CRISCO, ETC.

CRISCO, ETC. GETS NEW MEANING

2012-01-22T18:59:00.000-08:00

When I began this blog, Crisco was a positive thing and for many years had been a very inexpensive skin cream with multiple uses.

While in Mission Hospital for 44 days, I contacted Heather Hamilton, a mother of patients and the founder of Zoe Organics skin product company.

I asked her if there was something she could add to Crisco to make it smell better. After about a week she emailed that she didn't think I wanted to continue to use Crisco, because a butane derivative called TBHQ had been added to Crisco. I emailed the Crisco website to ask them when they had added TBHQ to their product and received the following answer:

Dear Mr. Shannon,

Thank you for contacting Crisco®. We are always pleased to hear from consumers who enjoy our products.

In response to your inquiry, Crisco Shortening was reformulated to contain zero grams trans fat per serving. The reformulation includes many of the same ingredients as the previous formula; we have reduced the level of the partially hydrogenated soybean oil and added several ingredients, including TBHQ, required to maintain the superior taste and high performance requirements consumers expect from Crisco. TBHQ is an antioxidant approved by the U.S. Food and Drug Administration and is used commonly used in food products. It was added in 2006. . . .

Sincerely,SusanConsumer Relations Representative

So Crisco and Smucker's, who owns them, have decided that adding a butane derivative is better for them because they can use less soybeans and it will last longer. They have done this without considering the future of our children, and for that reason, Crisco becomes a thing of the past and one of the many examples of companies that make changes in their products for financial reasons and not for our long-term health.

Since we no longer have Crisco, I ask Heather if she could create a new totally organic product that we could use in it's place. She has created such a product using totally organic ingredients, which contains antioxidants, vitamins A, E and D and omega fatty acids. We are currently in the process of preparing this product for marketing and hope to have it available before the end of February. I will post a notice blog when we are ready to go!

SUNSHINE FOR VITAMIN D

2011-06-04T07:46:00.001-07:00

As we head into summer months and regarding other months of the year, I found clarification about how much sun in takes to make Vitamin D through our skin.

“In general, 5 to 10 minutes a day between 10 a.m. and 3 p.m.with
minimal clothing is considered good.”

This advise works with qualifications. You can make ~2300 IU of Vitamin D if::

A) 10 minutes Full Exposure Face Up (or Down) in bikini or boxers 45% exp.
B) You are Skin Type (ST) 2 with no previous sun exposure
C) Location is 42° N Lat Clear Skies August 13th +/- 2 days @ 12 Noon
D) Almost forgot. You are 20 years old.
ST 3′s can make ~1400 IU is same time frame. 17 min to 2300 IU
ST 4′s can make ~1000 IU is same time frame. 22 min to 2300 IU
ST 5′s can make ~600 IU is same time frame. 37 min to 2300 IU
ST 6′s can make ~400 IU is same time frame. 55 min to 2300 IU

Every 25% “Base Tan” reduces Vitamin D production 25%
Every 10 Years reduces Vitamin D production by 10%

Every Hour Before or After Noon reduces another 20%

GRACE OF GOD

2011-05-18T06:37:00.000-07:00

Only by the grace of God am I able to write that at 5:45 a.m. on March
29, I was involved in an almost deadly car accident in Dana Point and
survived! My recovery is being chronicled on CaringBridge by
Vanessa, who has already walked my path.

www.caringbridge.org/visit/drmichaelshannon

I will blog again, but it may be several months before I continue.

MWS

GRANDPARENT'S ANSWERING MACHINE

2011-02-03T02:34:00.001-08:00

This is so good it deserves a separate blog. You will only truly appreciate this when you get to be one - and Lala and I love being one.

GRANDPARENTS' ANSWERING MACHINE

Good morning. . . . At present we are not at home but, please Leave your message after you hear the beep.. beeeeep ...

If you are one of our children, dial 1

and then select the option from 1 to 5 in order of "arrival" so we know who it is.

If you need us to stay with the grandchildren, press 2

If you want to borrow the car, press 3

If you want us to do your washing and ironing, press 4

If you want the grandchildren to sleep here tonight, press 5

If you want us to pick up the kids at school, press 6

If you want us to prepare a meal for Sunday or to have it delivered to your home, press 7

If you want to come to eat here, press 8

If you need money, dial 9

But... If you are going to invite us to dinner, or are taking us to the theatre start talking we are listening !!!

Photos are by GABRIEL RYAN PHOTOGRAPHERS

http://gabrielryan.net/#/gabriel-and-carlie--the-lead-photographers/

WHY FALL LEAVES CHANGE COLOR

2010-10-26T04:53:00.000-07:00

I just returned from visiting my daughter, Vanessa, in West Virginia. As you can see in the photos, she has a large bandage on her left forearm from suffering two broken fingers in an auto accident in which her car rolled many times and she was so fortunate to survive.

Once again I missed the "peak" fall color, but was close. This time it occurred in the next two weeks after I was there. Last year it happened the week before I was there. So I will go again next year and keep dreaming of hitting it right on!

Even though this blog is supposed to be about things I learned in pediatrics that weren't in the book, I figured most of us don't know why fall leaves change color, so the reason is below.

Why Leaves Change

Every autumn we revel in the beauty of the fall colors. The mixture of red, purple, orange and yellow is the result of chemical processes that take place in the tree as the seasons change from summer to winter.

During the spring and summer the leaves have served as factories where most of the foods necessary for the tree's growth are manufactured. This food-making process takes place in the leaf in numerous cells containing chlorophyll, which gives the leaf its green color. This extraordinary chemical absorbs from sunlight the energy that is used in transforming carbon dioxide and water to carbohydrates, such as sugars and starch.

Along with the green pigment are yellow to orange pigments, carotenes and xanthophyll pigments which, for example, give the orange color to a carrot. Most of the year these colors are masked by great amounts of green coloring.

Chlorophyll Breaks Down

But in the fall, because of changes in the length of daylight and changes in temperature, the leaves stop their food-making process. The chlorophyll breaks down, the green color disappears, and the yellow to orange colors become visible and give the leaves part of their fall splendor.

At the same time, other chemical changes may occur, which form additional colors through the development of red anthocyanin pigments. Some mixtures give rise to the reddish and purplish fall colors of trees such as dogwoods and sumacs, while others give the sugar maple its brilliant orange.

The autumn foliage of some trees shows only yellow colors. Others, like many oaks, display mostly browns. All these colors are due to the mixing of varying amounts of the chlorophyll residue and other pigments in the leaf during the fall season.

Other Changes Take Place

As the fall colors appear, other changes are taking place. At the point where the stem of the leaf is attached to the tree, a special layer of cells develops and gradually severs the tissues that support the leaf. At the same time, the tree seals the cut, so that when the leaf is finally blown off by the wind or falls from its own weight, it leaves behind a leaf scar.

Most of the broad-leaved trees in the North shed their leaves in the fall. However, the dead brown leaves of the oaks and a few other species may stay on the tree until growth starts again in the spring. In the South, where the winters are mild, some of the broad-leaved trees are evergreen; that is, the leaves stay on the trees during winter and keep their green color.

Only Some Trees Lose Leaves

Most of the conifers -- pines, spruces, firs, hemlocks, cedars, etc. -- are evergreen in both the North and South. The needle- or scale-like leaves remain green or greenish the year round, and individual leaves may stay on for two to four years or more.

Weather Affects Color Intensity

Temperature, light, and water supply have an influence on the degree and the duration of fall color. Low temperatures above freezing will favor anthocyanin formation, producing bright reds in maples. However, early frost will weaken the brilliant red color. Rainy and/or overcast days tend to increase the intensity of fall colors. The best time to enjoy the autumn color would be on a clear, dry and cool (not freezing) day.

Enjoy the color; it only occurs for a brief period each fall.

Courtesy of SUNY College of Environmental Science and Forestry. Text prepared by Carl E. Palm, Jr., Instructional Support Specialist, Faculty of Environmental and Forest Biology

THE SUNSHINE VITAMIN

2010-06-27T05:47:00.000-07:00

Until the second half of 2009, I knew that Vitamin D was in multi-vitamins and my calcium tablets, and way in the back of my mind somewhere was the stuff about Vitamin D and preventing rickets, but that's about all I knew. When the Panic Swine of 09 arrived and talk of a "new"vaccine hit the press, I began searching Google for other alternatives than a new, briefly tested vaccine.

I didn't have to look far to find Until the second half Dr. John Cannell, a psychiatrist at Atascadero State Hospital in San Luis Obisbo county. Dr. Cannell had become interested in Vitamin D and it's protective effect against influenza. He found that there were certain patients at his hospital who never seemed to get the flu, year after year. When he measured Vitamin D levels he found that these patients had really good levels, whereas the other patients had insufficient levels.

In addition to Dr. Cannell's work, I also found out that Dr. Michael Holick of Boston University Medical Schoom had been researching Vitamin D for over 40 years and realized that there is a Vitamin D receptor in every organ in our body. Preventing rickets in young children is just the tip of the iceberg as far as human diseases and prevention by Vitamin D sufficiency.

"When human skin is exposed to sufficiently powerful ultraviolet (UV) radiation from sunlight, a form of cholesterol contained in our skin ("7-dehydrocholesterol") is converted into the precursor of Vitamin D, called "cholecalciferol". This is then converted by our liver into the inactive bulk storage form of Vitamin D that blood tests measure ("25-hydroxyvitamin D"). Although Vitamin D is present in limited amounts in cod liver oil and some fatty fish (salmon, mackerel and tuna), it is essentially unavailable in metabolically useful quantities from dietary sources.

As we age, our skin gradually loses its youthful cholesterol and its ability to synthesize Vitamin D declines over time. Although it has not been widely studies, some reports indicate that by the age of 50, Vitamin D production has fallen to approximately 50% of its original rate, and by age 65 production will have fallen to just 25% of its original capability. And independent of age, the skin's melanin pigmentation - either from natural genetic racial coloration or tanning adaptation -- acts to absorb much of the sun's visible and ultraviolet radiation. This skin darkening has the beneficial effect of protecting our skin from UV radiation damage, but at the expense of further reducing the skin's rate and capacity for Vitamin D production. (Melanin is 99.9% efficient in absorbing the energy from ultraviolet light, converting it into harmless heat.)" These two previous paragraphs are from Steve Gibson. http://www.grc.com/health/vitamin-d.htm

There is in fact, an epidemic of Vitamin D deficiency which is now worldwide. This has occured because of several factors. The first is that the current Institute of Medicine recommendation for the daily requirement for Vitamin D was established in the 1960s and has not been revised since that time, even though most of the research about Vitamin D has occurred in the past 10 years. And the "recommended daily allowance" or "minimum daily requirement" of vitamins listed on foods is based on the minimum amount of Vitamin D to avoid rickets in young children and has nothing to do with the real requirement to prevent "long-latency" diseases like diabetes, auto-immune diseases like arthritis, heart disease, thyroid disease, mental disease, cancer, multiple sclerosis and for our immune system function. A second reason for the widespread deficient Vitamin D levels is the changes in our life style. The average American spends 95% of every day inside and the average American child spends 6 minutes per day outside. And the third reason is that even if we are outside, how much Vitamin D we can absorb is determined by our skin pigmentation, the latitude in which we live, the time of day we are outside, the season of the year (and the angle of the sun). A rule of thumb is that if your shadow is longer than you are tall, you are absorbing no Vitamin D. And effective sunscreening effectively blocks Vitamin D absorption. A fourth reason, which is especially important in sunny climates is that dermatologists have long recommended avoiding sun exposure because of the fear of skin cancer.

