Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Reducing Poverty And Improving Health

Yesterday marked the 50th anniversary of Lyndon B Johnson’s 1964 State of the Union address where he made a proclamation to commit to end poverty in our rich nation. Nationally, there has been a huge and beautiful focus on the anniversary. Despite the political divisions and tense partisan discussions on how to proceed in poverty reduction, I heard many reports on the radio, read newspaper coverage, and saw chatter all day on social channels about where we stand. I was floored by the statistics. I’d not, unfortunately, ever before spent time thinking about Johnson’s proclamation and the line in the sand created by his words.

After his proclamation, the country went to work creating Medicare, Medicaid, Head Start (promoting school readiness through social, nutritional, developmental support for children from birth to age 5), food stamp programs, and Job Corps. Since 1965, Head Start alone has served more than 30 million children and set precedent for contemporary thinking on early education and consortiums today like Thrive by Five. Much of the media coverage yesterday focused on the profound progress we’ve made helping Americans quit or reduce cigarette smoking with the Surgeon General’s first Report on Smoking and Health. Still, nearly 1 in 5 Americans (18%) smoke in a country that has proven cigarettes to be the #1 leading cause of preventable death. Dr Thomas Frieden wrote in JAMA yesterday, “Tobacco is, quite simply, in a league of its own in terms of the sheer numbers and varieties of ways it kills and maims people.” Read full post »

2013-2014 Flu Is Here

Influenza December 2013

Influenza currently has widespread activity here in Washington and fortunately the news media has really picked up the story the last couple of days. I say fortunately, because as we know more about flu in our community, the better we can work to protect our families. There’s no question clinic was full of coughs and colds yesterday!

At of the end of last week, the CDC reported that 25 states in the US have widespread influenza (see above map). In addition, public health officials confirm that H1N1 Influenza A is causing more serious, sometimes deadly disease in young adults. This post is simply a reminder that flu is here in our communities, work, and schools. The best way to reduce the risk of serious influenza infection is still to get a flu shot. Particularly if you’re a middle-aged adult (!!), as young adults are bearing a particular burden of serious disease this season. In fact,there have already been a number of deaths in WA state. Many of the individuals who died were unvaccinated.

This is still true: pregnant women, young children, those over 65 years, and anyone with underlying medical conditions are at higher risk for serious infection from influenza. Read full post »

My Adorable Activity Tracker. I’m Streaking!

First Day With My Shine

Self-tracking, life-logging, activity-tracking, “the quantified-self (QS) movement” as the smarty-pants say, or as some have asked, “What’s with the weird watch?” Well, I’m hooked. I don’t go anywhere these days without my device. My activity tracker had me at hello.

Over the summer I started wearing the Shine. I’d been waiting for it–it had a significantly delayed shipping date–which only heightened my desire. I’ve worn it every day (except one) since. The world really is different to me now. Before you start to criticize and marginalize my proclamations, know that I waited nearly 1/2 a year to write about this to ensure it wasn’t just a fad.

How My Activity Tracker Is Changing Me:

First things first: I realized how sedentary some of my days are. Especially when I’m writing or working intensely; knowing this has changed how I think about walking. Secondly, I’m really much happier knowing how much movement I have during a day rather than guessing about it. Even when I’ve hardly moved a few paces, I’m thankful for the insight. I mean, some days we pig out, some days we aren’t as hungry and eat salad, some days we run miles. Other days we work and write and sit far too long. My activity tracker helps me understand the patterns and think about new ways to live differently. The boys always want to know how much we’ve moved. This tracker has power around here. If there’s any New Year’s “resolution” that may be worth committing to–it may simply be to check in on how you’re moving. Find a tool to give you observable data. Behavior change perhaps will follow.

To be clear, it isn’t the device I’m attached to that is changing my life, it’s the new experiences I’ve having because of it. New insight from my Shine changes my mood, the way I map out my day, and has undoubtably made me more self-aware. I’m thankful for my consultant.

Reality is, many of us are tracking our lives and our movement without realizing it. Before you write we trackers off, read on.

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Greatest Hits & Greatest Inspirations 2013

Maui rainbow, December 28th

Maui rainbow, December 28th

I’m so thankful and humbled by all of the comments and dialogue here on Seattle Mama Doc. Since the inception of the blog in 2009, we’ve had more than 1 million different readers. For that I remain somewhat amazed and also astonishingly grateful. I really love detailing what I learn about caring for children and hold dear the opportunity to share what science holds. Writing about health care while wedding evidence with anecdotes remains a huge focus for me. I am so thankful to be a mother and doctor, practicing and writing, today. I am so grateful for all of your help.

