Archive for March 2011

“For your own good” Feeling guilty about giving shots

I’m sure every parent feels some guilt when they give their child shots. Today, after my son got his 2nd series of shots at 4 months, I felt this weird sort of guilt for every one of the 1000′s of kids I’ve ordered shots for.

At the time of the shots, I didn’t even mind that he cried for a moment. I took it in stride, knowing the immunizations are good for him. I’d rather see him cry, than see one of his limbs shrivel up from polio. Or even more saliently, rather than see him with Pertussis (Whooping Cough) snotty, unable to eat, and crying from a constant minute-long stacatto cough, then turning blue, then sucking in a breath (the Whoop) and crying some more, when the serial cough finally ends. And then see that cycle all over again a few minutes later…for a month. Yes, I’d much rather see him cry for a minute, or even a day, than have even a few days of any of the diseases the vaccines protect him against.

But later that day, I babysat for him for only the second mommyless (or more specifically boobiless) time. As he became increasingly fussy, I felt a weird, different sort of guilt. I felt like my child’s fussiness from the shots was some sort of karmic payback for those 1000′s of kids.

Don’t get me wrong. I have no doubt they are still worth it, and no regrets. I still had that tinge of guilt, bigger than just the guilt of doing something for my child’s own good. I felt like my child was paying for all the other children. Weird.

Actually in the end, it turned out he just missed the boob and needed a bottle. It was only my second time without Mommy and I didn’t think he could possibly need to eat again already! Welcome to the world of parenting, Daddy Dr.

The Danger of Car Seats! The new recommendations

According to a new recommendation put out by the AAP (American Academy of Pediatrics) and the National Highway Traffic Safety Administration, children under 2 years of age should be put in rear facing seats. There is a 75% higher chance of dieing in an accident under the age of 2 if facing forward. The old recommendation was up to 20 lbs, or around one year of age. The new recommendation actually says, up until they are 2 years old, or until they outgrow their rear facing seat.
Another interesting article put out last year, shows the dangers of a car seat when used around the house. There are lots of injuries.
Here is a summary of the recommendations from the U.S. News and World Report Health article:
* Don’t put a car seat on a table, chair, or sofa while at home.
* Don’t follow the advice of the “baby whisperer” types who recommend placing the car seat on top of a running washing machine to help put the kid to sleep.
* Shopping carts can be perilous, too; the American Academy of Pediatrics cautions against putting the car seat on top of a shopping cart, despite those nifty slots on the bottom of the baby bucket that invite that.
* Avoid the temptation to put the car seat on the tailgate or roof of the car in parking lots.
* Put babies in a playpen or crib if you need to keep them safe from pets or siblings. Use a car seat only as a travel device.

Like the author of that article, I’m guilty of using the car seat in the house. I’m sure we all are. For one, they snap out of the base when your child has finally fallen asleep in the car. At 6 wks, my little guy after a long 3 day road trip (we didn’t want to subject him to airplanes and the germs in them) started to fall asleep real easily in the car seat. So we use it to lay him down in for naps sometimes during the day in the house. After working in the ER for so long, I’ve seen many of these injuries. I am aware of their ability to miraculously flip over in car seats, and have avoided placing him in the seat on chairs, table tops, and counters. I still bring him inside, I just am extra careful he’s not in a spot where the seat can flip or he can flip out.

Some grocery carts fit my seat really well. It clicks in and locks in place. I guess I will avoid leaving him on top of the grocery cart, if it doesn’t click in.

One rule of thumb I’ve always used (even before having had babies) is to NEVER put anything on the roof of the car or on the tailgate.
I don’t even want to forget my coffee up there! So if I have to put my drink down (or maybe the baby) I’m putting it on the hood, where I’ll see it when I get in!

I think the guiltiest moment of my wife’s career as a mother was when my little Houdini managed to slide out of one of his chairs and clunk onto our wood floor at 2 months of age. I was so used to hearing about that happening, I knew he would be fine. Kids have been falling out things since the dawn of time. I’m sure that will be the first of many falls. Still, I’ll be even more careful now, I can’t heal scars.

Have you had bad mishaps with car seats? Bad baby slips? Comment here:

Our children’s, and our children’s children’s future. Japan Nuclear threat.

First of all, there is NO radiation threat in the USA from the March 11, 2011 Japan Earthquake, Tsunami, and now nuclear plant explosions.  At least so far, according to the The U.S. Nuclear Regulatory Commission.