Perhaps the most important medical issue at stake related to Vitamin D status is the Vitamin D level of pregnant women. Prenatal vitamins contain the minimum required 400iu of Vitamin D. This is the same amount that is recommended for the newborn baby after birth. As Dr. Reinhold Vieth from Canada says, "Do the math!" The amount getting to the fetus when the mother is taking 400iu of Vitamin D is inadequate. Dr. Carol Wagner and others from the Medical University of South Carolina has completed a study of pregnant and lactating women and shown that mothers with sufficient levels of Vitamin D has 50% less C-sections, 50% less prematurity and 30% less high blood pressure in late pregnancy. With this information available, it is prudent for all pregnant women to measure their Vitamin D level and get enough Vitamin D from sun or supplement to maintain a sufficient level. (Food is not a good source.)

One would expect that all of us residing in sunny southern California should have wonderful Vitamin D levels, but there are actually a significant number of children and adults who are in the insufficient range. I measured my Vitamin D level, 25(OH)D, in September after a summer of sun and my level was insufficient. In my own personal case, I had been having chronic knee pain related to years of running down hills and mountain trails (and finding out after 64 years that one leg is shorter than the other). Once I began taking enough Vitamin D to get my level into the preventative range, my knee pain virtually disappeared. This decrease of muscle and joint pain has been reported from many different sources.

The Swine Panic of 09 was an unpleasant experience, but learning about Vitamin D and it's importance in our ongoing health made all of that Panic almost worth it. If you don't know your Vitamin D level, ask you physician to measure 25(OH)D and compare it to the following chart which shows the protective ranges of Vitamin D levels related to long latency diseases.

The next photo shows the Vitamin D levels of primates and early man.

Just as I was unaware of the far reaching implications of Vitamin D deficiency, most physicians are likewise unaware of this information. It is actually the media that is spreading the word to the public and then the public going to physicians and asking to measure Vitamin D levels.

Of final note is that the Chicago Blackhawks became the first professional sports team to be Vitamin D sufficient. The result was that they won the Stanley Cup for the first time in almost 50 years. Might be coincidental, but next time you ask your favorite sports star for an autograph, ask "What's your Vitamin D level?"

DOUBLE DIGIT YEARS OF MY LIFE

2010-04-12T06:12:00.000-07:00

I WAS 11 IN 1955.

I LIVED IN NORMAN, OKLAHOMA. O.U. WON EVERY GAME AND AND I SAT IN THE SOUTH END ZONE FOR EVERY HOME GAME. IT WAS CALLED THE THE BIG 7 AT THAT TIME. THEY WON THE ORANGE BOWL AND BUD WILKINSON WAS THE COACH. I FINISHED 5TH GRADE AND STARTED 6TH GRADE AT MADISON ELEMENTARY SCHOOL. I WAS PLAYING TROMBONE WITH THE JUNIOR HIGH SCHOOL BAND AS A SIXTH GRADER. I WAS IN BOY SCOUTS AND A FIRST CLASS AND I ATTENDED THE NATIONAL BOY SCOUT JAMBOREE IN VALLEY FORGE, PA. OUR FAMILY DROVE TO LOS ANGELES FOR THE ROSE BOWL GAME AND OHIO STATE DEFEATED USC ON THE FIRST DAY OF 1956.

FAVORITE MUSIC: BOOMER SOONER, OKLAHOMA, THE MUSICAL

I WAS 22 IN 1966.

I GRADUATED FROM EASTERN NEW MEXICO UNIVERSITY. I LEFT PORTALES IN MY 66 PONTIAC LEMANS AND DROVE TO CHICAGO TO BEGIN MEDICAL SCHOOL AT NORTHWESTERN. I LIVED IN ABBOTT HALL ON THE SHORE OF LAKE MICHIGAN. MY FIRST YEAR IN CHICAGO IT SNOWED LIKE NEVER BEFORE, INCLUDING 23" IN 29 HOURS ON JANUARY 27, 1967. I GOT A 90 ON MY FIRST ANATOMY EXAM IN MED SCHOOL AND IT WAS A C. I LEARNED THAT TRASH CAN PUNCH IS DANGEROUS! I LEARNED ABOUT DA BEARS AND BECAME A BLACK HAWKS FAN. I LEARNED TO COOK FOOD IN A POPCORN POPPER TO SAVE MONEY TO GO OUT. WE ATE SUNDAY NIGHT DINNER AT A CLOSE-BY HOTEL THAT HAD ALL THE FISH YOU COULD EAT FOR $1.

FAVORITE MUSIC: THE ASTRONAUTS AND THE BEACH BOYS AND SOON TO BE CHICAGO.

I WAS 33 IN 1977.

I HAD BEEN MARRIED TO LALA FOR 9 YEARS AND LIVING IN LAKE FOREST IN THE "OLD WOODS" ON JERONIMO LANE. MICHAEL PLAYED K-LEAGUE SOCCER. I HAD STARTED RUNNING AND ABOUT THAT TIME RAN MY FIRST 1OK WHICH WAS CALLED THE LAKE FOREST "MARATHON". SADDLEBACK PEDIATRICS WAS FOUR YEARS OLD AND STARTING TO GROW RAPIDLY. VANESSA TURNED ONE YEAR OLD AND MICHAEL TURNED 5.

FAVORITE MUSIC: CHICAGO, MERLE HAGGARD, EMMYLOU

I WAS 44 IN 1988.

I HAD RUN 4 MARATHONS (SAN DIEGO, SAN FRANCISCO, HUMBOLDT REDWOODS AND NYC). LALA WAS A LAWYER. I WAS COACHING GIRL'S SOCCER. SADDLEBACK PEDIATRICS WAS 15 YEARS OLD AND WE HAD MOVED TO BUILDING #3. MICHAEL TURNED 16 AND VANESSA 12. IT WAS OUR 9TH YEAR TO GO TO ALISAL AND WE HAD BEEN TO SNOWMASS FOR 10 SKI SEASONS.

FAVORITE MUSIC; CHICAGO, EAGLES, MICHAEL MCDONALD, RICKY SKAGGS

I WAS 55 IN 1999.

I HAD MOVED TO SEAVIEW PEDIATRICS. LALA WAS ALMOST RETIRED FROM LAW. MICHAEL WAS IN DENTAL SCHOOL AT UT HOUSTON AND VANESSA GRADUATED FROM RICE, ALSO IN HOUSTON, WHERE THEY LIVED TOGETHER. MY MOUSTACHE AND LONG HAIR HAD DISAPPEARED.

FAVORITE MUSIC: CHICAGO, EAGLES, MERLE HAGGARD, RICKY SKAGGS

I AM TURNING 66 ON APRIL 18.

I HAVE BEEN IN PEDIATRICS FOR 40 YEARS COUNTING RESIDENCY. I AM TAKING CARE OF THE BABIES OF MY BABIES AND I HAVE THE BABIES OF MY SON, MICHAEL, LIVING AT MY HOUSE. LALA IS ENJOYING BEING A GRANDMOTHER. VANESSA IS AN ASISSTANT PROFESSOR OF SPORT PSYCHOLOGY AT WEST VIRGINIA UNIVERSITY. MICHAEL HAS A WONDERFUL PEDIATRIC DENTAL PRACTICE WITH SAMMY AS HIS OFFICE MANAGER. SPENCER IS IN PRE-K AND PLAYING T-BALL. OWEN WILL START PRE-SCHOOL IN THE FALL.

THE DOUBLE DIGITS HAVE BEEN GOOD YEARS!!

LOCATION: PANIC SWINE OF 09

2010-03-22T14:37:00.000-07:00

http://thepanicswineofo9.blogspot.com/

PANIC SWINE OF 09

2010-03-20T22:29:00.000-07:00

The full blog of the H1N1 swine flu panic is on a separate blog listed on my profile. Here I will only list the highlights of the longer blog.

Pigs, birds, and humans are each susceptible to many flu viruses. Typically, these viruses infect only one species. However, sometimes these viruses swap genes and create new viruses that can infect more than one species. Even then, new viruses that are capable of infecting two species typically are very difficult to transmit from human to human. Sometimes, however, further recombinations or mutations of genes create a virus that can spread rapidly among humans – thus creating a global pandemic. The worst global pandemic in modern times was the flu pandemic of 1918-1919. It affected about a third of the human race and killed at least 40 million people in roughly 1 year.

Simultaneous Appearance in Humans and Swine (1918)

Before 1918, influenza in humans was well known, but the disease had never been described in pigs. For pig farmers in Iowa, everything changed after the Cedar Rapids Swine Show, which was held in September of that year. Just as the 1918 pandemic spread the human influenza A (H1N1) virus worldwide and killed 40 million to 50 million people, herds of swine were hit with a respiratory illness that closely resembled the clinical syndrome affecting humans. Similarities in the clinical presentations and pathologic features of influenza in humans and swine suggested that pandemic human influenza in 1918 was actually adapted to the pig, and the search for the causative agent began.

The breakthrough came in 1931 when Robert Shope, a veterinarian, transmitted the infectious agent of swine influenza from sick pigs, by filtering their virus containing secretions, to healthy animals.

CNN March 2009

Doctors: No definitive answers on flu deaths among young

For most, the flu is a winter inconvenience -- stuffy nose, fever, body aches and a few days of bed rest. But what seems fairly routine also can become life-threatening. The virus causes inflammation throughout the body and disturbs the functions of the body, including breathing. Typically half of the flu deaths occur in children who have degenerative heart or lung disease or immune risk factors, but the other half are seemingly healthy.

"There isn't a good understanding of why that happens," said Dr. John Treanor, professor of medicine and of microbiology and immunology at the University of Rochester School of Medicine.

