Seattle Mama Doc

A blog by Dr. Wendy Sue Swanson.

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

Status Update: Facebook Changes For Teens

Facebook imageFacebook changed its privacy policy for teens this week, despite work from advocacy groups and media experts against the change. On Wednesday October 16th teen privacy settings were adjusted to allow teens to share status updates and photos publicly. The change literally allows the public a window into a teen’s thoughts and photos on Facebook for the first time.

Fortunately, teens can control this by opting out of public sharing. The default setting at this point for teens when joining Facebook will not automatically allow for public sharing. Teens can opt-in after clicking through a pop-up notice. This step could of course change.

Visit the privacy setting page on Facebook with your teen.

In my opinion this is not in the best interest of our children. As we evolve and adapt to using social tools, we’re all still getting our footing. So are our teens as they begin to create a digital footprint of thoughts and photos online. Further, concerns about this shift include public access to teen sharing that will likely be data-mined and scoured by advertisers and companies hoping to target teens with goods and services.

Read this blog post from pediatrician and social media expert, Dr Megan Moreno, on the new changes for teens. Information and links on how to talk to teens about changes along with resources for learning more are included. A recent Q&A she completed online about parents and teens is linked. She says it best when she says:

This situation presents an enormous opportunity for parents to have conversations with their teens about privacy settings online.  For parents who have already had these conversations in the past, it’s time to sit down and discuss Facebook’s decision, review your family’s rules about online safety, and review your teen’s current privacy settings on Facebook – both their overall  “privacy settings” and the “audience” for their posts.

Read full post »

Nothing Better

sleepNothing better than watching our children sleep peacefully. Independent of our circumstance there is nothing more settling, or prettier, than a child at peace. A day of happiness and good health or one where a child has battled pain or a fever, one filled with challenges at school or one where we’ve simply had a bad day at work. Doesn’t really matter what’s stirring or what’s not, there is something precious we all discover once we become parents–we can stare at our children endlessly while they rest. It can provide a sense of ease unmatched elsewhere in our lives.

Slipping back into the room to catch a glimpse of our children enjoying a peaceful rest is truly one of life’s greatest gifts.

Years ago an experienced father said to me, “Don’t let a single night go by where the last thing you do before heading off to bed isn’t kissing your kids goodnight one more time.” I took the advice. The ritual has perhaps compounded the obvious truth ~ nothing better than witnessing the beauty of our children at peace. Sleep is such a treasure.

Consistency May Be The “Secret Sauce”

Consistency may be the “secret sauce” in parenthood. Anything from helping children survive temper tantrums to helping your children eat more diverse foods, providing consistency with expectations and daily routines may be the very special thing we do that allows our children to thrive. Like most challenges in life, talking about and identifying the need for consistency is easy, implementing it throughout our daily lives is much more of a challenge. Finding and securing a consistent bedtime is one place where this “secret sauce” may really work. New data on sleep patterns for young children drives this point home. Getting your children to bed at the same time each night is powerful.

A study out today in Pediatrics evaluated data from over 10,000 children in the UK. As a part of a larger study (UK Millennium Cohort Study) researchers collected bedtime data at age 3, 5, and 7 years for children. They found children with nonregular bedtimes had more behavioral difficulties. Further, as children progressed through childhood there was incremental worsening in children’s behavior scores as they were exposed to more and more inconsistent bedtimes. Read full post »

The Lion Dad And Over-Enrolled Kids

photo[1]Someone mentioned recently that I was potentially a Tiger Mom. That’s when I realized we have a Lion Dad situation around here.

So many of us now “co-parent” our children. We share the responsibilities of raising children with our spouse or partner. Although co-parenting usually describes parents separated or divorced who take turns raising children, I think “co-parenting” describes many of us living together while raising children, too. In our home everything from feeding to toilet training, preschool pick-ups to soccer sign-up, and bathing to bedtime routines are divided and diced. The dance is typically elaborate and often it can be very messy. Sometimes it makes no sense how we split the tasks and of course sometimes we mess up– both forgetting something that needs to be done. I often feel like we’re always the last ones signing up for parent conference or preschool home visits–we just aren’t entirely always on top of our game! I know you know what I mean—so many of us divvy up the tasks necessary in raising children these days I’d suggest this co-parenting is just a part of modern parenting. A tango of sorts.

