Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

TV Tip-Overs Are Real

One of the most horrific memories of my residency training was caring for a little girl after she sustained a life-threatening injury from a TV and dresser tip-over. When I met her she was unconscious, non-responsive, and simply gorgeous. She was just so little and there was so much suffering around her. These real stories harbor horror but also hope.

Injuries from tip-overs are worth talking about. Securing furniture or new TV’s (especially after the holidays) are those things that end up on the long, “Honey-Do” lists that we often push aside and that we often de-prioritize. No reason really except that the tragedy just seems so unlikely. Injuries to our children from tip-overs or children who visit our homes are entirely preventable. Statistics and quick tips for how to get it done tonight below.

The U.S. Consumer Product Safety Commission  recently released this video featuring mothers who have lost their children to a terrible, but preventable tragedy: a TV or furniture tip-over incident. It’s a horrifying thing to reflect on — almost too hot to hold in your thoughts. But these parents ring out with a true reminder of the importance of always anchoring your screens and furniture. Hashtag anchor it… #AnchorIt Read full post »

2015 Mama Doc Greatest Hits

I’m not thrilled to close out 2015 — there were special parts of this year I’m a little desperate to hold onto. Not certain I always feel this way, but on this final day of the year it’s true: there’s a tiny bit of me bracing for the flip on that clock. I somehow skipped an end-of-the year 2014 “Greatest Hits” (most read blog posts) post last year and am eager to bring the tradition back to life (here’s 2010, 2011, 2012, 2013)! Of course, 2015 had highs and lows. For me it included all sorts of mid-life-forty-year-old-woman-type thoughts about life and parenting. There’s wild hyperbole in the middle — recognizing profound hand-clutched-to-chest privilege like good health, good friends, unique opportunity and the immutable joy it is to raise little children. Yet in the middle zone of life, these momentous realities are often chased by the overwhelming epiphany that life is uniquely precious and finite. So much to contribute and so much also to learn and so much we all want to witness with our children. Every single day.

Over the year I had significant learning about communicating about health. I did dozens of interviews regarding the measles outbreak that stemmed in Disney, I’ve experienced heart breaking and continued stun at ongoing gun violence, I had a painful goodbye to my beloved dog, Luna, I’ve witnessed great suffering with illness in those I love and those I’ve cared for, and my ever present work-life balance quandary and curiosity toils on. But 2015 also had me soaring with things like The Supreme Court Of The United States voting 5-4 in majority to make gay marriage legal in all 50 states, quiet snowstorms, hikes in the mountains and hours running on trails here in Washington. I was able to continue to spread public health messages on national news outlets like NBC Nightly News, Al Jazeera, The Washington Post, The Today Show & NPR, and USA Today. I traveled to Australia late in the summer for a speaking engagement with my delicious 9 year-old and discovered how much I want to go back. I was an invited speaker at the NFID Influenza News Conference at the National Press Club in Washington D.C. to explain the seasonal launch of influenza vaccinations and I got to see healthy and sick children and their families in clinic nearly every week. I continued to learn and grow and partner with like-minded groups working to improve public health and messaging in pediatrics/parenting like The American Academy of Pediatrics, The CDC, The Washington State Department of Health, The Washington Dental Service Foundation, a new start-up called Mother.ly, and continued our ongoing partnership here with Know Your OTCs. In addition to my trip to Australia, this year I was lucky enough to learn and contribute to conferences and health systems in Iowa, Minnesota, Illinois, Washington, Colorado, California, Washington, D.C., North Carolina, and Maryland. Read full post »

It Was Never A Dress: Raising Boys And Girls To See Things Differently

Mamas are superheroes in disguise ❤️

A photo posted by The Glow (@theglowdotcom) on

Last night, around dinnertime the doorbell rang. When I opened it to find a clipboard-clad solicitor obviously looking for donations or a signature, earnestly I wasn’t thrilled. But she had me at hello when she said, “I’m here to work for equal pay and equal rights to health care.” After we talked for a few minutes, my little boy curiously also appeared at the door and asked what we were discussing. We explained and he stayed quiet. But later in the evening he said to me unprompted, “it sure made sense” that women and men were paid the same amount of money for the same job.

Then this morning I stumbled upon this cartoon on instagram. Hidden truths re-imagined in the pant suit! Something about this felt exceedingly timely with 2015 being a time where a woman is a front-running candidate for President of The United States, girls now report more than anything else they’d like to grow up to a doctor, and a time where we’re still working hard to chip away at supporting women and men equally in the workplace as they raise families. As we raise our little girls to feel unencumbered and as we raise our little boys to feel the just the same, I couldn’t help but feel the thrill from this “superhero” re-design. I say we share it with our children…also consider these 3 articles today:

3 Things To Read While Raising Girls And Boys To Value Each Other Equally:

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Parenting In 2015

My little love in the snow yesterday. Part of my #worklifebetter life hack!

