Parenting

All Articles in the Category ‘Parenting’

How About An Old Fashioned Family Meal

kid phone dinnerCompartmentalization is obviously a huge challenge for all of us, if we admit it or not. But clearly we have to have limits in our days — mealtime is one place that can be a non-negotiable, device-free space. Meals are gold for families. Breakfast, lunch or dinner…whenever your family is able to come together to eat and connect…the devices gotta go. Even toy companies are partnering with restaurants to help keep families engaged with one another. Here in Seattle this week a company called Fort Boards is providing families a $25 gift card for staying off their phone during a meal at a local restaurant (Phinney Market Pub & Eatery). Kind of nuts that you can get a coupon for toys just for putting the device away! But the gimmick and point is well-taken. While incentivizing our children every meal certainly isn’t sustainable, this is a great attempt to start fresh make a plan to stay off devices during meal time. Clearly it’s not just children who need support staying off phones/devices while eating, we do too.

A study from Boston Medical Center a couple years back comes to mind as it reveals that parents who are distracted on their phones with email, games, apps and texting have more negative interactions with their children & also may make their children feel like they’re competing for attention with these phones. We just aren’t the parents we want to be when failing at compartmentalization (I know this TOO well from experience). I like this TIME recap of the study and this quote from the author Dr. Jenny Radesky: Read full post »

Spring Cleaning: How To Dispose Old Medicines

PharmacySpring has sprung and many of us are feeling that familiar itch to tidy and purge our homes & closets. One more chore to add to the spring cleaning list: clean out your household supply of over-the-counter (OTC) medicines.

Just like the dosing instructions and additional information on the label, the expiration date on the packaging is there for reason. Once a medicine has reached its expiration date, it may not provide the treatment that you need. Smart to refresh the cabinet annually. Now is the time and this weekend, ideal!

To ensure the medicines you take are both safe and effective, keep an eye on the expiration dates and safely dispose of any expired or unwanted medicines. I talked with my friend and colleague, Dr. Suzan Mazor who is an expert in toxicology and emergency medicine about expiration dates and here’s what she had to say:

Drug manufacturers are required to stamp an expiration date on their products. This is the date at which the manufacturer can still guarantee the full potency and safety of the drug.”

Traditionally, I counsel families to be really careful with life-saving medicines. Injected epinephrine (for life-threatening allergies) is a perfect example — after expiration it’s less effective. So it’s a MUST to replace those injectors at home and school after expiration as they are used in acute/urgent/life-saving situations (and I’m not exaggerating). Other products like sunscreen are less effective after expiration, too. Not life-threatening but what chore to use it wisely and well and then be using an inferior product. Read full post »

Tips On Avoiding Arsenic In Baby Rice Cereal

rice cerealWhat we feed our babies matters. No question one delightful and soulful part of raising our babies is introducing the world of solid food. I mean really, it’s hard to describe a competing parenting moment with feeding our children healthy food, at any age. For decades, rice cereal as a first food seemed to make sense but major groups reporting out on only feeding rice with caution. The Food and Drug Administration (FDA) recently proposed new limits for inorganic arsenic in rice cereals (think: potentially cancer causing toxin that is increasingly known to cause harm early in life). Many families start their transition from breastmilk/formula to solid foods by adding in rice cereal. Doing so is convenient, makes for great consistency, but rice cereal is a leading source of exposure to the toxin. Arsenic is an abundant element in the earth’s crust, coming in two forms (organic, inorganic), the inorganic form being tied to bad health outcomes. The reason rice has more arsenic compared with other foods is how rice is grown (in watery fields) and its unique tendency as a crop to absorb the arsenic while growing. Here’s what the World Health Organization (WHO) says about inorganic arsenic:

  • Arsenic is naturally present at high levels in the groundwater of a number of countries.
  • Arsenic is highly toxic in its inorganic form.
  • Contaminated water used for drinking, food preparation and irrigation of food crops poses the greatest threat to public health from arsenic.
  • Long-term exposure to arsenic from drinking-water and food can cause cancer and skin lesions. It has also been associated with developmental effects, cardiovascular disease, neurotoxicity and diabetes.
  • The most important action in affected communities is the prevention of further exposure to arsenic by provision of a safe water supply.

