‘parenting’

All Articles tagged ‘parenting’

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.

 

Circumcision For Newborn Baby Boys

Last week, the American Academy of Pediatrics (AAP) issued an update to their circumcision policy statement that attracted significant attention. In it, the task force clarified the previous neutral policy for boys’ circumcision. The AAP stated that research has advanced since it’s most recent report in 2005 to conclude the health benefits of circumcision outweigh the procedure risks. Like any medical test or procedure, circumcision carries both benefit and risk. With global data expanding about benefits of circumcision and protection against sexually transmitted diseases, the AAP changed its stance. Risks from circumcision are reported to be very unlikely and happen less than 1% of the time. Most common side effects can be a small chance of bleeding or a need for antibiotic ointment. The most frequently reported adverse event from parents is a concern not enough foreskin was removed. Fortunately, circumcision revisions are very rare.

The statement doesn’t go so far as to recommend that boys undergo circumcision, rather the task force stated that the procedure should be done under sterile technique by a trained, experienced clinician. Importantly, they stated for the first time that it should be covered by Medicaid and insurance. This with the hope that every family ought to have the right to make a choice for or against circumcision, not just those with private insurance.

Clearly, the decision to circumcise a newborn baby boy isn’t made simply in the content of medical data. Families weigh religious traditions, cultural practices, family history, and medical information when choosing to circumcise or not. The AAP statement maintains and honors this belief. Ultimately, the decision is a private one for families to make. A pediatrician, family doctor, or ARNP should help you go over medical benefits/risks as needed. As a parent, you go over the rest. Read full post »

First Day Of School: An Interview?

September is upon us. I’m back to blogging after my August pause. Life has been very busy and peppered with bits of flurry, but more on that later. School is about to start.

As we all return back to the routine of the fall and ready ourselves for winter, it’s a good time to check in on where we stand. This month really can feel like packing our cheeks with acorns. The transition to school brings on all sorts of stress, anxiety, sleep changes, and anticipation. Of course, it also brings great joy. So many parents, friends, and families relay sadness they feel on the first day of school (particularly Kindergarten). We shed a layer of innocence it seems when our kids advance. However, one good friend recently described his son’s first day of Kindergarten as one of the happiest of his life. He mentioned he could tell me, unlike other days, what his son was wearing, the pace of his son’s stride that morning as they walked to school, and how he remembers clearly the huge sense of pride both he and his son felt when they landed in the classroom. It was by all accounts, “Marvelous and immensely joyful,” he said. It’s his description that is allowing me to keep my chin up.

We flew kites with friends in celebration of the last night of summer tonight. I teared up at bedtime. It isn’t going to be pretty. Not only does F start Kindergarten this week, he also just announced a wiggly tooth. Be still my Mama-heart…

The beginning of the academic calendar marks a perfect time to pen in milestones for the memory books. Utilizing my coping mechanism for the school start this week, I did an impromptu interview with F on Friday. It wasn’t premeditated so it’s not entirely sophisticated and therefore, very reproducible. I’m hoping to make it an annual tradition to help me both mark transitions but also celebrate his incredible journey growing up. Here’s the 20-question interview with his verbatim responses. Please feel free to provide added suggestions for questions and I’ll do a a follow-up interview!

5 Year-Old Interview, 5 Days Prior To Kindergarten Start

  • What is your favorite color? “Yellow”
  • Favorite number? “5”
  • Favorite food?: “Strawberries”
  • Favorite toy?: “This is going to be a tiny bit hard……airplanes.”
  • What are you most happy about this summer? “I got to spend more time with Mommy and Daddy” (be still my heart, again)
  • Favorite memory from the summer? “Going through the Costco carwash.” (you can’t make this stuff up) Read full post »

Katie Couric’s Biggest Accomplishment

Without question, for nearly all of us, parenthood is the center, the privilege, and the highlight of our lives. Like a glowing pin at the center of a large target in the middle of the night, our children are really our focus points. We often see that very clearly, even with dark glasses.

