Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

This Makes It Tougher: LuluLemon’s False Claim

lulu lunch bagSometimes it can feel that a career of crafting prevention messages can be snuffed out in a moment. Every once and a while this work in media/messaging can take my breath away, for all the wrong reasons. Today, I realize my work educating parents and children about sunscreen use, UV radiation, aging, and skin cancer risks may pale in comparison to the potential power of a single quote on the side of a shopping bag. I mean, how can I compete with a company that sold $1.6B of merchandise last year and likely distributes tens to hundreds of thousands of reusable bags around North America everyday? Shopping bags have the luxury to walk around for years and tuck into peoples lives in remarkably intimate ways. Even I use these bags (or used to) to carry my lunch on a daily basis. It wasn’t until yesterday that I realized I’d been carrying my lunch around in a bag that goes, in part, against my entire mission. When I read about recent dermatologist outrage for Lululemon bag quotes I literally turned my head to my kitchen counter (see photo) and there sat my lunch bag on my counter just staring at me. Under the tote’s handle was the devious myth, “Sunscreen absorbed into the skin might be worse for you than sunshine. Get the right amount of sunshine.”

Now, that’s not true. In fact there is no “right” amount of sunshine and absorption concerns for sunscreen haven’t proved more dangerous than sunshine. Also, absorption varies with age and body site, here I review information about why to use physical sunscreens (and sun protective clothing) in infants when possible to reduce any risk from ingredient absorption because of their more immature barrier. That being said, I’d always recommend sunscreen over sun exposure for infants and children. The conversation about getting sunshine is centered around getting enough vitamin D. Although minutes (not hours!) in the sun provides vitamin D, we can safely get vitamin D entirely from the food we eat or a daily supplement (all children are recommended to have at least 400 IU Vita D daily). We don’t need to consume sun. In fact all sun exposure comes with UV radiation that contributes to mole production, aging, and skin cancers– even the most deadly kind, malignant melanoma. Sun protection keeps skin looking beautiful (prevents aging) and prevents skin from discoloration and cellular/immune changes that can lead to cancer.  Sun-protective clothing, seeking shade, and sunscreen are our best bets for beautiful, healthy skin. Read full post »

It’s Hot Out But The Water Is Still Cold

igram lifejacket jumpThere have been 4 teen drownings around here just in the last week. I’m left with a pit in my stomach that as the sun shines and our region heats up we lose children to preventable injuries at rapid-fire pace. This happens every year; drowning is the 2nd leading cause of injury-related death in childhood (and the #1 cause of injury death in toddlers between age 1 to 4). In general there are two groups of people who drown the most: toddlers and teens. The spaces and places (and circumstances) for typical drownings for those groups are different but the foundation is the same: water, especially cold water, is always lovely on a hot day but always poses unacknowledged dangers.

This really isn’t meant to be a finger-waggy post. This is meant to inform us all with refreshers to the opportunity we all have when living near water with children in our midst. Forward these reminders to anyone you can think of who may benefit. We may never know if we prevent a death but it sure is worth the effort to keep trying…

Drowning Statistics & Risks:

  • Drowning is second leading cause of injury-related death in children in our country following motor-vehicle crashes. In general, the risks come from improper attention to the risks of water, improper supervision, and surprise (i.e. the current moves faster than expected, the water is colder, the child toddles into the pool while no one sees in a matter of seconds).
  • Toddlers AND teens are the most likely groups of people to drown; risks are higher for boys than for girls. Toddlers drown because of improper supervision, teens tend to drown because of improper awareness of risks. In fact it’s also where you are that matters. Data has found, for example, that you’re at a 6-fold increase risk for drowning when visiting a friend’s home with a pool.
  • Cold water, alcohol & drug use (for teens or supervising adults), and distractions increase risk for a drowning or near-drowning event.

Read full post »

Women At Work

My husband is often in earshot when people probe, “I don’t know how you do it all with your family and your career.” In asking the question there is doubt, of course, that it’s possible. My husband is never the recipient of the same question regardless of the facts: we both have intense, high-demanding careers in medicine as physician leaders. Reality is, there may be little different in our level of responsibility, time commitments, and our opportunity to improve pediatric health care while there is no difference in our passion and commitment to raising our boys. So the calculus around the questioning doesn’t equate — nobody ever asks him about his balance with work and family.

