Wendy Sue Swanson, MD, MBE, FAAP2013-05-22T17:23:45-04:00Wendy Sue Swanson, MD, MBE, FAAPhttp://www.huffingtonpost.com/author/index.php?author=wendy-sue-swanson-md-mbe-faapCopyright 2008, HuffingtonPost.com, Inc.HuffingtonPost Blogger Feed for Wendy Sue Swanson, MD, MBE, FAAPGood old fashioned elbow grease.I Love Being a Working Momtag:www.huffingtonpost.com,2013:/theblog//3.31561522013-04-25T15:50:05-04:002013-04-25T17:01:24-04:00Wendy Sue Swanson, MD, MBE, FAAPhttp://www.huffingtonpost.com/wendy-sue-swanson-md-mbe-faap/
Today is "Bring Your Kid To Work Day," but really, any day we do it counts. Pick an ideal time and involve your child. My contention is that you'll rapidly recognize the incredible fortune it is to live this lunatic life that requires navigating the dreaded work-life-balance ordeal.
When my 6-year-old joined me on a work trip earlier this month, it was as if two huge ships met at sea. All of the sudden, my little boy was welcomed into the world of making change. I felt like I represented more of my whole self while at work that day. And let me tell you, his eyes were wide open. All day.
One of the post-it notes on my computer at home says, "Design a beautiful day." The quote stems from Dr. Marty Seligman, who founded the field of positive psychology. He devised the concept of the beautiful day activity (I seriously encourage you to click on that link).
Thing is, every time I've talked about designing a beautiful or meaningful day, work is a part of it. If I only had one more day to live, I'd work for a few hours in the morning, no question about it. I really do love working as a doctor. Of course, I really do love being a mom. Valuing both of these roles takes skill, and I'm not always sure I have it...
Priorities
And that's the thing. I often feel like all the writing about work and balance and parenting, especially for women, causes spectators on the sideline to question a commitment towards family, children and self for those of us also working outside of our homes. It's as if when we admit we love to nurture those outside of our family, we somehow don't value the nurturing of the people at home as much. And it doesn't work that way in my heart.
My priorities are clearly stacked with my children first, but one tension that I never can articulate well is the reality that I don't just work to earn money (although the paycheck is necessary); I work to get things done and to make the world more of what I know it can be.
Two weeks ago, I gave my first TED talk in the Netherlands. And lucky enough for me, my 6-year-old was in the third row. I felt more whole than I can remember feeling since returning back to work after his birth. Having him at my side allowed me to feel less pull than other work days. It's also very clear that he understands who I am in an unexpected, new way.
I know it's not plausible for most of us to bring our children to work most days, but I encourage you, whenever you see an opportunity -- whether it's on Bring Your Kid To Work Day or not -- to do so. Even if just for an hour or two. Make "going to work" real, tactile and vivid for them.
The Lesson
I didn't see it coming, the meaning and mindfulness of the work day with my boy. Although I had hopes that a trip to the Netherlands with my 6-year-old would be unique and cherished, I didn't understand that the long day of work was the one that would be so meaningful and so fueling for us both. He sat through the entire day of TED talks, met dozens of colleagues and seemed to take it all in. The talks spanned birth to death, with the morning focused on early life and the end of the day honed in on the end of life and the positive experience we can have as we age and as we die. It was heavy, but as I checked in on him throughout the day, he continued to reflect his interest and sense of calm.
It was only late at night, during pillow talk in the hotel, that I understood how profound a day with adults can be for a curious child.
As he lie tucked in bed surrounded by origami cranes he had collected during the day, he said:
"Oh, Mommy, life can be soooooooo beautiful."
"Yes, Lovie, it can," I said, my stomach flipping with surprise. And then he uttered:
"Mommy, death can be beautiful, too."
That's when I knew, whenever possible, that I had to involve my boys in my work. Share with them the luxury it is to have an education, a chance at making other people's lives better and the fortune of a meaningful career. It's so nice to have the rare episode that cemented the truth: I love being a working mom. ]]>Why Do Babies Wake Up at Night?tag:www.huffingtonpost.com,2013:/theblog//3.29734452013-03-29T11:18:02-04:002013-03-29T11:18:08-04:00Wendy Sue Swanson, MD, MBE, FAAPhttp://www.huffingtonpost.com/wendy-sue-swanson-md-mbe-faap/Dr. Maida Chen, a pediatric pulmonologist, mother to three and director of the Pediatric Sleep Disorders Center in Seattle. I put this list together regarding why babies wake up at night. I'll author a follow-up blog on ways you can help your baby when they wake up, too.