My little love in the snow yesterday. Part of my #worklifebetter life hack!

Time capsule entry. Although I suppose every parent since creation felt that the time in which they were raising their children was somehow novel, I’m moved by our 21st-century digital connection to share a transparent take on being a mom and pediatrician today. It’s the end of 2015 and overwhelmingly, I think many of us are stretched thin. And although our children are more-than-ever-before extraordinary, somethings gotta give.

First things first, as a perhaps totally-exhausted-working-full-time-emotionally-laden-at-baseline mom trying to find center, I keep reaching for poetry from Mary Oliver. Here she sets me flying in a portion of her poem, Spring Azures:

Sometimes the great bones of my life feel so heavy,

and all the tricks my body knows–

the opposable thumbs, the kneecaps,

               and the mind clicking and clicking– 

                                                                                                                         don’t seem enough to carry me through this world

                                                                        and I think: how I would like

                                                                         to have wings–

                                                                         blue ones–

                                                                          ribbons of flame.

Oh, how our minds always seem to be clicking and clicking and clicking and clicking…and those blue wings, the ones of flames? Yes, please sign me up.

A friend, a few years ago referred to their spouse as having a “busy brain” and I’ve thought on it since. Don’t all parents? Or is that the 2015 talking?

The 2015 realities aren’t surprising to any of us: the earnest tether to a smartphone, the wild ease to immediately compress and access news from the entire globe, the immense pressure to have a career wed to the impressive surge in being asked to be wildly productive everywhere (at home, at work, at volunteering, at exercising, at being present). The heavy burden of being told to elegantly role-model (hello, parenthood), the urgency we feel to then perfect raising children, all the advice (!!) out there floating around and intentionally pushed our way in social networks. And then the never-ending stream of in-arm’s-reach science of what we know to be good for us (sleep, flossing, daily exercise, leafy greens, friendship, “balance”, a job with purpose, BPA-free) and what we know even more is bad for us (sleep deprivation, unemployment, stress, smoking, divorce, bad cholesterol, processed meat, sedentary days). I mean…. Read full post »

Quick Tips For Healthy Winter Skin

Winter SkinWinter tests our skin differently than summer. This is because of cold temperatures, recirculated air (without outside humidity) and lots of exposure to the elements. If you think your skin looks older in winter, you might be right. Winter skin is likely really dry and probably chapped, making us perhaps look a bit like we’ve been at this a while…same can be true of your child’s skin. Giving your skin the TLC it needs during these dark months will keep it healthy (and looking great) once it’s time again for spring exposure. Lots of OTC lotions and creams to choose from. Here’s a bit on which and why:

Dry Skin And “The Itch That Rashes”

Winter is also a time when we see an increased risk for eczema flare-ups, a chronic, relapsing condition that brings incredibly dry, itchy patches of skin. The icing on the cake is that eczema primarily affects kids! A recent study suggests at least 10% of children in the US suffer from eczema, the “rash that itches.” A patch gets started, a child can’t help but itch it and the rash blooms. Between 2000 & 2010 pediatric cases of eczema came close to doubling and while this condition not only affects how skin looks and feels, it can have a direct impact on a child’s quality of life. Nearly half of kids with eczema report a severely negative impact on their quality of life, including sleep deprivation (from the itching), activity restriction and even depression. If your child suffers from eczema, talk to your pediatrician to create an action plan for combating these dry months and hopefully avoiding such severe tolls and trolls on everyday life.

Protecting Your Skin From Sun

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Calming Down And Talking To Our Children About School Violence

Gun Safety family on hillSchool violence and threats of violence are scary and seem to be happening more and more frequently, but the fortunate reality is that they remain rare.  I’m almost telling myself this like a chant — trying to keep myself centered. Because like many other parents I’ve talked to, instead of worrying about my son getting lice at school I kiss him good-bye and say a blessing for safety. Happened today again.

2015 has been hard for all of us in this respect. The increased media discussions about violence are shaking us up and focusing light on violence, especially from guns and mass shootings, in ways no one ever wanted or could imagine.

Although mass shootings are dreadfully more common now than in the past, the rate of crime at U.S. schools that involve physical harm has been declining since the early 1990s. According to the Centers for Disease Control and Prevention (CDC), fewer than 1% of all homicides among school-age children happen on school grounds or on the way to and from school. The vast majority of students will never experience violence at school or in college.