So it’s awkward at times that women, particularly those of us who work outside the home, are the key go-to or point person for outside institutions, families, and sports teams when someone tries to reach in and coordinate with us. I often feel the world is behind the times. Read full post »

Undervaccination

There isn’t a lot of research on children’s safety when a child is on an alternative vaccine schedule. While we clearly know that the longer you wait to immunize a child for vaccine-preventable illnesses, the longer the window of time a child is left susceptible, there isn’t a huge data set on children who are late to get shots or who are considered “undervaccinated.” Although it’s intuitive to think that a child who is not getting immunizations on time is at higher risk for infections (particularly during times of epidemics), it’s helpful when the science backs up our instinct and thinking.

This is likely something you already knew but there’s new research to compound our understanding.

Children Late On Shots Are At Risk For Whooping Cough

Recent pediatric research found that when it comes to whooping cough, children who were late on getting their shots are more prone to infection. In fact the more doses of the DTaP shot that a child misses, the more likely it is that they could be diagnosed with whooping cough.

A JAMA Pediatrics study published online in September 2013 evaluated children between 3 months to 36 months of age. During the first three years of life children are recommended to have 4 doses of the DTaP (Diphtheria, Tetanus, and Pertussis) shot starting at 2 months of age. In the JAMA matched case-control study children who were late on 3 doses of DTaP were 18 times as likely be diagnosed with whooping cough compared to children who were up to date on their shots. Children unvaccinated (missing 4 doses of DTaP) were 28 times more likely to be diagnosed with whooping cough when compared with fully vaccinated children.

The takeaway reminder? When you start a series of immunizations for your children, make sure you complete all shots in the series. Most experts believe children aren’t fully protected from whooping cough until they’ve received 4 doses of DTaP (at 15 months of age if on-schedule).

We have to finish what we start — another reason to get in on-time for well-care visits during the first few years of a your child’s life. And as a final note, the value of well-child care extends well past immunization.

Easy Ways To Prepare Your Family For An Emergency

In the past I’ve hated preparing for emergencies. It made me nervous and like most people I procrastinated because I hated playing out a potential tragedy in my head. However it’s easy to say:

I am really happy I made an emergency kit about 3 years ago. I really don’t regret the time or money I spent getting it done. I do think I’m less anxious now.

September is Emergency Preparedness Month so hopefully in the nick of time we can all make preparing our family a priority. Before you read on know that pacing yourself and setting a goal for completing a full preparation can be set months out. Make a goal perhaps that by the end of 2013 you’ll have a communication plan, a 3-day emergency kit prepared, and have met with or talked with a neighbor or two about how you can work together in the event of an earthquake, tornado, other weather-related emergencies, fire, or safety threat that cuts you off from others’ help. Experts recommend you have enough supplies, first aid kits, medications, water, and some battery backup to last you for at least 3 days. If you’ve already purchased and/or assembled a kit, don’t forget to refresh it. I realized just this week that the water in our emergency kits had somehow leaked and/or partially evaporated. Time to replace it. Water does expire so instructions for “making” safe water from the Centers for Disease Control help. Read full post »

Texting And Driving Again


The research published about texting and driving never seem to add up to my in-real-life experience. In a typical day driving in Seattle I see countless people with their phones out, many with it wedged at the steering wheel, stuck between their right hand and the right turn signal post. Like all of us have come to observe, it’s the unusual or unexpected driving patterns that alert me to look into their car window and confirm my suspicion.

I hate feeling like an old lady, angry at those few reckless decision-makers who compromise my family’s safety on the road. I also hate feeling powerless amidst the problem. After a few feeble and failed attempts to influence others’ decisions on the road (waving my hands, pointing my finger or honking my horn and screaming in my fury), it’s clear to me that we citizens can’t police the issue. Further, trying to change others’ behavior from our own driver seat is an entirely imperfect solution – yet another distraction. I can’t help but ranting that I remain angry about this significant human frailty–the inability to follow the law and put down the devices and drive. Read full post »

A Cab Ride In Canada

It was sunny when I landed in Toronto on Tuesday evening so I felt a bit lifted as I sat down into one of the most pleasant cab rides I can remember. The driver was 69 he said, and his claim to good health was avoiding alcohol, shunning cigarettes, and waking up each and every morning to exercise. “Just 30 minutes a day,” he said, “Changed everything in my life.” I held my tongue as he kept talking. The coincidence with the first meeting I’d have while in Toronto was startling. As Dr. Mike Evans and I talked over coffee the following morning, the serendipity of the unified voice in Canada was an unexpected delight. A patient and doctor sharing the same similar thought—one from experience, one from expertise: 30 minutes a day could change your life. If you haven’t seen the video, please watch 23 ½ hours now.

