Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Tina Fey’s Triannual Sob, The Mommy Wars, And A Truce

Tina Fey, I hear ya. As working moms, we’re asked an unfair question when we are asked about “juggling it all.” And I’m with you on the angst about working and parenting, except your triannual sob is my quarterly crisis.

Tina Fey, about-to-be-Momma-again-hilarious-comedian-“ridiculously-successful-and-famous”-deserving-it-girl, was showcased in an article in yesterday’s New York Times. It was in The Sunday Styles section, a portion of the paper I fondly refer to as the “Ladies’ sports section.” I can’t remember who coined the name, but the section is defined by wedding announcements, articles about junky TV, and snapshots of random strangers carrying coffee or poodle accessories in Manhattan. But I sincerely don’t mean to marginalize it. Often the section houses little storytelling gems that sit with me all week. Yesterday’s piece about Ms. Fey got my heart pounding. There she was, one of the funniest people on the planet, saying the same things that I do. Well kind of. Our only similarity really may be that I’m just another working mom. But it made me want to listen to her even more.

Tina, like the rest of us, is asked to defend her work, her “juggle,” her parenthood differently because she’s a mom. Curtis Sittenfeld writes that in Ms Fey’s new book Bossypants (dying to read it–can you find me 4-5 hours?) Ms Fey asserts, “‘The rudest question you can ask a woman’ is, ‘How do you juggle it all?”” Simply put, it’s archaic to think of life this way. Women are continually reminded to question their choices differently than male counterparts in the work place even when we share parenting responsibilities. The questions alone arguably bring the working-mom struggle back to our windshields. And it ultimately perpetuates gender inequality. Why is it any different for me than it is for my husband? He works just as many hours as I do. But no one asks him about balance. Or commitment. True, this struggle really doesn’t tug on him like it does on me. I believe cultural norms play a role in this. Read full post »

Atta Boy, Coach Madden

I believe all media is instructive. I know we (adults and children) learn about health care when watching (reruns) of ER, Scrubs, or Grey’s Anatomy nearly as much as we do from the nightly news, Dr Oz, or our newspapers. And although entertainment may not feel instructive, I know it is. Media, from what’s online, to what’s on the television, to what’s on your phone, to what’s in your Xbox, informs and instructs. I don’t care how you cut it, I believe that every second of media produced has the potential to make change and educate. That’s why I’m so pleased to have heard some news. The husband pointed out that ESPN announced last week that Madden NFL 12, a hugely popular video game (5 million copies sold of the last edition alone), is about to have some new rules. And a new role.

It turns out, Coach Madden (a giant in football) is really putting money where his mouth is, working to educate and make change. EA Sports announced that their newest version of Madden NFL (12) will now incorporate new rules surrounding concussions and play. The game, coming out August 2011 (regardless of player lockout) will emulate the real game. When a player gets a concussion, they are not only out for the remainder of the game, the announcers will explain that the player was removed because of the seriousness of head injuries. The new video game will also block the ability for players/avatars to make helmet-to-helmet tackles, dangerous headfirst tackling, and hits to the heads of defenseless players.

I don’t play football and I don’t play video games, but I do know that: Read full post »

My 3-Day Family Emergency Kit in 6 Minutes

Is it on that ever-present, ever-too-long to-do list of life? Can you bring it up in the queue?

This week I did a segment (above) where I showed my actual emergency kit and talked about ways to start making your plan. But really, this isn’t just about the kit. It’s about preparing your family for unexpected events. Fortunately, terrible-nesses like Katrina, the Japan Tsunami, large earthquakes, volcanoes erupting, and tornadoes are rare. But prepping your family for unexpected large events may really help in prepping for smaller ones like a family illness, accident, or power outage. Knowing what your risks are specifically (what is the biggest risk on your block–a flood, transportation issues/bridges/tall trees/earthquake) is also a great start.

In prepping, I bet you’ll never be sorry you got to know your neighbors (I hope), stashed water and emergency medications, put aside clothing and a first aid kit, and put in place a plan for how you’ll reunite with your family during a moment of chaos.