Still, it’s natural for kids and teens (and those who adore them, feverishly) to worry about whether something may happen to them. To help them deal with these fears, it’s important to talk to children who are in the know when these tragedies happen, and to know what your kids watch or hear about them. This helps put frightening information into context. This helps build trust.

Children should be informed about a disaster as soon as information becomes available. Children can sense when critical information is being withheld and when trusted adults are not being genuine; this, in turn, undermines their trust and sense of safety and compromises the ability of these adults to be later viewed as a source of support and assistance. Even very young children or those with developmental disabilities can sense the distress of trusted adults. Children also often overhear or otherwise learn information about the events, such as through the Internet or social media or from conversations with other children. We probably need to shift the conversation sometimes away from talking our children out of having legitimate concerns to how do you deal with your concerns.” ~Dr. David Schonfeld

8 Tips To Support Your Children’s Understanding Of School Violence

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10 Reminders And Updates to Pediatric Check-Ups

Pediatric Wellness Visit

Prevention is genius medicine. By making smarter choices, detecting risk early, not only do we improve our quality of life, but we can prolong people’s lives. Pediatrics is the perfect place to master this. Because of the incredible opportunity we have to prevent injury and illness during a person’s childhood, the American Academy of Pediatrics (AAP) updates and refreshes their schedule of recommended screenings and guidelines for wellness visits every year. It’s put into a huge “periodicity table,” basically a chart that reminds us all what to do when. This year some of the recommendations are making headlines. I’ll explain reminders about what you should expect from wellness visits, include all the new updates, and explain a bit more about a couple of the new recommendations (HIV screening for all teens 16-18) in these 10 tips:

  1. Vision: annual, regular vision screening is important. Pediatricians evaluate vision from day one but your child should stand in the hall and screen vision formally at age 4 years (at 3 is great if they can follow directions!) and yearly until  age 6, and then every two years. At age 18, the vision screen will only be given to those at risk or who flag concerns.
  2. Oral Health: an oral exam from physician or dentist is a must at the time of baby’s first tooth eruption. This year, the AAP also endorses that pediatricians provide annual fluoride varnish to children between 6 months – 5 years to reduce cavities.
  3. Drugs & Alcohol: CRAFFT (Car, Relax, Forget, Friends, Trouble) tool will be used to screen adolescents for drug & alcohol use. This screening tool is used to help teens share ways they use alcohol or drugs and identify any risks. Writing it down can help teens share information that may be hard to talk about and the recommendation to formalize this and build this into our electronic health records so it is captured each and every time is smart.
  4. Depression: all children ages 11-21 will be screened for depression. Screening can be done through a combination of filling out survey questions and also questions we ask teens and their families directly. Suicide is a leading cause of death among adolescents — picking up depression or sadness, intervening with counseling, social support, and sometimes medication is essential for supporting teens without proper treatment or support.
  5. Cholesterol: the AAP recommends a blood test will be given to patients between age 9 and 11 universally to screen for elevated blood cholesterol and other blood fats. Because 1/5 children between 12 and 19 have one or more abnormal lipid level, screening is a way to pick up those we don’t suspect. The reason for recommendation is this: atherosclerosis (cholesterol sticking to the insides of your arteries) begins in childhood and accumulates throughout our lives. The more atherosclerosis, the more your risk of a heart attack or stroke. Because heart disease is the #1 killer of both men and women, PREVENTING the accumulation in childhood can potentially lower lifelong risk. If children have a family history of high cholesterol, early heart disease or death in the family (under age 55 years) are obese or have other underlying health conditions like diabetes, children will be screened even earlier (between age 2 to 5). With no risk factors, all children should be screened once between age 9 to 11. The original policy and statement with this recommendation came out in 2011 and I’ve picked up children with elevated cholesterol since. I’m thankful for this recommendation!
  6. Development & Autism: developmental screenings will happen at all ages and all wellness visits. Formal autism screenings will occur at 18 months and the 2-year check up. No changes to this schedule this year.
  7. HIV: every teen age 16-18 should be screened for HIV regardless of sexual activity. In years before 16, and after 18, this is based on risk, social history, exposures. But the reason for screening teens universally is help children know their HIV status, keep them negative, and ensure we’re picking up HIV early when it’s unexpected for early treatment. The facts behind this recommendation:
    1. 1 in 4 new HIV infections occurs in youth ages 13 to 24
    2. 60% of all youth with HIV do not know they are infected
  8. Pap smear & HPV: doctors and nurses will do internal gynecologic exams if any concerns (pain, unusual discharge, menstrual cycles concerns, sexually transmitted disease exposure or diagnosis) but will wait to do a pap smear and HPV testing as screening to look for the presence of pre-cancerous cells on the surface of the cervix, at age 21. Here’s a video where I explain recommendations for “well-women and well-girl” gynecologic exams.
  9. Newborns: AAP recommends all babies get screened for heart disease by auscultation of the heart using a stethoscope and ALSO by using pulse oximetry before leaving hospital or in the first 3-5 days of life.
  10. Growth & Nutrition: your child’s doctor should show you and teach you at EVERY VISIT how your child is growing. They should review their height and weight gain as well as their BMI (or weight/length at young ages) at every visit. Growth is a great marker of thriving health and concerns around growth can really help change a child’s live.
    1. 1/2 of parents underestimate their children’s weight so it’s important to review the numbers every year as they sometimes surprise. 1/3 of children in US are overweight or obese and knowing this early can provoke big changes.
    2. AAP recommends toddlers be checked at 15 and 30 months for iron deficiency — iron is not only important for building strong blood it’s essential to support proper development.
    3. Supplemental Vitamin D also very important for infants and children — 400 IU typically recommended for all infants and children, every day. Ask your pediatrician or family doc for more information.

