Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

All Children Need A Flu Shot

This is part deux to an earlier video/post describing the global effort to reduce flu & reasons why we need one every year. Infants and children under age 5 are at higher risk for serious complications from influenza infection. Influenza (“the flu”) is an illness that strikes during the late fall and early winter annually in our country. Great thing is, there is a global effort to coordinate knowledge to reduce the consequences of severe infections. Each year a new flu shot is released to protect us. All children need a flu shot. The reason? It’s estimated that somewhere between 10-40% of all children, each year, get influenza. Sometimes it’s a mild upper respiratory infection, but sometimes it can cause severe lung infections and even death. Each year hundreds of children die in our country from flu even though it is a vaccine-preventable illness. I hear lots of myths and rumors about the flu shot in clinic (more than any other vaccine). Check out my friend Dr Claire McCarthy’s post on de-bunking the myths.

Of those children who are seriously ill and hospitalized, somewhere between 1/3 to 1/2 can be children with no underlying medical issues. Healthy children get the flu, too. If your child has underlying neurologic problems, wheezing or asthma, or diabetes they are also considered higher risk for severe infection.

It takes a well-immunized community to reduce the spread of influenza. And our children, swapping spit and snot at school, are one of our most precious groups to protect.

Which Flu Vaccine And How Many to Get?

Infants 6 months of age and up can get flu shot. Most infants will need two doses, separated by 1 month, while all children over age 9 years need only one dose. If you have a young child (<9 years) and they have never had the flu shot before, they will need two doses. Ask your child’s doctor how many doses your baby, toddler, or child needs this year.  What you need to know about flu.

There are two types of vaccine, the flu shot & the nasal spray. Both protect against the same virus strains. Check out www.flu.gov. Here’s a quick explanation: Read full post »

Ways To Decrease Risk Of Breast Cancer

When we have children, many of us slip in the self-care department. We may not eat as well, not exercise like we did “pre-baby,” and don’t have time to go and see our own doctors. Simply put, our own care doesn’t come first. Parenthood immediately demotes our status…

All fine in some ways. It’s astonishingly wonderful to care so deeply about our children. That devotion still catches me off guard.

But we have to keep on top of our preventative screening. No reason not to when it may allow us a longer time to parent our children! So that’s where I come to breast cancer screening. As women, breast cancer will affect about 1 in 8 of us during our lifetime, the most common cancer in women after non-melanoma skin cancer. It can be highly curable if detected and treated early. Most women diagnosed with breast cancer are over age 50, but many are younger and some are new moms. There are some risks we need to know and scientific evidence that can help us do a better job caring for ourselves.

Share this widely, please.

Yesterday I teamed up with Dr Julie Gralow, the head of breast cancer oncology at the Seattle Cancer Care Alliance (SCCA) and the UW on Twitter for a 1 hour conversation about moms and breast cancer— lifestyle choices, genetic risks, screening, & coping with breast cancer. I learned a ton preparing for the chat and have already tried to think about changes I’ll make in my own life. When I finished the fast-paced hour conversation I sent a note to a friend on Twitter  that I now had to head out for a run, pour out the wine in the house, call my friends to schedule mammography, and ask about a breast MRI. You’ll see why:

Lifestyle Choices May Decrease Breast Cancer Risk

Helmets Or Health Or Happiness?

A recent piece in the New York Times highlighted the reality that some cities are ditching required bike helmets to encourage bike riding, even here in the US.  Too much of an inconvenience, I guess. Too much of a hassle and impediment. Public planners all over the world don’t want helmets to get in the way of, ummm, health.

And it got me thinking, in places like Europe where cycling is far more mainstream, and where helmet-wearing isn’t, are they just that much more laid back? Are they healthier and/or possibly happier, too?

Does zooming out and thinking of the crowd (better active population, lower BMI, less diabetes, less rules) while avoiding the thought of the catastrophic realities of few individuals (those who suffer harm from traumatic brain injury) make us healthier and happier as a community?

The question of course can only be answered if we agree on a definition of health and if we agree on one for happiness, too. And if we’re not the one whose child is injured.

But just this week three things happened that made me wonder if there are competing goals when I spend time chatting about bike & sports helmets and on using carseats properly, too. The issues are somewhat similar. A study last year found that the majority of parents don’t take pediatricians’ advice with car seats and another found parents are far more lax with booster seats when they carpool, too. And it was these 3 things that got me thinking on this again: Read full post »

Why A Flu Shot Every Year?

