Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Mandatory Flu Shots: “Ethically Justified, Necessary, & Long Overdue”

This year, The AAP issued a statement urging pediatric hospitals and clinics to require mandatory immunization against influenza for all health care workers. They stated it’s “ethically justified, necessary, and long overdue.” The Advisory Committee on Immunization Practices (ACIP) began recommending influenza immunization (flu shots/mist) for health care workers back in the early 1980s. Even after 3 decades of the recommendation, overall immunization rates for health workers remain around only 40%. Evidence suggests a clinic or hospital unit needs an 80% immunization rate to protect themselves and their patients from the flu. In the US, we’re nowhere near it. Last year for example, the CDC estimated that for health care workers, only 61% got seasonal influenza shots, 37% got the HINI shot, and only 34.7% of workers received both.
Totally unimpressive for a group of people committed to protecting patients, curing illness, and preventing disease.

I believe the mandate is long overdue. No one likes to be told what to do, but there is reason behind this policy. For example, in the statement, The AAP used patient safety as part of their rationale, citing 2 studies: Read full post »

Similac Powdered Formula Recall: Gross But Not Dangerous

Worth mentioning: There is a large Similac powdered formula recall. It’s not dangerous, but gross. ICK. Ick, Ick, Ick.

The FDA announced today that Abbott (who makes the formula) voluntarily recalled formula due to concerns about bug contamination. Yup, bugs. Beetles and Beetle larvae in the powdered formula. The recall involves powdered formula made by Similac:

  • Certain Similac powder product lines offered in plastic containers.
  • Certain Similac powder product lines offered in sizes such as 8-ounce, 12.4-ounce and 12.9-ounce cans.

The recall states that babies could have a bit of tummy upset (GI distress) or refuse a bit of formula if they ate contaminated samples. I’m not worried at this point about harm or danger for infants drinking this formula. The stomach acid (& pH) and GI tract of a baby can likely handle this without any trouble.  Instead, it’s a disgusting reminder that when we don’t make food ourselves, we remain vulnerable to companies who do, to keep and hold high standards of safety and hygiene.

If more information unfolds that is alarming or worrisome, I will update this post.

I read lots of reports on Twitter and online proclaiming this is a great reminder to breastfeed. I agree, offering breast milk will never involve a recall. But I will say this (and loudly): some of us had or have a difficult time making enough milk for our babies. Sometimes parents offer formula because they need to, not because they choose to. THIS IS NOT ANOTHER REASON TO FEEL GUILTY. Just a reason to check your can of formula if you have Similac lying around and follow recall instructions. Don’t let this shake you.

Online sources of information about the formula recall:

Call your pediatrician with any further questions, although I doubt you’ll need to.


Killing The TV Won’t Cut It

Even if you kill your TV, you’ll still have Hulu, iTunes, your DVDs, and your smart phone. Today we’re never separate from streaming entertainment. So the old slogan of killing the TV just isn’t going to cut it. “Turn off TV, turn on life.” Better…

Around here, we’re not big TV people so this TV Turnoff week (a week to go without “screen time”) isn’t as hard as it could be. F did, however, ask if he could watch a Thomas the Train DVD tonight as we drove home. And I must say, it took decent energy to deny him. It would have been great (for me) to let him plug in before bedtime after a series of haircuts and swim lessons late this afternoon. I was zonked. Instead, we walked around the block (3 times). I was mid-way through this post and felt obligated to comply.

Not surprisingly, of course, remaining unplugged was the right decision. We met a new neighbor and spent an additional 45 minutes outside playing and navigating the sidewalks. Everyone was happy about it. But… Read full post »

Wellness: 5 Words That Need To Be Spoken

This past week I was reminded of the power of wellness. From the other side. And it came wrapped up in sound. Five words, to be precise.

I was instantly reminded how powerful a few words can be in the exam room.

We all want to feel wellness. The freeing kind, as in the way you feel when towered over by big objects. You know what I mean, the wide open wellness you feel in the presence of grand nature. Mountains, canyons, 342 degree skies. Those spaces that decipher size and scope and are without haunts. It’s the hands to the sky, wind in your hair, rocks underneath, clock-less type wellness. Liberty from suffering, time to breath, acheless, carefree days, type wellness. We all need and want these days. Particularly after recovering from illness.

Sometimes, this sense of wellness is granted from the absence of things. Sometimes, the presence. Fortunately for me, sometimes this sense arrives within the confines of an exam room.

What doctors say can remain with us. Read full post »

A Spoonful of Bacteria For Baby?

I’m becoming more of a believer in giving children probiotics. Not for everything and not for everyone; I really don’t think we should put them in the water. Probiotics, essentially live “good” bacteria we use to supplement our diet (usually Lactobacillus Acidophilus in the US), are becoming more and more available and recommended by more and more physicians. The role microbes play in our health is a hot topic. Probiotics are thought to improve intestinal health by restoring/elevating levels of  helpful bacteria while concurrently diminishing the population of harmful ones. Bacteria in the intestine are a normal part of our digestive health, but population counts of  bacteria living in our gut may be altered by illness, antibiotic use, ingested/modified foods, or life circumstance. What we eat and where we travel to drink water, change what lives in our gut. Research also finds that which bacteria cohabitate on our bodies may impact other illnesses outside the gut like eczema, allergies, and/or asthma.

In children, probiotic supplements may promote recovery from acute diarrhea by decreasing the number of episodes of diarrhea & the number of days. They also may help prevent the development diarrhea when children are taking antibiotics. The reality is many decisions we make affect our populations of bacteria. This starts on the day of birth. We know for example that babies born by C-section have different populations of bacteria in their poop when compared with those babies born vaginally, within a week after birth. So from the very beginning, the choices we make (or our parents make) may change the environment in our bodies. This ultimately may change our wellness. A set of doctors studied the effect of probiotics on colicky babies… Read full post »

Please And Thank Yous

From the archives (deep in the Word files of my computer).  Take a look at this. Seems like a century ago:

August 7, 2009

It happened today.