Why are infants particularly vulnerable to arsenic in rice? The FDA says: “relative to body weight, rice intake for infants is about three times greater than for adults.” In their evaluation, they tested 76 different rice cereals and found that 1/2 exceeded the inorganic arsenic limit. Some companies and products are advertising for safety — for example Gerber rice cereal manufacturers announced that their products already meet the FDA’s proposed limits but it will be with time that the food source is changed for good in all products packaged and marketed for babies.

Knowledge about what exactly rice cereal does to babies and their developing bodies continues to unfold but infancy is a time of profound growth and development. Also a time we really want to limit toxins that could change risks. Researchers in JAMA Pediatrics explain: Read full post »

Take Me Out To The (Peanut-Controlled) Ball Game!

ThinkstockPhotos-508446509Having food allergies (specifically to peanuts) might prevent you and your family from attending certain events, but baseball in Seattle hopefully won’t be one of them. The Seattle Mariners are offering 5 “peanut-controlled” games this season at Safeco Field. No peanuts will be allowed in sections 313, 314 and 315 in the view box level during these games. And although fans should note that peanut-controlled does not mean the game will be entirely peanut-free, this does offer a new way to improve safety for children with serious allergies. The Mariners certainly deserve an “Atta Boy!” for this one. (More game information below).

While peanut allergies have doubled in the past decades and are reported to have tripled between 1997 and 2008, they are just one food allergy of the nearly 400,000 school-aged children who suffer from mild to severe reactions if exposed to an allergen. Some food allergies are serious and life-threatening.

One in every 13 children has a food allergy so this isn’t a rare experience for children or their families. How we support our own children and children in the environment, at school, in sports, and at our homes is also changing. We really are perhaps becoming more compassionate and sophisticated (peanut-free tables, thoughtful policies for birthday treats, more open discussions about how best to include children with dietary restrictions). The Mariners games are just a lovely example of how to do things better at scale.

When To Introduce Peanuts To Babies?

Data is still evolving for recommendations for all babies, but about a year ago (March, 2015), new recommendations (comprehensive blog post) were given regarding introducing certain foods to babies. The New England Journal of Medicine found if allergy-prone infants were introduced to peanuts early in life (between 4 and 11 months of age) their risk of peanut allergy at age 5 years significantly decreased. The current American Academy of Pediatrics policy on food allergy introduction (revised in 2008) states there is insufficient evidence to support delayed introduction of potential food allergens to reduce the risk of developing allergies. This means holding back on foods during infancy isn’t recommended! Try introducing things like wheat, egg, soy & fish before 12 months. We’re moving towards not waiting on any foods in late infancy and this data on peanuts is the beginning of understanding creating recommendations to start foods early. More data will help make these recommendations for all babies. Check in with your baby’s doctor with any questions or concerns, especially if food allergies run in the family. Read full post »

Your Children Not Sleeping? It Might Be YOU

parent sleep

No question sleep — the good and restorative kind of sleep — changes our day. Sleep is tied to our outlook, our mood, our performance, our safety, and our sense of stress/anxiety. We’re nicer people after we sleep. I often say that after a good night of sleep I get to be more of the mom I earnestly want to be. Sleep is magical that way.

Thing is, sleep has a profound effect on our perspectives and attitudes about life. In fact research has found that sleep loss causes bias in our memory — the less sleep we have the more we focus on negative events and the more our memory builds space for memories of the negative details in our life. Yikes.

You know how it is…we all do. You start the day exhausted or you head into work tired, clutching your coffee, trying to rev up for the day. Your child didn’t sleep well through the night and therefore neither did you. Happens all the time, of course and to some parents more than others. You’re wondering (and likely doing some research online) what you can do to improve their sleep. What tricks haven’t you tried? What schedule should you be following? The hidden answer might be the last thing you’d think of …your own sleep.

Thing is, if we didn’t sleep well last night we may be misrepresenting the facts of the night.