"There's speculation that these children, for genetic reasons, had unusual immune response to the flu, resulting in deaths."

August 26, 2009

CDC Confirms Ties to Virus First Discovered in U.S. Pig Factories

Starting in the early 1990s, the U.S. pig industry restructured itself after Tyson's profitable chicken model of massive industrial-sized units. As a headline in the trade journal National Hog Farmer announced, "Overcrowding Pigs Pays—If It's Managed Properly."

The majority of U.S. pig farms now confine more than 5,000 animals each.
Researchers also found that when farms were packed close together, as is increasingly the case in high pig-density areas of North America and Europe, pigs appeared to have up to 16.7 times the odds of testing positive for swine flu. "Close location enhances the possibility for windborne, personnel, and fomites disease transmission from one farm to another." The "spread of pig slurry [urine and feces]" on nearby land may also play a role.

JealousBrother.com

August 10th, 2009

What does the CDC consider a confirmed case of Swine Flu?

The CDC uses the following guidelines: A confirmed case of novel influenza A (H1 N1 ) virus infection is defined as a person with an

Influenza-like illness (ILI is defined as fever (temperature of 100°F [37.8°C] or greater) and a cough and/or a sore throat in the absence of a KNOWN cause other than influenza.) with laboratory confirmed novel influenza A (H1 N1 ) virus infection by one or more of the following tests:

1. real-time RT-PCR

2. viral culture

The CDC has this to say about the real-time RT-PCR test, “If reactivty of real-time RT-PCR for influenza A is strong it is more suggestive of a novel influenza A (H1 N1 ) virus. Confirmation as novel influenza A (H1 N1 ) virus by real-time RT-PCR was originally performed only at CDC, but at this time may be available in your state public health laboratory ."

The CDC has this to say about Viral Cultures: “Isolation of novel influenza A (H1 N1 ) virus is diagnostic of infection, but may not yield timely results for clinical management. A negative viral culture does not exclude infection with novel influenza A (H1 N1 ) virus.”

So what exactly am I getting at? There is no way for a physician or health organization to definitively tell a patient whether they have H1 N1 , H3 N2 , or any other Influenza A sub-type (Which includes seasonal flu) when using readily available RIDT’s. The only diagnostic results come from the lengthy process of laboratory analyzed cultures and rRt-PCR swine flu panels.

2008 Oct

Influenza vaccine effectiveness among children 6 to 59 months of age during 2 influenza seasons
Strong Memorial Hospital, Rochester, NY

OBJECTIVE: To measure vaccine effectiveness (VE) in preventing influenza-related health care

visits among children aged 6 to 59 months during 2 consecutive influenza seasons.

CONCLUSION: In 2 seasons with suboptimal antigenic match between vaccines and circulating

strains, we could not demonstrate VE in preventing influenzarelated

inpatient/ED or outpatient visits in children younger than

5 years.

“Surprisingly little information exists regarding influenza vaccine effectiveness among young children receiving vaccine in routine health care settings.”

Oct. 21, 2009

Swine Flu Cases Overestimated?

Study Of State Results Finds H1N1 Not As Prevalent As Feared

If you've been diagnosed "probable" or "presumed" 2009 H1N1 or "swine flu" in recent months, you may be surprised to know this: odds are you didn’t have H1N1 flu. In fact, you probably didn’t have flu at all. That's according to state-by-state test results obtained in a three-month-long CBS News investigation.

The ramifications of this finding are important. According to the Centers for Disease Control and Prevention (CDC) and Britain's National Health Service, once you have H1N1 flu, you're immune from future outbreaks of the same virus. Those who think they've had H1N1 flu -- but haven't -- might mistakenly presume they're immune. As a result, they might skip taking a vaccine that could help them, and expose themselves to others with H1N1 flu under the mistaken belief they won't catch it. Parents might not keep sick children home from school, mistakenly believing they've already had H1N1 flu.

NOVEMBER 2009 ATLANTIC

Does the Vaccine Matter?

More than 200 known viruses and other pathogens can cause the suite of symptoms known as “influenza-like illness”; respiratory syncytial virus, bocavirus, coronavirus, and rhinovirus are just a few of the bugs that can make a person feel rotten. And depending on the season, in up to two-thirds of the cases of flu-like illness, no cause at all can be found.
. The only way to know if someone has the flu—as opposed to influenza-like illness—is by putting a Q-tip into the patient’s throat or nose and running a test, which simply isn’t done that often. Likewise, nobody really has a handle on how many of the deaths that are blamed on flu were actually caused by a flu virus, because few are confirmed by a laboratory. “I used to be a family physician,” says Jefferson. “I’ve never seen a patient come to my office with H1N1 written on his forehead. When an old person dies of respiratory failure after an influenza-like illness, they nearly always get coded as influenza.”

“Launched early enough and continued long enough, social distancing can blunt the impact of a pandemic,” says Howard Markel, a pediatrician and historian of medicine at the University of Michigan.

Washing hands diligently, avoiding public places during an outbreak,

and having a supply of canned goods and water on hand are sound

defenses, he says. Such steps could be highly effective in helping to slow the spread of the virus.

Fear of Flu: Shifting the Goalposts

KAISER HEALTH NEWS

NOV 2009

Is the 2009 H1N1 more dangerous than garden variety seasonal flu, for healthy kids compared to kids with underlying illnesses? According to a paper published last month in the New England Journal of Medicine, probably not. The authors found that 60 percent of children who were hospitalized with swine flu had underlying illnesses. In years past, only 31 to 43 percent of children who were hospitalized with seasonal flu had similar underlying illnesses – meaning that the rate at which 2009 H1N1 causes serious illness in healthy children is lower than with seasonal flu.

As of August 31, however, the CDC said that anyone 18 years or older who dies with a syndrome known as influenza-like illness, or ILI, can be included in the count. The CDC has no requirement for uniform reporting of flu deaths by the states. Twenty-eight states, according to the agency, report only laboratory-confirmed flu deaths, while the others are now reporting deaths that look to doctors like they might be the result of flu.

That decision could dramatically inflate the numbers of reported flu deaths this year. By the CDC's weekly estimate, when doctors think a patient has the flu, they are wrong between 46 and 82 percent of the time.

Why should any of this matter? In part, because statistics, when filtered by the popular media, can scare the daylights out of the public and feed pandemic worries that may not be justified. The numbers also matter to public policy. As reported deaths rise, the CDC tends to enlarge its recommendation for who should be vaccinated, and who should receive anti-viral drugs. For example, based on rising pediatric deaths, the CDC issued new recommendations in 2009 that all children from 6 months to 18 years should get the flu vaccine each year. Previously, the vaccine was recommended only for high-risk children.

Pandemic preparedness for swine flu influenza in the United States.

In March and early April 2009, Mexico experienced outbreaks of influenza caused by the H1N1
virus, which has spread throughout the world. With the pandemic of H1N1 infections, we have
discussed in this scientific article strategies that should limit the spread of the influenza A (H1N1)
virus in our country. Specific vaccines against the influenza H1N1 virus are being manufactured,
and a licensed vaccine is expected to be available in the United States by mid-October 2009.
However, some health-care workers may be hesitant to take a vaccine because it contains a
mercury preservative-thimerosal-which can be harmful to their health. When caring for patients
with respiratory infections, the health-care worker should be wearing a facial respirator. In a report
from the Centers for Disease Control and Prevention (CDC), it was indicated that each healthcare
professional should be required to do a respiratory fit testing to identify the ideal model.

Because it has been well documented that a vitamin D deficiency can
precipitate the influenza virus, we strongly recommend that all health-care
workers and patients be tested and treated for vitamin D deficiency to
prevent exacerbation of a respiratory infection.

11/20/2009

By Sen. Joseph Lieberman

Homeland Security and Governmental Affairs Committee Chairman

While this new flu strain is affecting most people mildly, it has affected a small percentage

severely, and vaccine production problems have meant that some identified by the Department of
Health and Human Services as high risks for infection have not been able to get inoculated.

HHS promises national delivery of millions vaccine doses a week for the next few months.

But it does not ease my own concerns about HHS' miscalculations….Furthermore, unlike traditional seasonal flu that disproportionally affects the elderly, the H1N1 virus is impacting young people, with over 50 percent of hospitalizations and a quarter of all deaths occurring in people under the age of 25. Alarmingly, young children are at very serious risk, with about 540 pediatric deaths tallied so far.

I LIKE JOE LIEBERMAN, BUT SENATORS SHOULD USE ACCURATE NUMBERS WHICH ARE MORE AVAILABLE TO THEM THAN ANY CITIZEN IN ORDER NOT TO FRIGHTEN THEIR CONSTITUENTS. THE NUMBERS FROM THE CDC ON NOV 21, 2009 RECORD 243 PEDIATRIC DEATHS.

WHO’S TELLING THE TRUTH? – A BIG PROBLEM DURING THE SWINE PANIC

December 10, 2009, 1:00 p.m.

THOMAS FRIEDEN, DIRECTOR OF THE CDC

Thomas Frieden: Good afternoon, everybody. Today we're releasing new estimates as we said we would. The bottom line is that by November 14th, the day up to which those estimates include, many times more children and younger adults, unfortunately, have been hospitalized or killed by H1N1 influenza than occurs during a regular flu season.

What we have seen so far reiterates that people under the age of 65 are most heavily impacted by influenza. By November 14th, many times more children and younger adults, unfortunately, have been hospitalized or killed by H1N1 influenza than happens in a usual flu season. Specifically, there have been, we estimate there have been nearly 50 million cases, mostly in younger adults and children. More than 200,000 hospitalizations which is about the same number that there is in a usual flu season for the entire year. And, sadly, nearly 10,000 deaths, including 1,100 among children and 7,500 among younger adults. That.s much higher than in a usual flu season.,,, The estimate we have – the estimate that we're releasing here is not done in the same way that gives us the 36,000 estimate. That estimate is a different methodology. And will give a slightly larger number than this number would give. But if you were to compare, even though it's not a directly applicable comparison, under 50 in that estimate, there are less than 1,000 deaths a year in age under 50. We didn't break out in this —we’re not able to at this time, the 50 to 64 versus 50. But a large portion of those adults are under 50. So it is really many times more severe in terms of severe illness and hospitalizations are several times higher for children and young adults as well in H1N1 than in a usual flu season.

REALLY?????

THE CDC DIRECTOR’S FIGURE DOESN’T QUITE JIVE WITH THE CDC REPORT OF MARCH 2010 WHICH RECORDS 331 PEDIATRIC DEATHS.

