Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Verbatim: “You Mean Because I’m Fat?”

Recently, one of my teenage patients was in to see me. I’ve seen him a lot this year. I think about him nearly every day because I’m desperately trying to help him. I’m just so stinking worried about the choices he’s making. At the end of the visit, I said, “We’ve got a lot of work to do so I’ll see you in 2 weeks.”  He responded, “You mean, because I’m fat?”

No, I didn’t. We hadn’t even talked about his obesity at the visit. We’d talked about all the other stuff clogging up his path to happiness, long life, good health, generous love and earnest support. He’s had a heap of trouble this past year. He’s run away from home about 4 times (once for over 40 days–his poor mom), he’s currently living in a shelter, he was using drugs, he was self-tattooing with an ink pen under her skin (eeeeep!), he stopped taking his daily medicines, he’s obese and gaining weight, he got an STD….it goes on and on. My worry is real and rationale, you see.

But his comment at the end of our visit reminded me about how hard I work to talk to children and their families about overweight in ways that don’t alienate them. And how I obviously need to work harder. A new study points out the importance of letting kids know they are overweight. Read full post »

Atta Girl, Michelle Obama: Let’s Move!

Let's Move Atta girl, Michelle Obama. Thank you for the personal, passionate and most excellent articulation of a big problem facing nearly 1/3 of all children in the US today.

Michelle Obama’s introduction of Let’s Move to end childhood obesity in one generation will do wonders.

Thank you, Michelle. I know we’re not personally friends but you do send me regular e-mails and sign them, “Michelle.” So we’ll go forth on a first name basis. And whenever you’re ready for a play date, I’m game.  Let’s meet at your house; we’ll introduce the husbands.

Let’s end the obesity challenge for our children, now. Speaking of now, now that about 1/3 of the children I see in the office are overweight, I spend hours (read: hours) every day in clinic talking about it. I worry our country’s problem with obesity isn’t going away any time soon. As a pediatrician I can help my patients gain perspective and knowledge but I ultimately need my patients to help themselves move more, eat right and turn off the TV. They need help from their families and communities to do this. Hard to do. Like most things in my life, these kids (and all of us!) need a lot of help from our friends. Read full post »

(Our) Doctor (To)day Keeps Those (Pull-ups) Away

F woke up with a wet bed. First time since the amazing transformation this past month where he decided to wear underwear. It felt like a miracle. New Year’s hopes and dreams come true. Wait until you hear how it happened.
I just couldn’t bring myself to write about toilet training until now. Didn’t want to jinx it. Now with the wet bed this morning, I’m safe. Can’t blame the blog for any future wetting-messiness. You’re off the hook, SeattleMamaDoc.

There is some new data suggesting there is an ideal time for initiation of toilet training. A recent study suggests half way between age 2 and 3 years is the golden age. Ditch the diapers between 27-32 months, the urologists say.

Finally, a data-driven answer to the question of “When should I toilet train little Jane?” Read full post »

Dear Sleep, Come Home.

You’ll be pleased to know in response to the poor quality of sleep in our house, for 4 consecutive nights, due to colds and random screaming I’ve just sent a memo to the boys. It reads:

Beloved Boys,

Sleep starts at 8pm and no later.

We rise around 7am in our home, just after Mommy and Daddy are ready for the day.

Thank you for adjusting your schedules accordingly.

I love you,

Mama

I’m waiting for them to respond. A re-tweet or Facebook status update would suffice.

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 »