The cab driver was one of 10 children to his mother and father born in the Philippines (5 boys, 5 girls – how’s that for biology playing out) who has lived in Canada for 11 years. All of his siblings were living now in Canada or the US and he’d asked why I’d arrived in Toronto. I’d arrived to, “Share some ideas on using social tools to transform health care,” I said. Maybe it was our deeply political and nearly anthropologic conversation that charmed me. Maybe it was the story I re-read just prior to taking off in Seattle detailing the generous cab drive a man offered a dying woman. Yet Tuesday night in the cab I realized instantly, like I usually do, that although I was there to share my thoughts with a number of people, I would learn potentially much more from Canadians than I would impart. It really is so good to get out of Dodge and see how other people do things. Read full post »

An Annual Interview: 20 Questions

new leafYesterday our 6 year-old asked if I’d snap a photo of this leaf. He suggested that it may in fact be the first orange leaf of fall. His need for the photo alerted me that autumn truly is upon us.

Last year I started a few traditions when my oldest started Kindergarten. One was asking the 20 questions below. Although last year we asked these just prior to school start, we finally got around to asking them yesterday. The four of us had a hoot reviewing the responses. Our 4 year-old got a chance this year, too. I may update the questions next year but I’m thrilled to be stacking these responses in the boys’ memory boxes. I’ve included both 2012 and 2013 responses because it’s the evolution that is so valuable. Traditions are like that, better with each repetition. I also included some responses from our 4 year-old that are just too good to leave out…

  • 20 Questions At School Start

  • What is your favorite color? “Yellow”—>2013 “Orange”
  • Favorite number? “5″ —> Not surprisingly this year he said, “6″ and our 4 year-old chimed in with this, “9,000… no wait, 199.”
  • Favorite food?: “Strawberries”—-> “Bananas” and to keep us honest our O said, “Cotton Candy.”
  • Favorite toy?: In 2012 he said, “This is going to be a tiny bit hard……airplanes.” —> This year just, “Airplanes” (no hesitancy).
  • What are you most happy about this summer? “I got to spend more time with Mommy and Daddy” (be still my heart). Nothing quite so romantic this year. All our 6 year-old said was “Swimming in Lake Washington.” But our 4 year-old produced this doozy: “Going to the radiology summer party with the bouncy house.”
  • Favorite memory from the summer? In 2012, “Going through the Costco carwash.” (you can’t make this stuff up). This year nothing just so comic, rather he said, “Going down the water slide in Berlin, Wisconsin.” Read full post »

It’s Time For Flu Shots

Please don’t tune me out on this one. Don’t let this post resemble Gary Larson’s The Far Side cartoon where you only hear, “Blah, blah, blah, Flu shot, blah, blah, blah, Flu shot, blah, blah, blah”

I write about flu every year because it’s one infectious disease that is not only more aggressive and dangerous for babies and young children, it’s vaccine preventable. The flu causes high fever, terrible cough, body aches, and significant discomfort. It can also potentially cause more serious infections like pneumonia. Unlike viruses that cause the common cold (rhinovirus or RSV), we have a vaccine for influenza.

I’ve had multiple patients in only 7 years of pediatric practice refuse the flu shot and subsequently get influenza. A few of my patients have required hospitalization for influenza and several have had serious infections requiring multiple visits to clinic, ER trips, and respiratory distress. Whenever this happens in an unvaccinated patient, I feel I’ve failed.

The great news with flu is that we can improve protection for our children and teens easily. The majority of the 150+ children who died last year from flu in this country were not vaccinated. And although it’s true that the vaccine doesn’t protect 100% of those who get it, it does protect most from life-threatening illness. Getting a flu shot is the #1 best way to prevent a life-threatening infection from the flu.

It’s flu shot season. You thinking, “blah, blah, blah…?”

The American Academy of Pediatrics has a new policy statement out this month. Their big message is to get all children up to date on their flu shots as early as possible. Read full post »