‘parenting’

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Engage With Grace

It is the wonder of life that makes this beautiful day so remarkable. A national day, every year, to give thanks and prioritize togetherness. Happy Thanksgiving!

May we be so brave that we can live with integrity, with love, and with compassion as we raise our children. May we find ways to revolutionize things, too.

One team is trying to do just that with end of life challenges.

On this day, when you are together with those you love and trust the very most, can you embark on a journey to share a universal human experience more thoughtfully? Please consider the Engage with Grace discussion today. Share with loved ones around the fire, around the table, or on the walk what it is you value most about your life and what you value most about your death.

Print out the 5 questions ahead of time. Speak openly as best you can and listen intently. Engage with Grace with all those at the table, teens included.

More info here in a guest post from the Engage With Grace team, and more about this project in a previous post I’ve written (great video included).

I am thankful for you all and will do my best to Engage with Grace today, too.

Young Children Are More Generous When Observed

Our 5 year-old keeps forgetting to draw arms on his people at school. The lack of arms has evolved since school started in September and even came up in his parent-teacher conference recently. I found it odd– he always seems to remember that humans have arms when he draws at home. We didn’t mention it to him. And when his brother got an easel for his birthday recently, F painted this picture. Something jumped out at me. I loved it. Not just that hands are present on this figure but the perspective it imparts. Something about this little person looks so generous and so ready to give.

It’s important to help our children understand the need to give back, provide, share, and act generously. ‘Tis the season, too. When I’ve thought of it before, I’d attributed our role (as parents) as role models, that is I thought if we act generously in front of children they will learn how to give more freely.

Recently a beautiful study in PLOS ONE conducted at Yale illuminated the complexity and the maturity of our young children when it comes to giving. It made me realize we may have to be more deliberate and outspoken about how and why we give. Social conditions matter when it comes to generosity and this isn’t just true of adults. Read full post »

Switch Witch

The Switch-Witch is coming to our house tonight. A friend mentioned the concept of Switch Witch to my husband and I was immediately thrilled. A shared solution to the Halloween hangovers. Some genius parent came up with the idea of having a witch arrive at your home during the night to swap out any remaining halloween candy with a small prize. The plan is that we’ll leave the candy by the door tonight and she’s due anytime after bedtime. When I presented the idea to the boys they were thrilled, engaged, and don’t seem to even notice that they’re saying good-bye to a pound of chocolate.

Even though we’ve rationed the halloween candy to a piece a day since November 1st, I’m looking forward to returning to candy-free days. One and a half weeks of a sugar focus is long enough.

Better than the exodus of the candy is the reminder of how beautifully children believe in magic. O asked me this morning,

“Will the Switch Witch ring the door bell when she comes?”

McClinic? Drive-Thru Health Care

I can’t stop thinking about a drive-thru. Not the one for burgers and shakes but the one for ear checks, sports forms, quick med refill visits or a lingering rash. For those things you just want to know fast or need done now, but don’t want to spend 2 hours resolving. For those things that really make you worry as a parent. Instead of the millisecond-mall-type clinic, we all want our doctors, our clinics, and our child’s team to provide health care. In my opinion, parents and pediatricians both believe in the medical home.

McClinic?

Imagine if you knew your doctor did the drive-thru on Tuesday afternoons. Would you swing by to ask about that rash you’re worried about or to check in on your child’s ears? Follow up on a new seizure medication? What if it didn’t even require a call ahead of time? What if tight time restraints were agreed upon (say 7 minute visits or so) in advance so the patient/physician agenda was aligned? Swing by on your way to daycare?

We want quality, trust, and mobility when it comes to health care. We want easy access, too. Of course we must fight for improved electronic visits and online advice. We want comprehensive, compassionate preventative care. We will need in-office visits, yes. And sometimes we need hands-on more urgent care, too. Now the “kwik-clinic” idea isn’t new, I know. Even hospitals are opening urgent-care clinics throughout the country. But your pediatrician often isn’t involved.  So what about that drive-thru: Read full post »

Vote With Your Children

Four years ago I took an early discharge from the hospital to go home and vote on election day. My son O had just been born. We were both stable (me after a c-section and he after a brief stay in the NICU).  Things were going well enough that although the medical team suggested I consider staying another night at the hospital, I was determined to get out of there and cast my vote. Fortunately the medical team agreed. I remember thinking it was the beginning of ensuring that O knew how marvelous and luxurious it is to be heard. Voting is quite possibly the loudest thing we do.

There is nothing else to say today but that I urge you to vote. As my kindergartner left for school–his voter registration in hand for the mock election– I felt hopeful. Hopeful that we’ll increase election engagement, that we’ll advance the gift of democracy by increasing the vote, and that our children’s generation will be active, vocal stewards for the truth. Today I’m excited that we can raise children who spend energy working to improve equality of all people, improve access to health care for all people, and bring equal rights for all families.

