Author Archive

5 Quick Things: Hot Cars, 13 Reasons Why, Marijuana Smoke, Single Sports, Co-Sleeping

May 22, 2018  |  News WorthyComments Off on 5 Quick Things: Hot Cars, 13 Reasons Why, Marijuana Smoke, Single Sports, Co-Sleeping

I recently changed up the format of reporting I do with my local NBC affiliate station KING5 News. I’m doing more of a weekly roundup of pediatric studies, current events and newsworthy topics that I think are important for parents to know about. For those of you who aren’t able to tune in, I wanted to share a brief synopsis of what I’m covering. Let me know what you think! What topics would you want me to talk about?

1. 13 Reasons Why: Netflix released the second season of “13 Reasons Why” a popular show about a high school student’s suicide. A recent Pediatrics study that found hospitalization rates are increasing for suicide attempts and ideation (doubled between 2008-2015), so this show’s release was particularly untimely. I really appreciate the HealthyChildren.org page with strategies for parents to discuss the show with their teens. These portrayals in media matter: using Google Analytics, data found that there was a significant increase in online searches for suicide, including searches for how to kill oneself, in the days after 13 Reasons Why debuted. This increase reflected as many as 1.5 million more searches than expected, with a 26% spike in searches for the phrase “how to commit suicide.” Reminder that all teens should be screened every year for depression starting at age 12. Here’s a fantastic piece with 13 Things All Pediatricians Should Know About 13 Reasons Why but I think all parents should, too.

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Is Co-Sleeping Safe? Do You Do It?

May 22, 2018  |  Parenting, The Value Of Sleep3 Comments

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The short answer to the title is —- not really, and the risk varies. But I sure get why so many parents want to co-sleep despite most pediatricians urging against it.

I was up early yesterday morning listening to NPR when a story about parents’ love and desire to sleep with their babies grabbed my attention. The headline reads: “Is sleeping with your baby as dangerous as doctors say?” I mean, parents (like me) want(ed) to co-sleep and bond with their babies, of course, especially when their babies fuss and cry and especially when parents are exhausted. Every pediatrician hears and understands the parent who says something like, “By 3am I was just so tired I plopped her in bed with me after feeding and gave up on the bassinet.”

Parents ARE tired and want to make that crying, noise, and a baby’s sadness go away. The piece opened up the challenge in parents feeling judged or insecure about sharing truths with pediatricians who have strongly advised them to separate sleeping spaces. Many parents may feel that if they continue, in overwhelm, or instinct, or in love to bed-share and co-sleep, they have to keep it from their pediatrician.

The rub here is pediatricians want what is best for families and what’s best for the bond between babies and their parents. But they also want to protect babies as best they can with the evidence fueling guidelines and advice.  How we’re talking about this may miss some salient points in American family lives.

Putting babies on their back in safe sleep environments has proved so helpful for protecting babies. But the guidelines may have focused too little on the risk that comes with over-tired parents who just can’t follow the advice and the risks co-sleeping may pose particularly when a tired, working mom co-sleeps out of desperation. Sleep experts have helped me understand that sleep deprivation changes arousal and it may be riskier for an over-tired parent to co-sleep than a better rested one. Read full post »

Car Seats and Booster Seats And Your Precious Cargo While Carpooling

April 9, 2018  |  Podcast, Toddler5 Comments

A friend pulled me aside last week urging me to write about car seat and seatbelt safety. His family had been involved in a rollover accident on the way home from school — literally, just turning in an intersection, as I understand it, they were plowed into by another car which caused their car to flip. No one was seriously injured, thank goodness, but the children were left dangling upside down, hanging by seat belts, until the medics arrived. Clearly they were shaken…and reminded how precious our time is on this planet — and how the most dangerous thing most of us do everyday is drive. All the children had seat belts on and all the children were in the back seat. Phew!

Thing is, just after this dad urged me to write this, I mean literally, just minutes later, we pulled away from a group of parents at pick-up and I watched an 11 year-old get into the front seat of her family’s car and drive away. My stomach dropped. Children under age 13 shouldn’t be in the front seat and goodness gracious, the irony of the timing just got me in the gut. Hard to message and write about something that I feel parents don’t want to know more about. Something about a laxity here for many people remains…seems this is advice many already feel they know (and don’t want to take).

