Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

7 Truths About The “Stomach Flu”

As we hit hour 40, heading into day 2 of vomitorium here at our house (O has been sick), I will suggest a couple of things I know as a mom and pediatrician about gastroenteritis or the “stomach flu”:

  1.  Hand-washing and keeping things clean is your best defense from getting ill with a stomach bug. Not surprisingly, this is particularly true after touching or supporting your child and when preparing food and/or eating. Some viruses will survive on surfaces for days. And some viruses can even survive hand-sanitizer. But even with ridiculous meticulous detail to hygiene, every parent knows that when the vomit if flying it’s hard to lasso every single errant particle. So simply commit to do you best. Change the sheets and clean up areas of vomit immediately after supporting your child. Soapy warm water is your friend. Wash surfaces immediately, use hot water for the wash, and use high heat in the dryer.
  2. 24 Hours (or so) In general most pediatricians will tell you that vomiting doesn’t exceed 24 hours with typical gastroenteritis. But really, it can. Many kids don’t follow the rules. Once a virus that causes gastroenteritis takes hold of a child, vomiting starts. Children tend to vomit more than adults but I’ve never read or learned why this is. With most viruses that cause the “stomach flu,” as the infection moves through the stomach and intestines, vomiting stops after about 24 hours. But not always. If you advance liquids too quickly, or a child eats more solids than they are ready for, even after the first meal 1-2 days into eating again, they may have a vomit encore. If you have one of those, start back where you started (sips of clear liquids) and go very very slow advancing their diet. If vomiting is accelerating at 24 hours, it is time to check in with your child’s doctor.
  3. Disgusting & Terrifying It’s creepy-eepy to take care of a child with vomiting. Read full post »

What Is A Foreskin? Mama Doc 101

Caring for your son’s foreskin is pretty much a hands-off job. But knowing what is normal and how your son’s foreskin develops and changes over time is essential for every parent to a boy with an uncircumcised penis.

In the beginning, during infancy, your son’s uncircumcised penis needs no special care. The foreskin is a piece of skin overlying the outside of your son’s penis. You never need to pull the foreskin back or detach it in any way. You clean it just like any other skin surface on his body.

Over the first 5 + years of your son’s life, the foreskin will gradually “retract” or pull away from the head of his penis. This happens without intervention as the connective tissue bonding the foreskin to the head of his penis dissolves on its own. As this happens, you can teach your son to wash the end of his penis with soap and water and rinse it well. Some boys will be able to fully retract or pull back their foreskin by the time they start Kindergarten while others may not fully retract it until puberty. Both are okay. Read full post »

5 Things I Say (In Clinic)

Five things I say in Clinic (in no particular order). After reading this, you’ll be all set for Family Feud when the category is Things Pediatricians Say.

Number One: I’m so sorry you’ve been waiting for me.

The reason is often varied. I’ve not been picking my nose or even doing something as productive as blogging. Usually I’m running behind because a patient or two arrived tardy for check-in or I’ve had to return a call to a doctor at the hospital or a family needed more time for an urgent health concern or a patient scheduled an appointment to talk about one thing (say a medication refill) and then wants to talk about three things like starting birth control or their struggle with obesity or a new challenge at school or a rash or because I needed to “double book” a sick infant who needs urgent care. The reasons are unpredictable, clearly, and I hate to make anyone wait, but I also hate to have families leave without comprehensive care. I work my tail off (as do my magical medical assistants) to stay on time, yet inevitably I am set up to fail. It’s an unusual doctor who never runs even a minute behind in a general pediatric practice. I sincerely hate to have people wait for me, as it’s a huge added stress for us all. Starting all visits with an apology makes for a terrible day. So next time you find yourself stuck in some waiting room with your toddler (+/- your 3 other children) and you’re going bananas, know that when your child needs the extra time or attention, they’ll get it, too. And if they never do—lucky you. Read full post »

Preventing Sexual Abuse: Seattle Mama Doc 101


With the Penn State tragedy and recent news out of Syracuse this past week, most parents have thought of, and/or worried about sexual abuse more than once this month. The wretched reality is, we will keep getting reminded about sexual abuse in children because it is so common. Thankfully, we can help our children define, get words for, protect against, and support them in their understanding about how to prevent sexual abuse. You can start this today.

If you’re worried or unsure how to proceed at any moment, it’s always okay to visit the pediatrician or clinician your child sees for support, help, and a check-up.

Open up channels of communication about preventing sexual abuse as early as age 3. Start by defining “good touch” from “bad touch.” Use anatomic terms (vagina or penis) and answer questions your children have. Return to these conversations occassionally, every few months, every single year. Always trust your instincts if something doesn’t feel right. Explore and ask questions if your child expresses concern, confusion, or fear.

Preventing Sexual Abuse

  • Trust your child. Children rarely will lie about sexual abuse.
  • A great overview on preventing sexual abuse including possible signs of sexual abuse (at the end)
  • A hand-out defining sexual abuse, some statistics, and characteristics of abusers composed by perpetrators of child sexual abuse while in recovery. A note on this–I found this upsetting to read but did gain insight from it.
  • HHS information about programs and curriculum for children (and adults) on preventing sexual abuse
Please share tips, strategies, research, or wisdom you have in helping educate parents and children in preventing sexual abuse here:

Plan B Back Behind The Counter

I was disappointed to hear the news that Kathleen Sebelius blocked the FDA’s recommendation to make Plan B available to all girls, over-the-counter (OTC). Plan B is an oral tablet containing hormones (similar to what is in a birth control pill) that when taken within 1 to 3 days of unprotected sex, can prevent an unwanted pregnancy. It is used as a back-up birth control. Primarily, Plan B works to delay ovulation thus making it less likely that a girl could be pregnant. Effectiveness increases the earlier a girl takes the pill after unprotected sex, so we want sexually-active teens to have it on-hand, just in case.