My grudge with this disparity wavers in intensity. I bring this up now because of Matt Lauer’s controversial conversation with General Motors CEO, Mary Barra. He wondered if she could be a good mom and run GM on national TV. He said,

“You’re a mom, I mentioned, two kids, you said in an interview not long ago that your kids said they’re going to hold you accountable for one job, and that is being a mom,” he said. “Given the pressure at General Motors, can you do both well?”

It’s not only his egregious comment that aggravates, we’ve all gotten used to similar questions for women who work. What sets the interview on fire is his deflection of bias and responsibility. With this episode in the never ending media series on women and work-life balance we learn again that there is quite a bit of:

  1. Ongoing persistent cultural bias against women in leadership roles: we constantly wedge women and their success into the construct of balance with work and home when we rarely project men against the same backdrop.
  2. Ongoing anxiety about this bias coupled with a desire to eradicate it. Culturally, most of us don’t want to think about men and women’s responsibilities in the work place and home differently. We like to mature past our current realities when it comes to equity and sharing responsibilities for child-rearing and work.

Can we acknowledge the ongoing, profound cultural bias against women leaders and control that doesn’t exist in similar ways for men? Read full post »

Summer Reading From Day One

boys readingThe boys and I read two extra books last night — we almost skipped it altogether as it was late and we were beat from a long day and yada, yada, yada…you know the drill. But reviewing this data changed me, yet again. I knew some of the value of reading to young children before I had kids because of my experiences being a teacher and my training in pediatrics but the refreshers provided this week only compound my interest in screaming the value of reading from the rooftops.

It’s NEVER too early to start reading to your baby. Reading aloud before bed is always the right thing to do.

This week The Clinton Foundation with Too Small To Fail, The American Academy of Pediatrics, Reach Out And Read, and Scholastic got serious about ensuring our country takes reading seriously right out of the gate. For the first time ever the groups have come together to proclaim that parents should start reading to children “as early as you can” after birth. The new policy and partnership emphasizes the need for early reading to all infants and children while also emphasizing the necessity that all pediatricians promote this healthy habit at birth and through all preschool doctor visits. Profound health disparities currently exist for US children and book time. I suspect the numbers will surprise you.

It’s a no-brainer to most parents I talk with that reading books enhances development, literacy, and school readiness. What may surprise you is that reading has also been found to enhance the relationship between a child and parent. Reading books (or even the newspaper) to your infant from day one can have profound effects on how they live, how they talk, and how they learn — the impact extends well into adulthood. From the very beginning, though, some children are missing out. Children from low-income families hear fewer words in early childhood and know fewer words by 3 years of age creating the “word gap” early in their lives. The more words a child hears during early, critical times for language development, the more they’ll know. And although reading books can be a great resource to introduce an expansive, enriched vocabulary, less than 1/2 of children are read aloud to in this country every day.

All families face issues of limited time, limited parental understanding of the key role of reading aloud, and competition for the child’s interest and attention from other sources of entertainment ~  The American Academy of Pediatrics Council on Communications And Media ( 2011)

Read full post »

You Mamas Taking Iodine?

A new policy statement from The American Academy of Pediatrics finds that many women, including up to 1/3 of pregnant women, may have low levels of iodine putting them at risk for iodine deficiency. The reason for the deficiency is the changing food source. Over the last 20-30 years our major source of salt has shifted away from table salt (supplemented with iodine) to salt from processed foods, sea salt or gourmet salts that have no supplemental iodine. This is especially important for breastfeeding and pregnant women as iodine is essential for thyroid function that supports fetal and newborn brain development.