Watch 6 minutes for a 3-day kit. Although I admit it will take you far longer than a few minutes to make a plan and a kit (I’d set aside 10-15 hours to get it done top to bottom)…
Start today with buying water and a embarking on a communication plan.

Make An Emergency Communication Plan For Your Family:

  • Teach your children age 4 and up a contact cell phone number for Mom or Dad. Once they master those, try for additional contacts like Grandma or neighbors. Try it out with your precocious 3-year-olds in school, as well!
  • Designate a location, outside of your home, that you will meet if your home isn’t a safe place (local park, fire station, community center, school). Inform all family members, babysitters, nannies, and relatives where you’ve selected.
  • Make a card for your wallet, your child’s back pack, your partner’s wallet, and your daycare and/or school with your out of state contact number (the MIL or a favorite trusted friend). Call your friend (or MIL!) and review with them their role in case of an emergency.
  • Remind everyone in your communication plan to try to use text messaging if cell phone use is difficult. Text messages don’t use as much bandwidth and may go through when a call doesn’t.
  • Remind everyone that often in times of natural catastrophic emergency, 911 is not always able to respond immediately. Having a good plan for your family can be a great start to put you all at ease and keep you safe. Practice your plan; quiz your kids!
  • In the next week, get to know 5 new people on your block if you don’t already know every one. Even Boo Radley…. Tell them you’re creating a kit and plan. Ask them if they have one. Make a new friend. May come in handy for a less tragic moment, like needing an extra egg for that cake you’re baking.
  • Get 3 gallons of water for every human and animal in your home. Put it in an easy to reach area like a shed, garage or porch.

Tell me if you’re in the works making a plan and a kit. How much time it is taking you? How does it feel to assemble this kit and what struggles have you had?

Girls In The News: Beyonce, Bikinis, And Breast Milk Baby

Girls in the news…It just has to get better than this. I’m a bit deflated with the amount of time and energy going into three stories this past week or so.

Last week it was the push-up-padded-bra bikini marketed to young girls (age 8 years) from a big retailer in the US. The company has a bad track record and nonetheless, outrage ensued about early sexual images, contorting body image, and simply pushing girls to “grow up too fast.” This month, I started to hear murmurs about a group of  8 year-old girls in a national dance competition, dressed in bikinis dancing to a Beyonce song with controversial choreography. The dance hit sparked thousands of comments on media Facebook pages and the blogosphere lit up like a sunbeam. And then this week it’s about a breast-feeding baby doll that mechanically sucks on nipples (via a bib worn by the doll’s owner). Concern about young girls being asked to act like grown women, perversion by the doll’s manufacturers, and a too-soon anatomic education about physiologic breast function before kindergarten…

But wait a second. What is this really about? We get so lost when this chatter fills our water-cooler moments we remember all the wrong things: Read full post »

Colic, Crying, And The Period of PURPLE Crying

Every infant cries. It’s a part of being a newborn, yet infant crying still puts many of us on edge. As parents, we want to calm our babies and prevent crying; it’s simply instinctive to want to make it go away. The period of time when our babies cry most (between 1-2 months of age) can be entirely exhausting, unsettling, and unnerving. As we transition into parenthood, one of the most difficult challenges can be learning to soothe our crying newborns. One expert, Dr Ron Barr, refers to this period of crying as the PURPLE period. I’ll explain, but first, let’s talk a bit about colic and news today about using alternative “folk” treatments, and ultimately what it may mean when someone, a doctor or not, tells you that you’ve got a “colicky” baby.

This morning I did an interview for Good Morning America Health about a Pediatrics systematic review evaluating 15 large studies (including nearly 1000 babies) to determine if things like infant massage, probiotics, chiropractor’s manipulation, herbal supplements, and sugary/glucose solutions really helped “colicky” babies stop crying. The results proved unfortunate. No, these interventions don’t tend to help infants who are crying/fussy/screaming their heads off. Two things to think about with the new findings: first, when you’re frustrated with a baby’s fussing/crying, don’t reach for these remedies as solutions or as “cure alls.” As we know it now, there’s not a lot of evidence to use any of these remedies. Secondly, don’t confuse the word “natural” with “harmless” or “safe.” Many of these herbal and complementary remedies come with labels that say “natural.” Natural doesn’t confer safety. Some limitations of interpreting data from the 15 studies reviewed was the reality that little time was spent reporting side effects to interventions and therapeutics. It may simply be because there were few, but researchers are unsure. We only want to use medications in infants that prove effective.

