Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

She-Woman Wednesday

She RaOur nanny called in sick yesterday. I felt like a She-Woman (think gender equal of He-man circa 1988) after making it through the day. Maybe it’s more, She-Ra. Between the hours of 7:50am when I got the call and 5:50pm when I sat down to dinner with my little boys I : Read full post »

If It Were My Child: Infant Swimming Lessons

It turns out, I don’t think you do have to be careful what you wait for when it comes to swimming. A study published a few weeks ago suggested that children under the age of 2 were at higher risk for bronchiolitis, a common pediatric lung infection, if they swam in chlorinated pools when they were babies. I’ve mulled this over and done additional reading. If it were my child, I’d sign up for infant swimming lessons. Believe me, I’m not getting off any swim/pool wait list any time soon! Yet, I do think the study offers a chance to re-frame how we think about protecting our kids around the water.

Although O will be well over 2 years old when he gets off the decade long wait list for the pools in our area, he’ll be swimming in chlorinated pools before then. From how I see it, chlorine exposure is only one side of the story when it comes to infant swimming and safety. It’s okay, maybe even wonderful if I dare say, to swim with an infant. The video we have from F swimming in the first time is hilarious. I am far more ecstatic than any normal human should be in a pool. It’s true; most babies simply love the water. So do plenty of adults (read: me).

Swimming if not only delightful, it is also dangerous. Worldwide, drowning while swimming is the 2nd most common injury that kills children under age of 14. Therefore how our infants and children come to know the water may be as important as how we think about using car seats. Read full post »

Tape Measuring Time

I had a great weekend. Nothing truly spectacular happened. I, for the most part, tucked the blog away in my top drawer. I wasn’t on call and didn’t connect into my clinic computer. I tried to be really present with all 3 boys in my house.

I played with my kids. We did the typical things that dress up weekends for normal people: errands, a grocery store trip, naps, dinner, test drove a car, met friends and their kids for lunch, met friends and their kids for dinner, went to IKEA, had dinner with grandma, took out the recycling, rearranged the living room.

Usually, that little “trip to IKEA” sandwiched in there would be a back/mood/weekend breaker. This time, no.

In the midst of this wholly normal yet stupendous weekend, I had mentioned to a friend how F was having a hard time with the concept of single digits forming greater numbers, especially in the teens. That is, he can count pretty easily from one to fifty, but when I point to the clock and ask what time it is, he says “seven, one, three.” Read full post »

Wait lists: Be Careful What You Wait For?

Luna waitingWelcome to wait list country. That sounds like some bad pick-up truck ad. But it’s true; Seattle is known for mountains, water, coffee, grunge, rain, evergreens, and the Space Needle. And then as it turns out, wait lists. I know what it feels like being stuck on a list. Hip deep stuck. Somewhere between the Andersons and the Steins just above the Grahams on page 6. Buried with no chance for arrival or survival.

The wait list: are you on one of these lists?  Is your equivalent w-e-n-d-y-s-u-e-s-w-a-n-s-o-n spelled out and nestled nicely on some school, pool, or horseback-riding list? I think about these lists a lot more now that I have two kids. I generally let all people involved (the kids, the husband, the babysitter/nanny, the MIL, my own mother) down due to my inability to follow through and get on the list, let alone get off the list. Any list. I know you turbo moms and dads out there are really good at this. For me, it’s usually well after the list is formed, a true tardy, and only with 3 people telling me about an activity, that I get on the list. Precisely why I’m at the bottom, I suppose. Read full post »

100 Calories

Rainbow WalkWhile I’m talking about the red/orange/yellow rainbow spectrum used on food packaging to lure you into eating more, let me mention one great new study published today that may change your world. Especially if you have a child living in your house. If you acknowledge the finding that about 1 out of every 4 children between the age of 4- 8 years old eats fast-food on a typical day, this has relevance to at least about 1/4 of us. Today!

A study published today in Pediatrics found that when parents are aware of the calorie count in McDonalds fast-food items, they order less caloric foods for their preschoolers (age 3-6). In a Seattle pediatric clinic, about 100 parents filled out McDonald’s menu choices for lunch for themselves and their preschooler. Families who had menus that included calorie content for each item listed selected meals that were about 100 less calories for their kids compared to families who didn’t have nutritional information (calorie count) on the menu. Just by having the number of calories listed for each food item on the menu, families made better choices for their child!

Brilliant and then seemingly simple, huh?  However, lots of fast-food chains don’t readily provide nutritional info. As menu-labeling laws may be incorporated into health care change and reform, this study helps define how important access to nutritional information is for all of us.

100 Calories may not seem like a big deal. It is. Over time, just eating an excess of 100 calories every day can cause a child to get fat. Read full post »

Constructing Snacks into Mini-Meals

Over the past 20 years, the amount of calories consumed by children from snacks has increased by 30%. Kids eat a third more calories everyday from snacks! What kids snack on certainly can reflect how their diet is shaped and how they grow. Plain and simple: snacks make us fatter by packing in lots of calories in relatively small bits of food, the definition of “calorie dense” foods. They also discourage our eating of things like fruit and veggies because they fill us all up. One recent study found it was our over-consumption of snacks more than our under-consumption of fruits and veggies that is getting us into trouble.