A new sleep study published in Pediatrics showed that parents who don’t sleep well may mistakenly believe their children didn’t either. The researchers studied the sleep of 100 2- to 6-year-olds in Finland and their parents. Children wore bracelets (devices called actigraphs that track movement and quantify sleep) for a week to estimate sleep duration and quality while parents kept a sleep diary for their children and filled out a sleep questionnaire. Parents’ age and education were included as relevant variables in a the study as well as the child’s age, gender, chronic illnesses, medications, and number of siblings.

People who sleep poorly overestimate their children’s sleep problems.” ~Marko Elovainio, author of Pediatrics study

Read full post »

Candy Or Medicine? Safe Medicine Storage

candy or medicine

Image c/o Strong Health

The role parents play in poison prevention is paramount. The above image shows just how easy it is to confuse medicine with candy. Especially if we message this improperly. When my boys were young I started calling liquid medicines “yum-yums” in an effort to get them to take acetaminophen or other medicine easily only to realize as I was doing it I was advertising the wrong thing…totally novice move as a mom and pediatrician. Clearly as parents we’re always a work in progress.

Safe medicine storage is one of those obvious things we feel we have under control. But numbers for accidental ingestion in the US prove we don’t. Young children are earnestly dependent on us doing this better.

Check out the above image — the packaging of medication earnestly isn’t any different to most of us than the packaging for candy. Imagine a 3 year-old trying to differentiate between the two in a moment of discovery. Pretty easy to imagine a 4 year-old stumbling upon a skittle and seriously impossible to imagine them over-riding their curiosity to explore/enjoy with their mouth. Chances are, that medication/skittle is going into their mouth.

Medication storage isn’t just for your typical over-the-counter (OTC) medications. With our households changing and many people coming though them, we have to think about prescription medications, liquid nicotine, marijuana and household products that all need to be up and out of reach. To that end, safe medicine storage is an important part of family and household safety. This week is National Poison Prevention Week so the perfect time to perfect our homes a little more. This includes any home your child plays in or stays in. Read full post »

One Image Of Parenthood

Usually I arrive here to write and share things that might help. I mean, my hope as a mom and pediatrician is to elevate research, share vulnerability, toss out the irony in the isolation of ideas trapped in an ivory tower and bring in hope for more understanding. I’m usually here to share because I believe if we swap ideas through narrative we all move towards calm and confidence or knowledge and skill as parents, caregivers, adults, children, and partners.

But today I’m just here at my kitchen counter wanting to share an incredible image. Just wanting to make sure you’ve beheld it, too. I haven’t read a single word about the image and I will keep it that way. I don’t want others’ ideas or personal narratives or their agendas to taint what I see. And my hope here is to do the same for you.

All I can say is that for me the image is a triumphant, loud reminder of the immense privilege, the singular honor, and the wired intuition we hold when we get to parent a child. I mean life happens. In all its messy truths and horrific pains, mistakes and brilliant saves, and in our jubilant discoveries and the small gifts given every…single…day. But there was moment this past Saturday, captured by a lens, that explains so much about what and how we fear, what comes flying at all of us on Planet Earth, and what we can truly handle.

Enjoy this photo worthy of a long stare. I get lost in it.

High Stakes: What Can You Explain To A 6 Year-Old?

IMG_4114A couple of weeks back my mom spent a bit of time with my little love on the sideline of his brother’s soccer game. She’d brought in an unusual pine cone to show him that she had picked up on her way in. It showcased the delicate symmetry and stun of nature — twelve seeds spiraling around a centered seed perfectly nestled in a whirly cone. It’s a marvel to hear her explain how the pine cone works to potentiate future life and it’s instructive with how well she understands it. I couldn’t have explained the process so well but I’m not the naturalist my mama is.

As I witnessed their conversation, his unrelenting questions, and the profound knowledge a parent or grandparent needs to know to satisfy a curious 7 year-old’s natural intrigue, I tripped. Not literally, but almost. I was also immediately reminded of an Einstein quote I’d read the week prior that has been STUCK in my head ever since. When you read it, you’ll know the loud truth in it. And it has me reflecting on the enormous task and wild skill it takes to raise a child. I mean our children are exceptionally creative (unclipped, if you will), wildly ready to learn about the sights and sounds around them, and innocently unexperienced. As parents and their obvious anchor, our children constantly look to us to explain.