10 Reasons Babies Wake Up At Night:
1. Sleep Cycle: Babies wake up during the night primarily because their brain waves shift and change cycles as they move from REM (rapid eye movement) sleep to other stages of non-REM sleep. The different wave patterns our brains make during certain periods define these sleep cycles or "stages" of sleep. As babies move from one stage of sleep to another during the night, they transition. In that transition, many babies will awaken. Sometimes they call out or cry. Sometimes they wake hungry. It's normal for babies (and adults) to wake 4-5 times a night during these times of transition. However, most adults wake up and then fall back to sleep so rapidly that we rarely remember awakening. At 4 months of age, many parents notice awakenings after a first chunk of deeper sleep. This is normal, and often due to development of delta wave sleep (deep sleep). The trick for parents is to do less and less as each month of infancy unfolds during these awakenings; we want to help our babies self-soothe more and more independently (without our help) during these awakenings so that sleeping through the night becomes a reality.
2. Brain Waves: The majority of babies are really capable of sleeping for a prolonged 6+ hour period of time 1/2 way through infancy, around 6 months. As Dr. Chen explains, "When doing sleep studies we follow brain wave activity." After 6 months of age she says, "We see brain waves at 6 months of age and up that are similar in pattern to that of adults." Now that doesn't mean that babies that wake throughout the night have abnormal brain waves, but it does mean as they progress through infancy, they get more and more mature when it comes to sleep. Dr Chen says, "If you look at sleep studies on newborns and infants, they will look very different compared to older children. But by 6 months of age, the baby's brain wave patterns will look much like an 18-year-olds." That being said, unlike an 18-year-old, once some babies are awakened during transitions, they may call out for your help!
3. "Good Sleepers" Versus "Bad Sleepers": Some babies are just better sleepers right out of the gate. Dr Chen reminded me, "There are good sleepers and there are bad sleepers. Part of that is organically hard-wired. But there are also good sleepers with bad habits." Our job as parents is to do the best we can in creating good sleep habits. Most of that has to do with consistency from one night to the next. Some babies make habitual associations like always nursing to sleep, always being rocked to sleep or always being held to fall asleep. Then, when they have awakenings at night, they may cry out to have those associations (bottle, nursing or rocking to sleep) to get back to sleep. These associations can cause a good sleeper to have bad sleep, because of the habit.
4. Crying Is Part Of Being A Baby: There is a pretty serious ongoing debate and national dialogue between parents, psychologists, pediatricians, lactation consultants and scientists about letting babies cry-it-out versus not cry-it out. I'll not delve into much of the debate here, but if you're worried that letting your baby cry-it-out will damage them, try to relax. Dr Chen says, "We don't think that some crying is bad for a baby. The evidence to support long-term damage from crying at night is nil." Many pediatricians recommend letting your baby gradually learn to self-soothe or cry-it-out once they have self-soothing skills (turning over, sucking on fingers or hand, and more mobility) starting somewhere around 4-6 months of age.
5. Mom or Dad's Role At Night: Studies have evaluated how parents can change an infant's sleep. Studies have found that infant sleep disorders are affected by how many times a parent comforts them at night. The more parents camp out (remain in the room until baby is asleep), the more parents transfer the baby into the crib after asleep and the more they picked the baby up at night, the more likely the baby has sleep challenges. And although most studies have evaluated a mother's role in overnight awakenings, a 2010 Tel Aviv study found that when fathers were more involved in infant care (day and night), in addition to mothers, their babies had fewer overnight awakenings. Take turns!
6. Development: Developmental milestones shift and change sleep. As described in the video, after 4 months of age, most babies have a prolonged period of sleep and then wake up every couple of hours because of sleep cycle changes. Sometimes they will wake up and roll over and then freak out and cry when they get stuck or move into a new position. The rolling milestone may translate into awakenings. At 6 months of age, babies are exploring the world, putting all sorts of objects and germs in their mouths, and subject to more infection. They're also learning to sit at 6 months of age and this milestones often triggers awakenings. At 9 months of age, babies learn how to pull themselves up in the crib and stand-up -- don't be surprised if they are awake more. Most parents are unpleasantly surprised to find their 9-month-old up and awake in the middle of the night standing up, ready to rock and roll.