This policy statement was news to me. I had no idea that the salt used to make most processed foods lacked iodine, that the majority of prenatal vitamins didn’t provide iodine, and the number of women who may have a deficiency. I’m not alone; when I polled my Mama Doc Facebook community most moms & many doctors also commented this was a newsflash. Here’s more:

Iodine Deficiencies– Shifting Sources Salt

  • WHY ARE WE DEFICIENT? Most processed foods made are with salt that is not iodized.  Since we get most of our salt from those foods we’re taking in less iodine than we used to.
  • TABLE SALT INTAKE: Table salt is iodized, many gourmet salts are not. Consider ensuring that when cooking in your home (ie putting salt in the pasta water or salting the veggies) you use iodized table salt so your intake of iodine goes back up. REMEMBER: this doesn’t mean you should eat MORE salt, just swap in the table salt for the fancy salts when you can.
  • WHY DO WE NEED IODINE? We need iodine for thyroid hormone synthesis as thyroid is essential in brain development and metabolism. The policy reminds us that even mild iodine deficincy can affect fetal and early childhood neurocognitive development stating, “adequate thyroid hormone production is critical in pregnant women and neonates because thyroid hormone is required for brain development in children.” The recommendations from AAP spelled out:

Read full post »

Living In A Museum: Safe Medication Storage

OTC Safety Info Where Do Kids Find MedsJune is a lot of things to me this year: the month I turned 40 (yipeee!), the earnest start of summer, the beginnings of an awesome USA performance in the 2014 World Cup and also National Home Safety Month. Of course it may be easy to make time to celebrate turning 40 or to watch the taped game where USA beats Ghana (go team!) but there really is one thing we should move into position numero uno. Can you make your house more museum-like, at least when it comes to medication safety this summer? Here’s why it should be placed at the top of the list.

A quick digression: no question I’d really like to live in a museum — unlike lots of others, it seems — I’m one of those people who hates a messy house although our house really does get highly disorganized (I find errant legos in every room/every day, our beds aren’t always made and may I ask where in the world do all the dirty socks come from?). I would prefer a museum-like home, beautiful stone on the floor, gorgeous lighting, thoughtful works of art on the wall and no distracting debris. A clean surface on which to place my purse when I walk in the door would be a good compromise! When I looked at the Up & Away tools that helps provide tips for parents on medication safety at home it reminded me that yes- museum living is definitely what I want (I mean, heck, look at that kitchen!!). HOWEVER, the realities of having 2 kids and limited time to keep organizational systems in check I’m going to have to settle for my not-always-perfectly cleaned floors, the walls of childhood art, the stacks and piles of mail and school forms, and the lighting I’ve got. But one thing I won’t sacrifice are the safety systems we’ve made to keep medications and toxins out of reach, even as our boys get older. Some data here reminded me I need to revisit our systems. Read full post »

Let The Teens Sleep

As teens nestle into their deep, unrestricted summer sleep, let’s think clearly about setting them up for success in the upcoming school years. Today there is a pressing need for our attention and our action. An opportunity to improve the lives of teens exists this upcoming week here in Seattle and I suspect, in ways, the outcome will inform the nation. The School Board is revisiting their commitment to do an analysis of feasibility & community engagement in 2015 around start times and will discuss this next week. They’ll vote July 2nd.

Nationally, there is mounting pressure to move school start times later for middle and high-schoolers due to a known health impediment: teens don’t naturally fall asleep until around 10pm and yet need 8 1/2 to 10 hours of sleep for good health. If you do the math and consider a need to eat in the morning and commute, if school starts prior to 8am it’s unlikely teens are set-up to get the rest they need.

The far majority of high schools in the US may make it impossible for teens to get necessary sleep with an average start time prior to 8am. The CDC’s Youth Risk Behavior Survey in 2011 showed that 69% of U.S. high school students get fewer than 8 hours of sleep on school nights, and 40% get 6 or fewer hours.

I touched base with Dr Maida Chen, a sleep expert about why this movement matters so much. “I have to start by saying that it is impossible to place a ‘price’ on the health, safety and achievement of a child,” she told me. She mentioned she’d spent significant time this week documenting the evolving data and cost-effectiveness of moving school start times. She’s written, “Rational start times, which align with students’ fundamental sleep needs, are a cost-effective and scientifically robust approach to improve equity, opportunity gap, and academic achievement on a large-scale with the greatest positive impact on students at the most disadvantage.”  Translation: this makes sense and will affect a large amount of teens.