I started 2013 blogging about my experience of being diagnosed with malignant melanoma, the process of renewal, and my hopes for 2013. I set out goals for the year:

 

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Peanut Brittle For Preggers

Photo from Edwart Visser Flickr Creative Commons

Photo from Edwart Visser, Flickr Creative Commons

“Children appear to be less at risk for developing peanut or tree nut allergies if their mothers are not allergic and ate more nuts during pregnancy,” according to a study published today in JAMA Pediatrics. And although this doesn’t mean that you need to run out for the peanut brittle the minute you’re pregnant, it may mean we can reassure pregnant women that if they have no allergies themselves, what they eat during pregnancy should contain nuts, among other things.

As you’ve likely heard, children with peanut allergies have more than tripled in the United States this last 15 years. Food allergies affect 1 in 13 children in the United States and up to 40% of children have had a life-threatening or severe reaction. Any family with a food-allergic child will tell you this is a BIG deal.

The rapid rise of food allergies is incompletely understood, but more and more research suggests that waiting to introduce “high allergy” foods (traditionally thought of as peanut, egg, or shellfish for example) may have actually caused more allergies than prevented them. As this was being discovered this last decade or so, flip-flopping recommendations on what to eat ourselves when pregnant and what to feed our babies have left many of us confused.

When Should I Start Baby Food?

New recommendations really encourage introduction of a variety of foods, including nuts, eggs, shellfish, wheat, and soy within the first year of life. The theory is that early introduction of the components of these foods allow a child’s developing body to create a tolerance to them, thus potentially avoiding any allergy or reaction to them later on. Read full post »

Alcohol At The Holidays?

Screen Shot 2013-12-22 at 10.12.17 AMOur children are growing up with mixed messages about alcohol and drugs, at least that’s how it feels to me here in Washington. It seems to me we’re grappling with using pot and what to do with alcohol as a community. As our state legalized marijuana use this past year, we sent a big flare into the sky. It’s possible we really do one thing and then say another in front of our children and teens, particularly at times of celebration. No question they are watching. Can you seriously imagine a pro football game without beer ads or a holiday party without booze? I can’t. The great luck is that we have profound influence over our children (tah dah!); we have a huge opportunity to help them survive.

One of the biggest mistakes parents to teens make is to believe that they no longer have influence on their kids — Lara Okoloko, LICSW

I read a tweet about a month ago suggesting that perhaps we should never drink alcohol in front of our children. At first glance it seemed somewhat absurd — that we’d ban a legal adult substance from our lives as parents to young (or teen) children that we can enjoy and drink (even in moderation) all because of the risk that our children may abuse it if they saw us drink while children. However when I read the statistics on teens and alcohol it got me thinking that perhaps I needed to be more thoughtful, not only how I talk about this but how I live with my children these next 15 years. At first glance, avoiding alcohol just seems like an inconvenient annoyance. Yet I started to read the data I recognized the incredible opportunity we all have to speak clearly and repeatedly about alcohol and risk with our children, early on.

Parents are the #1 influence on whether teens choose to drink (or smoke weed). Experts really stress we need to share data and opinions with our teens before they start drinking. The hope is that when we explain how we feel, when we share facts, when we clearly articulate that alcohol could kill a teen or their friends, that we can help our children understand their actions can greatly affect their happiness and their survival. I really don’t think I’m over-framing this in terms of survival. Teens are 3 times as likely to be in a fatal crash than older, more experienced drivers and the 3 main causes of fatal crashes among teens are drunk driving, speeding, and distracted driving (think cell phone). Alcohol-related car accidents are the leading cause of death for teens and young adults.

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Attempt To Maintain Mindful Gifting

cutting down the treeIt’s a commercial time of year, of course. It’s a challenge to help our children enjoy the holidays mindfully amidst all the products, gift-giving, and hopes for things. The rip-open-all-gifts urgency is seemingly innate to most young children. Amazing how our kids can stay on task when it involves opening awesome toys and gifts!

It’s really hard to celebrate the real bounty in life, that of friendship and generosity, in a world that really does focus so much attention marketing what we “need.” Holidays can get swept sideways if we don’t do a good job describing what they mean, why we celebrate, why we go way out of our way to stay home from work to ritualize things, cook huge dinners, and fly all over the country to be with those we love. I’m clearly not doing a perfect job. Exhibit A: Read full post »

Left To Chance With The iPotty

I got in a heated discussion with a researcher last week. We were chatting about strategies to improve challenges with overweight and obesity.  He mentioned it was media controls (automatic locks on devices) that would change children’s habits regrading screen time in the home — he just didn’t want to leave it up to parents anymore. As I understood his perspective, left to chance it’s unlikely parents will avoid screens when it comes at the cost of convenience. I mentioned to him that my young children watched very little television, that in fact, “They’d never turned the television on themselves.” He looked at me sideways, he called my bluff. I told him again they literally had zero access to TV or other screens on their own.

He didn’t believe me.