7. Teething: There's no question that teething wakes children at night and disrupts sleep. Teething typically commences around 6 months of age but I hear about teething waking babies all the way through their toddlerhood. Acetaminophen is the only medication I recommend for teething.
8. Behavioral Changes: Many babies will have more frequent awakenings around 6 or 9 months of age due to advancing sense of independence and self-awareness. At 6 months of age, I often hear from parents their babies will wake up in the middle of the night and start talking, just go through their different sounds. No need to go to them if they are not fussing! When babies develop separation anxiety around 9 months of age, they will often change their sleep patterns. Often during those times of behavior change they will wake and scream out when they realize you're not at their side.
9. Infection: Infants and children typically have an upswing in infections after 6 months of age. This occurs primarily because once a baby reaches 6 months, they are capable of putting lots of new objects (including their hands) in their mouths, so their exposure to germs increases dramatically. Many babies who have colds or upper respiratory infections will wake due to congestion or coughing. Fever, vomiting and diarrhea will awaken babies at night, too. Hang on and support your baby with a little TLC. Sleep schedules typically go back to normal within a few weeks after the illness began, especially if you can keep up good sleep routines.
10. Pacifiers/Bottle: Many babies are conditioned to fall asleep (or fall back to sleep) while sucking on something. This starts just after birth, when newborns instantly fall asleep with breastfeeding or a bottle in their mouth. Many infants who use a pacifier will wake up between 6-12 months of age when the pacifier falls out. The easiest solution is to get rid of it all together! But remember, big habits die hard, if a baby learns to fall asleep sucking and does so for 6+ months, it can take awhile to unlearn the habit...
WATCH: Why Do Babies Wake Up in the Night?
]]>Is It Really an Ear Infection?tag:www.huffingtonpost.com,2013:/theblog//3.27690182013-02-28T15:21:25-05:002013-04-30T05:12:01-04:00Wendy Sue Swanson, MD, MBE, FAAPhttp://www.huffingtonpost.com/wendy-sue-swanson-md-mbe-faap/
Ear infections can be caused by viruses or bacteria when excess fluid gets trapped in the middle portion of the ear, behind the eardrum. When that space fills with mucus or pus, it is put under pressure and it gets inflamed, causing pain. Symptoms of ear infections include pain, fever, difficulty hearing, difficultly sleeping, crankiness, or tugging and pulling at the ear. This typically happens at the time or soon after a cold -- therefore, the fluid in the ear can either be filled with a virus or bacteria.
The most important medicine you give your child when you first suspect an ear infection is one for pain. Antibiotics only help if bacteria is the cause. When a true infection is present, causing pain and fever, antibiotics are never the wrong choice. Often, you'll need a clinician's help in diagnosing a true ear infection.
There's been a lot of work (and research) over the last 15 years to reduce unnecessary antibiotics prescribed for ear infections. There has been great progress. Fewer children see the doctor when they have an ear infection (only 634 out of 1,000 in 2005 vs. 950 out of 1,000 back in the 1990s), and they're prescribed antibiotics less frequently. Recent data finds that less than half of children with ear infections receive antibiotics (only 424 of every 1,000 children with ear infections). However, the far majority who go in to see a doctor do still receive a prescription for antibiotic (76 percent).
The American Academy of Pediatrics(AAP) just released new guidelines to help physicians do a better job treating ear infections. Sometimes children really benefit from using antibiotics, and new research has led to an update on the 2004 previously-published recommendations. Overuse of antibiotics can lead to more resistant and aggressive bacteria, so we want to use them at the right time. These recommendations may help improve care for children.
In my opinion, NPR published the best article I've read covering the new recommendations. I especially liked the balance provided:
"When the diagnosis is correct, then antibiotic treatment is never wrong," says Dr. Ellen Wald of the University of Wisconsin School of Medicine and Public Health in Madison. "Kids tend to recover more often and they recover more quickly if they're treated appropriately with antibiotics."
That's especially important for working parents, Wald notes.