The most important thing to do for a fussy infant is to find ways for you to soothe your baby. But know that you won’t always be successful. Read full post »

New Rule: Be Without a Ceiling

I’ve got a new rule. And this is coming from a woman who grew up in Minnesota and who lives in Seattle. I’m stating clearly first: weather is no excuse.

I’ve talked in many places on this blog about the reality that there are only a few “rights” to parenting. In my opinion, as a mom and pediatrician, the “rights” include things like getting your children immunized and properly using car/booster seats. Beyond that, the rest of the parenting is a smattering of “doing right,” versions that vary and resonate from person to person and child to child. The thing is, most of us do it very well, without strict rules. That is, out of love and instinct, we parent our children well. We shelter them. Protect them. Feed them. Shield them from harm. Provide opportunity.

Often, the information we read about parenting does more to break our spirits than it does to bolster phenomenal, inventive ideas. And even though a physician friend recently told me that he subscribes to “‘good enough’ parenting,” and that I tend to agree, I believe this week I’ve stumbled upon the third possible “right.” Tell me if you think I’m wrong because I just can’t conceptualize the counter-argument to my claim:

Go outside with your children every day. Move in a space that has no ceiling.

With the rising digital demand on our lives and with technology seeping into every space, getting outside remains one basic and beautiful way to stay healthy, connected, and opportunistic with your children. And better yet, it’s a great way for your children to be afforded the luxury to roam, create, and play. Not only will your children move and exercise, they’ll experience nature. Nature, as simple as the sticks on the sidewalk or the grass in the boulevard–or nature, like the spaces where you see-hear-smell-touch nothing man-made. All of it, any of it, every day. It seems to me that nature is something we’ve nearly forgotten to prioritize with our time here on earth.

So don the coat, the mittens, the hat, or the sunscreen. Whenever illness doesn’t get in your way, do whatever you can to remain comfortable and protected, and then get outside each and every day with your children. Move in a space with no ceiling.

2 is Now Officially The New 1: Rear Facing Car Seats Until Age 2


Did you hear the news? The AAP has made it official. 2 is now officially the new 1.

Last year I wrote a blog post entitled “2 is the new 1″ that discussed my opinion that you keep your children rear-facing in the car seat until at least age 2. This week the AAP announced the official change in recommendations for car seats, which includes the rear-facing until at least age 2 years and also adds some additional pointers on how to keep kids safe at all ages.

Some highlights of the new report and policy that uses evidence to guide the best way to protect your infant or child from serious injury in the car: Read full post »

Radiation Disasters And Children: Why No Potassium Iodide Now

There is a lot of talk about radiation and radiation effects because of the ongoing tragedy in Japan. It’s a bit overwhelming and confusing, to say the least. Ultimately, fear motivates us to act in bizarre ways and this current catastrophe in Japan is no exception. I find myself a bit nauseated when my mind drifts to Japan, yet I can’t seem to curb the urge to watch the updates. I don’t normally watch live news because I sincerely don’t think it’s good for me. But this horrific human tragedy steals me away from my typical distance while simultaneously reminding me of two quotes, one posted earlier:

Disasters are about people and planning, not nature’s pomp.” ~The Economist

and

Human inability to detect radiation can pose more of a psychological threat than a physical one. ~The Washington Post

The ongoing tragedy in Japan will help motivate us to prepare. But fear of the unknown can eat away at us, too. Anxiety surrounding Japan’s struggle may be higher than what we experience typically with catastrophic events, in part because of the complexity in understanding the effects of radiation. Because radiation is invisible to the eyes and undetectable to the nose, its presence is difficult to detect. We know that fear and anxiety are common in children affected by natural and radiation disasters but its psychological effect may be the most lasting and intrusive to health.

