New Research about Childhood Sleep (Article)

Research is proving what we all instinctively know; children need adequate sleep. Two new studies suggest that too little sleep in children, younger than age seven years, can have a negative aspect on all facets of their young lives. Scientists and physicians are still trying to sort out what happens to a child’s brain during sleep but one thing seems certain, the function of sleep is vital. For many children, life in the 21st century is go, go, go and time for children to sleep seems not to be the priority it once was.   Ask any pediatrician, sleep problems have become common with the advent of screens in children’s rooms, access to disturbing media content, children living in multiple households, and a general rise in anxiety experienced by children.

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Children and Pools (Article)

​Summer is a season when parents need to be especially vigilant about their children’s safety. One of the biggest summer risks starts when the pools open for business. What summer vacation signifies for youth is cooling off from the summertime heat by jumping and playing in a pool. For children, the neighborhood pool means freedom, friends, and fun. For parents however, their immediate concern needs to be, “safety first!” As beautiful and harmless as backyard appears, parents must remember it can be dangerous and even lethal for their children. A 2013 report found that children younger than 15 represented 78% of deaths from pool-related injuries. These data certainly cast a dark shadow over the image of fun in the sun. ​Since when did swimming at the pool become dangerous? The report “Pool and Spa Submersions: Estimated Injuries and Reported Fatalities” discusses findings related to this class of injuries. This 2013 report found that the majority of these pool-related fatalities involved children “15 years or younger” at neighborhood pools. Interestingly enough, the report also found interesting demographic information related to these incidents. The Centers for Disease Control and Prevention found African American and Hispanic children at higher risk of drowning. Particularly, African American children, between ages 5 and 19, were “six times more likely to drown in pools [versus] white and Hispanic children.” They also found that 70% and 62% of African American and Hispanic children, respectively, could not swim adequately. The report did not identify the exact origins behind these figures but point out a serious health hazard threatening a large group of children. ​How do we solve the problem of childhood drownings? Should we outlaw community and backyard pools? No, we need to increase our efforts to make sure every child learns to swim and know how to safely be around water. Thanks to organizations like the American Red Cross, the YMCA, and most public swim facilities, families can teach their children how to swim and remain safe during this and all future summer seasons. Proper swimming is a vital life skill that all beachgoers, children and parents should know. It may seem obvious but the solution to childhood drownings is really simple, professionally taught swim lessons along with good adult supervision around water. Smo Notes: Written collaboratively by Norman Spencer an Paul Smolen M.D.

Feed, Read, Play and Thrive (Article)

Malnutrition can stunt child development, but what about improper and infrequent social interaction? Could isolation inhibit a child’s psychological growth? Dr. Paul Gertler of the University of California at Berkley thinks it can. Dr. Gertler and his colleagues set out to determine if providing appropriate socialization could help disadvantaged children succeed in the academic and employment worlds. Maybe programs such as “Feeding America” would be more effective if social welfare agencies were able to improve the parent-child interaction. Could proper socialization of young children really make that much of a difference? To answer this question, Dr. Gertler conducted a twenty-year longitudinal study of malnourished Jamaican babies. His results are amazing! On a weekly basis from the ages of one to four, researchers provided structured positive social interaction and nutritional support to the experimental group, solely nutritional supplements to one control group, and no support at all to the final control group. At age twenty, the nutrition-plus-social-interaction group were earning 25% more than the controls, less likely to commit a crime, more physically fit, and more successful in school. The success of the experimental group over the controls led Dr. Gertler to conclude that nutrition is not the only factor controlling a disadvantaged child’s well being—frequent and healthy social interaction can help prepare a child for a productive life. Although many programs provide adequate food to struggling families, offering healthy social interactions to toddlers and young preschoolers may be just as important. Is it surprising that giving young children attention and stimulating their language/cognitive development can have a positive impact on their adult lives? The Head Start Program was designed in the 1960’s to provide social and cognitive stimulation to low income children, ages 3-5 years. Today, a similar kind of assistance is available through The Early Head Start program, reflecting the changing tide in child development research. We now know that by helping a child learn language and social skills from a very young age, we improve their chance of achieving success. With what we have learned recently about the negative effects of stress and deprivation on infants and toddlers combined with this new information that social skills training in very young children can dramatically improve their lives, we can begin improve academic and societal performance and maybe even help win the war on poverty.  Let’s hope so. Your comments are welcome at Until next time.

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Smo Notes: 1. Written collaboratively by Sam Allen and Paul Smolen M.D.

White Noise Machines Can Be Noisy! (Article)



I am an old enough pediatrician to have seen a number of sleep fads come and go in my career. I recall a device that gently shook the crib and made the noise similar to a car ride that was very popular back in the 80’s.  I also recall, a set of springs that were fitted to the bottom of the crib so as to create a rocking motion each time the baby moved.  Who could forget the stuffed animal that had placenta noises or heart beat sounds emanating to help the infant replicate the womb-like environment in their crib. The current trends in infant sleep aides seem to be  swaddle devices and white noise machines, to a large degree popularized by Dr. Harvey Karp, a pediatrician in California.


It was with great interest to me when I recently read a study that has questioned the safety of the white noise machines that are currently sold in the US. The authors recorded the decibel level of a variety of these machines and found that, at close distances, the amount of noise they produce could potentially cause hearing loss in an infant, especially if they were run all night. Currently, experts recommend that noise in hospital nurseries not exceed 50 decibels but many of these machines tested reached 85 decibels sound levels, far above what is considered safe. Exposure to noise of that level over an extended period of time can potentially cause permanent hearing loss.


Parents need to use caution when they introduce any external device into an infant’s sleep ritual as we have recently been reminded with revelations about swaddle devices and now sound machines.  Yes, there might be some short-term advantages from these devices but those unintended consequences often come back to haunt us.  In the case of white noise machines, exposure to a lot of noise is clearly a limiting factor. Although difficult for many infants, maybe learning to settle oneself down and control one’s own environment by creating their own “Comfortable sleep environment” is an important learning step for infants.


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