Science

December 2009:

VIRUS OF THE YEAR: The Novel H1N1 Influenza

For years, scientists have been warning about the potential for an influenza pandemic on the order of the 1918 Spanish flu. They imagined the culprit would surface in Asia--and, since 2003, have worried that the avian influenza strain H5N1 might be it. Health officials worldwide drafted one preparedness plan after another. But the pandemic that erupted last spring looks nothing like the one in the plans. Not only did it begin in North America, but the swine virus behind it is a novel form of an H1N1 strain already circulating in humans. And although the new H1N1 is unusually dangerous for the young and for pregnant women, in most otherwise healthy people it causes a disease no more severe than seasonal flu. Scientists have repeatedly warned that this relatively mild virus could mutate or swap genes with cousins and become deadlier. But for now, it looks as if this H1N1 will go down in history more for causing confusion than catastrophe.
THE CDC HAS CONTINUED TO PUT OUT PERIODIC ESTIMATES OF PEDIATRIC DEATHS WHICH ARE EXAGGERATED BY 2-3 TIMES. THEY CONTINUE TO HAVE ADDS ON TV RECOMMENDING VACCINATION AGAINST THE H1N1 FLU EVEN THOUGH THE H1N1 HAS ESSENTIALLY LEFT THE U.S. THE LAST ARTICLE ON THE PANIC SWINE 09 BLOG IS ABOUT THE SUSPICIAN THAT MUCH ABOUT THE SWINE FLU PANDEMIC MAY HAVE BEEN DRIVEN BY MONEY!

THE STRESS OF THE SWINE FLU

2009-12-28T21:38:00.001-08:00

TIRING LESSON IN MISINFORMATION

Only as the last few days of 2009 draw to a close have I been able to not think about the H1N1 Novel Swine (or whatever other name you want to call it) Flu. It has occupied my every waking hour much of the past four months, as you can tell by the fact that I had to suspend one of my favorite passtimes, my blogging.

Much has been learned in these past four months, mostly about how hard it is to get to the truth and to know who can and can't be trusted to be telling the truth. I will summarize what I have learned about influenza in a subsequent blog and try to tell the truth as I can decipher it.

To me the most important revelation of the H1N1 Flu was for me to learn that probably more than 2/3 - 3/4 of Americans are deficient in Vitamin D. This came to me in the way of literature about the influenza preventative effects of really good levels of Vitamin D3 and I was amazed to

find that there is a wealth of information about the importance of Vitamin D in an increasing number of human illnesses, including cancer, heart disease, arthritis, pain, and mental illnesses.

I will also soon into the new year of 2010 add a blog about Vitamin D and it's many benefits.

Once I am done talking about the Swine Flu and Vitamin D we can continue with the long list of things I have learned in practice and outside the box.

Happy New Year

Happy New Year!

MINDFUL PARENTING

2009-09-06T16:24:00.000-07:00

In my mind this is the most important topic that I have added to this blog thus far. Mindfulness is the parenting buzz word of the future and if carefully practiced in parenting and our personal lives will lead to more functional families and children and young adults who don't already have "issues". This is a long read but worth the time.

"Mindful parenting is the hardest job on the planet, but it's also one that has the potential for the deepest kinds of satisfactions over the life span, and the greatest feelings of interconnectedness and community and belonging." Jon Kabat-Zinn

YES! Magazine Spring 1998:
Millennium Survival Guide

Mindful Parenting
by Jon and Myla Kabat-Zinn

Sarah van Gelder talks with Jon and Myla Kabat-Zinn about how the Buddhist concept of mindfulness can help us to see the wholeness and beauty of our children in each moment.

Jon and Myla Kabat-Zinn, the authors of Everyday Blessings: The Inner Work of Mindful Parenting, were married in a Zen ceremony in which their wedding vows were to help each other “attain ‘big mind' for the sake of all beings.” Jon Kabat-Zinn is founder and former director of the
Stress Reduction Clinic. He is also the author of Full Catastrophe Living and Wherever You Go, There You Are. Myla Kabat-Zinn has worked as a childbirth educator, birthing assistant, and environmental advocate. The Kabat-Zinns are the parents of three children aged 22, 18, and 14.
Sarah van Gelder recently met with them to learn more about the art of mindful parenting.

SARAH: What do you mean by “mindful parenting?”

JON: Mindfulness, which lies at the heart of Buddhist meditation, means moment-to-moment, non-judgmental awareness. It's cultivated by refining our capacity to pay attention, intentionally, in the present moment, and then sustaining that attention over time. It means
becoming more in touch with our life as it is unfolding. Parenting through mindfulness has the potential to penetrate past surface appearances and behaviors and allow us to see our children as they truly are, so we can act with some degree of wisdom and compassion. The more we are able to keep in mind the intrinsic wholeness and
beauty of our children – especially when it's difficult to see – the more our ability to be mindful deepens.

SARAH: You mentioned in your book that “unconscious parenting” – dealing only with your child's surface behaviors and not looking at the feelings beneath – can have long-term consequences.

JON: In my work in the Stress Reduction Clinic, I see people all the time whose feelings were not respected when they were children. For many people, childhood was a time of betrayal, when one or both parents were out of control to some degree, raining down terror out of their own addictions, deep unhappiness, or ignorance – even when they loved their children. One woman, whom I describe in the book, attended a five-day mindfulness retreat with me. After a meditation session, she said she felt there were pieces of her missing, as if she were
“Swiss cheese.” She realized she'd given parts of herself as a child to feed her parents – who had gone into a deep, lifelong depression after her sister died – and now she felt she couldn't get them back.
This is a chilling image, but it shows that the consequences of unconscious parenting can reverberate throughout the lives of the children.

MYLA: These days we're pushing our children to be independent so early that they're really ending up being incredibly dependent. The whole cycle of addictive behaviors – of children reaching for alcohol, drugs, sex, or whatever – is a symptom of this dependency. Many young
people use addictive behaviors to try to take the place of their deep need for love, nurturance, and for feeling as if they're a part of something.

SARAH: Kids, as you point out in the book, know how to push our buttons. So we may be reacting as parents in ways that are much more based on the way we were raised than on our truest values.

MYLA: Right. And half of the work of mindful parenting is being aware of those old patterns that so often rule our behavior as parents. Those patterns come from deep wounds in our past, and they don't have anything to do with what's really happening in the moment. The wonderful gift of mindfulness is that we can stop ourselves and ask: What am I feeling? What is it like from my child's point of view? When you can do that, you often see things that you didn't let yourself see before because you were so caught up in the reactive mode, which
is very limiting.

SARAH: I think the “Aha!” for me in your book was the notion that a spiritual practice isn't just something you do in isolation, or in retreat centers; it's part of parenting, which is one of the grittiest parts of life. Could you talk a little about how that works?

JON: Well, I believe that spiritual practice is about life, not about retreat from life. The real work of spiritual practice in any tradition is to come to a deep understanding about what it means to be human. Sometimes it's wonderful to just be very, very still for long periods of time, but for most of us, that can only happen occasionally. The real meditative practice is to open up to the full range of what happens in life. And parenting is a fantastic arena for doing that kind of spiritual training. It's as much a potential door into enlightenment as anything else. It's interesting to look at your children as live-in Zen masters who can put their finger on
places where you're resistant, or thinking narrowly, in ways no one else can. You can either lose your mind and your authenticity in the process of reacting to all of that stuff, or you can use it as the perfect opportunity to grow and nourish your children by attending to what is deepest and best in them and in yourself. We're not trying to erase conflict and send messages like, “Only harmony allowed in this family. Let's all behave like little Buddhas.” That kind of requirement imprisons the family.

SARAH: There is this image of people who have a spiritual practice as being extremely eventempered. Particularly that a good parent is one whose emotional life – except for a vague affection – may not be expressed a lot around the children.

MYLA: Having everybody be nice all the time may mean that people don't get to be who they are. Certainly in our family, we really value authenticity. It's important to give children some latitude for trying out different behaviors. If they always have to be in a very constricted framework of what's acceptable, they don't get to explore different aspects of themselves. And they also don't feel the amazing transformational power of our acceptance. This doesn't mean we have no restrictions – we'll say, “You can't run into the street. No, you can't hit Johnny.” We might also say, “We're having a hard time with the way you're acting, but we love you.” We're able to look beneath the surface at what's going on. Often our children have lots going on, and we don't get to see it because we're so quick to label them, judge them, and see them within just the framework of our own expectations, which can be kind of a straitjacket.

SARAH: Can you share a story that helps to capture the kind of complexity and the vulnerability that you're asking of parents?

JON: One time, a friend of ours had taken her son to visit her mother, who hadn't seen him more than two or three times in his life. The grandmother had invited one of her friends over at the same time and proceeded to ignore her nine-year-old grandson as she chatted with her friend. Meanwhile, the child became bored and restless, and he proceeded to run around the room and knock into furniture.
Embarrassed by her inability to control her son's unruly behavior, the mother angrily dragged him out and took him home. She was furious and admonished him for behaving rudely and not listening when she told him to stop. He looked at her pleadingly and said, “But Mom, Grandma didn't even talk to me!”
Suddenly, a veil fell from her eyes. Here her mother had not made any effort to reach out to her grandson, to engage him, to think about what would be fun for him; yet when he reacted in a totally normal way for an active, energetic child, he was blamed. Her son could see that his grandmother was ignoring him, but his mother had been unable to see it until he pointed it out. Another example of how our children can teach us, if we are open to listening and learning. In thinking about this later, the woman said she felt that it would be unrealistic to expect her
mother to change, but that the next time they visited, she would bring some things for her son to do, or meet her in a park, or insist that her mother come to her house. She also did something that was very important in rebuilding trust. She acknowledged that she was wrong and apologized to her son for getting angry at him for having a difficult time in a difficult situation. No matter how hard we try to be mindful and present, there are inevitably many times when automatic behavior simply takes over. When that happens, we can apologize, or we can stop
and say to our child, “Let's begin again,” and do it over differently. In this way, we nurture –or begin to heal and rebuild – a trusting, caring relationship.

MYLA: Those moments when our children are disruptive or difficult can be tricky, because I think children want so many different things.
Oftentimes, what they say they want takes on material form, and because parents are so harried and overworked, it's often a lot easier to just give children what they want. The objects start to take the place of really soul-satisfying, connective moments. I think it's very useful to ask ourselves, “Does my child need this? Is this in my child's best interests?” When we ask ourselves that, it can lead us to see that something else is needed, and not necessarily something material or tangible. That's when this work of parenting calls upon our own genius to be really creative in those moments. Every parent has that ability.