We’re remarkably privileged to live in a time where all adults can vote. As parents we often vote on behalf of our children–how can we think of the future without them?

Facebook and Twitter are aflutter today with parents posting their election experiences with their children. Just as our children learn to speak by listening and by echoing what we say, our children can learn to vote by joining us.

Imprint the power of your vote…grab onto the hand of your child or steady yourself with the handle on the stroller or the car seat.

I say do anything and everything you can today to cast your vote. And make sure you bring those little ones along.

Helmets Or Health Or Happiness?

A recent piece in the New York Times highlighted the reality that some cities are ditching required bike helmets to encourage bike riding, even here in the US.  Too much of an inconvenience, I guess. Too much of a hassle and impediment. Public planners all over the world don’t want helmets to get in the way of, ummm, health.

And it got me thinking, in places like Europe where cycling is far more mainstream, and where helmet-wearing isn’t, are they just that much more laid back? Are they healthier and/or possibly happier, too?

Does zooming out and thinking of the crowd (better active population, lower BMI, less diabetes, less rules) while avoiding the thought of the catastrophic realities of few individuals (those who suffer harm from traumatic brain injury) make us healthier and happier as a community?

The question of course can only be answered if we agree on a definition of health and if we agree on one for happiness, too. And if we’re not the one whose child is injured.

But just this week three things happened that made me wonder if there are competing goals when I spend time chatting about bike & sports helmets and on using carseats properly, too. The issues are somewhat similar. A study last year found that the majority of parents don’t take pediatricians’ advice with car seats and another found parents are far more lax with booster seats when they carpool, too. And it was these 3 things that got me thinking on this again: Read full post »

Screening For Risks Of Sudden Cardiac Death

More than anything else, we want our children protected from harm. Particularly when we hear about sudden cardiac collapse and death in young athletes. The far majority of children who suffer from sudden cardiac events and sudden cardiac death have no symptoms prior so comprehensive cardiac screening can improve protection for all children.

5 Things To Do Before The Sports Physical:

  1. Print out the pre-participation sports physical form and medical history form. Bring it to the appointment for your child’s doctor or ARNP to fill out. This form can help direct a more comprehensive sports physical and will require documentation of necessary medical history and physical exam findings as recommended by the American Heart Association.
  2. Find out about your own family’s medical history. Inquire is there is any heart disease, any history of seizures, or unexplained or sudden death. Complete that medical history form.
  3. Check in with your child/teen to find out if they ever have any symptoms during exercise that may require more attention–things like fainting or near-fainting, chest pain with exercise, easy fatigue with exercise.
  4. Find out if your school has an AED. If they don’t, work on having the sports director get one for play fields and gymnasiums.
  5. Refresh your CPR skills. Review how to do hands-only CPR (this links to a 1 minute video)

Your child’s physician or nurse practitioner can screen them however there are also free screening events for sudden cardiac death in our area include (please include others you know of in the comments and I will add to the list):

Nick Of Time Foundation (Auburn, WA on 9/29 & Renton, WA 10/3 and ongoing)

Play Smart Youth Heart Screenings (ongoing)

Antibiotic Use May Increase Risk For IBD

We’re surrounded by bacteria– literally. They live on the surface our skin and set up camp in our intestines immediately after birth. The complexity of the colonies that live there diversifies throughout our lives–many sticking around for the duration. And we’re dependent on the ka-billions of bacteria that co-exist with us to maintain our health. Without them, things can go off-kilter as bacteria really are a part of our wellness–supporting digestion and maintaining harmony on our skin. Of course, some bacteria come in that we’d really rather not have. That’s when we use antibiotics.

As cough and cold season returns, a study published today serves up a needed reminder. Antibiotics can cause significant changes to our body. Because many infections are caused by viruses (not bacteria) antibiotics are often unnecessary. When we take antibiotics by mouth (or IV/injection) they may kill the bacteria causing a troubling or painful infection yes, but they can also kill the desired “good bacteria,” too. This is a side effect all antibiotics carry. Often we witness this in our children by changes in their poop—after a course of antibiotics they get really runny poop or diarrhea or it will smell entirely different. You really are witnessing the change of colonies in their intestines when you see this.

Sometimes antibiotics are absolutely necessary and life-saving. But recent research has found that antibiotics are prescribed in 1 out of 5 pediatric acute-care visits. And of the 49 million prescriptions for antibiotics given annually, some researchers estimate that 10 million of those are unnecessary. Avoiding those unnecessary courses is up to all of us–parents and clinicians.

