Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Safe Holidays For Your Children

This is a wonderful time of year. It’s also a really stressful one for many of us. Some quick reminders about ways to stay safe while bringing holiday decor into your home, traveling, while arguing with your brother about gifts, and when potentially having more alcohol around than is typical…

  • FIRE: Be careful of lit candles and check the safety of lights you place on trees or around the outside of your home. Christmas trees are like kindling for house fires. Check out National Fire Protection Agency’s info or watch this video of a tree catching fire.
  • DECOR: Holiday decorations often bring hazards for young children. This include candle holders, Christmas tree ornaments, plants, decorative garlands, and hot liquids. I’ve cared for many children with scald burns from soups and hot liquids. With decorations, anything longer than 12 inches can pose a strangulation risk. Make sure your trees and larger decorations are mounted in a way that your child (of any age) can’t pull them down upon themselves.
  • ALCOHOL: With holiday and New Year’s parties fast approaching, it’s good to have a plan for alcohol–if you’re serving it or drinking it. Many sober alcoholics relapse this time of year and many small drinkers consume alcohol more excessively. We have to be careful with our guests and ourselves — for our children. Clean up after parties, too–don’t want toddlers finding the punch!

This kind of advice feels heavy-handed and self-evident. It’s not as if we wouldn’t have thought of most of this. Read full post »

HPV Shot Doesn’t Trigger Teens To Have Sex

In 2006, I entered pediatric practice. It was the same year that the Advisory Commission on Immunization Practice (ACIP) recommended to start giving 11 year-old girls the Human Papilloma Virus (HPV) vaccine. Therefore, I’ve really never practiced pediatrics (outside of my training) without the ability to offer up immunization and protection against HPV virus; I’ve been discussing this for about 6 years. We now give HPV shots to both boys and girls because it’s so common–about 50% of all adults who are sexually active will get one form of HPV in their lifetime.

HPV virus can come into our body and do no harm. But it also can come into our bodies and cause vaginal, penis, anal and oral/throat warts. Other strains of HPV also cause changes in the cervix that can lead to cervical cancer and can rarely lead to penile cancer and/or tongue/throat cancer. Teens and adults can get HPV from oral, vaginal, or anal sex. Condoms don’t provide 100% protection from getting it.

GREAT NEWS: Being protected (by the HPV shot) doesn’t trigger risky sexual behaviors in teens.

Nice to have an immunization to protect against the potential development of such disfiguring, embarrassing, and uncomfortable lesions. And what a windfall to have a vaccine that prevents cancer. I often say to my patients, “If my grandmother only knew that I’d see the day where we could prevent cancer.” I mean it—if she only could have seen the day (she died in the late 1980’s).

The reality is though, parents to teenage girls have consistently been hesitant in getting the HPV vaccine in my office.  Over the 6 years hesitancy around getting HPV vaccine has lessened, but many of my patients’ parents have told me they don’t want their girls or boys to feel that getting the shots is a green light for sexual activity. And many have worried that having their girls immunized will make them more likely to engage in earlier sexual activity. Read full post »

When Parenthood Exceeds Expectations

We surfaced the other day, my husband and me. Bobbed up after having been submerged in the challenges and complexities of stress, tantrums, hectic schedules, holiday crunch time, and career responsibilities. When we surfaced we found ourselves in one of the most luxurious moments of life. It was one of those spells I want to compound. More than just burning it on my brain, I want to relive that memory again and again. I want to hit play and repeat…I suppose that’s part of why I’m sharing it here.

Here’s what I mean: Have you had one of those meals or nights or walks or adventures with your children recently where you realize there is simply nothing better? Where you wake up in a moment and consider that it is for this moment, this one space in the continuum of time, that you were made to be? When you come to feel like it’s why you’re alive?

In my opinion it happens to all of us in profoundly new ways when we are lucky enough to raise children. And it’s usually unexpected. These pristine, magical moments with our children and family don’t come with proper planning. They don’t usually happen on vacation, at the fancy meal, or at the picnic we’ve planned for 2 weeks. We often don’t have our fancy shoes on. The moments tumble into our lives when we least expect it with absolutely zero material value. But like falling in love for the first time, these moments sweep us up off our feet and arrive without a hint of warning.

This is, I believe, the gift of the season of our lives. When parenthood exceeds expectations.