JON: When our son was in nursery school, his teacher was struck by something that happened one morning. As the children sat on the floor in a circle, she asked each of them what they liked to hold when they went to sleep at night. Some children mentioned stuffed animals, others, their baby blankets. When our son's turn came, he looked at her and said simply, without embarrassment, “My mommy.” We might ask ourselves, is it healthier for our children to be reaching for blankets or toys when they are distressed, or reaching out to human beings?

SARAH: Finding time has become one of the real big issues for many people with both parents working, and with so many more single-parent families. Is the kind of attentive parenting you're describing doable in this society?

MYLA: I think attentive parenting requires the desire to really examine the fabric of your life. If we look at our family life, and we ask ourselves, “Is this really working for all of us?” that may mean making choices. And that's very difficult.
It's not just the economic pressure to work – it's also the desire that we have to fulfill ourselves in our work. It would be wonderful if the culture supported both parents working part time, because children need both parents. But I think that sometimes if we're willing to give up things and find some creative solutions, we do find them.

JON: There are very few people who, on their deathbeds, smack their heads and say, “My God, I wish I'd spent more time at the office.” I think a lot of people reflect back on how they were as parents, and they realize that they did not bring enough perspective to it. They were too economically focused, or too stressed. All understandable, but not necessary. It just takes attention – attention in the present moment.

SARAH: Could you talk a bit about the effects of media and especially television on the family?

MYLA: In some ways, the media is raising our children instead of us. Whatever we can do to create a haven in our home from that broader culture, which has a lot of very toxic elements to it, is a worthwhile endeavor. And I think that people don't realize that it's not just the TV that's turned on that affects your family. Just the mere presence of a TV in the home controls what happens in those moments when there's nothing to do. It's hard to compete with something that's such a quick fix. I think that one thing that we can do with our children is to start asking them when they turn off the TV, “How do you feel?” Very often you see that they're grumpy, that they're fighting, that in some way, the watching has not really given them anything.

JON: It hasn't sustained them. But it has erased time, and it can erase very large amounts of time from your life.

SARAH: One of the things that helps us raise our eight year-old and our 12 year-old is that we live in a cohousing community where there are always other children of all ages for our kids to play with. I'm very aware from having spent time in Third World countries that the isolated single family is rare in other parts of the world, and it was here, too, until recently.

JON: As they say, “It takes a village to raise a child.”

MYLA: That's wonderful that you have your village, because so few people do. We all need support in this. In some ways due to the pressures on us, we are becoming managers of our children's lives rather than really loving, connected human beings in relationship to our children.

JON: Society conspires to disrespect the work of parenting in many ways. It's totally socially acceptable to give 150 percent of your energy to work. It's so misunderstood what the potential would be for a kind of wise attention given to the children. It's not smothering attention. It's not neurotic attention. It's not an overprotective attention. It's the recognition of the relationship and the sacred quality of the parent/child relationship.

SARAH: How can you start to bring this sacred quality to your parenting?

JON: The first thing is to intend to bring mindfulness into one's parenting on a daily basis. You also need to focus. It's through sustained attending that we develop insight. We're not saying that this is easy to do. There's no formula for a perfect way to raise children, or that results in “perfect” children, whatever that would mean. What we are saying is that our children are perfect just the way they are – including their imperfections. It's important that we are authentic, and that we honor our children and ourselves as best we can, and that our intention be to, at the very least, do no harm. Mindful parenting is the hardest job on the planet, but it's also one that has the potential for the deepest kinds of satisfactions over the life span, and the greatest feelings of interconnectedness and community and belonging.

Twelve Excercises for Mindful Parenting

1. Try to imagine the world from your child's point of view, purposefully letting go of your own. Do this every day for at least a few moments to remind you of who this child is and what he or she faces in the world.

2. Imagine how you appear and sound from your child's point of view; imagine having you as a parent today, in this moment. How might this modify how you carry yourself in your body and in space, how you speak, what you say? How do you want to relate to your child in this moment?

3. Practice seeing your children as perfect just the way they are. Work at accepting them as they are when it is hardest for you to do so.

4. Be mindful of your expectations of your children, and consider whether they are truly in your children's best interests. Also, be aware of how you communicate those expectations and how they affect your children.

5. Practice altruism, putting the needs of your children above your own whenever possible. Then see if there isn't some common ground where your needs can also be met. You may be surprised at how much overlap is possible, especially if you are patient and strive for balance.

6. When you feel lost, or at a loss, remember to stand still. Meditate on the whole by bringing your full attention to the situation, to your child, to yourself, to the family. In doing so, you may go beyond thinking and perceive intuitively, with the whole of your being, what really needs to be done.

7. Try embodying silent presence. Listen carefully.

8. Learn to live with tension without losing your own balance. Practice moving into any moment, however difficult, without trying to change anything and without having to have a particular outcome occur. See what is “workable” if you are willing to trust your intuition and best instincts.

9. Apologize to your child when you have betrayed a trust in even a little way. Apologies are healing, and they demonstrate that you see a situation more clearly, or more from your child's point of view. But “I'm sorry” loses its meaning if we are always saying it, or if we make regret a habit.

10. Every child is special, and every child has special needs. Each sees in an entirely unique way. Hold an image of each child in your heart. Drink in their being, wishing them well.

11. There are very important times when we need to practice being clear and strong and unequivocal with our children. Let this come as much as possible out of awareness and generosity and discernment, rather than out of fear, self-righteousness, or the desire to control. Mindful parenting does not mean being overindulgent, neglectful, or weak; nor does it mean being rigid and controlling.

12. The greatest gift you can give your child is your self. This means that part of your work as a parent is to keep growing in self-knowledge and in awareness. We have to be grounded in the present moment to share what is deepest and best in ourselves.

http://www.yesmagazine.org/article.asp?ID=856

OFFICE VISIT = AN ANXIETY ATTACK = MENTAL MODEL

2009-08-01T06:59:00.000-07:00

When infants and toddlers come to the office for "well" infant/toddler visits, there is a sequence of events which transpire. The baby/toddler is taken into or enters the exam room, their clothes are removed, they are taken to the scale to be weighed, they are placed on "the table", the doctor comes and "gets into their space" (without asking) and the nurse comes in and "stabs" them.

Parents are often surprised and embarrassed by the behavior of their child in this situation. And it seems to only escalate with each visit even though the child is getting older and "should be getting used to it". I have created a new Spanish colloquialism which might apply to this situation: Dola? (which is a contraction of duh + ola and means duh, hello!)

Actually, the neurobiology/neuropsychiatry researchers have in fact figured out exactly why the infant/toddler brain does what we see. A lot of this information is in a book listed on the Sea View web site entitled "Parenting From The Inside Out" written by Daniel Siegel (UCLA, sorry USC people) and Mary Hartzell. The following is a quotation from an article by Dr. Siegel and helps us to understand what is going on in our infant/toddler's mind and the behavior which follows:

"Memory is the way in which past experience is encoded in the brain and shapes present and future functioning (McClelland, 1998; Milner, Squire, & Kandel, 1998). The processes of memory and those of development in fact are closely aligned. For the first year of life, the infant has available an “implicit” form of memory that includes emotional, behavioral, perceptual, and perhaps bodily (somatosensory) forms of memory. Implicit memory also includes the generalizations of repeated experiences, called “mental models” or schema (Johnson-Laird, 1983). The way that the brain readies itself for retrieval of certain memories in response to specific cues is also a part of implicit memory and is called “priming” (Schacter&Buckner,1998). When implicit memories are activated, they do not have an internal sensation that something is being recalled. They merely influence our emotions, behaviors, or perceptions directly, in the here and now, without our awareness of their connection to some experience from the past."

It is no surprise that we don't know why our infant/toddler is behaving this way because she doesn't know either. But she has created a "mental model" and that model ends with getting the shots (pain). And the obvious reaction to knowing the end of the sequence is to call on the "fight or flight" response and that is exactly what they do.

Now, instead of feeling anxious, embarrassed or irritated, we can all just say "Dola?"

More about Dr. Siegel:

http://www.latimes.com/features/la-mag-july122009-taste-siegel,0,1272981.story

From the Los Angeles Times

Tastemakers

Daniel Siegel, MD

by Nancie Clare

July 12, 2009

When Siegel was a med student, he was actively discouraged from finding out what patients were thinking. Now in his current practice as a clinical psychiatrist, executive director of Mindsight and codirector of the Mindful Awareness Research Center at UCLA, it’s the mind he is most interested in—specifically how it can be channeled to help the whole body. One of the core practices of “mindsight” is concentrating on the breath. “Mindsight can increase one’s ability to perceive the world,” he says. Siegel created practical applications from his research: He has lectured to school superintendents, and educators confirm mindsight’s effectiveness as a foundation for social and emotional intelligence. Even the world’s spiritual leaders are interested—he met with Pope John Paul II and the Dalai Lama. And what of Freud? Siegel thinks he would approve—heartily.

SAFETY AND SET UP

2009-07-19T21:05:00.000-07:00

One of my one liners I have often used over the years applies to children's behavioral development, their self-value development and their safety.

"If we don't set it up (meaning their world they live in), we set them up."

This applies to safety as much as any other part of parenting. Many parents have trouble seeing and understanding that providing the proper fences and gates around the house is nothing more complicated than helping a child learn about boundaries in life. It has always been my impression that as soon as a baby leaves the womb, they are looking for the walls of the uterus and those boundaries that they have known for nine months. Most babies love to be swaddled and they will move themselves into the corner of the crib and wedge in there as soon as they can. In the office, babies are always most calm in their mother's lap (as close to the place where they loved the boundaries as they can get).

So, when we confine an infant to a playpen or to a play yard and put inside with them all the things

that they can do and can play with, we are setting up a place that they can be happy entertaining themselves and where they don't need our opinion about how they are doing. It also creates a place where they cannot misperceive what we say in trying to "redirect" their behavior if such boundaries do not exist. If a parent is continuously saying to you, "Don't touch that", "Come over here", "Get out of there" or "Stop doing that", I consider that they are micromanaging the baby and my impression is that there is a high likelihood that they baby may easily perceive that he is not doing a "good enough" job of being himself.

When it comes to safety, it's not even a question of helping a child learn about boundaries, it is about keeping her alive. Infants and toddlers and 3-5 year olds cannot be trusted because they have an intense curiosity which will get them into trouble every time they have the opportunity.

There should be no way that your child can open the front door of the house alone and they should not be able to reach the garage door opener or the latch on gates out of the back yard. There is no reason for any young child to be in the kitchen or the bathroom - fence them out. They can figure out most safety devices and we forget to latch them and they create a false sense of security regarding needing to know where the child is at all times. A fenced-in child is just one more layer of safety which protects us as parents as well as helping the child learn about boundaries. Safety must be an absolute boundary. We can't set them up for accidents and injury.