We need a flu shot annually because influenza virus changes structure and shape as it moves around the globe each year. The strains that cause human disease are different from one year to the next, so we update and add to our protection annually by getting a shot or nasal flu spray. Children, especially those under age 5, are at higher risk for severe disease from influenza. In children and adults, influenza can cause a mild illness, but unfortunately, sometimes it can cause severe or even life-threatening complications. Children may have a more difficult time fighting off influenza partly because they don’t have years of exposure to other strains of flu and no real immunity built up. Therefore all children are considered a priority group for flu shots. Pregnant women, families with infants at home, and those with underlying medical problems like asthma, diabetes, or neurologic problems really need to get them, too.

It takes a well-orchestrated, worldwide effort to help predict which strains come to our country and which 3 strains are included in the annual flu shot or flu nasal spray here in The United States. The video explains more.

What You Need To Know About “Flu Season

How Experts Determine Flu Strains for Shots/Nasal Spray

Find A Flu Shot Clinic Near You

Every Year Is An Influenza Pandemic For Children (commentary)

BPOD: A New Acronym

This may be the best decision I’ve made in a decade. In August, we came up with a new acronym around our home and a tradition was born. Our boys take this very seriously now. Consider starting one at your home, too? Gratitude is powerful stuff.

Marissa Mayer Back To Work

Yesterday I started to see a number of tweets from parents and fellow pediatricians on Twitter criticizing Marissa Mayer for announcing that she’d return to work within 1-2 weeks of the delivery of her first child.

First off, I’ll start with my assumptions:

I’m authoring this post in the belief that Ms Mayer has access to quality health care–that is, she has the ear of a board-certified obstetrician, a board-certified pediatrician, and access to a lactation consultant as needed. My hunch is that if she needs info on evidence-based ramifications, from a health perspective, of going back to work 1-2 weeks postpartum, she can get the data she needs. Since she used to work at Google, I suspect she understands how to find what she needs online as well.

Assumptions acknowledged, I’d like to give Ms Mayer the respect she deserves. Faulting her for not making a traditional choice is devoid of context. She is lauded for her enormously successful career at a young age. She is the youngest CEO of any Fortune 500 company. To me it appears she has savvy and skill, invention and grit. Thanks in part to Ms Mayer as the first-female engineer at Google, we enjoy an entirely different electronic world with Gmail, Google search, maps, and images.

As we expect and work to have women hold an increased share of leadership jobs, academic or not, we must acknowledge we can’t have it both ways. “Women are still missing from medicine’s top ranks,” for example. We can’t want and wait for more and more women to have their hands at the wheels of powerful companies and organizations, only to question their commitment to their personal and their children’s health and well-being when they return to work. One week or 6 months postpartum… Read full post »

Bring Paperwork To Life: Food Allergies

One of the most important forms I fill out in the office is the allergy action plan. The action plan is a spelled-out, step-by-step instruction form on how to care for a child who has a food allergy in the event of an accidental ingestion. Food allergies can be serious, even life threatening, yet adults are often unprepared to respond with speed and confidence. We know that 16-18% of children with food allergies have an accidental ingestion at school.

This past weekend a friend and pediatrician showed me how she is protecting her son at his new school. Instead of only filling out the paper forms for his severe food allergy, she and her son created a Youtube video action plan. Turns out, it worked. Not only was it viewed by the teachers who may need to support him in the case of an accidental ingestion, it was broadcast throughout the school. This is the new world in which we are lucky enough to live.

If your child has food allergies, consider bringing the paperwork to life. Not only can you inform caregivers on proper use and timing of antihistamines or Epipen injection, you can confirm and review the plan with your child.  All you need is a smart phone and some time on Youtube. Every child’s allergy action plan is unique. If you’re confused about when to give your child diphenhydramine (Benadryl), when to use an inhaler (albuterol), or what symptoms demand injection with an Epipen (epinephrine), don’t hesitate to call the doctor now to review.

Bringing School Paperwork to Life:

Allergy Action Plan Form courtesy of Food Allergy & Anaphylaxis Network (FAAN). The form is fantastic–there’s even a spot for your child’s photo, decreasing chances for confusion.

Pediatrician-mom Dr Lee goes behind the scenes in the making of the above video

Screening For Risks Of Sudden Cardiac Death

More than anything else, we want our children protected from harm. Particularly when we hear about sudden cardiac collapse and death in young athletes. The far majority of children who suffer from sudden cardiac events and sudden cardiac death have no symptoms prior so comprehensive cardiac screening can improve protection for all children.

