Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Being On The Other Side

Over the past few weeks I’ve had ample opportunity to be on the other side. Not like some parents with chronically ill children or those with children who have suffered tragic illness. No, not like that; I am fortunate that hospitals aren’t a part of my family’s everyday (except for work). My children have had amazing fortune and I remain in awe of good health. Lately though, we’ve had some stumbles. Literally.

O broke his leg a week ago after falling from some play equipment while we were on a trip to California. Six days before that, he turned blue in his lips and mouth and we ended up in the ER for a 6 hour investigation. My mom finished a week of chemo this past weekend and we’ve got follow-up visits for nearly everyone. Two today, in fact. I’m still living a part of the generational sandwich. And we go to see doctors. Allowing ample opportunity for being on the other side.

When I tell others about my experiences in the ER with little O or with my mom at the cancer center, or going to the doctor for my own health care, people often point out how good it is for me. Enter broccoli with a side of brussel sprouts. People want doctors to go to the doctor. I get it.

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The “Inherent Risk And Implied Immorality” of Distracted Driving

Distracted driving = drunk driving. All doctors in and out of primary care should be telling patients this. Oprah talks about it nearly every day. We should, too. We have the rare privilege of an often captive audience. Our patients come to us for advice.

Framing distracted driving with drunk driving conveys the “Inherent Risk and implied immorality” of the situation, wrote Dr Amy Ship in today’s New England Journal of Medicine.

She says, “more than 275 millionAmericans own cell phones, and 81% of them talk on those phoneswhile driving.” It’s time for primary care doctors to not only talk about the issue, but frame and explain the risk that distracted driving poses for patients.  In my world that is teenagers who are driving.  And then all the children who ride around in cars with drivers who are distracted.

In the editorial, Dr Ship uses a Youtube video for storytelling and education. It’s a brilliant use of new media. A little morsel for all of us to endure.

If you have a teenager, will you please show them this video? Graphic, real, and powerful, it tells the story of consequence. And what it looks like to suffer from risks taken while driving distracted. If we can put down the phone, maybe we can all learn how to drive again. Don’t some people say they wish they were 16 again? This may be our chance.

Competitive Parenting

Raising children in a world full of accessible opinion is a funny thing. Everyone seems to have an idea about how to do this right. Stay home, work full time, work part time, return to work, cry to sleep, not cry to sleep, pacifier, no pacifier…the recipe for each of us is different, of course. Often we’re all right in what we’re doing from picking out baby food to enrolling our child in preschool. But it doesn’t always feel that way when a barrage of comments and advice from relatives, friends, and people in the supermarket hit us in the shins. What people say about how we care for our children hurts far more than salt in a wound. Editorials on our parenting can seriously linger.

Recently I talked with Liz Szabo at USA Today about this issue. She wrote a popular article called, Why do mothers judge one another and their parenting? where she quoted me and a number of other moms & doctors about our experiences. There is a video interview from New Day NW at the end of the post where I discuss competitive parenting, too. Read full post »

Protecting Children In The Sun: What To Use & Why

It’s cloudy and cold in Seattle. The rest of the northern hemisphere is starting to grill, swim at the beach, and play in the sun. Here in Seattle we’re shivering (literally) under raincoats and fleece. It’s pouring. My space heater is running. Think rain, space needle, cold. It’s not always like this, though. And in the great hope that the clouds will clear and the ball of fire will reappear in the sky, I’ve been thinking about sunscreen and ways to prevent melanoma.

Every season we hear that cancer of the skin related to sun exposure (and tanning bed use) is rising, even in children. This post covers my thoughts, the off-the-cuff thoughts of 2 dermatologists and 1 environmental health expert/pediatrician. We’re all still learning. But we do know a few things that may help.

Although melanoma is rare in children, sun exposure is more dangerous for children than adults. Here’s why: the more sun exposure children have, the more moles they make in their first few decades. The more moles, the bigger the risk of a mole turning into a melanoma. So, here’s how to stop being scared of the sun and enjoy it safely. Sunscreen is what most parents reach for when they worry about the sun, yet when it comes to infants and toddlers, long sleeved UV suits, hats and sunglasses are far easier. And maybe cheaper depending on how many times you use them.

