Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

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 »

Vote With Your Children

Four years ago I took an early discharge from the hospital to go home and vote on election day. My son O had just been born. We were both stable (me after a c-section and he after a brief stay in the NICU).  Things were going well enough that although the medical team suggested I consider staying another night at the hospital, I was determined to get out of there and cast my vote. Fortunately the medical team agreed. I remember thinking it was the beginning of ensuring that O knew how marvelous and luxurious it is to be heard. Voting is quite possibly the loudest thing we do.

There is nothing else to say today but that I urge you to vote. As my kindergartner left for school–his voter registration in hand for the mock election– I felt hopeful. Hopeful that we’ll increase election engagement, that we’ll advance the gift of democracy by increasing the vote, and that our children’s generation will be active, vocal stewards for the truth. Today I’m excited that we can raise children who spend energy working to improve equality of all people, improve access to health care for all people, and bring equal rights for all families.

We’re remarkably privileged to live in a time where all adults can vote. As parents we often vote on behalf of our children–how can we think of the future without them?

Facebook and Twitter are aflutter today with parents posting their election experiences with their children. Just as our children learn to speak by listening and by echoing what we say, our children can learn to vote by joining us.

Imprint the power of your vote…grab onto the hand of your child or steady yourself with the handle on the stroller or the car seat.

I say do anything and everything you can today to cast your vote. And make sure you bring those little ones along.

Buy Organic Food Or Not?

I was surprised by a recent clinical report on organic foods. I summarized the findings in the video. Sure, I thought organic foods didn’t offer any more nutrition (vitamins, minerals, fatty acids) than foods grown conventionally. I’d seen a large study published in the Annals of Internal Medicine evaluating research spanning 1966 to 2011 that didn’t cite evidence that foods were more nutritious or better for us, per se. But I did recognize that data was on the side of organics when it came to keeping our children healthy and safe–because of pesticides.

I wasn’t entirely correct.

The American Academy of Pediatrics’ clinical report found that although levels of pesticides differ on fruits and produce, the effects on the health of our children remain inconclusive for recommending organics. Read full post »

5 Things From Thing 1 And Thing 2

Truly, I’m distracted this Halloween. I think more than anything else, we should take the time (and money) today to donate to the Red Cross. Then put the costumes together. The destruction and suffering from hurricane-storm Sandy are at the forefront of our thoughts as families. For some communities, Halloween is postponed or delayed. It’s just a holiday, of course, but a big one for our children. It’s one holiday where children take center stage and create lasting memories. So I don’t want to de-value this, either — celebration is a really important part of our lives.

For those of us able to celebrate Halloween today, here’s some quick reminders. Fortunately, Halloween injuries are not all that common. A 2010 report found that there were more trips to the ER from sports injuries on Halloween than holiday ones. That being said, here are some tips I’ve read that are worth repeating.

  1. Sidewalks: On Halloween I worry most about injuries for children while walking around (getting hit by a car, tripping on a costume, or falling down), not razor blades in apples. Children are injured more as pedestrians on Halloween than from anything else the holiday inspires. When you set out with (or without) your children tonight, think about maximizing their safety on the sidewalk and on the street. Remind your kids never to believe that they are the right of way on the street. Yielding has great power and protection. Stay on sidewalks whenever you can.
  2. Be Seen: This is fairly self-evident but…..bring your cell phone, a light stick and/or a flashlight when trick-or-treating. Be seen and reachable when necessary. And remind teens about getting around while they are texting. Recent data finds teens are having more and more pedestrian injuries (up 25%), partly due to texting and walking. When distracted, they’re far more likely to get struck by a car. Read full post »

Should I Feed My Children Rice? Arsenic & Rice

Recent reports have heightened concerns about arsenic levels in rice products here in the US. This has left many parents wondering if we should be serving rice to babies and children. The video summarizes my current recommendations.

Read the report from the Pediatric Health Environmental Specialty Unit mentioned in the video. References on authors and sources are at the end of the report. This report is calm, informative, and backed by experts—there appear to be no false claims.

Remember, arsenic is a naturally occurring element on earth. However, natural doesn’t necessarily mean “good for you.” There are two types of arsenic–organic and inorganic. In general, it’s the inorganic arsenic that we worry about. The big picture goal for all of us is to eat a diverse diet full of a variety of foods thus protecting us by decreasing exposures to any one thing.

Arsenic is large quantities has been found to pose health risks. So taking steps to minimize consumption of foods high in arsenic may be beneficial. Before you bail on rice althogether, know that not every group is ready to tell you to rid your pantry of rice. Here’s what the American Academy of Pediatrics says currently (fall 2012).

5 Tips To Reduce Arsenic Consumption For Your Family:

  1. Have your water checked for arsenic if you have well water or a private water supply. The Environmental Protection Agency (EPA) mandates arsenic levels in public water. But if you have any questions or concerns about public water, call your water company and ask about report data. Read full post »