Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

A mom, a pediatrician, and her insights about keeping your kids healthy.

Your Social Network, Your Kids’ Vaccines

network

We live in a profoundly different time today when it comes to caregiving, parenting, and gaining health care/advice than we did even 5 or 10 years ago. The internet has changed things dramatically. During an interview recently a reporter asked, “You were raised on digital media, yes?”  Well, no. I didn’t started using email until late 1995 just prior to leaving college, didn’t get a cell phone until I was teaching, didn’t have a working computer in my apartment until I started my master’s degree (after med school), and didn’t join social media until 2008. It was bedrest with my second pregnancy that urged the establishment of a profile on Facebook. That online community changed everything.

I’m no digital native but I may act like one.

My husband, my friends, and the doctors I’ve chosen to help me raise my boys certainly do color my belief about the world. So do the things I read and watch online.

There has been 3 measles cases in Seattle this July and 58 cases of measles in Brooklyn, NY since March. Measles is preventable with a very effective vaccine. The vaccine is so good that after 2 doses of the MMR shot, over 99% of people are protected against measles for life. However, often our community shapes our decisions to vaccinate…

An insightful Pediatrics study and accompanying editorial published earlier this year illuminate the reality that social networks carry big weight for parents making decisions about immunizations. We do make decisions in the context of our lives and the social network we choose to use as a sounding board really does help us determine what to do in moments of confusion. Read full post »

Measles In Seattle

There is a report of more measles here in Seattle. Measles is a highly contagious and potentially severe infection that causes fever, rash, cough, and red, watery eyes. It is mainly spread through the air after a person with measles coughs or sneezes. King County Public Health released information today detailing new cases and potential places for public exposure to measles infections between July 9th & July 15th. These two new cases are unrelated to the measles case earlier this month in a traveler at the Sea-Tac airport. Much of the information here is thanks to the public health department.

Local public health officials have confirmed measles infections in two siblings, an adult and a child, who were in several public locations during the time that they were contagious. The siblings have been visiting from out of state and public health officials believe that they acquired measles outside of Washington State.

Locations where possible exposures may have occurred:

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Jenny On The View

450px-Jenny_McCarthy_Addresses_AudienceJenny McCarthy is officially joining The View. “Do I have opinions?” one reporter asked today. Yup.

My concerns center around Jenny McCarthy’s past willingness to trade-in her experience for expertise. That is, she widely shared her theories and anecdotes about her son’s experience with learning challenges and falsely placed blame on vaccines for his then-diagnosed autism. I will not discount her private experience. What I discount is her decision to leverage a modeling/pornography career to message about health. She aligned herself with pseudoscience. She mistook “mommy instinct” for fact. She partnered with the debunked Andrew Wakefield and has been an ardent spokesperson for Generation Rescue. She directed families away from life-saving vaccines and pointed them towards costly and unproven treatments like chelation for learning and behavioral challenges. In sum, she created fear.

She created myths around “greening” vaccines, a concept that lives on today and make very little sense.

Her myth (stating the MMR vaccine caused her son’s autism) has potentially increased disease burden. Outbreaks of measles in Europe have overwhelmed France and Wales in the past few years and under-vaccinated communities persist here in the US. In part, this is because of Jenny’s megaphone.

The auspicious truth is when Andrew Wakefield was debunked her fervor slowed. I hear less about Jenny McCarthy in the exam room these days. She’s retreated from the vaccine discussion. Trouble is, I still hear about the myth she methodically created. Some families remain scared and confused about true benefits/risks when it comes to life-saving vaccines. I’m angry she’s made so many parents falter. Read full post »

Arsenic In Apple Juice

apple juice?Juice is never necessary is a child’s diet. Unpopular as this is to say, juice is always an extra, add-on, treat-type part of what children should eat. High in sugar and low in nutrition, excess juice in a child’s diet is linked to poor nutrition, obesity, and dental cavities.  Although 100% juice comes from fruit, after it’s smooshed and pushed through machines to produce clear juice it’s separated from much of the health benefits (fiber) from whole fruit.

Late last week the FDA provided an updated “action plan” and recommendation for monitoring inorganic arsenic levels in apple juice. Back in 2011, the controversy about arsenic in apple juice began when Dr Oz presented data on his afternoon television show that was quickly rebutted by Dr Richard Besser on Good Morning America. Dr Oz reported high levels of total arsenic (organic and inorganic) in apple juice but there were concerns of unnecessary scares. Up until this point, the FDA wasn’t mandating arsenic levels in apple juice. After a cascading series of events (much criticism and then more reports and analytics) it is now more widely accepted that up to 10% of apple juice may have higher levels of inorganic arsenic than we tolerate in drinking water. Inorganic arsenic consumption can damage organs in our body and in high quantities it’s linked to an elevated cancer risk. Organic arsenic isn’t harmful to our body (it passes right through) and is found naturally in many foods we eat like shellfish or seafood.