"We live in a society where there is so much pressure for both parents to be working outside the home and it's just complicated when our child is sick. Besides which, there's always parental anxiety and concern when their child is sick," she says.
Information For Parents: New Ear Infection Guidelines
Pain: Use medication like ibuprofen and/or acetaminophen to treat pain when a child has a suspected or confirmed ear infection. These infections really hurt and don't wait for antibiotics to "kick in" or make your child tough it out. Here's a summary on dosing pain meds for infants and children.
Diagnosis: The AAP recommendations apply more strict criteria for making the diagnosis of an ear infection. For true diagnosis they say, the ear drum has to be bulging, there has to be middle ear fluid and/or draining fluid from the ear. The ear can't just be red or have a bit of fluid behind it. It's important that the doctor confirm an ear infection is present before antibiotics are prescribed. If a clinician says to you, "It looks like an early ear infection," or "The ear drum is a little red," or "I think this may be an ear infection," chances are it doesn't meet criteria and shouldn't be treated with antibiotics. Press the clinician to explain to you if the ear drum is bulging and full of fluid. If no proof, antibiotics may not be necessary. Time may be the best medicine.
No Antibiotics: Many children don't need antibiotics to heal from ear infections. When a confirmed ear infection is discovered in a child over two years of age who has no fever or no severe ear pain, they can be observed without antibiotics. However, if pain is still present or symptoms not improved in 48 hours, it is suggested they have follow-up. Make sure you have a good follow-up plan or a prescription to use if you child isn't improving.
Follow up: the recommendations remind us that if you chose not to use antibiotics, you need to have a system in place for a follow-up visit or call or electronic visit in place 48-72 hours later. If symptoms of the ear infection resolve in two to three days with use of pain medications and time, the ear infection is likely healing. If symptoms (on or off medications) aren't better in two to three days, your child needs to be re-seen either to start antibiotics or switch medications.
Antibiotics: All infants under six months of age, children six-23 months of age with a double ear infection, those with severe infections, and those at risk for complications all need antibiotics. Penicillin (Amoxicillin typically -- the pink stuff) is the medication used first for ear infections. However, if your child has had Amoxicillin in the last month then the clinician should advance the antibiotics (typically to a penicillin with an ingredient called clavulanate to fight resistant bacteria that may be present). Lots of parents worry that Amoxicillin isn't the best first choice. Data continue to suggest it is. Read a summary of recent studies in The New England Journal of Medicine on treating ear infections.
Eye and Ear Infection: If your child has conjunctivitis ("Pink Eye") or drainage from their eyes along with an ear infection, they should immediately get a dose of amoxicillin-clavulanate (Augmentin) rather than amoxicillin (penicillin). Infections that cause both infections (ear and eyes) tend to be more likely to be resistant to amoxicillin.
Vaccines: Immunizations do a good job preventing many ear infections. Make sure your child is up-to-date on all vaccines but specifically ensure your child is up to date on Hib, Prevnar 13 (updated pneumococcal vaccine) and their annual Flu Shot. Both Prevnar 13 shots and expanded recommendations to use Flu Shots for all children over six months are attributed in part to decreasing rates of ear infections.
Prevention: Breast feeding and avoidance of cigarette smoke remain data-proven strategies to prevent ear infections in children.]]>Preschoolers Can Learn Great Things From TVtag:www.huffingtonpost.com,2013:/theblog//3.27040972013-02-18T13:03:55-05:002013-04-20T05:12:01-04:00Wendy Sue Swanson, MD, MBE, FAAPhttp://www.huffingtonpost.com/wendy-sue-swanson-md-mbe-faap/over four hours per day watching television at home and in day care. My good friend, Dr Claire McCarthy, offers up her opinion in this week's Pediatrics.
Television viewing is only on an upswing over the past five years as more and more devices interdigitate into our children's lives. I'm a perfect example. When my first son was born six years ago, we had one television and one computer. Today, we have a smartphone, an iPad, a computer and a television. The screen choices continue to grow, the television shows continue to become more alluring and the opportunities for viewing with new convenience is abundant. It's true: some of the stuff out there designed to delight our children is awesome.
But not all of it.