Why No TV Before Bed Is Better

I’ve carried this conversation with the researcher with me since. Not only because of how it rubbed me the wrong way  but how his presumptions are based in new realities. It was easier, even just 7 years ago, to rear our children screen-free. I mean, the iPhone didn’t exist when my 7 year-old was born. It’s far more difficult to moderate screen use now that the majority of parents have smart phones in their pockets, laptops in the kitchen, and tablets near the couch. Three quarters of young children now live in homes with mobile devices (like my children). Those of us who avoid or limit screens have created huge work-arounds in our world.

Earlier this year Common Sense Media published their Zero To Eight report detailing young children’s media use. The report is worth a glance as the stats are fairly mind-blowing. A snaphot shows us:

  • 3/4 of young children live in homes with mobile devices, some 38% of infants and toddlers have now used a mobile device.
  • 1/3 of children have a television in their bedroom (16% of infants have one) and the likelihood that one ends up there increases with age. For children between 5 and 8 years of age, nearly 1/2 (45%) have a TV where they sleep. Most noteworthy for me: the main reason parents report that a child has a TV in the bedroom is to, “Free up other TVs so family members can watch their own shows.”
  • Over 1/3 of families say the television is on “most or all of the time” in their home.
  • 63% of children have played a game on a smartphone or mobile device with 17% of parents reporting their children (0-8 years) use a mobile device every single day.

The stats go on and on and it can all feel a little reckless. I’m keenly aware that stats don’t really change behavior and I also really believe that if moderation is king guilt-free is queen. This post isn’t designed to inspire guilt. The American Academy of Pediatrics reminds us that there is no developmental benefit to screen time prior to age 2 . Sometimes learning what TV does to your child’s brain helps. I’m writing this because of 2 recent announcements: Read full post »

Simplifying Health Care

StrikeWe all want simple solutions to living a healthy life.

It feels like I was born at just the right time for my work in health care. I completed my medical training just as social tools were percolating out to the masses. Motherhood and my practice of pediatrics auspiciously coincided with the bounty of information that technology has distributed, offered up, and shared unlike ever before.

I can search and learn about health wherever I am –  at the park or in the walls of my own clinic or home. For me, using my phone, Twitter, my blog, apps, Facebook, activity tracker, and patient online communities to provide health care, consume it, and engage in it is my new reality. It turns out, amidst all the clutter and stress of health care reform and our reduced time with our own doctors I can see clearly that intuitive ways of learning about science wed with thoughtful technology will let us care, cure, and prevent illness and injury like never before.

A survey published today finds that more that 3/4 of moms search online for symptoms. The majority of mothers in the US also look up information regarding their child’s development online, read about a medicine, or track their pregnancy with online tools. I’ve done, or do, all of those things. Don’t you?

I’ve just started a new job in the hospital overseeing a group in Digital Health. Our goal is to rapidly improve the way we serve children and their family’s unique needs in the hospital, clinical setting, and community. I want to help facilitate elegant communication between parents, patients, families, and their clinicians & surgeons when they are outside the hospital or clinic. Reason is: it seems to me that the luxury of our time is the one-to-many communication we have in our pockets. Over 60% of all American adults have a smartphone in their pocket and  crowd-sourcing happens at virtual water coolers (ie Facebook) every day. Over 40% of Americans log onto Facebook everyday to listen, lurk, snoop, learn, and vet ideas. Read full post »

Yes, Vaccines Are Naturopathic!

Dr. Mary Alison HigiThis is a guest blog from Dr. Mary Alison Higi. Dr. Higi is a naturopathic physician in her final year of residency at Cascade Natural Medicine specializing in pediatrics under Dr. Candace Aasan. She studied at Bastyr University where she earned her Doctor of Naturopathic Medicine. She emphasizes the importance of the physician’s role in preventative medicine and public health. Dr. Higi has a special interest in implementing Naturopathic Medicine programs for under-served communities. 

I’m publishing this post because I think there is significant confusion about naturopathic physicians’ support of vaccines. I’m hoping this sheds a little light. Would love to learn more from you all about your experiences with naturopathic medical care and vaccines. Please leave comments!

 

 

I have frequently heard from parents, “You give vaccines? I thought you were a naturopath!” I can only reply, “Vaccination follows three of our most important guiding principles”

1. Premum non Nocere — First do no harm; weigh out risks and benefits and follow the least harmful path.
2. Docere — A physician should be a teacher to her patients.
3. Preventir — Practice preventative medicine.

By providing routine vaccinations to my patients I have the opportunity to help them weigh risks and benefits of vaccine preventable disease versus costly, painful and the often dangerous consequences of preventable infections.

When I counsel and give vaccines I get to teach about disease prevention and public health; I get to help patients prevent some truly life threatening diseases. So yes, vaccines are naturopathic! In that light, following our naturopathic principles, there are a few vaccination myths that I’ve heard so often, I feel compelled to dispel them:

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