3 reasons children shouldn’t sit it front seat until age 13 years: 1) It’s always safer to ride in the backseat (it’s also illegal to ride in front under age 13 years in WA state), 2) children under age 13 years are at increased risk for injury from airbags (designed for a 140 lb male), and 3) children’s bone development at the hips and breastbone is immature leading to increased risk of more serious injury in front seat

When it comes to infants and little children, maybe it’s different — I feel like parents are more interested in the data and reminders. Research out last week confirms what pediatricians have been recommending for years: rear-facing car seats to keep children safer in rear impact collisions. “We found that the rear-facing car seats protected the crash test dummy well when exposed to a typical rear impact,” said lead study author Julie Mansfield. If you’re hit from behind or the side or the front, we want children under 2 years of age rear-facing! Read full post »

5 Things You Should Know About Concussions

March 12, 2018  |  Doctoring & Healthcare, Guest PostsComments Off on 5 Things You Should Know About Concussions

This is a post authored by J. Forrest Bennett, ARNP who works in the rehabilitation department and on the concussion team led by Dr Samuel Browd (@DrBrowd), medical director of Seattle Children’s Sports Concussion Program. Forrest has had the unique experience to care for children after concussions in the immediate time after injury and in weeks to months thereafter when symptoms are prolonged. His wisdom can help us all understand the opportunity we have to improve children’s recovery after a head injury. In this post he explains what happens to the brain cells during a concussion, what constitutes risk for concussions, and the 5 things all of us need to know about concussions. I certainly know more after reading this and suspect you will too. Please leave comments or questions if you have them. Click here to read the first post in this series. 

Soccer is the highest risk sport for school-age girls.

Soccer is the highest risk sport for school-age girls.

What Happens During A Concussion?

A concussion is a complex process affecting the brain, brought on by biomechanical forces (like a blow to the head, car crash, etc.) The force is transmitted to the head and can result in usually short-lived symptoms such as headaches, brief loss of consciousness, nausea, and/or dizziness. These symptoms are believed to be due to a temporary shift in the neurotransmitters (chemicals that allow cells to communicate) in the brain. This helps explain the symptoms associated with a time-limited injury such as a concussion.

This also explains why diagnosing and managing concussions can be frustrating for families and medical providers. Unlike a broken bone, we do not have imagining or blood tests that enable definitive diagnosis of concussion. Medical providers will sometimes order head CTs or brain MRIs to make sure that there is not a more severe injury, but the scans cannot diagnosis concussion.

Diagnosing concussion currently relies on a detailed history and physical exam. If an injury occurs when a child is playing in an organized sport, a sideline assessment should be performed to look for common post-concussive symptoms. In 2017, the guideline for sideline assessment for concussion was updated. Depending on the severity of the initial presentation, one may need to be evaluated in an emergency department to help rule out a more severe injury.
The goal is to prevent injuries, screen for potential head injuries when appropriate, and to diagnose injuries so that we can treat the symptoms and limit the impact.

How To Prevent Head Injuries

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Sore Throat Versus Strep Throat

March 8, 2018  |  ParentingComments Off on Sore Throat Versus Strep Throat

When you or your child has a sore throat, it can be hard to tell if it might be something that needs medical intervention, like Strep throat. Strep throat is an infection caused by group A Streptococcus (GAS). When you confirm (by throat swab in the lab) that GAS is present, your child needs 10 days of antibiotics. If the test is negative, it’s unlikely you need any Rx medical treatment! More below:

  • Sore Throat
    • Tonsillitis refers to tonsils that are inflamed. Inflamed tonsils (and even when they have white stuff on them) doesn’t necessarily mean your child needs antibiotics. If enlarged tonsils make it hard to swallow or changes the sounds when your child breaths, they need to see a pediatrician.
    • Pharyngitis refers to an inflamed throat. Most episodes of pharyngitis are caused by infections from viruses. Some are caused by other bacteria that live in the throat that aren’t as problematic as GAS and don’t require antibiotic treatment.
    • Viruses, bacteria, allergens, environmental irritants (such as cigarette smoke), and chronic postnasal drip can all cause a sore throat. Most tonsillitis & pharyngitis will typically resolve on their own without prescription treatment.
    • Try acetaminophen or ibuprofen for pain, throat lozenges, warm beverages, gargling salt water and get lots of rest. In time, sore throats typically improve in a few days.
  • Strep throat is an infection caused by a specific type of bacteria, Streptococcus. Infections from the bacteria can be minor or severe. When your child has Strep throat, their tonsils are usually very inflamed, they likely have a fever and swollen lymph nodes in the front of the neck, a BAD sore throat, and sometimes a headache. Many children complain of lots of pain with swallowing. Strep throat symptoms typically come in isolation from other “cold symptoms.” With typical strep, most children do not have cough, runny nose or hoarseness (changes in your voice that makes it sound breathy, raspy, or strained). No one can diagnose strep throat just by looking at your throat. Instead, healthcare professionals use two tests to see if group A Strep bacteria are causing a sore throat. A “rapid strep test” involves swabbing your throat and gives results quickly, usually in about 15-20 minutes. The test is accurate about 95% of the time meaning only 1 in 20 people (5%) who have a negative test actually may have the infection. If the rapid test is positive, your doctor or provider will prescribe antibiotics. If the test is negative, your healthcare professional may likely send the swab for a full throat culture (to catch the 5% that falsely didn’t show an infection). A throat culture involves sending a throat swab to a lab for 1-2 days to see if bacteria grow from the sample. If it turns positive, then your child should be treated with an antibiotic for 10 days.

Great information from the American Academy of Pediatrics on the differences between a sore throat and strep.