Explaining takes great skill, inordinate preparation, and earnest mastery. Perhaps this is obvious, but the skill it takes mesmerizes me. Einstein’s quote rings out like a bell.

If you can’t explain it to a 6 year-old then you don’t understand it.

~Albert Einstein

Read full post »

New Birth Control Laws: Preventing Unplanned Pregnancy

Birth ControlEasy, confidential access to affordable birth control is essential if we’re going to decrease the rate of unplanned pregnancies. The dynamics of birth control access are changing, thank goodness. As we’ve heard about parts of the world simply telling women NOT to have babies (Hello, Ecuador) we really do have to think about how women and men prevent pregnancy when not ideal. And how we support women getting information they need to make the safest and most reliable choice. This can start way before teens are sexually active.

Things are changing here in the US. As of Jan. 1, 2016 women 18 and older in Oregon can get hormonal contraceptives directly from a pharmacy, without having to go to a doctor for a prescription first. Pharmacists who supply birth control are required to complete formal training before being allowed to write prescriptions. In addition, teens and women must take a 20-question health assessment before obtaining the prescription that details risks and family history. This is why I always want parents to tell their teen if there is a family history of blood clots, family history of migraines, etc. That way, they can answer correctly!

The good news, here in the US, contraception is covered by insurance and protected by Obamacare (Thank you, Mr. President). Birth control options covered by the Affordable Care Act include: IUDs, emergency contraception, implants, pills, patches & rings.

California has also passed similar legislation that will take effect in the coming months to make it even easier for women to access birth control. National work is ongoing as well to make birth control over-the-counter. More on that to come!

When it comes to teaching our teens about sexual education, we know the topic is fraught with contentious beliefs and cultural sensitivities, and we also know that it’s really hard to speak about certain topics openly. But over and over, we are told by our kids that it’s us – the parents – their trusted adult community – they want to hear from most. Even when they squirm in the seat, DO KNOW THEY ARE LISTENING. I’ve written about this before for parents preparing those kids going off to college.

But really, talking to your teens about how to protect their bodies from sexually transmitted diseases, unplanned pregnancies, or violence should start much earlier. Normalizing the conversation appropriately for kids as young as five is encouraged in many parts of the world. We can talk about how we time growing our families in age-appropriate contexts. I’m thinking of writing a post, in partnership with a health educator, about what to say to a 5 year-old, an 8 year-old, an 11 year-old, and a 15 year-old. Would that be helpful? Please leave a comment…

I also want to offer a few great resources, thanks in part to my friend, teen advocate and digital educator, Susan Williams (@estherswilliams) for other parents to use as additions to or as guides for helping their kids understand their bodies and their decisions when it comes to sex and relationships.

There are three initiatives underway that I believe are truly shifting how sexual education and access to the right care, contraception, and information is achieved. Being able to get the right information when you need it and then being shown how to act on that information is crucial to preventing unplanned pregnancies and reducing cases of STDs. For adults who love their (our!) kids, we also need resources to help guide how we talk about sex:  Read full post »

7 Quick Tips For Healthy Mouths

oral health 1

Valentine’s Day this weekend….Even if you think it’s a card-store holiday chances are your children LOVE it. So power on Super Mama & Super Papa and learn something that makes it worth it. The American Dental Association declared February National Children’s Dental Health Month (I’m thinking because of the holiday and all those sugar hearts). This may have to do with candy…..but please read on even if you DON’T have a sweet tooth. Setting a good example and teaching children from an early age how to take care of their teeth is worth all of our time. It’s something I’m STILL working on as a parent. This matters because tooth decay is the most common chronic disease in kids age 6-11 and adolescents age 12-19. Additionally, at least 20% of children ages 5-11 have at least one untreated decayed tooth. Flossing and brushing 2 times a day changes the odds. Boom.

7 Tips For Healthy Teeth:

Read full post »