mind

One of the most important things to be aware of if you see an older child or teen drowning is they are usually in water that is deeper and poses more risk to the rescuer. Always take time to consider personal risks before attempting a rescue. This requisite step plays counter to our instincts to act fast as parents and guardians of children…but I can’t overstate this. The size and strength of the child who is drowning should always be taken into consideration. Children and teens can be large enough to actually drown the rescuer.  Dr. Quan says,

For this age, the “Throw or Reach” rule is the key safest rescue action.

Reach to the child with something they can grab (a stick, paddle or your hands), only if you’re in a safe place and not at risk of being pulled in by the victim. Alternatively, you can throw something that floats (a life jacket, ball or safety ring) toward the child. Do not jump in to the water to rescue a drowning child or teen unless you are trained to do so. Only those who are experienced in water rescue and have some type of floatation with them should go into the water to perform a rescue.

If possible, get your child or teen comfortable in the water. If they have had some experience in water it might be easier for them to overcome panic and either reach for a flotation device or flip over, float and breathe.

If You Think A Child Or Teen Might Be In Trouble:

  1. Tell someone to call for help – a lifeguard or 9-1-1
  2. Stay well clear of the water and any incoming surf unless you are trained, qualified and equipped to make an in-water rescue in these conditions
  3. If the child has been taught to float, yell to them to flip over, float and not fight the current.
  4. Immediately throw the child who is old enough something that floats (e.g., a lifejacket, ball, body board, empty cooler with lid secured)
  5. If you can safely do so, reach to the child with something they can grab (eg., stick, paddle) – STAY out of the water.
  6. Safely remove the child from the water without endangering yourself.
  7. When you get the child to shore, if the child is conscious, provide warming and comfort. If the child continues to have any breathing trouble, such as shortness of breath, fast breathing, coughing, labored breathing or seems too tired, seek medical care immediately. If the child is unconscious, lie the child down on his back, chin up.
    1. If the child is blue or not breathing, give several rescue breaths ( mouth to mouth).
    2. If the child does not take breaths or respond on his own, start CPR (chest compressions with ventilation).
    3. After several rounds of CPR, call 911 if they have not been called yet.

To learn more about child CPR check out this article.

What To Do If Your Child Is Drowning: Infants & Toddlers

6-1 baby in waterWarm weather is here and summer is approaching and if mother nature is kind, we’ll have plenty of sun-filled days over the next few months to spend by the pool or at the beach. Unfortunately, this is also the time of year when drownings increase. Young children are especially high-risk because of their profound curiosity around water and lack of awareness of danger.

Drownings are preventable deaths but even the thought of them spooks most of us. Often, a drowning event looks, sounds, and appears unlike we’d expect. I’ve written before about the silent danger of drowning, but rather than reiterate the warnings of how to prevent drowning, this year I wanted to find out what you should do if you realize your child is actually drowning. Put a couple thoughts and tools in your hands to know WHAT to do if faced with an emergency.

I tapped Dr. Linda Quan, an emergency attending physician and drowning expert at Seattle Children’s for information on what to do if you come upon a infant/toddler, school-age child or teenager is drowning. Preparing for this can help boost awareness and response if ever you support or discover an infant or young toddler in need for rescue.

Drowning In Infants Is Different Than Older Children

Children ages 1 to 4 have the highest drowning rates. Because they are so small in stature and often easier to retrieve, drowning prevention for infants and toddlers will always be more important than water rescue techniques. Never leave children alone in or near the water, even for a minute. This includes the bath, a kiddy pool, a pond, a river, lake or larger pool. Close supervision is vital in preventing water-related injuries and drowning. Since it only takes seconds for a child to slip silently under the water, parents need to make sure there is always a lifeguard on duty, or another adult, or a parent watching attentively when children are in or around the water. Dr. Quan says,

For an infant, a child younger than a year old, drowning usually happens in a bath tub, bucket or ornamental pond or water collection device, so rescue does not usually pose a risk to the parent or rescuer. This small child is easily pulled out of the water if within arm’s reach.

What To Do If You Think Your Baby or Toddler Is Drowning:

  1. If the child is blue or not breathing, immediately give several rescue breaths (mouth to mouth breathing).
  2. If the child does not take breaths or respond on his own, start CPR (chest compressions with ventilations).
  3. After several rounds of CPR, call 911 if they have not been called yet. The video below gives a quick overview of infant CPR. You can also check out this article for more information.


 

Power Of A Google Search: Community

5-22 Addison

2-year-old Addison Hyatt survived a  pediatric stroke at birth. (Image courtesy: Kaysee Hyatt)

One Google search can sometimes change everything.

After learning something new about our child’s health or condition, especially for worried parents and caregivers, leveraging online search as a resource in diagnosis, clarification and education is typical behavior. Searching out support, camaraderie and tips online just makes sense. In fact, 2013 data from the Pew Research Center finds that 1 in 3 Americans goes online to search for information and support in finding a diagnosis. If you’re a woman, college-educated, or younger (under age 49) the likelihood of searching online increases and approaches 50%. Not only are we searching for health info and connection online, we’re doing it more so with mobile devices. Pew data from April 2015 finds that 64% of Americans have a smartphone and that 6 in 10 are searching for health info on a mobile device.

That smartphone in your pocket can connect you to information yes, but also to others like you.

Of course most clinical care still happens in the office and most decisions, especially important ones, are made offline. Yet preparing for visits, strengthening resolve, finding other parents in similar situations can potentially improve the way we care for and raise children with underlying medical challenges. It can also change how we feel about it. In my mind, one of the most precious resources will always be the people. This includes our family, our nurses, our therapists, our relatives, our clinicians and our peers. In the words of Susannah Fox, a technology and health researcher who is now Chief Technology Officer at the U.S. Department of Health and Human Services, when it comes to caring for yourself or others in your life, “Community is your superpower.”

I’m still the doctor who encourages online search, especially when looking for resources in networked communities. Social networks have simply shrunk the distance between us and facilitated robust connection. Finding others like you, who’ve been down the road before you, can often provide support, help reduce anxiety, provide tips and connect you with resources you didn’t even know existed. As a pediatrician, there’s no question that expert patients and their families often teach me about resources available to them I’ve not previously known — as a clinician I’m grateful. Once I review the sites and organizations, I can then share those communities and education sites with other patients I’m lucky enough to partner with.

Community is your superpower   ~Susannah Fox

Mom Kaysee Hyatt drives this point home. After months of concern surrounding her infant daughter’s delayed development, Kaysee Hyatt finally got the diagnosis: her daughter Addison had suffered a perinatal ischemic stroke at birth. After receiving the news, Kaysee was told to go start therapy but in her words “there really was no plan.” Out of curiosity and intent, she turned to the Internet. A Google search on pediatric stroke led her to CHASA.org (Children’s Hemiplegia and Stroke Association), a nonprofit group founded by parents that provides resources and dozens of discussion groups for families dealing with pediatric stroke. Kaysee told me that when she found the site and learned more, “It changed everything.” When talking with Kaysee what stuck with me most is how Kaysee’s sense of isolation dissolved when she found these resources online. She remembers that she was stunned to find so many families with strikingly similar stories to her own. “It was amazing,” she told me, “we all shared the same stories.”

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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:

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…

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?

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 »