When it comes to Plan B, timing is everything.

Girls 17 and up can get Plan B for about $50 without a prescription. They can walk into any drug store, head back to the pharmacy counter, show an ID and purchase the pill to prevent a pregnancy. Those 16 years-old and under cannot; they must see a health provider to get Plan B. Trouble is, not every girl can see the physician when they want. Many girls at risk for an unwanted pregnancy may not have access to a clinician immediately or within a day or so. Further, girls may be too embarrassed or concerned about judgment to talk with their parent. And that’s where I start to worry; an unintended pregnancy can have significant physical and emotional health consequences.

Let me be very clear: I’m all for girls seeing their pediatrician for health advice. Read full post »

Getting It “Right”: Birthdays In Mommyland

My quarterly crisis is rearing its very ugly head. See, it’s birthday season around here and while the boys’ birthdays overlap with the holiday season, I tend to feel an irrepressible need to reflect. Holidays and birthdays are momentous moments, but also markers of time. Places on the calendar and spaces in my heart for subscribed reflection and perspective gathering.

So it is now, this time of year, where I seem to struggle the most with my choices as a mom and a doctor, a wife and a daughter, a community member and a girl just trying to get it all “right.”

I cry every year on my boys’ birthday. The tears well up both out of joy (wow-wow-wow my little boys love getting older & their joy with the special day grows annually) and also out of sadness. Sadness in my ongoing strife with the question of shifting balances, purpose, goals, and daily mindfulness. Am I working too much, am I missing something, am I as present as I can be? Should I be home more? Should I contribute and write more? Should I be seeing more patients? Can I help more people than I am helping today?

I’m torn. Shred up about what is “right” (for me) and on birth day, I’m nearly emulsified. This is tough stuff. As the years tick by and the acknowledgement of mortality grows as the days seem seep into the ether, I really want to have no regret. Sometimes, like most humans, I do.

Part of the trouble is the words of all the parents around me. They all say the exact same thing. And they have been saying it to me for over 5 years. I know they say it to you, too. The woman at the grocery, the mentor or peer, my good friend, the doctor across the country, the parents in my clinic, my mother, the barista, the man helping me at the parking garage…. They all say the exact same thing when they see my boys:

“It just goes too fast.”

 

Read full post »

How Much Salt Is Okay? Seattle Mama Doc 101


I’m a salt-fiend. I really really love it. I’d choose a pickle over a piece of cake any day. Problem is, I’m realizing my palate for the salt lick out ba

Happy And Thankful

Happy and thankful. The holiday served up a great reminder. Time offline, outside, and away from work is absolutely priceless. We should use all of our vacation time. We should fight fiercely to protect it. Thanksgiving reminded me that I am just so happy and thankful. For the holiday, we traveled to see F & O’s grandparents and the boys had some real deal time with their cousins. We played with a lot of balls (tennis, basket, bocce, foot). Little did I know that having two boys would ensure a deluge of round things.

We went to a high school football game an

Pediatricians’ Conditional Comfort With Alternative Vaccine Schedules

I had coffee with Dr Doug Opel last week to discuss his study about pediatricians and alternative vaccine schedules that published today. I learned a lot while we spoke. There is great wisdom in what he said (below in the interview & on video) that extends far past what he learned in the study.

Dr Opel is one of those genuinely authentic, kind people. The kind of person you meet and wonder, gosh if only I could be a fly on the wall when he’s making decisions for his kids or decisions for his life or decisions for his patients–I’d be so much better off. Not just because I’d see the answer, but because I’d have a front row seat while he asked the questions. He’s just remarkably thoughtful so there is no wonder this study illuminated some helpful observations.

Dr Opel and his colleagues conducted a survey of WA State pediatricians to find out how often they were being asked about alternative vaccine schedules and how doctors felt about it. Seventy-seven percent of pediatricians reported they are regularly being asked to use an alternative vaccine schedule. And in general, the majority of pediatricians (61%) are comfortable with alternative schedules but only for particular vaccines. Meaning that although pediatricians are okay with parents’ request to delay some vaccines (Hepatitis B vaccine or Polio) they are not comfortable waiting on others (DTaP, Hib, or PCV). The reason, Dr Opel suggests, is that pediatricians are unwilling to leave kids unprotected for potentially devastating diseases that still circulate in our communities.

In this interview, Dr Opel lends insight to the culture of concern about vaccine safety, how the changing health care environment has shaped how we ask questions in the exam room, and how the concern about autism and vaccines is simply emblematic of concerns about vaccine safety in general. Read full post »

Establish Traditions: Seattle Mama Doc 101

Establishing traditions can be an incredible way to connect, mark time, and affirm a sense of well being in your family. You can establish any tradition you want–one of the rare perks of being a grown-up. Even if family circumstances change (a divorce or separation, a death in the family, a move to a new city) you can adapt, addend, and alter your traditions. Your kids can help you sort out new rules as necessary. Those traditions really may establish a sense of calm for your children.

And really, as you make or restart some traditions at home, don’t stress about extravagance. Sometimes the best traditions are the most simple and come with absolutely no price tag. A walk with a football after dinner each Thanksgiving. Unscheduled or unplugged time the same day every year. Eating pickles on Black Friday. Standing outside in the snow as the New Year arrives. Whatever it is, it can be all yours. And your children will remember.

Start or establish rituals this holiday season and then repeat, repeat, repeat. Share your favorite traditions; what can we all be doing that we haven’t thought of?

Create A Spirit of Giving

15 Meaningful Holiday Traditions