Finally, I continue to say that "Second boys following girls are the most dangerous children ever made." Girls tend to be much less physical than boys, but second boys learn by watching their sister and figure out how to do things much younger than the sister did. And as parents, we are not ready and can easily be caught off guard. So remember boys following girls are DANGEROUS and set-up is everything with them.

HOT OFF THE PRESS:

New advice: Rear-facing car seats safer for children until they are 2

Lori O’Keefe
Correspondent

Toddlers between the ages of 12 and 23 months who ride rear-facingin a car safety seat are more than five times saferthan toddlers in that same age group who ride forward-facingin a car seat.

Overall, children under the age of 2 are 75% less likely todie or experience a serious injury when they ridein a rear-facing car seat, according to the first U.S. datato substantiate the benefits of toddlers riding rear-facinguntil they are almost 2 years old

COMMENTARY

Rear-Facing Car Safety Seats: Getting the Message Right

Marilyn J. Bull, MD andDennis R. Durbin, MD, MSCE

Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

Information learned during medical training changes frequentlywith advances in nearly every field of medicine. Now we areasked to learn new advice to give parents and caregivers ofinfants and young children regarding the safest way for themto ride in a car.

Child fatalities and injuries in motor vehicles have been significantlyreduced since initiation of occupant-protection measures inthe 1970s.¹ The combined efforts of the counseling of primarymedical care providers, the education and research providedby the National Highway Traffic Safety Administration, the carsafety seat manufacturers, and many research facilities, andthe support of child passenger safety advocates across the countryhave been largely responsible for these results. Many challengesremain as we strive to continue to reduce the rates of injuryto children on our nation's highways. It is critical to realizethat, despite marked improvement in rates of restraint in allage groups, over half of children killed are improperly restrainedor unrestrained. Our first priority must be to ensure that everychild is restrained appropriately for his or her age and sizefor every trip in a car.

Helping parents make the best decisions for selection and properuse of car safety seats and seat belts is very important. Continualevolution of knowledge, safety information, and changes in carsafety seat designs make this task extremely challenging forhealth care providers.

One significant change in counseling is now emerging that maygreatly improve the safety of infants and young children. Arecent analysis of the protection provided in rear-facing comparedwith forward-facing car safety seats has revealed that childrenunder the age of 2 years are 75% less likely to die or sustainserious injury when they are in a rear-facing seat.² This findingwas true regardless of direction of the crash, even those crasheswith side impact, which typically are the most severe.

Although the study could not provide data dividing the agesby individual months, it is notable that rear-facing car safetyseats were more effective than forward-facing car safety seatsfor both infants under 1 year and children aged 12 to 23 months.The odds of severe injury for forward-facing infants under 12months of age were 1.79 times higher than for rear-facing infants;for children 12 to 23 months old, the odds were 5.32 times higher.

This information is additionally supported by data from Sweden,where children have ridden in rear-facing seats up to 4 yearsof age for many years, and very low death and injury rates havebeen documented³.

For many years the American Academy of Pediatrics has recommendedthat for best protection, children should ride in a rear-facingseat to the highest weight that is allowed for use by the manufacturerof the seat.⁴ Health care providers and many parents with olderchildren, however, have learned the earlier message that childrenshould ride in a rear-facing seat up to 1 year of age and 20lb,⁵ although that recommendation was later modified to "atleast 1 year of age and... at least 20 lb."⁴

Now we are challenged by greater evidence to implement whatwe know to be best practice: Children should ride in a rear-facingseat to the highest weight or height allowed for use rear-facingby the manufacturer of the seat. As an infant approaches 20lb, when his or her head is within an inch of the top of theseat, and at the 4-, 6-, or 9-month visit, it is appropriateto counsel families that they should transfer the infant toa convertible seat that is approved for rear-facing use to higherweight and height limits.⁶ Parents may be helped to understandthe importance of using the convertible car safety seat in therear-facing position longer than 1 year if they are counseledthat children are 5 times safer than when riding in a forward-facingseat into the second year of life.

At this time, it is not possible to determine at what monthof age, if any, that this is no longer true, but as more andmore parents follow this advice, we hope it will be possibleto elicit these data in the future.

Another barrier to implementation of this best-practice recommendationis the common myth that if a child's feet or legs reach theback of the vehicle seat, he or she is at increased risk fora lower-extremity injury. Current data do not substantiate thatmyth. Lower-extremity injuries are rare for children facingthe rear, on the order of 1 per 1000 children (Partners forChild Passenger Safety Study, unpublished data, 2007). In addition,riding facing front does not eliminate a child's risk of lower-extremityinjuries, because these injuries, as well as injuries to thehead and spine, have been described among forward-facing childrenin child-restraint systems.⁷

THE IMPORTANCE OF FATHERS ON THE 100TH FATHER'S DAY

2009-06-20T22:16:00.000-07:00

Growing up in the 50s and 60s, the importance of fathers was basically to be the "bread winner" and to provide food, clothing and a roof over the top of our heads. A father's self-value was closely tied to "what he did". And men's success and value was measured in society by what they accomplished in their work. Two phrases were commonly spoken to children (especially boys) as they grew up: "What do you want to be when you grow up?" and "When are you ever going to amount to anything?". I vaguely remember my mother, when I finished medical school, saying something like, "Now you have become a man."

Consequently when I became a father, I thought my job and my part of the marriage was to be the bread winner. When children came along, that was my wife's "job" as I was busy getting a pediatric practice off the ground and running. Fortunately for me, I married a woman who had other ideas, and those ideas began a long process of learning why men (and a high percentage of women now) have two jobs - the one they go to and the one they come home to, the latter being equally if not more important than the first. The job we come home to is the privilege of being a partner in a marriage and a father to (not of) our children. Most of us fathers cannot start to compete with our wives in terms of the amount of things that are done everyday to make the family and our children a success. But in big picture of how our children succeed in life, fathers may in fact be the parent, who by presence or absence (either physical or mental or both), can absolutely change the life of each child for the better or for the worse.

My perception is that large majority of babies come into the world knowing that their mother unconditionally loves them. We see this love as we look into our mother's eyes while being fed, and we feel it in the way she holds us and murmurs to us. And somehow we have probably already started feeling this love even while inside the uterus. So our mom is considered a constant in our life and this is known in neurobiology as secure attachment. Her love and attachment provide us with a basic feeling of security during the first year of life.

But during this same period of time there is another person who comes into our life who also holds us and talks to us (usually in a slightly less gentle voice) and on occasion even feeds us, though not in the same snugly way. This other person, our father, is our first outside contact with anyone who is not a given or a constant, and during the first year we must evaluate how this person feels about us. In a way, we are trying to determine if we have self-value and we are also trying to confirm that the feelings we received from our mother about our wonderfulness were accurate. If our father is there and interacts with us frequently, we begin to accumulate repeated evidence that we have value and that we were accurate in our interpretation of our mother's actions and feelings.

As we go through the next two toddler years, we have more and more opportunities to interact with our father (especially since most fathers like more physical types of interaction). If our father is there for us (physically and mentally), we gradually come to realize that he also

unconditionally loves us and we develop a comfortable secure attachment to him as well. And subsequently we wind up doing certain things in life with our mother and other things with our father and girls do shopping with their mother and boys do more physical things with their father (generalizations, of course). This all sounds rather obvious and fairly simple, but it is a lot more complicated than it sounds because of the variables which can change what happens in drastic ways. But for the purpose of this discussion, I want to just talk about some observations I have made regarding girls whose dads were not (or were not emotionally able to be) in their lives and regarding boys whose dads were or weren't in their lives both physically and emotionally.

The initial scenario that I became aware of was girls who fathers left their life and the family in the first year or two of life. These girls did not have that other person to reach out to seeking responses that would confirm their self-value. Two things in general would follow in their lives. They often made poor choices of males to date and to marry; and when their first baby was born they would have great difficulty allowing anyone else to care for the baby and sometimes greater difficulty in allowing the baby to attempt to solve any of his own problems (self-soothe or self-calm). These babies often had significant excessive weight gain and very often had long-term sleep problems. My interpretation has been that these women were desperately seeking "that other person" who would confirm their self-value and in their hurry to find such a person they settled for the wrong men. Then when they married and the baby arrived, here was "that other person" who every minute of every day looked into the mothers eyes and completely fulfilled her need to be valued. This feeling was so intensely needed by these mothers that they wanted all of these good feelings and were not willing to share the baby with others and answered the baby's every peep because it was a chance to receive more of these value feelings. Even, if by chance, one of the girls had married the right other person, problems could still arise because of not wanting to share the baby and becoming enmeshed with the baby thus preventing fathers from becoming attached.

A second time in girl's lives when their father is extremely important is as the approach and go through puberty. It is very essential at this time that a girl's father acts like and tells her that he still unconditionally loves her as she changes from a girl to a young lady. I have known several women whose fathers were not able to be emotionally present during these crucial years. Fortunately most of these women were able to realize on their own, after a few "not the right guys", that they were wonderful; and then found the right man and now are happily married and have children whose father is physically and emotionally there. Other girls were not so lucky and continued to make bad male choices. I have always said that Las Vegas is the capital city of women whose fathers weren't in their lives. It's very sad.

In boys lives, physical or emotional absence of a father, seems to have effects mostly on behavior. It could be referred to as a form of attention deficit, and I have even had pre-school age boys who were "kicked" out of school for behavior and the underlying problem was a missing father. The pattern that I see in teen years, when we all search for our identity, is boys who start to wear the costume of making fun of others. They cover up the feelings of not thinking they are wonderful by trying to bring down others kids to their level. Later as boys without fathers go on into the working world, it appears that they often are very compelled to climb to the top of the work ladder, as if the higher they go and the more they succeed, the more they are proving to their father that they were "worth his time"

The hardest part of this whole subject is the fact that every father is set up by all the generations of fathers before him (and mothers) to either have the tools necessary for attaching with babies and considering family as his most important job or to not have these tools. One of the most important tools is the ability to listen as children say what they have to say and to appreciate what it looks like when they are "acting their age". These tools can be acquired after getting married and after having a baby, but like all life lessons, they are easier to learn before we are stressed and sleep-deprived with a new baby. The important thing to know is that we can acquire the tools and we can break the cycle from generation to generation. We have such vast new information about how each baby stores memories about self-value and we have a chance as new parents to present life to them in a way that is hard to misperceive. This is certainly one of my passions in life and I am always available to discuss the subject and attempt to guide any new parents toward helpful information and resources. These are my individual thoughts about this subject as observed over 36 years of practicing pediatrics.