Here is a great advisory from the American Academy of Pediatrics HealthyChildren.Org website regarding talking to your children about the disaster.  When I spoke on a local network affiliate morning show after 9/11, I stressed not to let your preschool aged children see the disaster on TV.  They are not always able to discern between replays, and the same bad thing happening over and over again as if it were live coverage.

As a parent now, the future of our planet, and our fragility and susceptibility to disasters really hits home.   Look at these satellite pictures of Japan before and after the disaster featured on The New York Times website.  Normal neighborhoods.  Normal homes.  Unimaginable devastation.

Can we really do anything to protect ourselves against these threats?  Yes and no.  Earthquakes and Tsunamis?   No.   Hurricanes, tornadoes, volcanoes, not much we can do.  Of course, we can regulate safety to avoid things like oil spills, and blown nuclear plants.  Of course, we worry about alternative energy because those future generations won’t have any oil left and may need nuclear power.  But then there’s the nuclear waste.  Arghh.

What we can do is teach our children to love our planet.  Love our oceans.  Love our open spaces.  Think conservation and preservation.  Everything, except maybe sun and wind, are finite resources.

Yesterday we took our 3 month old baby to see Monterrey Bay Aquarium.  Okay, my wife and I wanted to go see the aquarium. What I didn’t count on was seeing

Father and Baby in Aquarium

when fish swam by in the tanks.   It may have just been the lights and the movement, but he will grow up learning about wildlife and experiencing the outdoors.

I also ran into a heartbreaking story about a little 5 year old girl named Maddie James who was recently diagnosed with brain cancer.  She will die soon.  Her dream is to help expand an ocean educational center for children. This is a dream her parents want to make into an everlasting memorial with our help.

Maddie James’ story reminds me about the fragility of our lives.   Japan reminds me about the fragility of our planet.  While I won’t teach my child to live in fear, he will see me go back to the car to get a cloth bag instead of plastic that may end up in our oceans or landfills.  And for now, he’ll be in cloth diapers.



Tricks and Myths. How to Initiate Labor Naturally (My almost second post)

Here is my “almost second post” I wrote while sitting in the hospital waiting for my child to be born. You can see the first post above, also written while my wife was in labor. She ended up in labor for 26 hours! No epidural, natural labor with 23 hours of contractions… then another 3 hours of pushing…then a vacuum extraction since that didn’t work…then a Cesarean birth since that didn’t work. She did it all (except an episiotomy!).

Tricks and myths. How to initiate labor naturally.

What works to help a woman go into labor? We’ve heard it all.
My step-mother swore by the bumpy dirt road she drove down before she had my brother and sister. Of course, that sure doesn’t sound very comfortable to a pregnant woman who’s carrying an extra bowling ball over her belt.

My mother is an advocate of stair climbing.

40 Weeks Pregnant Stair Climbing

40 Weeks Pregnant Stair Climbing

We went to the pro NFL stadium yesterday to watch the local high school football championships, and climbed plenty of stairs. I thought maybe the crowd noise, and the game excitement might push her over the edge. Scratch that one off the list too.

We were told to walk the mall by a friend who is a doctor’s wife. The same advice was also given by the OB nurse we called a few days in a row, with our first Braxton-Hicks contractions. Several mall walks (and pregnant brain purchases) later, still no baby.

Red raspberry tea, was a potion we avoided prior to being full term. Primrose tea and mineral oil, are also rumored to start off labor. We didn’t try those. Mineral oil is also used to treat constipation, and that wasn’t an issue.

The jury is still out on the hot wings we had last night, volcano hot. As my wife says, if she’s been eating hot food throughout the whole pregnancy, why would that set her off now? I don’t think the delicious jalapeno chicken sausage did it either (neither of the 2 times we ate it!)

BMJ, the British Medical Journal, publishes a book they give out free to doctors every year, which reviews the latest medical evidence on a variety of topics. According to their evidence based medicine review, some studies say sex can spark labor, while other studies failed to prove that. Considering a couple is not supposed to have sex for 6 weeks after delivery, it seems like any couple that still feels frisky should take advantage of this potentially beneficial opportunity.

A new one we hadn’t heard, was steamed spinach. According to the entertaining Judy, owner of the somewhat famous Big Kitchen Cafe in San Diego (where Whoopi Goldberg once washed dishes), it takes 4 days of steamed spinach to induce labor. We’re on our 3rd day of spinach, and started to have stronger contractions at 3am, but got induced with pitocin for other reasons this morning. She was induced, though she also did have the baby 4 days after starting the spinach. I may have to research this further, but so far, our first experiment testing the spinach theory worked!