That’s why it’s not surprising that when Katie Couric interviewed this morning in Seattle at KING5 News, she responded that it was her motherhood she was most proud of:

 

I think I did a pretty good job

She meant raising what she described as her “nice girls with good values.” Her daughter is just 21 years and her younger girl is 16 years old. But out of all of her opportunities in the media, all of her fame and celebrity, all of her fundraising and initiatives in cancer prevention, and her very public life on the news, she is most proud of her motherhood.

I’m not surprised. The complexity of raising children draws upon our instinct, our wisdom, our decision-making, our education, our communities, our families, and our values. Getting our children to adulthood with judgment, respect, vision, and compassion is a enormous task. This job we parents hold demands extraordinary things–and success here is more respectable than any other accomplishment we complete. Parenthood is that important. Parenthood is that precious of a resource.

Katie listed her work to improve cancer screening and raise hundreds of millions of dollars for cancer research “dream teams” as her second biggest accomplishment.

After I did my live colonoscopy we saw colon cancer screening go up by 20%

She briefly discussed the role of epigenetics in cancer prevention and the exciting time to improve health. When asked about all of the work that we see–that public work like reigning on the Today Show for years and the CBS evening news–she said: Read full post »

Surviving Tantrums: The Anger Trap

We survived one of the biggest tantrums of all time in June. At the Oakland, California airport check-in of all places. Did you happen to hear about it? I literally had to physically hold and restrain my son from running off into moving traffic. The tantrum caused for lots of staring and avoidance. It does feel like judgment sometimes, which only makes us feel worse. In a low moment, I explained to my 3 year-old that he was acting like an animal. I got progressively more and more embarrassed and progressively more and more frustrated. It was one of those moments we never expect and have a hard time forgetting. The forgiving, that comes easy. Have you read the book, How Do Dinosaurs Say I Love You? That helps, too.

Same thing happened this weekend. I missed a meeting when I got stuck in a tornado-like tantrum and spent a big part of the weekend trying to optimize days to support my son to avoid tantrums. When it comes to tantrums, we all know we’re supposed to calm down, but it’s difficult to say the least. Our children find all of our hidden buttons and can escalate rapidly. You can’t avoid every tantrum, but some ideas to help you survive them more gracefully:

8 Tips To Survive A Tantrum

  • Giving your child enough attention and “catch them being good.” Provide specific praise in successful moments. However, don’t feel that if one child tantrums more than another that you aren’t providing enough attention. Personality is infused in behaviors, including tantrums.
  • During a tantrum give your child control over little things (offer small, directed choices with options rather than Yes/No questions). Read full post »

Sick Day

I had an unexpected gift this week: a not-so-sick sick day with my 5 year-old. And it really couldn’t have come at a better time.

We’ve never had a sick day like this before and he’s off to Kindergarten in September so the days were running out for preschool stolen-away sick leave.

In the past when he’s been ill he’s been well enough for me to head off to clinic or work and he’s been home with my mom or his nanny. I’ve ached in the absence but pushed through knowing it really wasn’t me he needed but rest and time away from school. Previously I knew that my patients needed me more.

This time he spooked me. Late Sunday night he developed a booming fever and complained about significant abdominal pain. He skipped dinner, plodded off to bed, and made a series of sweat circles on the sheets. My husband and I were both sitting on the edge of his bed hovering near midnight negotiating the logistics of heading to the ER. I went through the lists of the different diagnoses I imagined could cause his symptoms. I worried. We made plans for his brother, figured out who would go to the ER, and started solidifying next steps. Just then, he stopped complaining of pain and went back to sleep.

I didn’t lose my worry. I tossed and turned. I got up and organized my closet late into the night and tidied little piles repeatedly. I didn’t really sleep.

By morning, the fever was gone. The pain had improved and he joined us at the breakfast table. He downed his breakfast so we took his brother to school. And me? I got the day with my boy all to myself, I got to be home with him–worry changes everything. Read full post »