So as our children continue to tug on our sleeves and hang on our pant legs asking for the iPhone just after they beg for TV time before dinner, we need to think clearly about an action plan. We need to make a thoughtful "media diet." We need to think ahead of time what time we'll offer up the devices and what content we want them to see. We should care -- it really changes how they think and what they do. When we use a media diet, we improve both our own satisfaction as parents and our children's lives, in my opinion. Dr Dimitri Christakis, a pediatric researcher at Seattle Children's Hospital, agrees: "We often focus on how much kids watch and don't focus enough on what they watch."
New research out today by Dr Christakis finds that putting our time and energy into working to improve what our children watch, not just how much they watch, can have a positive impact on their behavior -- even for children as young as 3 years of age.
Modifying Media Content for Preschoolers:
Researchers in Seattle studied 565 English-speaking parents of preschool-aged children ages 3 to 5 who reported that their children watched TV or videos each week (that's most of us). They randomly assigned families to two groups: one in which families received training on a "media diet," and one in which families received information about eating healthy (the control group). Families kept media diaries -- what and how much their children watched while being followed by a case manager who supported them. Researchers then evaluated children in these families at 6 and 12 month time intervals on their social competence and behavior. Of note, there were no attempts in the study to decrease the total number of hours children used screens. The intervention from case managers focused more on encouraging positive media use such as watching TV together as a family and substituting violent shows for more friendly ones.
Parents who learned about the "media diet" learned about prosocial programming. Prosocial programming is that kind of TV show that promotes children acting in kind ways or shows children sharing. In prosocial shows, adults are portrayed as dependable and helpful.
Results proved exciting. At 6 months, children with the "media"diet" had significant improvement in their overall social competence and behavior scores. Over the months, the children in the "media diet" group demonstrated significantly less aggression and more prosocial behavior compared to the control group, and the effect lasted throughout the 12 months. At six months and 12 months, the children in the media diet intervention group were spending significantly less time on violent programming than they did at the start of the study.
"Media diets" helped change what children watched. Although both the intervention and control groups increased viewing time during the study, the control group increased its minutes of violent content while the media diet group increased its minutes of prosocial and educational content.
Parents liked the intervention and "media diet." Overall, 77% said they would recommend the program to other families.
Researchers concluded that a "media diet" can reduce exposure to violent screen time by replacing it with prosocial programming and that this may really impact how our children behave.
5 Tips for Making a "Media Diet" for Your Young Child
1. Make sure you're aware what your child is watching.
Dr. Dimitri Christakis suggests keeping a media journal, documenting what they watch and how much time they are in front of a screen. Try it for a week. Use your smartphone to track how long they're viewing what content.
2. As you make the plan, sit down with your children and watch shows together.
Not only will this improve your insight, this will allow you to help them understand the benefits of the shows when goodies like kindness are offered up. Continue to check in with your children and watch shows as their interests change.
3. Remember that the channel (or app) is just as important as the clock.
Make rules for your child about which shows are acceptable ahead of time. If you have challenges keeping your child on the pre-selected channels, allow viewing on the device or TV only when you're in the room. Don't make exceptions.
4. Take a few minutes to read up on what your child wants to watch.
Like I've said before, I think Common Sense Media is a fantastic guide to help you make decisions about media and apps that are right for you and your family. I often tell parents of teens to use Common Sense Media as a back-up supporter for the rules they make. They have an app, too.
5. Prosocial programming may really enhance your child's behavior proving not all TV is bad.
The study with preschoolers highlights opportunities for using TV to improve our children's lives. And while we're likely never going to get rid of our screens, Dr Christakis reminds us that, "While too many children watch too much TV, this study shows that content is as important as quantity. It isn't just about turning off the TV, it's about changing the channel."
Kill the TV if you like or toss out the iPhone. But if you're as attached to your screens as I am, consider making a "media diet." Let's march forward with our screens and our more delightful children.]]>Love: Unequal And Incomparabletag:www.huffingtonpost.com,2013:/theblog//3.26799972013-02-13T17:39:56-05:002013-04-15T05:12:01-04:00Wendy Sue Swanson, MD, MBE, FAAPhttp://www.huffingtonpost.com/wendy-sue-swanson-md-mbe-faap/
If anything, I think I expected my love to feel equal for each boy, despite not understanding the mechanics of how it would happen. Part of that came from my mother telling me that she loved my brother and me equally when we were growing up. This often came up at incredibly sentimental times like epic battles in sharing or when choosing which one of us needed to take the garbage out.
