Tag Archives: death

Dr. M’s Women and Children First Podcast – Omicron Update #2

COVID Omicron Update #2:
Let’s continue to breakdown the new variant and what we know overall. The world according to SARS2 Covid 19 is now the world according to Omicron. What does this mean for us today? How are the vaccines faring? Boosters? Natural illness?
Enjoy,
Dr. M

Lunchroom Lowdown- Safe Sleep Guidelines for Infants 2011 (Article)

 

I convened a “lunchroom lowdown” the other day on the topic of new AAP Safe Sleep Guidelines, and my partners eagerly offered their opinions and impressions when it comes to safe sleep for infants. My partners–Drs. Plonk, Riley, Downing, and Moorman–are outstanding doctors, and I can’t thank them enough for sharing their expertise with me.  Let me try to summarize our conversation about “Safe Sleep for Infants.”

 

A lot of the discussion revolved around the practicality of running a household with three or four children following the new recommendations.  I think all the doctors felt that the guidelines are good goals but are not always practical.  Dr. Riley doubts that parents can always be present when their infant is asleep.  Also, can the surface they sleep on always be on a “sleep safe surface” as outlined in the guidelines?  Probably not. Dr. Plonk wonders what happens when an infant falls asleep in a swing or car seat: should they always be awakened and moved to a safe place?  Again, unlikely.  Dr. Downing thinks that it is very unlikely that after a child feeds in their parents’ bed that the child will always be put back onto a safe surface by an exhausted, half-asleep mother.  Since only one person is supposed to be in the bed with the infant, does that mean Dad gets exiled with every feeding?  Dr. Downing doesn’t think that will happen, and neither do I.

 

Drs. Plonk and Riley felt that not only are some of the guidelines impractical, but some are ambiguous.  The “no monitor recommendation” seems to imply not to use audio or video monitors; why?  If not, do parents need to watch their children sleep 24/7 in person? What about that “no over-bundling recommendation” (not to use more than one layer more than would make an adult comfortable)?  How many layers are in a swaddle?  Is swaddling with a large blanket now forbidden?

 

 

 

Dr. Downing felt that the new guidelines are excellent recommendations, but wondered if they will change very many parents’ behavior.  We all know how difficult it is to change someone’s behavior.  There was uniform agreement that despite the new guidelines’ impracticality and potential ambiguity, overall the AAP’s new guidelines for safe sleep are a big step forward for children.

 

As we were discussing this topic, the thought crossed my mind that hospitals should be the number one place where these guidelines are followed, but that is often not the case.  Hospitals should be setting the best example for parents and physicians.  If anyone should know what actually happens in a hospital, it is the group at the Lunchroom Lowdown; combined, we have over 100 years worth of hospital nursery experience.   We know what goes on in hospital nurseries.  Many of the guidelines are not being followed on a routine basis to this day.  For instance, twins are often put in one bassinet together (“Babies should sleep on a safe surface by themselves”).  Babies are routinely swaddled with multiple wraps (“No more than one layer above others in the room”) and placed on their sides (“Back only”).  Additionally, the bassinets have solid sides which could get up against a baby’s nose and cause obstruction (“No surfaces near a baby’s face that can cause suffocation”).  It is not unusual for lovies to be placed in the crib from the day a child is born (“No toys”).  What about those cute little hats that almost every newborn wears: could it get down over a child’s face? You bet. Finally, the move toward infant bonding, skin to skin, and rooming-in encourages very exhausted moms and dads to hold their newborns when everyone may be very sleepy (“No sleeping on unsafe surfaces”).  Hospitals, let’s get with the program!

 

The death of a otherwise healthy infant is a terrible thing, and the new guidelines are a big step toward making such an event a thing of the past.  When you really dig down into the recommendations, you begin to see how difficult they are to follow at all times.  Let’s hope that both parents and hospitals can do a better job in the future of providing the safest sleep possible for our newest citizens we call our children!

From the Desk of DocSmo- Teen Driving Safety

This week is National Teen Driver Safety Week (October 16th-22nd), an attempt to improve our awareness of the dangers young drivers face as well as giving parents ideas on how to reduce their young drivers’ chances of being injured in a car.  It is very tragic that on average 8 children a day die in preventable automobile accidents.  These are young, healthy, energetic, bright adolescents who die before their adult lives even begin.

During my pediatric career, I have witnessed improvement in both car safety and in the teaching of driving skills to teens.  I am a big fan of the graduated driver’s license.  My children benefited from the slow introduction of driving skills.   I also think  that automotive engineers have done a wonderful job over the past 30 years of improving the safety of cars.  I have seen teens walk away from crashes that would have surely killed a generation ago, protected by airbags, safety cages, restraint systems, and anti-roll technology.   My first car didn’t have a seat belt!

The highlight of National Teen Driver Safety Week campaign is to get parents more involved in teaching safe driving to their children.  Here are some suggestions for improving your teen’s driving skills:

-Drive with your teen as much as possible, the more the better.  Practice makes perfect.

-Be very clear about your expectations for your teen’s driving.  Lay out the rules and write them down. Make a formal agreement and get everyone to sign it.  Make sure your agreement addresses your teen’s car privileges as well as financial contributions to driving, cell phone use while driving, calling home when away from home, driving after dark, radio use while driving, driving non family members, and the consequences of driving infractions or breaking house rules.

– Share your rules with other parents.  Having similar rules for your child’s friends will make them easier for everyone to enforce.

-Lead by example.  Set a good example for your children by being a safe driver yourself.  Never drink and drive.  Be defensive in your driving.  Wear your seat belt and make sure your passengers do as well.  Don’t drive when you are too tired.

I am now going to share with you something that I invented that I think helped when my children were learning to drive.  I realized that the more I reminded (nagged)  my children to follow the rules the more they ignored me.  My reminders, instead of reinforcing the messages of safe driving, seemed only to emotionally agitate my children.  I therefore decided to communicate with them using “hand signals” to remind them of my safe driving tips.  Here are Dr Smolen’s hand signals for safe driving:

– “1 finger then  10”.   Meaning- stay 1 car length back for every 10 miles per hour.  Example- 3 car lengths back at 30 mph.

– “Repeated downward hand motion”.  Meaning- Don’t drive too fast.  Stay BELOW the speed limit.

– “The double head turn with fingers pointing both ways.”  Meaning-  Look twice before you pull out into oncoming traffic.

-“Shake head no with phone to ear”- Meaning- No talking, texting, surfing or anything else with the phone while driving.

– “2 fingers pointing from eyes”- Meaning-  Keep your eyes on the road!

Feel free not only to use my hand signal method of communication with your young driver, but also to add your own variations.  It was actually fun to talk to my children with just hand signals and have them know exactly what I was talking about.  I am posting some web resources for you to check out if you want to read more on this subject.  You can find a sample driving agreement to use as a starting point on the CDC website.  Good luck and happy driving.

 
Slow Down:

 
Pay Attention:

 
No Cell:

 
Look Two Ways:

 
1 per 10:

References:

CDC – Teen Driving – Parents Are the Key Homepage

Get Behind National Teen Driver Safety Week (NTDSW)

CDC – Teen Driving – Graduated Driver Licensing – Parents Are the Key