We should always be driven to do what is best for the child, and not what is convenient for society.  And ultimately, there’s no money that will take back the life of a child who has died in a sleepy driver related accident – a known consequence of early start times ~Dr Maida Chen
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3 Reminders For Summer Sleep

Bed as throneOur house is teeming with excitement about the impending reality: it’s almost summer break. As the hard-core school, sports and carpool coordination chaos eases up, you wanna know one thing I’m really hoping for this summer break? A bit more sleep. I do a great job protecting my children’s sleep and a mediocre job protecting my own. I work on sleeping with my cell phone off and away from while getting 7 to 8 hours of sleep but reality is my phone has a tendency to creep back up next to the bed and I am often up early to start working. Clearly I’m not unusual in this way. Parenting and sleeping a lot don’t necessarily go hand in hand. Studies find 14% of grade school children are still getting their parents up. The news is grim when it comes to sleeping with our phones, even 4 out of 5 teens say they sleep with their phone (on or near the bed). It’s becoming clear that quality sleep is one of the most undervalued power solutions to preserving wellness in our families. The more data I review, the more I know we have to get the word out on the value of sleep and the way that we protect it as we raise our children. Culturally, this is a swim upstream; we’re bred to revere those who do so much during the day they are left with limited sleep at night. Some new data, a funky article ending, and a 4-minute TED talk lay the foundation for my 3 quick reminders: Read full post »

On hand-holding

handholdingThe boys still eagerly hold my hand when we go out and about. And it’s not just when we cross the street. I find that, my 5 year-old in particular, will just show up alongside me while we’re walking and all of the sudden his hand will be in mine. Divinity. This little hand doesn’t go unnoticed and I suspect although it won’t always come so frequently or so eagerly or so spontaneously, I’ll get to hold my son’s hands throughout my life if I ask. I really do treasure that hand in mine.

There is nothing of more value than this love of family we find as our children grow. Nothing more striking really than the intimacy that can exist between a family totally in love.

When we’re walking hand-in-hand my mind often slips to a stunning obituary I read last summer. In it, Jane Catherine Lotter (who wrote her own obituary) details her life’s achievements, her love for family, her gratitude and wisdom, and her memories. As she’s closing the piece she says, “At any rate, I am at peace. And on that upbeat note, I take my mortal leave of this rollicking, revolving world-this sun, that moon, that walk around Green Lake, that stroll through the Pike Place Market, the memory of a child’s hand in mine.”

There’s wisdom in clarity and it seems to me Jane had it and was generous enough to share it. One distillation of life’s joy being a child’s hand in her own. When you hold onto that hand today perhaps take notice of the extraordinary thing it is to have it curled up inside your own. I mean, wow.

Is It Allergies Or Is It “A Cold?”

Screenshot 2014-05-13 22.58.02It’s the time of year for seasonal allergies. It’s also still, unfortunately, the time of year for “colds.” Although it may be intuitive for many parents to decipher the causes of symptoms in their child during the month of May, some of us have a hard time determining what’s causing our children to wipe their nose!

In general, it’s time unfolding that helps us know if our children are beginning to suffer from allergies as opposed to another cold. If steady,unwavering symptoms of runny nose, coughing, sneezing, and/or  itchy eyes persist longer than a week this time of year, allergies to pollens are likely be blame –with one caveat– if your child is a toddler seasonal allergies are far less likely. Although there are exceptions to every rule, most children don’t start to develop hay fever symptoms until around age 3 or 4 years of age after their bodies have been exposed to a few seasonal changes and pollen counts and their body starts to mount an over-reaction. Allergy symptoms are created when the body basically over-does-it to triggers (allergens) and starts an immune response to a normally harmless particle. Instead of having no response to a dandelion, for example, allergic people rapidly release a series of chemicals (including histamines) after encountering the flower that cause their eyes to itch and run, their mucus membranes to swell, and their airways sometimes to cough.  There’s no sure-fire, singular way to know at first glance if your child has seasonal allergies when they start sneezing in the spring (or fall) but in general children will suffer from a constellation of symptoms and a set of circumstances: Read full post »