Of course, I'm sure my mom's feelings are more complex, but her assertion of equality was the foundation of my thinking. Out popped my second son in November of 2008. And just like everyone said, I fell in love with him... desperately.
But my love wasn't simple; it wasn't the same. My heart didn't mimic any pattern I'd developed for my first. My second was an entirely unique person in my life. And I generated an entirely new sense of connection.
As my boys grow this incomparable inequality persists. It weaves and changes. They tug and pull on my heart each and every day in entirely different ways.
My love for my boys isn't "equal" in height, weight or circumference. The love I feel for my second is absolutely incomparable to the love I feel for my first. As if it's a different color, a different language, a different texture or a different tonality. The space they occupy in me is immense and limitless, separate and only occasionally overlapping. I don't love one more than the other, but I can't articulate how I love them in unequal ways. But I do.
Does the love you feel for your child equal that for anything else?]]>Two Pediatricians Speak Out: We Need Effective Interventions to Protect Our Childrentag:www.huffingtonpost.com,2012:/theblog//3.23522872012-12-23T11:01:22-05:002013-02-22T05:12:01-05:00Wendy Sue Swanson, MD, MBE, FAAPhttp://www.huffingtonpost.com/wendy-sue-swanson-md-mbe-faap/
We need to learn more about ways we can stop people from hurting our children with guns. We'd know more if handcuffs hadn't been put on research on gun control--we were stunned to read the article in JAMA by Drs. Kellermann and Rivara about the ways our government has suppressed funding for public health research that could prevent tragedies like Newtown. Since 1996, "none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control." In 2011, this was extended to all Health and Human Services agencies, including the National Institutes of Health. Really?
Guns are a public health problem, plain and simple. As pediatricians, this is patently obvious to us--which is why we could not understand why the state of Florida wanted to ban pediatricians from even talking about firearm safety in the exam room. Guns don't break arms, they break lives. Why wouldn't we talk about simple safety measures that could prevent our patients from dying?
That's the thing: injury prevention measures work. As Kellermann and Rivara point out:
Injury prevention research can have real and lasting effects. Over the last 20 years, the number of Americans dying in motor vehicle crashes has decreased by 31%. Deaths from fires and drowning have been reduced even more, by 38% and 52%, respectively. This progress was achieved without banning automobiles, swimming pools, or matches. Instead, it came from translating research findings into effective interventions.
Both of us have a child the same age as the children who were killed in Newtown. The days since the shootings have been really hard; we can put ourselves in the place of those parents so easily, and we have been depressed and haunted. But we don't want armed guards in our children's schools like the NRA is suggesting. More guns to fight guns?
As pediatricians, we've had had the privilege of caring for children this week in clinic and offering support and guidance through our work writing and talking with the media. It's felt good to be able to do something. It has helped us see that the antidote to anxiety and fear is action.
As Heather Borden Herve, a Newtown mother whose daughter was born the same day as one of the children killed, wrote in a powerful post: "Einstein's definition of 'insanity' is doing something over and over and expecting different results. Expecting things to change by doing nothing over and over again, when it comes to guns, is insanity too."
It's time for all of us to take action.
Here's what we can do:
The safest home for children is one without guns. But if guns are in the home, the risk of death is significantly less when guns are stored unloaded in a locked container. Ammunition should be locked in a separate location. This needs to happen in every home in America. Now.
We have to work for a balanced "media-diet." Extensive research finds that exposure to violent games and media contributes to aggressive behavior, nightmares, fear of being harmed, and desensitization of violence. The effects are real.
Instead of putting limits on research about guns and violence, we need more of it. Much more of it. Congress must rescind its moratorium on firearm injury prevention research.
We need to advocate for sensible gun control laws that protect victims, not gun owners.
Most of all: we need to speak out. We need to be heard--whether it's in blogs or letters to the editor or letters or calls to elected officials, or in our donations to places like Mercy Corps, or in whatever other ways we find to express our outrage and protect our children.
