Parenting

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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 »

Balance And Bad Parenting, Maybe

3-27 jumpingLast night four Swansons sat in row 6 of a little commuter airplane on the way to visit family, all plugged in. Four people who love each other with four separate devices hardly communicating for the two hours or so that we sped through the air. At first glance it can look like an utter failure — you can hear the criticism ringing in your ears — this family must not be connected, or these working parents, pounding out emails and prepping presentations while their children watch videos and play apps, really must have their priorities off, right? Right.

Maybe.

On that flight I read a beautiful blog post from tenacious pediatric researcher Dr Jenny Radesky that questions the new world in which children are being reared. The one where their parents are plugged-in, distracted, perhaps less attentive and less available while raising infants and young toddlers. It’s the same world today, where preteen digital natives may be connecting more by text than by talking. She cites data that found, “if you take away preteens’ mobile devices and make them hang out with their peers in the country for one week, they get better at reading other people’s facial expressions.” Perhaps these children and teens are swapping thumb skills for interpersonal ones. Radesky is the researcher behind the observations out last year evaluating parents’ use of mobile phones at dinner that alarmingly demonstrated children’s near need to act out to get their parents’ attention.  Are our parent-child connections forever changed because of the profound brilliance that digital devices have in capturing our attention? Radesky brings up the zone of proximal development (I’d not previously heard of it) and its profound value. She says,

In order to effectively teach children how to regulate their behavior, we need to interact with them in what psychologist Lev Vygotsky termed the child’s “Zone of Proximal Development (ZPD).”  This means  knowing their cognitive and emotional sweet spots: what they can do on their own, what they can’t do, and what they can do and learn with an adult’s help.  You can’t fit the puzzle pieces in yet?  Let me guide your hand a little bit until you figure it out by yourself. You can’t calm down when you’re frustrated yet. Let me help you identify what emotion you’re feeling and then show you some options for calming your body down. And I’ll slowly take my support away until you can do this skill on your own.

Oh yes, we certainly do need to be in this space and be available, eyes connected, body engaged, actively listening to the loves of our life (children). In championing this reality we can easily finger-wag that how things used to be (without smart phones and wild virtual connection to data and community) is better. Slow down, unplug, unwind, and CHECK BACK IN, right? Common Sense Media even has a new PSA campaign, that I happen to love, tagged #realtime guiding us back to life with a series of delicious, tight videos reminding us how we mess up. Read full post »

The Inconvenience Of Prepackaged Baby Food

dv2159103Feeding 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 »

Wellness Visits: A Magical Place To Communicate

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

1-28 CDC BMI chart

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 »

“I’m A Kid Like Everyone Else”


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.

Friends And Bacon

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.

Screenshot 2015-01-22 20.20.23A 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 »