Consequently, the FDA has decided to decrease the level of inorganic arsenic they tolerate in commercial apple juice to that of levels acceptable in drinking water (10 parts per billion). Inorganic arsenic in our diet typically comes from food contaminated with and/or grown in soil with high levels of inorganic arsenic (animals fed food with arsenic or food grown in contaminated fields with heavy industrial products). In the past couple of years arsenic has enjoyed quite a bit of media spotlight, especially in light of evolving 2012 information about elevated arsenic levels in rice (cereal, noodles, white or brown organically grown or not). Because of this, most pediatricians now recommend offering infants rice cereal only once weekly. As with all concerns about the food we eat, moderation is key…5 tips: Read full post »

Sprinklers

sprinklers

Just a photo. Couldn’t resist sharing this tonight as the moment washed over me and I realized that there’s something about children running in sprinklers that really makes it summertime.

Every once and a while we get ridiculously indulgent moments hand-delivered by our children. I was lucky enough tonight…

Enter The Smart Diaper

Screen Shot 2013-07-09 at 10.09.35 PMToday I learned about “smart diapers,” disposable diapers that have QR code indicators with colored sensors ready to detect not only wetness but risk of infection, dehydration, or kidney disease. Only a matter of time, I suppose, that infants’ clothing educates us about their health since it’s been just weeks since TweetPee, the diaper unveiled in Brazil that tweets parents when wet, was unleashed. By report, the smart diapers unveiled today will ring up at the register only 30% higher than a typical diaper. These highly capable diapers may therefore become mainstream whether we like it or not. Worried about your baby’s weird smelling pee and/or worried your infant is getting dehydrated during a bad illness? Just throw on a smart diaper for some insight. Not such a bad idea for a worried parent with a punky baby at 2am.

Formal self-tracking is thunderously augmenting human life as our experience with our bodies and health adapts to available technology. Mobile health apps (think Baby Tracker or Map My Run), self-trackers (think Fit Bit or Up), and devices (think smartphone camera) are continually providing us with new ways to assess and improve our self-awareness. Many Americans (infants to adults) self-track, or are being tracked, without knowing it. Susannah Fox, a researcher studying the intersection of technology and health care, introduced me to informal self-tracking last year when she mentioned the utility of “skinny jeans.” Each pair of skinny jeans out there in closets around America showcases the perfect tracking device for weight balance. We know just where we are when we try them on…

I saw a friend last week who showed me her son’s daycare app–throughout her workday she has constant access to his “feed”–how many ounces of milk he drank, his last dirty diaper, and live, uploaded photos of him on the play mat. These 2013 babies will grow up with a distinct digital timeline. A wealth of data to evaluate and mine, indeed. Yet while the genius of great tracking devices is ease of use and insignificant work for data transfer, the beauty of a smart diaper is that it may potentially alleviate parental concern in minutes.

Some quantified-self devices are clearly amazing. But I have just one hesitation on this one.

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Occupational Hazard Of A Mommy Blogger

family feet to the canoe fishing on dock

First day back to work after vacation is brutal. I do my part to weigh costs and benefits with my personal work-life-balance all the time, I chew on my decisions daily. The focus on balance may be a true occupational hazard of being a mommy blogger. When one part of your career centers on writing  parenting and pediatric content while thinking about balance for parents who work outside their home, the task of finding balance and meaning– true contentment of your own– can be arduous. Especially during the first few days back to work after a family vacation. Turns out perseverating on what others think about balance can be unproductive in moments of transition.

I’ve been away and a bit offline this past week or so. I’ve been lucky to be more present with my family. I haven’t been reading as much pediatric content. I was surprised to learn about the measles case here in Seattlethe multi-state listeria outbreak, and catch up on some new conversations about air travel safety. On vacation I traveled with my family to the Midwest to see one set of grandparents where I also pulled off a surprise 40th birthday party for my husband, I finished the book Lean In, I jumped repeatedly into a lake, I read a poorly written “beach novel,” and I started Infinite Jest (will be miraculous if I can finish it). I played and played with the boys. I did my part to check-in and check-out of the chewy challenge of striking a good balance between work and family in my head… Read full post »

For A Safe 4th Of July

Screen Shot 2013-07-02 at 7.23.25 AMAs we approach the 4th of July, a quick reminder about injuries and ways to protect your children. Each year, preventable injuries occur in young children and teens from fireworks. Children between the age of 5 and 14 are the highest risk for firework injuries—over double the risk of the rest of us. Serious injuries occur including devastating injuries to the eyes and face. Not surprisingly, the most common injuries are burns. Even sparklers can cause serious burns; sparklers burn at up to 2000 degrees, as hot as a blow torch and hot enough to melt some metals.

So…..