We can do things to protect our health, too. First, if your children are watching TV, sit with them and provide honest, age-appropriate explanations. Turn the TV off whenever possible. Next, discuss what your family is doing to help prepare for unexpected emergencies. Preparing your home and family for disasters with both a communication plan and an emergency kit can be a great way to decrease anxiety for both you and your children and will arm them with tools to protect themselves. A great antidote to fear is to regain your sense of control. I hope this post, and ongoing ones, help us all calm down.

The bottom line is this: with what we know now about Japan’s current disaster, even with the possible worsening nuclear crisis, medical countermeasure such as potassium iodide (KI) are not indicated here in the US. Don’t pop the Potassium Iodide (KI). And don’t feed it to your kids! Although Japan is advising KI use in the close vicinity to the damaged reactors, the US Nuclear Regulatory Agency and the Washington State Department of Health have both said that harmful effects of radiation are not expected in Hawaii or the US West Coast.

I believe every decision we make in medicine is a balance between risk and benefit, from intervention to doing nothing. This radiation question is no exception. Potassium iodide can protect the thyroid gland from the devastating effects of high levels of ionizing radiation. But, when used inappropriately or unnecessarily, potassium iodide has the potential to cause very serious side effects such has abnormal heart rhythms, bleeding, nausea, vomiting, and electrolyte abnormalities.

The risk of using KI far exceeds any benefit right now. Read full post »

Play

Recently, I started asking a standard question, exactly the same way, to children during their 3 to 10 year old check-ups. This wasn’t premeditated. Like all physicians, I go through phases of what I ask kids to elicit their experiences and beliefs, listen to their language and observe their development. I learn a lot about my patients from what they choose to answer. Both in their receptive language skills (how they understand me) and their expressive skills (how they speak–fluidly, articulately, with sentences) to their cognition (how they understand concepts and theories). No one talks as much when in the exam room as they do at home. Pediatricians know this (of course!), but these questions are a great way to learn a lot about a child’s wellness and get to know my patients. It’s also the part of the day I enjoy the most.

But when I started asking a recent question something became utterly clear. I’d say,

“What do you like to do at home?”

I expected the usual suspects. Things like, “Watch TV,” “Play the DS,”, or “Play with princesses or doll houses.” Not that I expected stereotypes, I just expected specifics. But instead, there has been a uniform, single-word response. Breath-taking. These children are all saying the exact same thing.

“Play.”

One word. Read full post »

Japan Tsunami: Reminder For Parents To Prepare

I was up until nearly 1:30am today watching the Tsunami in Japan live online. Terrible for the psyche and hard on the heart, I simply couldn’t stop watching it unfold. It’s utterly terrifying to imagine the devastation and separation that catastrophic events like this cause for people. In the face of this terrible news, there is much we can do as parents. In addition to donating to relief organizations, we can prepare our families. We have incredible strength and insight as the proud providers and nurturers of our children. Now, today, is the time to utilize this reminder for good and harness your concerns into preparedness.

On the news last night, reporters kept repeating that every home in Japan had an emergency kit…that every family had a plan for an earthquake. They detailed how children knew at a very young age what to do when an earthquake began and families had communication plans to re-unite.

Today is a day to begin to create the same for your family. Emulate the universal emergency plans of families in Japan. I trust these kits and plans have saved many lives in the past 12 hours and lessened the worry of the millions of parents reuniting with their children as I type.

Last year, I made a disaster kit and blogged about the experience. Today, in the wake the Japan Tsunami, please consider doing the same. I’m re-posting some of the content here.

I’m gonna be honest, making a disaster kit completely stressed me out. I hope my experience will make it better for you. I guarantee with each step you take, you’ll feel an incredible sense of relief as you ready your family. I’m no expert at this but have learned a lot along the way. And there is no question, I feel so much better with my family prepared and my preparedness tidied.

As The Economist said last year when discussing Iceland’s volcano, “Disasters are about people and planning, not nature’s pomp.”

Prepare.

I believe in the 3 tiered approach you see everywhere:

  • Make a Kit (detailed below and in my video)
  • Make a Plan (how to communicate and find your family)
  • Stay Informed (what disasters are likely to happen, where to find info) Read full post »