Our pledge is to keep talking to families and to the media about sensible ways to protect our children from violence. Tell us what you will do.]]>Organic or Not? Two Pediatricians Weigh Intag:www.huffingtonpost.com,2012:/theblog//3.20444462012-11-14T16:49:32-05:002013-01-14T05:12:01-05:00Wendy Sue Swanson, MD, MBE, FAAPhttp://www.huffingtonpost.com/wendy-sue-swanson-md-mbe-faap/
Producing foods organically is definitely better for the earth -- that much is clear. But whether we need to buy them to stay healthy -- that's a trickier question. Especially since organic foods are clearly more expensive. If we all had endless pockets of money, we'd recommend always going organic. Unfortunately, life doesn't work that way for most of us.
The American Academy of Pediatrics (AAP) recently weighed in with a clinical report to help families navigate the tough grocery store decisions. We were both lucky enough to be at the press conference. Here's what we learned about the different kinds of organic foods:
MILK
This one surprised us a little. Turns out that the AAP feels there's no health reason to buy organic milk. There's no evidence that pesticides get into the milk in any real quantities. And as for hormones, the thing many parents worry about, research says there isn't much data to cause alarm. Yes, cows are given bovine growth hormone to make them bigger and it gets into their milk. But bovine (cow) growth hormone doesn't work on humans (our bodies don't respond to it) and our stomach acids break down most of it anyway. As for the female hormone estrogen, which is also given to milk cows to make them produce more, only a really tiny amount gets into milk, not enough to have any real effect. Breast milk has higher levels of estrogen than cow's milk.
MEAT
Along with hormones, animals are given antibiotics to help them grow bigger. Another interesting fact we heard at the press conference: 80 percent of the antibiotics given in the U.S. are given to animals to make them grow -- not to treat an infection of any kind, animal or human. And whenever you give antibiotics this much, you increase the chance of creating "superbugs," bacteria that are resistant to antibiotics. Those we really don't want in our children or our environment. Through meat, these bugs can potentially spread to humans. Organic farmers don't use antibiotics, and so organic meat is has fewer of these superbugs.
The good news is that if you cook your meat thoroughly and wash your hands, you aren't likely to get a superbug infection from your chicken or beef -- so you don't need to buy organic meat for health reasons. There's no question superbugs are bad to have around, and are causing more and more infections in general, so if you can afford it, buying organic meats helps tackle the superbug problem.
Tip: Some market meat may be raised conventionally but without antibiotics -- grab that at the deli counter when you can!
PRODUCE
When it comes to the nutrients (vitamins, minerals, etc) in foods, there really doesn't seem to be a difference between organic and conventional foods. It's a really hard thing to study and be sure of, but the evidence so far doesn't make a great case for spending extra money on organics for that reason. There simply isn't data to say organic veggies have more vitamins.
The evidence is pretty clear, though, that conventional produce has more pesticides on it. What's difficult for scientists and doctors to determine is the level of pesticides your children and family get exposed to when eating conventional produce and then to know if it's dangerous or not. We're all pretty clear, though, that pesticides aren't good for you at any level -- especially for pregnant women and young children, because developing brains and bodies are very sensitive to their effects.
But before you shell out lots of extra money for organic veggies, there's some good news: Not all conventional produce has a lot of pesticides. There are choices to be made, and this is what we do when we go shopping. We really like the lists from the Environmental Working Group that include the "dirty dozen" (those fruits and veggies with the most pesticides, the ones you should buy organic when you can) and the "clean 15" (where you can save some money).
Tip: Whenever you buy produce (organic or not) rinse, rinse, rinse them prior to serving and cooking. Even those frozen blueberries...
The bottom (and boring) line, though, isn't about organic vs. conventional. The bottom line is that you should give your family a healthy diet, full of fruits, vegetables, whole grains and low-fat dairy and protein. You will be healthier if you eat lots conventional fruits and vegetables than if you eat only a little bit of organic fruits and vegetables (especially if you rinse that conventional produce really well).
Don't get caught up in the hype. Listen to the experts -- and remember, too, that lots of things go into making us healthy. After you unpack the groceries, take everyone and go for a walk.
Here's how Dr. Wendy Sue explained the report on her blog, Seattle Mama Doc:
]]>What Two Pediatricians Say NOT to Worry Abouttag:www.huffingtonpost.com,2012:/theblog//3.19554642012-10-12T15:19:54-04:002012-12-12T05:12:01-05:00Wendy Sue Swanson, MD, MBE, FAAPhttp://www.huffingtonpost.com/wendy-sue-swanson-md-mbe-faap/
As pediatricians and friends, we talk about this all the time. Every day, we talk with distressed parents -- and often parents stress out when they don't have to. Some of the concerns are common misconceptions. Some come from other parents who innocently pass on misinformation they've heard. And then there's the Internet. Everyone from your neighbor to your mother-in-law to your sister has an opinion. All this makes parents (including those of us who are doctors!) worry more.