Recently I was talking with a good friend about these rare moments. The ones that happen where your children are enticed by conversation, fully engaged in a game or meal, where they get along with each other, and you realize there is nothing more precious or intimate. Often it seems these moments follow illness or fear. But sometimes it doesn’t take a trigger or challenge. Recently a moment appeared for my friend when she and her husband had cancelled a date night. They were too exhausted, decided to stay home and have dinner with their children and just crash. And it happened–the moment–they connected, their children were angels at dinner, delighted and laughing, present and mindful. She and her husband looked up at each other and realized they were woven into one of those meals they wouldn’t trade the world for. Really.

For us it happened late Thursday night on the floor of our living room. Our six year-old had received Mastermind (a board game) for his birthday and the four of us teamed up to play. It was the first time I’d played in 25 years and each of us presented to the game with excitement. We were enticed to win, eager, and we each giggled as we navigated and explored ways to outsmart the others.

And there we were, lying on a hard wooden floor, surrounded by the darkness of winter entirely together with only little plastic playing pieces between us. Momentous connection and family intimacy. I can barely articulate why and how I knew it was one of those moments except that I realized this is really as good as it gets.

Emergency Contraception For Teens

Stating that unintended pregnancy is a major public health problem, The American College of Obstetricians and Gynecologists (ACOG) recommended that birth control pills be available over the counter this month. And this past week the American Academy of Pediatrics (AAP) outlined use for emergency contraception use in teens girls while urging pediatricians to provide information and access to emergency contraception for sexually active teens.

All this may seem exceedingly “progressive” until you examine some of the realities. As many as 80% of pregnancies in teen girls in the United States are unintended. The birth rate for 15 to 19 year-olds is 34 out of 1000. Most pregnancies are a result of non-use of contraception or mishaps with protection (condoms breaking, pills being missed and/or forgotten or used inconsistently). We know teens don’t take their birth control as well as adults and lapses in pills or misuse can put them at risk. This is where emergency contraception can come in. I was taught how to prescribe emergency contraception to teens as a back up for contraception failure when I was in residency. I’ve been educating teens, discussing their options, and prescribing emergency contraception ever since.

What is “Emergency Contraception?”

Emergency contraception (EC) is the use of hormone pills after sexual assault, unprotected intercourse, or contraceptive failures.

Read full post »

Mix And Match: Goldilocks Formula

Often new parents are nervous about mixing and matching infant formula they offer their babies. They worry if they switch from one formula brand to another, they may cause their baby fussiness, stool changes, upset or worse–that they could put their baby at risk.

It’s safe to mix and match infant formulas if you are following standard mixing instructions. Really.

Although spitting up or gassiness is usually not due to the protein in formula (cow’s milk versus soy versus hypoallergenic), sometimes changing formula helps new babies and their parents who worry. Switching them up can even help clarify worries in some scenarios when a parent worries about excessive gassiness, intolerance, or significant urping or spitting up.

Experimentation with formula brands in an otherwise healthy newborn is okay. But it’s not necessary at all, either.

It’s fine to make a bottle that is ½ formula from the blue can and ½ formula from the yellow one. Fine to serve Simulac one week, Enfamil the next, Earth’s Best or Goodstart followed by Soy formula the following day. Fine to buy one brand that’s on sale only to buy the other brand next week. Read full post »

Teasing Out Self-Talk: Our Inner Critic


I had the good fortune to hear Jim Webb, PhD give a lecture on the emotional needs for children.

During his talk he mentioned children and their self-talk. You know what that is, yes? Self-talk is that voice that constantly evaluates how you’re doing things, how the world is playing out, and ultimately how you feel about it. Dr Webb shared the tip that we can tease out and bring to light the inner critic our children have, too. Not only can we mention that this self-talk exists, we can demonstrate and model that voice for our children. We can show them we also have a voice that hovers to illuminate what we do wrong or what we do well.