I really do think the tide is changing in this regard. It’s rare that a family requests or urges for antibiotics in clinic.

New research is looking at how altering bacteria in our bodies may change our life-long health. It’s not just the alteration in our poop immediately after antibiotics that changes. A new study shows antibiotic use may set us up for chronic disease. And this may be especially true when antibiotics are used in infants and young children.

Research Finds Antibiotics May Be Associated With IBD Diagnosis

  • Dr Matthew Kronman and colleagues studied over 1 million patient records in the UK. They evaluated the infant and childhood exposures to certain antibiotics and the later development of Inflammatory Bowel Disease (IBD). The causes of IBD are incompletely understood; Dr Kronman wanted to understand if bacterial changes in the intestines at young ages affected inflammation that could potentially increase the likelihood of being diagnosed with IBD (Crohn’s disease or Ulcerative Colitis). They studied medical charts of a huge group of patients to determine if children prescribed common oral antibiotics in outpatient clinics (penicillin, amoxicillin, Augmentin, clindamycin, metronidazole, for example) had increased rates of IBD later in life. Read full post »

New Data On Infant Sleep You’ll Want To Know

We had one of each in our house: one baby that we let cry for periods of time to self-soothe and one where I simply couldn’t bear to hear the crying in quite the same way. You’d think it would have been just the same for both of our boys, but it wasn’t. Clearly I wasn’t the same parent each time around.

There are many things that go into the equation of how we get our babies to sleep thought the night. And those of us who struggled after our babies after 6 months of age are in good company. Research shows that about 45% of mothers say they struggle with their 6-12 month-old’s sleep.

Solving the sleep solution requires a diverse mix of instinct, patience with personal and baby temperament, timing, mood, advice we get, and good luck.

The reality is that there isn’t one perfect way to help support an infant who’s learning to sleep through the night. But there are few pearls I believe in: Read full post »

Eye Candy: PODS And Capsules

Laundry and dishwashing capsules & “PODS” are all the rage. Frankly, I love them. They’re less messy, take up far less space in the cabinet, and enticing to use. Throw them in the washer without a single errant drop. They’re pretty to look at, too.

That’s the trouble though.

These PODS and capsules look more like Halloween candy than laundry detergent. But this soap [eye candy] poses a unique and dangerous risk. The film that forms the capsule is designed to dissolve quickly. Toddlers are at risk, as small children explore with their mouths not only their hands. Toddlers and preschoolers may be both drawn to the visual appeal of these concentrated capsules and to their balloon-like texture and squishy feel. I wrote (did a video) about this earlier, when WA State issued a warning to all ER doctors.

Concerns for ingestions are continuing here (nearly 3000 injuries were reported in US children between January and August, 2012) and around the world. Highly concentrated laundry detergent can erode tissues, cause swelling, and cause burns to the mouth, throat, airway, and eyes of children who touch, break open or ingest them. The majority of injuries from PODS and capsules have been due to ingestion, but there are reports of many eye injuries as well.

Curiosity rules a toddler’s exploration. Judgment lags way behind.

New information released last week in the UK helps categorize the concerns. The National Poison Information Center shared a brief where they detailed that capsules and PODS were the most commonly reported ingestions in young children over a 14-month period. A group of physicians at The Royal Hospital For Sick Children in Glasgow also authored an academic letter detailing their concerns, reporting on 5 children who had been admitted and cared for in the hospital after ingesting (eating) the PODS/capsules. Their letter highlighted:

Ingestion Injury From Detergent PODS & Capsules:

  • 5 children, between 10 and 22 months of age, were admitted to the hospital with serious injuries.
  • Injuries for the 5 children included serious swelling and damage to the throat and airway (arytenoids, glottis, supraglottis, esophagus, gastro-esophageal junction). Children demanding hospitalization varied in the care needed. One was managed with steroids and antibiotics alone, while the other 4 children demanded intensive care. Four of the 5 children needed breathing tubes, 2 of whom were on the ventilator for a week.
  • Fortunately, all children recovered from their ingestions.

Protecting Children From Detergent PODS/Capsules:

  • Young children are ruled by curiosity. Make sure that capsules and PODS are up and out of reach.
  • Don’t display them due to their visual appeal.
  • Don’t allow young children to help use the laundry or dishwashing capsules. Becoming familiar will likely cause them to want to touch, explore, and possibly gnaw on these capsules.
  • Until containers selling these products have a child safety lock/top, inform your friends and caregivers about the risk to young children.
  • With any ingestion, no matter what the size, call poison control immediately 1-800-222-1222.
  • Read more about it (including my interview) at US News & World Report or here at WebMD.
  • Print out this Poison Control fact sheet for your daycare or pediatricians’ office.