Picture this:

F in his airplane jammies at the breakfast table, it’s just after 8:00am, the morning race is well under way. And then, a spontaneous, not requested, perfectly placed “Please” occurs. F proclaims, “More milk in my cup, please, Mommeee.”

I nearly fell over.  How wondrous a non-requested please can be…and from my little boy. Heaven.

Naturally, I said, “Thank you,” right back.

Little Boy = Violent Play?

So parenting news is aflutter with research talking about little boys, their genetic make-up, and their aggressive and violent make believe play. New writing posits that this violent and aggressive play may be needed, that boys will process their aggression via this play. But the jury is still out for some educators and parents. The debate is timely for me after a recent weekend with my two little boys and their 4 year old cousin. I must say, I have the experience in observation part down pat. I’ve seen this behavior, yes.

Boys Need Aggressive Make Believe Play

From how I see it, boys may gravitate to aggressive play but as parents, we never have to condone their violent or aggressive actions. I really believe the lines between imagination, play, and the “real world” are often blurred. There are countless examples of children not understanding the consequences of their actions precisely because they are children. If I let my son pretend to kill/shoot/fight, aren’t I somehow complicit in equating a violent response as an okay one?

What do you think? Do you think aggressive, violent play is an essential part of boyhood?

Don’t Make Promises

Don’t make a promise you can’t keep. Probably something your mother told you. I’m not pointing my finger, but I often tell this to families in anticipation of a pediatrician’s visit, too. Do your best not to promise “no shots” prior to a visit. Although you may think your child is “up to date” on shots, they may not be. Or, the pediatrician may order a blood study (seems like a shot to a child) or injection that you’re not anticipating. And then we’re all in a sticky situation. Trust broken.

Well the same goes for your pediatrician (or for this one), at least. Unfortunately, I’ve been making promises I can’t keep, too.

Recommendations for Prevnar, a vaccine used in infants and toddlers to protect against pneumococcal disesase, have recently changed. The vaccine is given at 2,4,6, and 12 to 15 months of age to protect infants and children from serious infections like bloodstream infections, pneumonia, or meningitis. Prevnar prevents some more minor infections like ear infections, as well. The vaccine previously (Prevnar 7) covered 7 strains of the bacteria that are most likely to cause serious or invasive disease. This year, the vaccine grew up. Now instead of just 7 strains, the vaccine contains 13 strains of the bacteria to improve protection to infants and children. All infants and toddlers getting their routine shots will get Prevnar 13. But if your child is under age 5 and previously completed their Prevnar series, it’s recommended they get one more catch-up dose. Therefore, don’t be surprised when your pediatrician mentions an additional dose for your preschooler at the next visit.

Clearly, no one likes to get shots, but pediatricians often spend a large part of their day writing orders for them. Prevention is one of the best things we do for children; immunizations are a major pillar. I’ve said to many people, “Outside of connecting and listening to family’s concerns, writing orders for shots is the most important thing I do when I go to work.”

No matter what your profession or job, delivering good news is a cherished part of the work day. I loved telling the parents to 18 month olds, “After shots today, no routine immunizations other than yearly flu shots until the pre-kindergarten shots at age 4.” But I was making promises I can’t keep. So I’m changing my ways. Will you?

The Sound Of Music In Seattle

I’m about to pull the curtains off the wall and make some shorts. Or a dress, handkerchief, and a set of lederhosen. If only I had a sewing machine…

F and O have been singing “Do-Re-Mi” all weekend. We’re nailing our knowledge of the octave (kind of). It’s been the theme song to our move even though they’ve never seen the movie. But the greatest little thing evolved over the weekend (via repetition) that I don’t have the heart to correct. It’s just too delicious. A little like O adding “eeee” to the end of his words. (He’s still doing it, thankfully.)

Here’s what it sounds like when F sings Do-Re-Me:

“Do, a deer, a female deer. Hur-ray! a drop of golden sun. Me, a name I call myself. Faaaaw, a long long way to run. Sew, a needle……”

Is this what happens when you grow up in Seattle?

I’m ready to sing and spin around on the top of a hill with my arms out. We know a drop of golden sun will come again; Happy Labor Day.

Moving Day: Double Take

Baby eating a popsicleDoes this photo look familiar? We moved again today. Yup, we moved homes just 10 months ago. Crazy or stupid, you decide.

I’m just home from a late night in clinic. The boys are in their new spaces while the boxes tower amidst the palpable tired. But the night still swells with possibility. I can see the stars from the back yard. And the bare walls blended with the smell of cardboard boxes, makes me feel like I just turned the page in a new hard-covered book. Moving, albeit chaotic and uniquely stressful, can feel like hope. Optimism prevails tonight.

But I’m still thinking of the last time around.

Here’s my moving day post from last year. Read about our terrible misfortune and improper planning. Learn from our mistakes. Especially if you’re about to do a moving-double-take, too.

My story of 9 stitches, 2 parents who feel as deflated, flat and small as the bottom of your worn shoe, a near 3-year-old boy, and 1 orange Popsicle. This is about our mistakes and the dangers of the events that followed moving day in my world, October 31, 2009.

But let’s go back in time; history is supposed to be one of our most sage instructors.

Circa 2003. I took care of a 3-year-old girl in the ER when I was an intern (my first year as a physician, while training in pediatrics) after medical school. In medical training, there are certain patients that stick out, jump off the exam-room-pages, of the hundreds of patients you can see in a month’s time. I know some will stay with me forever. Read full post »