There is a book on the Sea View web site (www.seaviewpeds.com) about this subject by Daniel Siegel entitled:

Parenting from the Inside-Out: How a Deeper Self-Understanding Can Help You Raise Children Who Thrive.

ON THE WEB:

http://www.fathers.com/documents/research/2009_Fathering_in_America_Summary.pdf

http://www.fathers.com/

http://www.fatherhood.gov/index.cfm

THE SAGA OF THE LOOSE CHILD

2009-05-31T20:53:00.000-07:00

One of my clearest recollections of childhood was crying to sleep with leg pains. I can't remember exactly at what age they bothered me and I can't remember what my parents tried to do, I just remember they ached. My childhood physical activity was confined mostly to trombone playing and tennis. Maybe I was a better slicer in tennis than some, but I don't remember any particular advantage in trombone that looseness might have provided me. I took up golf in high school and also don't remember any loose advantages there.

Shortly after I began practicing pediatrics, I began running around the block with some other dads on my street. Then we moved to Lake Forest and I left my running buddies behind and I began running by myself and increased my mileage. Without realizing why, I began to have knee pain. I tried changing shoes several times but with no real improvement. Finally I went to a sports podiatrist who told me that I had pronation problems and made orthotics for me which much improved my knee pains. However, after a certain amount of miles, I would start to have pains a gain and realized that even just a little wear on shoes could stress my knee joints. In my running days there were numerous times when I stepped in a hole or off a curb and thought I had severely sprained my ankle, only to walk a little ways and then continue running. I did actually sprain my ankle pretty severely in the dark of early morning near Lake Mission Viejo when we jumped over a barricade and I landed on a quarter-size rock on the other side. Even then, I went to physical therapy for a couple of days and was back to running. But I must truly say that there were only rare days in my running years when something didn't hurt.

Looking way back in the beginning of my life, I was born with a club foot on the left and had a cast on my lower leg for several weeks to correct it.

(Interesting, but not surprising, is the fact that my son, Dr. Mike the pediatric dentist, also had a cast on the same foot for the same reason.)

My parents also told me the story later of the very kind orthopedic doctor in Corpus Christi who treated my foot without out charging my parents because my Dad was in the Navy.

So in my personal life I had these three different circumstances which caused me to start paying attention to babies and children that are "loose", and what follows is what I have figured out by observation and researched a little on the Internet regarding "loose" children. Photo left shows a "loose woman".

It appears to me that most babies that are born with legs and feet which are folded around their bottoms inside the uterus come from mothers who are also "very flexible". Recently I asked a mother of a third baby who was very loose, "Where did you deliver?" She responded, "In the car!" I wasn't very surprised in that the pelvic ligaments loosen with pregnancy and if that happens in a loose mother, babies can almost fall out. It would seem that the size of the baby might also have an influence on the amount of torsion on the legs as they fold up in the uterus. And with that in mind it was

probably no surprise for our 11 lb. 1 oz. son to have a club foot. With my feet, even after having the cast on my clubfoot, I continued to have metatarsus varus which is a turning to the middle of the front of the foot and it still is somewhat visible today and I do better in straight last shoes.

As we watch loose babies grow, we see them start to put their toes in their mouths and often I can put a foot on each ear. When they get on their tummies, they tend to be "flatter on the mat" suggesting that they might someday be great at wrestling. It appears that the looseness of the ligaments prevents being able to lock their elbows and shoulders to push up. Thus we refer to them as combat crawling once they begin moving.

So they are "late to crawl" and when this is combined with the fact that many of them do not walk until a ways past one year, they also appear to be developmentally delayed. Standing means putting their weight on top of a loose ankles, loose knees and loose hips. This is a lot like standing on stilts, and I say that smarter loose babies walk later because they know that walking early will mean banging their head more. These loose babies also tend to sit with their legs in a "W" and my second grandson even walked first on his knees with his feet trailing behind. Loose toddler do fall significantly more because of their instability and the fact that loose hips allow their "tips to cross" and take them down. There appears to be some connection between loose ligaments and certain developmental disorders of children. Some of the loose babies who appeared delayed may actually have a more complicated situation. (See http://skillsforaction.com/?q=node/16#dcdhypermobile for a very nice discussion of developmental coordination disorder or dyspraxia and see reference summary from a study at the end of this blog). There are more stitches involved with being loose, but usually very few broken bones as they grow older because they sort of fall in segments instead of slamming into whatever they fall against.

As the years go by we see loose five and six year-olds at Disneyland saying "Carry me, my legs are tired" and "I don't want to walk anymore." Some of them don't like soccer or other sports because the running makes their legs tired. And often they complain of pains in the knees or shins after particularly physical days. These pains were often thought to be "growing pains" in past times, but it is becoming clear that they most often occur in children with hypermobile joints (loose kids). A simple way of looking at the situation is that the muscles are working so hard to hold the joints steady that they get tired and ache. I have found that often taking a regular strength Tums (calcium carbonate) at suppertime will alleviate the symptoms and perhaps the muscles are calcium depleted from overwork. There certainly are teens who grow a tremendous amount in a short time and probably do have some pain actually related to the rapid growth and stretching, but this is no doubt exaggerated in the loose teen who grows rapidly. There are more stitches involved with being loose, but usually very few broken bones as children grow older because they sort of fall in segments instead of slamming into whatever they fall against. Although sprains, subluxations, and dislocations are more common in hypermobile children, the amount of tissue damage occurring with these acute injuries may actually be decreased due to the increased laxity of joint structures.

What I have termed "loose" is in medical terminology called Benign Joint Hypermobility Syndrome and it ranges from 2% to 30 % of children. The highest freqiemcu os seem om families that have one or more affected individuals; in females; and among people of Asian, African or Middle Eastern descent. Although joint hypermobility is maximal at birth (and perhaps in utero) children between 3 and 10 years of age have the highest occurrence, perhaps because of changes in body shape and size during a period marked by the increased demands of physical activity.

Most commonly, hypermobility has been linked with developmental hip disorders, delayed motor development, anterior knee pain syndrome, joint dislocation/subluxation, back pain, TMJ disease and flat feet. Once of the most controversial debates is whether BJHS predisposes to early osteoarthritis and degenerative joint disease. (There is also debate about whether Benign should be in the name of the process.) Studies have demonstrated a significant association among fibromyalgia, chronic fatigue syndrome and joint hypermobility in school-age children.

Excessive joint movement is associated with the development of symptoms in patients with hypermobile joints. Vigorous and repetitive activities have be listed as aggravating factors. Over training, poor pacing, too many performances or competitions, and focusing on joint flexibility rather than stability may all increase joint pain and risk of injury. Exercise therapy to improve muscular stability and proprioception at specific joints are essential to symptom management.

Back pain tends mainly to affect adolescents and is often associated with poor posture, although the incidence of lumbar disc prolapse, pars interarticularis defects and spondylolisthesis are all more common in hypermobile teens. Sitting posture is particularly important as children can spend a lot of time in front of a computer, at a desk in school or playing electronic games in slouched or unsupported positions, which increases the pain and strain on ligaments. Carrying large heavy book bags slung over the shoulder can also add to the problem.

So in summary, most loose babies will eat their toes more, look a little slow developmentally but recover, fall a little more often and perhaps have a few more bruises and stitches, have more aches and pains in childhood and youth activities, and may or may not have more joint issues as adults than babies who aren't loose.

Addendum: An excellent review article is found at

http://www.thefreelibrary.com/_/print/PrintArticle.aspx?id=54963603

Infants with hypermobility have higher incidences of motor delay, even in the absence of an identified neurological deficit. Among infants between 8 and 14 months of age, 30.2% of those with HMS had motor delay versus 10.9% of infants without HMS. Six months later, 75.9% of the infants with HMS no longer had hypermobility; 83.3% of these infants caught up in motor development, whereas only 54.5% of the infants who remained hypermobile caught up.[43] At 5 years of age, children who had hypermobility and motor delay at age 18 months were 3 times as likely as other children to have motor delay.

THE BUMPS OF LIFE

2009-05-09T04:41:00.000-07:00

“The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.” - Scott Peck

The bumps of life can be physical or they can be mental. The mental bumps of life are about feeling out-of-control. The photo shows me gripping the rail (tighter than can be seen in the picture) at the top of Yosemite Falls (one of my favorite places). Even though I wanted with all my heart to be there, the situation made my feel very out-of-control. I also remember returning to the same place with my son, Michael, (then 18 years old) and feeling just as out-of-control as I waited for him to climb down to the rail at the edge, feeling that if anything happened to him I would never get over it. I even had a dream throughout childhood and youth of falling in a silo, unable to grab onto the sides. (Kansas out-of-control dream) It gradually became clear to me as I "grew" thru my mid 50s that "Life is a recurring out-of -control feeling." It begins when we slide out of our mother (or are lifted out, which is more often in today's world in an attempt to prevent birth trauma) into the crazy world outside the uterine hotel. The out-of-control (OOC) feelings continue as we experience touch (the ob's hands pulling us out), the bright light overhead, air on our wet body, suction in our nose and mouth, the sound of excited voices crying out in excitement at our coming, the softness of our mother's abdomen and the closeness of being held in her arms followed the flatness of the warmer and a lot more touching. Then there is the grease in our eyes and the stab in the leg. And this is only the beginning of dozens of OOC feelings which we experience in the first hours and days of life.

It continues as we are passed from warmer to bassinet to relatives arms to infant carrier(which when carried by anyone must feel like a quick jet ride to a new baby- they strap you in semi-tight and up, up and away!) to the car for the ride home. And we head off into the rest of our life.

An OOC feeling can be handled in two ways: we can avoid it and it will continue to cause us to feel out-of-control every time we are in the same situation, or we can move directly into it and gradually or suddenly realize that the feeling can be tolerated and that our mind and body can learn to deal with it in a positive and productive manner. In early life this process requires that our care takers be willing to allow us to enter situations which cause OOC feelings like the flat place in our bassinet, or the air on our body when changing diapers and clothes, or the voices and sounds of a normal home.

Everything that is not like the uterine hotel will create an OOC feeling for each baby initially and his first response will be an opinion, which in baby language is fussing or crying out. New babies are creatures of habit like all of us and they all have opinions about what is not their habit. Breathing, sucking, swallowing, peeing and pooping are all new experiences, at least when not done under water.

As Dr. Sammons says in The Self-Calmed Baby, "the babies experience. . .is not very different from what yours would be if I took you blind-folded and deposited you without explanation in outer Mongolia." Babies reactions and adjustment to each of these new OOC feelings and the amount of opinions they have vary with each totally unique baby. And the reaction of each set of parents to this transition and their ability to allow their baby to experience OOC feelings and to be understanding listeners as the baby has opinions is just as variable.