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Mama Doc Cliff Notes? Immunizations, Organic Milk, Formula & Swimming

Take a peek at this KCTS video interview for a recap on the science and rationale behind the most recent blog posts. My condensed (well, kind of) thoughts about a few recent studies, an AAP statement, and the news. It’s a little like Cliff Notes for the blog. But you don’t even have to turn any pages…

Links to studies discussed:
Study on immunization and neuropsychological outcome
Study on pesticide exposure

Reciprocity

Reciprocity. It happens in clinic sometimes, genuinely and lovingly. Someone says something in a way that gives me far more than I can dish out in a 20 minute clinic visit. It’s things like this, on top of genuinely getting to know my patients and their families, that keep me going back in each week. To steal a phrase from a friend, I’m really “happy to help & thrilled to be here.”

Really and truly. I’m not a PollyAnna; there certainly are bad days when I want to go home and snuggle with my boys, turn off the computer, and slow down. But really the general pulse of my life is that I’m thrilled to be here working, sharing, learning, and giving.

Primary care is fraught with difficulties. There is paperwork (read: piles), tedious e-mails, phone messages to return, lab values to review, refills to sign, new protocols to incorporate. This all sandwiched in between clinic visits with sick children and worried families. Emails and Twitter feed wedged between heart disease and plantar warts. It is complicated to manage this and busier that I ever imagined it would be. But it is still really good.

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To Cry It Out or Not To Cry It Out…

Sleep. We’d all love a little. Especially once we have children.
How have you, did you, or will you help your baby (and you!) sleep through the night?

Everyone has an opinion. Really, one opinion is rarely better than another. It’s one of those beautiful parenting truths where often, we’re all a little “right.”

Watch this segment from KCTS with insights from me and from sleep expert, Elizabeth Pantley.

AAP Speaks: You Swim? Swim Lessons For Toddlers

We were on the waitlist for swim lessons for over a year. Once off the list, F went in for the first lesson (pictured here) jumped in, did a great job, and then refused to ever go back in again. We went every week, twice a week, sat on the pool deck, and watched his peers swim. We waited. We watched. He often tantrumed. Parents stared. Friends commiserated. My mom tried to tell me what to do.

But then for the last class, last week, auspiciously F jumped back in again and gave it a go. Nothing is ever quite what I expect to be. When it comes to swimming lessons, at least in my world, everyone has an opinion and maybe a plan.

Yesterday, the AAP published a revised policy statement about the prevention of drowning. Most noteworthy, they have lifted the recommendation against swim lessons before the age of 4 for most children. With a cautious brush stroke, the AAP has painted the picture that swimming lessons are okay after age 1, depending on physical, emotional and developmental maturity. For most children, it is okay to start lessons after age 1. Really, it’s up to you if you feel your toddler is ready to take the plunge. Read full post »

More Distaste For Chocolate “Formula”

More information on the chocolate and vanilla product from Enfamil being marketed as “formula” for Toddlers:
King 5 Children’s Healthlink:

This video is no longer available from King 5.

Community: On The Phone Or While On Twitter

Community can mean different things to each of us. Yesterday, a 3 year old came to see me in clinic. She must have been a little nervous about the visit. When I got into the exam room, I found her accompanied by her dad, 3 baby dolls in a stroller, and 2 on her back. You see, I think she felt quite a bit safer surrounded by her community. I was charmed. But then reminded. Community is a combination of the people, words, geography, support, and sometimes even sounds that surround us.

A study published last week demonstrated the calming effect of a mother’s voice. In the study, while completing a stressful task, 7 to 12 year old girls’ levels of cortisol (a stress hormone) rose in expected ways. You get stressed, your cortisol surges. But when comforted by their mother’s hug or their mother’s voice on the phone after the task was completed, levels of oxytocin (a hormone associated with bonding) soared while the stress hormone cortisol washed away. Girls who didn’t get to talk with their moms didn’t have this hormonal shift. Just the sound of a mother’s voice was enough to shift the stress response in these girls.

This data help confirm what we already know; hearing Mom’s (or Dad’s, I suspect) voice can simply make things feel better. Read full post »