Beware of the foods in red/orange/yellow packaging; these are generally foods that are not very good for you. Research finds that these colors make you feel hungry, thus advertisers use the colors to increase the likelihood that you purchase (and eat) junk food. Think about food packaging like you think about the threat level at the airport. Red and orange are generally a no-go. Steering clear of this part of the ROYGBIV (red.orange.yellow.green.blue.indigo.violet) food isle is important. As snacks make up more of our entire diet, what we choose to snack on may be as important as what we make for dinner.

Whine with your snack?
Whine-fest 2010 continues in our house. Beautiful. I’ve gotten out my baton and I’m now conducting from a perch in the kitchen. All those years of band (yes, I played the oboe) and weekly orchestra practice are finally paying off. Play date sign-up for whine-fest in our house will be online soon. Guest conductors accepted. Read full post »

Complex Problem: Raising A Child

I had the fortune of seeing Dr Atul Gawande speak last week in Seattle. Truth be told, I entirely invited myself. I heard there was a group from the hospital going and I begged my way in. I sat in the corner.  Flashbacks to finding a seat in the junior high cafeteria. I made it through and forgot all about the awkward act of my self-inviting and seat-finding by the end. Despite my disrespect for Ms Manners and my loud mouth, my pushy ways afforded me the opportunity to witness a leader in medicine.

I enjoyed what Dr Gawande said about his work in using checklists to ultimately decrease complications and death in the surgical setting. I have read Dr Gawande’s books (or parts of them, I admit) and many of his articles in the New Yorker (whole thing, thank you). I marvel at his skill and ease of writing, his ability to translate complicated problems and make you feel like you thought of them yourself due to their apparent simplicity. His assertions, however, are not simple. It’s just that his skill in expressing his position, explaining the breakdowns in the system and offering opinion wed with solution puts us all at ease. His article, The Cost Conundrum, remains one of my favorite articles of all time. I have read it numerous times and think about it when caring for children on a weekly basis. He has affirmed the way I feel about over-testing in medicine. As I have said previously, in pediatrics so often less is more. Read full post »

The Whine: Up To My Nose In Noise

Meet Luna, our dog. She looks overwhelmed this morning, doesn’t she? I think she is thinking about our short night of sleep sandwiched between a fine nighttime whine and an early morning whine. The whining in our house is overtaking me. Imagine me in a pile of virtual sound, covered up to my nose in noise. Underneath layers of scratchy screech and howl, whine and cry, loudness and complaining, my hands reaching for the sky. It’s loud here. Wanna come over and play?

I’m wondering when our dog will enter into the chorus and begin to howl. She’s a remarkably patient and mild mannered 7 year-old lab but you’d think this would inspire a little bark or something. Her calm alarms. She remains quiet and patient despite the racket, waiting on the sideline for the respite of nap time silence. Silence can feel very present and nearly tactile right now. The presence of something as opposed to the absence. Read full post »

See Spot Run? Anterior Fontanelle, Part 2

seespotThe soft spot feels like an epicenter in O’s landscape. As every new parent gets to know their baby, the soft spot is just one of those places and spaces we come to know that makes our baby unique. I know O’s little spot is about to go away. Just another thing for me to cry about at the two-year birthday party.

I took a phone call from the husband recently who is a pediatric radiologist and who was reading a head CT scan, inquiring when I thought the soft spot closed in infants, exactly. He knows a lot more anatomy, physiology and imaging of the skull than I do, but he had a common question: just when does it close? Like so many things in medicine, I don’t think it’s entirely clear. There is no perfect answer.  The short answer is around 1-2 year of life. But like so many things, the range of normal is expansive. Read full post »

161 Years Later

Elizabeth Blackwell, MDToday while I was waiting for an elevator in downtown Seattle, a man whisked in front of me and another women to get in the elevator.  The woman had on a fancy coat and red, powdery lipstick. She stopped me as I was getting in and said, “Oh, it’s going down.” I stopped and waited and thanked her for alerting me to getting on the wrong elevator. I liked her. It didn’t really faze me that the man had pushed ahead of us a bit, but he had. The woman looked over at me and said, “what a man, can’t even wait for a woman to get on.”

I said, “well, chivalry really is dead.”  As if to state the obvious but also assert the okay-ness I had with it all. Then I said (maybe over-stepping my boundary with this stranger), “funny thing is, yesterday was January 11th and that marked the day that the first woman in the United States was awarded her MD.  And that was over 150 years ago.  So, if I lose the chivalry over those years and gain the opportunity to practice medicine as easily as I do, it seems a pretty good trade off.”

The woman just kind of looked at me, smiled, almost laughed a bit, and then stepped forward as the elevator re-opened. When we got in and headed up she said, “well, at least he’s not on our elevator.” Read full post »