Nervous New Father , My almost first post.

I first envisioned while my wife was pregnant.  As a nervous almost new father, wringing my hands waiting for a long 9 months to end, and a whole new life as I know it to start, I wrote this:


Mission: Medical advice about children for parents from the perspective of a new father who’s an experienced pediatrician.


Welcome to my blog.  I have been a pediatrician for 15 years, but never a father.  On my pediatric residency application I was tempted to joke, a pediatrician without kids, is like  a podiatrist without feet.  I am a great pediatrician, yet I have always known there is no replacement for personal experience over merely knowing good theory about raising children.  I have the advantage of having learned great pediatric knowledge without the emotional interference to cloud the facts and my judgment when making medical decisions.  Now I  am looking at the world through whole new eyes as a new father. 


I am writing my first entry as I sit in the hospital on the Labor and Delivery ward.  Our long anticipated due date was yesterday.  We came in this morning for our Non-Stress Test (hah!).  It is done after you’re full term to just check up on the baby and the womb.  Apparently, the amniotic fluid in there is low, so there was “no room in the womb” (say that 3 times fast), and they’ve decided it’s time for us to be put into labor.


In our case, it’s not a matter of the fluid leaking.  It’s that towards the end of pregnancy, the placenta naturally becomes more inefficient.  There are other reasons for someone to have low fluid, but ours was fine a few days ago, when we had an ultrasound with some early phase contractions.


It’s both a relief to finally be starting labor, and a disappointment that things didn’t happen naturally.  I am grateful we have the technology, to discover the fluid is low, and to catch problems before they arise.


What do you think?


Don’t let your kids fall asleep with the bottle.

Easier said than done! Check out my friend’s kid in this video.


Nodding off in high chair with bottle

Pura Vida=Pure Life

Pura Vida

When I gaze at my child, I see the purity of life.  It reminds me of the phrase Pura Vida, or Pure Life in English.  In Costa Rica “Pura Vida” is used as an everyday greeting, like hello, or Shalom in Israel.  It’s also good bye, like Shalom in Israel.  Best of all, it’s an answer to the question “how are you?”  They answer “Pura Vida”.  It creates a great mentality that is much better than our pat answer of “fine”.


I gaze at my sleeping child and it gives me great peace.  One because he’s my child.  Secondly, because I know he is at peace.  He is living life at it’s most pure form right now. When he’s been fed and changed, his little innocent mind has not a care in the world.  When he wants something, he screams.  And he gets it!  I wouldn’t have a care in the world either if I could just scream and get whatever I want.  And, while he’s only a few months old, I’ll give it to him.  Unconditional love=Pura Vida.

And when he grows up, I will teach him when people ask you “How are you?,” he will answer “Great!” like his parents do.


Pediatrician Turned Parent

Welcome to my blog.  I am an experienced pediatrician, who until now, has missed an essential ingredient in my ongoing education.  I have practiced for over 15 years, I am clinical faculty at 2 leading medical schools, and I’ve given parenting and child health advice to thousands, all based on a classic pediatric education.  Now I’m re-educating myself based on practical experience as a new parent myself.  As I once said, a pediatrician without kids, is like a podiatrist without feet.

As I rethink everything I’ve learned  (and taught) based on my new experiences, I’ll share some of those insights with you.  I already find myself answering questions from distraught parents in the office with a new understanding.  I knew in theory about the sleepless nights, but I hadn’t lived it.  I thought being up all night answering pages in the hospital was just as bad.  It’s different.  As I write this during some precious almost downtime, I have to reach up every few seconds to rock my new son’s bassinet until he falls into a deeper, less squirmy, less grunty, sleep.

I understand more.  I understand I’m still learning.  And, as I’ve always understood, every kid is different.  What might work for one, wont always work for another.  I’m experiencing that adage every day (and night!).

I welcome comments, discussion, and feedback from parents, and other providers.  I’m planning to learn a ton from your insights.  I do not intend to create an all inclusive medical advice forum.  I will do some product reviews.  (I am a techie at heart, and we are trying other fun things like cloth diapers out).  I will offer parent education about health matters.  I will comment on other interesting things I find on the internet.  Mostly, I will discuss those matters I feel passionate about (or at the least find interesting) as a parent now.  And we’ll have some fun.