Parents

From the Desk of DocSmo: Your Child and the Natural World

When you stop and think about it, it’s not hard to find examples of how the natural world influences the health of our children and us. We are an integral part of our environment, and our environment is an integral part of us. Weather, air quality, water quality, radiation levels, the presence or absence of light: these are just some of the environmental factors that determine the health of you and your child.

Like with most things, it is useful to look at extremes cases to try and define the more subtle affects of environmental factors.

Let’s begin with sunlight. Too much sunlight, especially when your child is young, and they get skin burns immediately (and skin cancers and cataracts in the long run). Some believe that light exposure to children at night can cause common vision problems like nearsightedness and astigmatism. Clearly too much sun is not good for your children. On the other hand, too little sunlight can give a child vitamin D deficiency along with its associated health problems both immediate (a metabolic bone disease called rickets) and long term (possibly multiple sclerosis, breast and prostate cancer, and adult onset diabetes).

Let’s also consider radiation exposure like that from the sun, the earth (in the form of discharges. Large amounts of radiation do very bad things to us just like visible light does. Occupations where people work near radiation are associated with premature illness and death. Examples of these are radiologists, nuclear power plant workers, and pilots and flight attendants. Naturally occurring sources such as radon gas, medical exposures (like those from a CAT scan), and pollutions exposures (nuclear wastes and, in my generation, above ground nuclear testing) to radiation can also be a negative influence on your child’s health. How about a lack of radiation? Could it be possible that we need a small amount of radiation to stimulate certain biologic processes in us just like light does with Vitamin D? I really don’t know, but I suspect so.

Finally, let’s consider our relationship with the microbial world. Traditionally in medicine, we have concentrated on the microbes that we know cause disease like Salmonella stomach infections, Strep Pneumonia (which causes so many lung infections), and Staph Aureus (which causes invasive wound infections). In the past 10 years, researchers have realized that the vast majority of microbes on and inside us are absolutely necessary to our health! We cannot be healthy without these little creatures. Furthermore, the very artificial and sterile world that we have created for ourselves may be causing a lot of disease! The point is that too many pathogenic bacteria are clearly bad for you and your children’s health, but equally harmful may be a lack of healthy bacteria that we cause by being too clean and sterile. Antibiotics for the treatment of disease, food irradiation, soil depletion, etc. may be robbing us of essential “health sustaining” microbial life.

Finding the balance with the natural world is a constant struggle as our species takes over and dominates the earth. I certainly do not advocate going back to the cave, but I feel we need to pull back and find a more natural balance with our surroundings. My approach is the minimalist approach. Any time I can replicate what I call a natural life, I will. That means walking or riding a bike whenever possible, being outdoors whenever possible, eating locally grown food, even from your backyard when possible, opening those windows and turning off the A/C system, handling and using complex chemicals such as pesticides and solvents as little as possible, living with animals, slowing down the pace of life with less media and more human interaction. Our relationship with the natural world is one of the great challenges facing us and our children.

From the Desk of DocSmo – “Safe Sleep for Infants” circa 2011

As our understanding of safe sleep practices have been evolving over the past 30 years, I have joked that when we finally figure out what the “safest” sleep environment is for infants, it will probably turn out to be laying on a rock (hard bedding), facing the stars (on their back), with only their fingers as comfort (no toys, pillow, bumpers), with fresh air (no cigarette smoke), and a little cool breeze in their face (making overheating almost impossible), in eyesight of their mother (at the campsite).  Sounds a lot like what our ancestors must have experienced who lived in relatively warm climates.  Most of us are living a life very different from our tribal ancestors, but the recent guidelines set out by the AAP sound like they would like to get us as close to our roots as possible.  Let me summarize the AAP’s dos and don’ts with regards to a safe sleeping environment for your infant:

DOs:

-Infants should be laid on their backs (not any other position) for every sleep that is not supervised by their parents until they are 1 year old.

-Only firm bedding  that conforms to safety standards should be used as a sleep surface.

-Room-sharing (without bed-sharing) is recommended for the first 6 months.

-Babies should be in a crib without bumpers, pillows, sheepskins, blanketing, or loose toys.

-Breastfeed your infant.

-Immunize your infant.

-Consider offering a pacifier to your infant.

DON’Ts:

-Avoid alcohol and illicit drugs around your baby.

-Do not expose your baby to cigarette smoke during pregnancy or after birth.

-Make sure your infant does not get overheated while sleeping

-Do not use sleep positioners, co-sleepers, or respiratory monitors in healthy babies

-Do not use crib mattresses that leave a gap between the crib and the mattress.

-Do not sleep while holding your baby, such as in your bed, a chair, or on a couch.

 

Well, that’s it in a nutshell.  The best that science has to offer to protect your infant in the first year with regards to sleep safety.  Longtime listeners of my podcast will recognize that the new recommendation for infants to sleep in their parents’ room is at odds with the advice I gave in my podcast, “Straight Talk about Sleep in Infancy.”  In light of these new guidelines, I will begin recommending  that sleep training for infants routinely begin at 6 months rather that the 4 months that I recommended previously.  Additionally, I have recommended what I considered safe toys be placed in the cribs of older infants.  I assume that an activity center tied to the crib side would be a safe toy, but I am not sure the AAP would agree.  Does all sleep for the first 6 months need to be witnessed by a parent, even when it occurs during the day?  To me, this is unclear from the guidelines.  How about swaddling: is the risk of overheating too high to be tolerated?  Every time we answer some questions, we pose more.  Hopefully these new guidelines will help make SIDS (Sudden Infant Death) and SUIDS (Sudden Unexpected Infant Death) a thing of the past. We can hope.

References:

1. SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment

2. The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk — Task Force on Sudden Infant Death Syndrome 116 (5): 1245 — AAP Policy

 

 

Let’s not forget to care for the Mamas and the Papas! (Pedcast)

As parents, it’s easy to become absorbed in your children’s well-being and forget to take care of yourself.  Don’t forget,  one of your most important assets is YOU. Taking care of yourself now can make a world of difference economically, physically, and mentally down the road.  In this “Pedcast”, Doc Smo reminds parents to be mindful of their well-being and illustrates some simple ways that you can improve your health for the betterment of you and your family.

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