Here are a few worries we hear the most -- and what we tell our patients to keep in mind:
1. Your baby's soft spot.
As Wendy Sue wrote in her post on this (3D image included), "I think we all conjure up crazy worries about an errant flying pencil landing in it. Or pushing too hard and squishing something important." When you have a newborn, it really does feel like his or her brain is a little too close for comfort.
It turns out, though, that the "soft spot", or anterior fontanelle, is pretty tough. Sure, you don't want to go poking or pushing it hard. But it's okay to touch it, and if your baby gets a little bump there, chances are she'll be fine. The fontanelle actually helps cushion the brain, as it gives some space between bones to allow the brain to grow. The soft spot closes between 9 and 24 months of age -- then no more worry at all!
2. Fevers.
We're not saying that you should never worry about a fever, as fever is a sign of illness. We all worry when our kids are unwell. But the fever itself is a natural response, and it's part of how our body gets rid of the germs that cause illness. Claire reminds patients that taking a fever away doesn't make your child heal quicker; in fact, the opposite may be true.
Most illnesses in childhood are not the scary kind. Most fevers come from viruses and go away by themselves. Here's one rule of thumb with fevers: Treat your child, not the number on the thermometer. If they are eating, drinking and acting fine, there's usually no reason to get that number down.
Here's when you do need to call the doctor about a fever:
• High fever (102 or higher) for more than a day
• Any fever 100.4 or higher in a baby less than 3 months old
• Your child is acting sick -- for example, they have trouble breathing, severe pain, are not drinking, there is lots of vomiting or diarrhea or there is a strange rash
• You're worried and don't know why (that's why you partner with a pediatrician!)
3. Which solid you should give your baby first.
People have strong opinions about this, but the reality is there is no one way to transition a baby to solids. At 4 months of age, a baby is on a strict liquid diet. By 1 year of age, it will be a solid diet. How they get there is different for every child.
Here's what we tell parents: Introduce a new food, whichever you want, every few days (check with your doctor if food allergies run in the family). Start with purées and cereals, and gradually add new textures and mushy table foods. Don't ditch any food and offer tons of variety. It can take many attempts before babies realize they like things! However you do this, it's the right way.
4. That your child isn't eating enough.
We hear this over and over, especially from parents of toddlers. And indeed, there are days when it seems like your toddler eats three bites of cereal, two bites of fruit and three bites of air. And yet somehow, kids grow. We like to say, "No child starves in a house with a full refrigerator."
Your job is to offer food; your child's job is to eat it. Learning how to eat when hungry and stop when full serves your child for a lifetime. So take a deep breath -- and then back off. Offer three healthy meals and a couple of small healthy snacks (like fruit or yogurt), and don't let them fill up on milk or juice. If you are worried, make an appointment with your doctor to get your child weighed and measured. We bet you'll find that he's doing just fine.
5. What other parents think of your parenting.
We refer to this as "competitive parenting." It's hard not to compare yourself to the parents you meet and wonder if they are doing things better than you -- especially when they say as much.
But here's the thing: every parent, every family and every child is different and has different needs. There are as many ways to parent as there are parents -- and children. That's what we love doing most as pediatricians; helping each family find their way. You know your child and your circumstances best. When it comes to your family, you are the expert.
6. Getting things perfect.
Perfection isn't possible. We all mess up. But more importantly, perfection isn't necessary. We're all for striving for perfection, and doing things like making your own baby food is great -- but it's not great if there's no time to play with your baby.
We all want to do everything we can to keep our children healthy and put them on the best path for life. But perfection shouldn't be the point. Your child doesn't need to read when she is 3, potato chips and cartoons are great sometimes and it's okay to buy the cheap shoes. It's all about moderation and about learning when to let your child lead the way. Most importantly, it's about enjoying your child and your life along the way, too.
There's no way to take all the worry out of parenthood. Use love as a guiding principle, ask for help when you're stumped, and we promise (hope) you will worry less.