As you prepare for the long weekend and take time with your family and friends to celebrate the incredible freedom we enjoy here in the United States, make sure your family is safe if you choose to use fireworks. Remind teens about safe driving, avoiding alcohol on the road, and distractions. A crummy fact: the 4th of July ranks as the deadliest day of the year for teen drivers.

Tips And Facts For Preventing Family Firework Injuries:

  • The most important (and likely most obvious) reminder is to never allow children to light or set-off fireworks. Injuries often occur when fireworks malfunction or are not set-off properly.
  • Don’t use or ignite homemade fireworks. All 6 firework-related deaths in 2012 in the United States occurred secondary to use of illegal or homemade fireworks.
  • If you think you’re too smart for injuries on the Fourth of July, hold on a second. Recent research found that higher levels of education do not protect against firework-related injuries.
  • If you have fireworks in your backyard, make sure you have a garden hose and bucket of water ready and full while enjoying fireworks in case of any emergency or fire.
  • Light fireworks one at a time, and move back quickly! Don’t ever allow your family members or friends to re-light a firework that didn’t go off properly or perform as expected.
  • All ages considered (children and adults), 3/4 of firework burns and injuries occur in boys and men. Males are most injured from firecrackers, sparklers, bottle rockets, roman candles, and re-loadable shells.
  • Here’s a complete, updated infographic from the Consumer Product Safety Commission about firework injuries and source of the drawing included here!

The Value of Play

bike ride 2013

As we transition to summertime we get to focus even more intently on play. Not as easy as it sounds.

There’s a balance with having a routine and structure for your child while also facilitating some time for creative play. Unstructured play doesn’t get the voice it deserves in my opinion. Parents ask me about the camps I’ve signed up for far more than they ask what downtime my children will get this summer. In my mind, the perfect summer is a blend of scattered exciting opportunities with swaths of time ready for unstructured play.

Boredom can be good for heavily scheduled children and can foster creativity

There’s lots of stress amidst the celebrations and change that comes with the end of the school year. Children thrive in routine, so even a good transition out of school can cause disruption. Some children will have insomnia, decreased eating, or even feelings of anxiety. Big changes can trigger feelings of depression in some children, too. Check in with your child if you’re worried and remember that more important than what you say will likely be that you listen.

Play

Maria Montessori famously identified the value of play saying, “Play is the work of the child.” Play is so important it is a protected child human right by the United Nations. Just as labor laws protect our children from hard labor and work, we parents must protect their chance to wander, dream, roam, and discover. Research shows play is important for brain development, an important platform to learn decision-making, and offers up a tool for children to identify their passions. I don’t mean time in front of the TV or DS. I mean time outside, in the backyard, or in a child’s room. In the 2007 American Academy of Pediatrics statement on play, Dr Ken Ginsburg wrote, “In contrast to passive entertainment, play builds active, healthy bodies.” Read full post »

Why You Should Make Sure The Helmet Fits


Buying the bike helmet isn’t enough, of course. We have to make sure our children actually wear them. We’ve gone through phases at our house (loathing to loving the helmet). The challenge isn’t often buying the helmet, it’s getting that helmet on every time and fitting it properly. I’ve learned the hard way– -after I pinched the skin on O’s chin a few times, I wasn’t even allowed to be the one helping him get it on!

Despite my lack of popularity with the boys on helmets, I’ve maintained hard rules: if the helmet isn’t on, the bike goes away and can’t be used for another 24 hours. I see helmets without buckled straps or hanging off the back of children’s heads everywhere I go. It wasn’t until I wrote a blog post about helmets when my oldest started to bike a few years back I learned to fit one properly.

Wearing a helmet reduces injury from bike & bike-motor vehicle accidents over 80% of the time. If the helmet isn’t snug and fit properly, it is far less likely to reduce injury. Hundreds of children and adults die annually in the US on their bicycles (primarily when struck by a car). Because 3/4 of all deaths on bicycles come from head injuries, wearing a properly fitting bike helmet can be a huge win. I hear over and over from children and parents in clinic that even though there is a helmet in the house their child isn’t always wearing it.

Further, when I review how important it is that the helmet fits, children and teens will often tell me they aren’t likely wearing it correctly.

Fitting A Bike Helmet

correct helmet fitYou want to ensure the helmet fits properly in 3 locations: above the eye, around the ear, and under the chin.

Eye: The helmet needs to be level on your child’s head (not back on their head like a baseball cap or yamaka) and needs to be positioned squarely on the forehead. Check with your fingers that the helmet is just 1-2 fingers above the eyebrow line.

Ear: The helmet straps should lie flat against their head (no twists!) and should form a “Y” shape just under the ear.

Chin: This is likely the point of most contention with children! The strap needs to be snug. Your child can help do the buckling (to avoid the dreaded pinched skin) but you make sure they are adjusted to the correct length. It should be snug enough to allow only a finger between the strap and chin with their mouth closed. When your child opens their mouth up wide, it should cause the helmet to move down on their head (see the video).

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