5 Things To Do Before The Sports Physical:

  1. Print out the pre-participation sports physical form and medical history form. Bring it to the appointment for your child’s doctor or ARNP to fill out. This form can help direct a more comprehensive sports physical and will require documentation of necessary medical history and physical exam findings as recommended by the American Heart Association.
  2. Find out about your own family’s medical history. Inquire is there is any heart disease, any history of seizures, or unexplained or sudden death. Complete that medical history form.
  3. Check in with your child/teen to find out if they ever have any symptoms during exercise that may require more attention–things like fainting or near-fainting, chest pain with exercise, easy fatigue with exercise.
  4. Find out if your school has an AED. If they don’t, work on having the sports director get one for play fields and gymnasiums.
  5. Refresh your CPR skills. Review how to do hands-only CPR (this links to a 1 minute video)

Your child’s physician or nurse practitioner can screen them however there are also free screening events for sudden cardiac death in our area include (please include others you know of in the comments and I will add to the list):

Nick Of Time Foundation (Auburn, WA on 9/29 & Renton, WA 10/3 and ongoing)

Play Smart Youth Heart Screenings (ongoing)

Antibiotic Use May Increase Risk For IBD

We’re surrounded by bacteria– literally. They live on the surface our skin and set up camp in our intestines immediately after birth. The complexity of the colonies that live there diversifies throughout our lives–many sticking around for the duration. And we’re dependent on the ka-billions of bacteria that co-exist with us to maintain our health. Without them, things can go off-kilter as bacteria really are a part of our wellness–supporting digestion and maintaining harmony on our skin. Of course, some bacteria come in that we’d really rather not have. That’s when we use antibiotics.

As cough and cold season returns, a study published today serves up a needed reminder. Antibiotics can cause significant changes to our body. Because many infections are caused by viruses (not bacteria) antibiotics are often unnecessary. When we take antibiotics by mouth (or IV/injection) they may kill the bacteria causing a troubling or painful infection yes, but they can also kill the desired “good bacteria,” too. This is a side effect all antibiotics carry. Often we witness this in our children by changes in their poop—after a course of antibiotics they get really runny poop or diarrhea or it will smell entirely different. You really are witnessing the change of colonies in their intestines when you see this.

Sometimes antibiotics are absolutely necessary and life-saving. But recent research has found that antibiotics are prescribed in 1 out of 5 pediatric acute-care visits. And of the 49 million prescriptions for antibiotics given annually, some researchers estimate that 10 million of those are unnecessary. Avoiding those unnecessary courses is up to all of us–parents and clinicians.

I really do think the tide is changing in this regard. It’s rare that a family requests or urges for antibiotics in clinic.

New research is looking at how altering bacteria in our bodies may change our life-long health. It’s not just the alteration in our poop immediately after antibiotics that changes. A new study shows antibiotic use may set us up for chronic disease. And this may be especially true when antibiotics are used in infants and young children.

Research Finds Antibiotics May Be Associated With IBD Diagnosis

  • Dr Matthew Kronman and colleagues studied over 1 million patient records in the UK. They evaluated the infant and childhood exposures to certain antibiotics and the later development of Inflammatory Bowel Disease (IBD). The causes of IBD are incompletely understood; Dr Kronman wanted to understand if bacterial changes in the intestines at young ages affected inflammation that could potentially increase the likelihood of being diagnosed with IBD (Crohn’s disease or Ulcerative Colitis). They studied medical charts of a huge group of patients to determine if children prescribed common oral antibiotics in outpatient clinics (penicillin, amoxicillin, Augmentin, clindamycin, metronidazole, for example) had increased rates of IBD later in life. Read full post »

Miserable School Drop-Offs

Sometimes it feels like we’ve got it all in control, a new school, a new schedule, a return back to work obligations. We can set the alarm early, burn the midnight oil, pack the school lunch ahead of time, rise up and meet the challenge. Sometimes it all works and everyone thrives.

Sometimes, no.

Sometimes it is simply miserable to leave our children behind and trudge off to work.

Miserable.

It doesn’t mean we don’t care about our jobs or that we lack compassion, or a passion, intent, or drive to serve. It really can mean that we just love our children.

A recent drop-off at school reminded me. Read full post »