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Ban Baby Crib Bumpers

bumpersI cleaned out the closet for houseguests last week and discovered an old bumper. Instead of giving it away I am literally cutting up the fabric for crafts and putting the rest in the garbage. A no-brainer savvy parenting tip: baby crib bumpers are dangerous. Don’t use them, don’t even give them to charity, don’t pass them on to friends. Let’s get them out of circulation, outsmart the marketers, protect these little babies.

Smart parents just don’t use crib bumpers. More data out this past month to prove it.

Crib bumpers are soft bedding that can pose risk of suffocation, entrapment, strangulation, or additional risks from causing a baby to be wedged into an unsafe position. It may seem like they protect babies, but there is no evidence they prevent serious injury in infants. Choosing a crib can be an exciting nesting activity, here’s tips for doing it with smarts.

Banning bumpers feels to many like an inconvenient truth. Perceived risk is low and they are so darn cute. But with all the time we spend as parents spend doing everything we can to protect our babies this is an easy opt-out. Forget spending time worrying about organic baby food and what brand of stroller of you want and just get rid of your bumper. Or better yet, don’t buy one in the first place. Let’s get them off baby registry lists, out of marketing and advertising and most importantly OUT of baby’s crib. Read full post »

No Kitchen Spoons! Correct Medication Dosing

OTC Dosing Image

Over the counter (OTC) liquid medications for children are packaged with a diverse set of various measuring tools sometimes making it confusing for parents to ensure we are giving our children the proper dose. To add to the confusion, sometimes the recommended dose is written with different units (mLs, mg, or teaspoons) than the dosing device. For example, the box might have dosing in “teaspoons” and the measuring device be divided up into milliliters. This issue is not new but guidelines and protections around the problem are increasing. A win!

This has concerned me for a long time. To drive this point home even further, I gave a dosing conversion quiz on my blog to my colleagues in medicine (also parents) who even struggled to get the dosing correct. The dosing struggle is REAL to non-pediatric docs and parents everywhere.

For example, you may even see differences in devices that would seem to be standard across medications. The dropper that comes with liquid acetaminophen may look very different than the dropper that comes with liquid vitamin D or infant multivitamins. And remember, the most important way to avoid a dosing error is to keep the original dosing device with the actual OTC medication. Read full post »

Why To Buy An Antibiotic-Free Turkey This Thanksgiving

Like I said last year, there’s one little thing we can do this month to change our safety and preserve the value of antibiotics. And although not all families can be without antibiotics on Thanksgiving due to chronic or even acute medical problems, we all can eat smarter turkey. This is an easy awesome.

I partnered with Dr. Scott Weissman this week for “Get Smart” week. On Monday we explained that we’re dependent on antibiotics for all sorts of medical miracles (bone marrow transplants, joint replacements, healing from a large cut, routine surgery, and chemotherapy). We when use antibiotics responsibly in the clinic, in the hospital, in raising food and in our agriculture we’ll preserve antibiotics for decades to come. Trends show if we don’t, we’ll contribute to more and more resistant and untreatable infections. Tuesday we explained how antibiotics are used in agriculture, Wednesday how to be a squeaky wheel in the hospital (speak up, ask about antibiotics EVERY day), and yesterday we reviewed 5 tips for avoiding antibiotics in clinic. Today…..drumroll…….we provide something super easy to be smart:

Make an effort to buy an antibiotic-free turkey this Thanksgiving. Animal agriculture uses four times the amount of antibiotics as human medicine, and mostly in healthy animals for growth promotion or disease prevention on crowded farms. It’s also worth noting that safe preparation is also key. Read full post »