Dr Webb made me realize we identify this self-talk early and help children acknowledge and own it. If I remember correctly, no one taught me about my self-talk growing up. I wonder if they had if my critic would be a bit more forgiving or generous…Maybe we can help our children identify their inner-critic and help them shape their critic into a more productive coach. Just knowing self-talk exists and bearing witness to this critic could be a great start to insight…

Teach Children About Self-Talk Early

  1. Teach children that self-talk exists. Once children are in school, start mentioning and letting them know that their voice and inner-critic is there. Help them recognize the self-talk they are participating in and ask them how it helps them during they day. Ask them if it trips them up. Read full post »

Engage With Grace

It is the wonder of life that makes this beautiful day so remarkable. A national day, every year, to give thanks and prioritize togetherness. Happy Thanksgiving!

May we be so brave that we can live with integrity, with love, and with compassion as we raise our children. May we find ways to revolutionize things, too.

One team is trying to do just that with end of life challenges.

On this day, when you are together with those you love and trust the very most, can you embark on a journey to share a universal human experience more thoughtfully? Please consider the Engage with Grace discussion today. Share with loved ones around the fire, around the table, or on the walk what it is you value most about your life and what you value most about your death.

Print out the 5 questions ahead of time. Speak openly as best you can and listen intently. Engage with Grace with all those at the table, teens included.

More info here in a guest post from the Engage With Grace team, and more about this project in a previous post I’ve written (great video included).

I am thankful for you all and will do my best to Engage with Grace today, too.

Young Children Are More Generous When Observed

Our 5 year-old keeps forgetting to draw arms on his people at school. The lack of arms has evolved since school started in September and even came up in his parent-teacher conference recently. I found it odd– he always seems to remember that humans have arms when he draws at home. We didn’t mention it to him. And when his brother got an easel for his birthday recently, F painted this picture. Something jumped out at me. I loved it. Not just that hands are present on this figure but the perspective it imparts. Something about this little person looks so generous and so ready to give.

It’s important to help our children understand the need to give back, provide, share, and act generously. ‘Tis the season, too. When I’ve thought of it before, I’d attributed our role (as parents) as role models, that is I thought if we act generously in front of children they will learn how to give more freely.

Recently a beautiful study in PLOS ONE conducted at Yale illuminated the complexity and the maturity of our young children when it comes to giving. It made me realize we may have to be more deliberate and outspoken about how and why we give. Social conditions matter when it comes to generosity and this isn’t just true of adults. Read full post »

Switch Witch

The Switch-Witch is coming to our house tonight. A friend mentioned the concept of Switch Witch to my husband and I was immediately thrilled. A shared solution to the Halloween hangovers. Some genius parent came up with the idea of having a witch arrive at your home during the night to swap out any remaining halloween candy with a small prize. The plan is that we’ll leave the candy by the door tonight and she’s due anytime after bedtime. When I presented the idea to the boys they were thrilled, engaged, and don’t seem to even notice that they’re saying good-bye to a pound of chocolate.

Even though we’ve rationed the halloween candy to a piece a day since November 1st, I’m looking forward to returning to candy-free days. One and a half weeks of a sugar focus is long enough.

Better than the exodus of the candy is the reminder of how beautifully children believe in magic. O asked me this morning,

“Will the Switch Witch ring the door bell when she comes?”

McClinic? Drive-Thru Health Care

I can’t stop thinking about a drive-thru. Not the one for burgers and shakes but the one for ear checks, sports forms, quick med refill visits or a lingering rash. For those things you just want to know fast or need done now, but don’t want to spend 2 hours resolving. For those things that really make you worry as a parent. Instead of the millisecond-mall-type clinic, we all want our doctors, our clinics, and our child’s team to provide health care. In my opinion, parents and pediatricians both believe in the medical home.

McClinic?

Imagine if you knew your doctor did the drive-thru on Tuesday afternoons. Would you swing by to ask about that rash you’re worried about or to check in on your child’s ears? Follow up on a new seizure medication? What if it didn’t even require a call ahead of time? What if tight time restraints were agreed upon (say 7 minute visits or so) in advance so the patient/physician agenda was aligned? Swing by on your way to daycare?

We want quality, trust, and mobility when it comes to health care. We want easy access, too. Of course we must fight for improved electronic visits and online advice. We want comprehensive, compassionate preventative care. We will need in-office visits, yes. And sometimes we need hands-on more urgent care, too. Now the “kwik-clinic” idea isn’t new, I know. Even hospitals are opening urgent-care clinics throughout the country. But your pediatrician often isn’t involved.  So what about that drive-thru: Read full post »