Parents often say "Our baby has her days and nights backwards". It's more likely that she has her days and nights straight, it's just backwards to ours. New mommies will say "She wants to eat every hour" without knowing that babies use sucking as their primary means to handle the stress of the outside world. A parent will say "The baby woke up because his diaper was wet" to which I respond, "These diapers will hold a quart and all the other babies are sleeping through with wet diapers." In the past we held babies facing up in our arms so we could see them and speak to them, and when they started fussing about the situation, we began to bounce them up and down. We now know that the face up position is disorganizing to babies and that they prefer ventral pressure against their chest which is organizing for them. This pressure can be created by laying them over our arm with their head at our elbow or by holding them against us with a hand across their chest and them facing away from us. In addition, babies open their eyes when they lean forward and looking can also be calming for them. (I was always told to keep my arms off the table when eating. Now my friend Tim Healey has given me permission to have my arms on the table because is allows my mind to engage in better listening) Guess I have to throw in a Shannon childhood story or I will forget it. One day my brother, Mark, was sitting at the table at lunch and (since he couldn't have his arms on the table) started waving his napkin in the air. My mother sternly scolded, "Mark, is that necessary?" to which Mark responded, "No! It's a nakin."

Even the sound of our voice and looking directly face to face can at times be too much stress for a new baby. " Understanding listening" means observing what we do to or for our baby that makes him more calm and relaxed. This can often include doing nothing. As Dr. T. Berry Brazelton suggests, we need to look for what babies can do rather than what they can't do. Each baby is born with a different temperment and with a variably mature nervous system. Some babies are very "laid back" and little seems to upset them, while others seem to have less good filters to noises and sensations and can be extremely stressed by normal baby life in the outside world. Even pooping can be a very confusing event for baby and parents. I had the privilege to learn from a very "colicky" baby the the sensations of pooping can cause great distress. This baby would only poop every 5-6 days, but he wasn't constipated because the stools were very mushy and soft. However, starting about the time he should have had his next poop (with normal frequency), this baby would get progressively fussier with each passing day until by the 5th or 6th day he would be screaming most of the day. Then he would finally pass a humongous stool and he would settle into the most calm, relaxed mood, as if "Whew, I survived and I didn't blow my bottom off!" Recent brain research has revealed that we have nerve fibers related to perceiving stress around every hollow organ in our body. So it is not surprising that a certain babies have what seems like exaggerated feelings about the volume of stool in their colon.

Bill Sammons in The Self-Calmed Baby provides the following insight into the importance of being understanding listeners:

"The key to putting everyone on a firmer foundation lies in the way we think about newborns. In the last twenty years (written in 1989) babies finally have been recognized as the human beings they are rather than the passive, bland slates they were once thought to be. (This change was in large part due to the work of Dr. Brazelton) From the moment of birth, a baby can see and hear and think. He's an individual, with unique concerns and abilities. Like his parents, the infant is a partner with equal responsibility for creating and sustaining a happy relationship with members of the family. To carry out his part of the bargain, however, he must learn to communicate and to develop clear behavior signals, skills for which is naturally competent."

"Self-calming makes all of this possible. With self-calming the infant is able to assert control over his own reactions to those things or events that used to make him cry or become disorganized. By sucking on his hand, staring out a window, maneuvering into a certain body position, or some other self-calming skill, he can keep himself from crying (feeling out-of-control = my words) or stop crying - without help from his parents. Thus he develops an enhanced feeling of security and competence. And the infant's success in self-calming is circular. The calmer the baby, the greater the quantity and quality of time his parents can spend with him (without them feeling out-of-control = my words). The more time the spend together, the better their relationship grows, as each becomes more adept at communication. Then, and only then, do love and attachment grow and flourish."

Dr. Sammons suggested that new parents can "learn what your baby is trying to say more quickly if you begin from a premise that your child is trying to provide some message through his cries. Rather than guessing at the message, which is likely to cause your responses to be inappropriate and confusing much of the time, start with a relative low-level response and then slowly build your involvement until the crying stops, indicating that you have met your child's need."

Possible initial things to try include:

1) listen, if the baby is just fussing to see if it continues and escalates

2) talk to the baby from across the room

3) go to the baby and apply pressure to his chest somewhat firmly

4) talk to the baby from closer distance

5) see if the baby will suck on his own hand

6) check to see if the baby needs to be changed

7) talk to the baby again

8) pick the baby up and walk over to a chair and hold in a ventral pressure position

9) hold the baby with ventral pressure and move side to side sitting or walking

10) do 8 or 9 while letting the baby suck on your finger

11) try feeding the baby

Feeding will always solve the problem unless the baby is extremely fatigued or overstimulated.

This is because feeding meets all the babies priorities except sleep. Feeding provides the baby with all the possible soothing behaviors including touch, warmth, sucking, rhythmic stimulation (rocking), social stimulation and food. But as Dr. Sammons points out, "But consider how excessive the response is if, in reality, the baby simply wants to be talked to and the parent responds by feeding the child: it is like the baby asking for a quarter and the parent gives him a twenty-dollar bill and telling him to keep the change. For a while the baby may be placated, but the parent soon goes broke. The physical and emotional demand is too high to sustain. And no communication is established; the baby always gets the same response."

Speaking of money, I would add my own two cents. Feeding a baby who is not hungry to calm him is "mood altering" with food. We now have a country in which there are more obese people than over-weight people. Can we afford to continue to teach young babies to eat to make themselves happy. Food is fuel and has the purpose of making our bodies go. If we learn to calm ourselves early in life (the idea that each person is in charge of his own happiness) without the use of food, we will be much better prepared for all the bumps of life and OOC feeling that come our way.

FOLLOW UP ON BLUE EYES

2009-05-07T17:37:00.000-07:00

I have always said that blue-eyed children with skin darker than pale had dark-eyed ancestors. Now that we know blue eyes are a mutation, I guess we have to say that we all had dark-eyed ancestors.

Another thing I have often mentioned is that children with lots of gooey ear wax had ancestors from cold places. It turns out to be only partially true. In fact, eax wax consistency is genetically determined: the wet type, which is dominant, and the dry type, which is recessive. Asians and Native Americans are more likely to have the dry type of cerumen (grey and flaky), whereas Caucasians and Africans are more likely to have the wet type (honey-brown to dark-brown and moist). For more than you ever wanted to know about eax wax:

http://www.abc.net.au/science/articles/2006/01/30/1558166.htm

http://www.expasy.org/spotlight/back_issues/067/

SIMPLE ANTHROPOLOGY OF BLUE-EYED PEOPLE

2009-05-05T03:57:00.000-07:00

Watching patients and families come through my office for the past several decades has allowed me to formulate some thoughts about blue eye color and physical characteristics of humans who have them. Thinking about where blue-eyed people came from geographically, it seems a high

percentage of them came from northern places where average temperatures are colder, such as Ireland and England in my case, and Scandinavia and other northern European countries. In

those regions it would make sense that there is adaptation to cold, just as it seems that people with darker skin and darker eyes seem to tolerate warmer geographical areas better and even prefer them. One of the adaptations that I have observed is the ability of blue-eyed babies to preferentially send blood to their core when they are exposed to decreases in room temperature, as in the first few hours after birth or taking their clothes off for a feeding or an exam. Their hands and feet become purplish, they may get blueness around the mouth and often their skin mottles.. Continuing to circulate blood to the skin only makes one colder. When

sleeping in the winter, they may wake in the morning with "freezing" hands, but the rest of their body is toasty warm. In warmer ambient temperatures, blue-eyed toddlers often get quite red in the summer heat or when running around and often wake from naps in the summer drenched with sweat. Just as they circulate less blood to the skin when cooler, they send more blood to the skin when hot to help lower body temperature. We often say babies "run hot" or adults will say, "I always run hot".

It appears to me that blue-eyed people in general have warmer bodies than dark-eyed people. Blue-eyed people are more comfortable living where it is cooler and dark-eyed people living where it is warmer like southern California. I have observed in the hospital that most of the babies who seem to be having trouble maintaining temperature are dark-eyed babies, and I have wondered if they are not having a normal dark-eyed lower temperature.

Living in a cold place, people wear more clothes and are exposed the sun and air less, whereas dark-eyed people living in a warm place do not wear as much clothing to cover up the skin. This appears to result in blue-end people having more sensitive skin because we accumulate less melanin in our skin. Another result of being warm and living in a warmer place is that blue-eyed people tend to sweat more because of being too warm. The combination of more sensitive skin and sweating too much leads to dry skin and the issues that go with it. In addition, we tend to dress babies in one layer more than adults and this is probably one layer too much for blue-eyed babies. Blue-eyed children and adults will as a result have to spend more time moisturizing skin and choosing soaps and skin care products which do not tend to dry the skin.

Blue-eyed children and adults are also much more sensitive to light in the eyes. When I first moved to southern California, I truly thought there was something wrong with my eyes because I was almost blinded by stepping out of buildings into the sunlight. I see the same reaction in the office when I use the

ophthalmoscope to check eyes on an exam. Blue-eyed children start squinting before I even get close to their eyes and often their eyes water. An interesting thing is that some brown-eyed children have the same reaction and then I look and either mom or dad has blue eyes, so brown-eyed children who have blue-eyed ancestors can have the same reaction.

Most babies will have their permanent eye color by 6 months, but I have seen babies who finally changed around 2 years old. And it turns out that eye color changes even later in life in a certain percentage of the population. As a general rule, babies eyes can change from blue to brown, but brown eyed babies never change to blue eyes.

A very detailed article on Eye colour: portals into pigmentation genes and

ancestry can be found at:

http://www.biosci.ohio-state.edu/~pfuerst/courses/eeobmg640/reading1eyecolor.pdf

In January 2008 information appeared in Scienceblog and in an article from the Wellcome Trust regarding the origin of blue eyes:

All blue-eyed humans have common ancestor

http://www.scienceblog.com/cms/print/15361

By BJS

Created 01/30/2008 - 16:14

New research shows that people with blue eyes have a single, common ancestor. A team at the University of Copenhagen has tracked down a genetic mutation which took place 6-10,000 years ago and is the cause of the eye colour of all blue-eyed humans alive on the planet today. “Originally, we all had brown eyes”, said Professor Eiberg from the Department of Cellular and Molecular Medicine. “But a genetic mutation affecting the OCA2 gene in our chromosomes resulted in the creation of a “switch”, which literally “turned off” the ability to produce brown eyes”. The OCA2 gene codes for the so-called P protein, which is involved in the production of melanin, the pigment that gives colour to our hair, eyes and skin. The “switch”, which is located in the gene adjacent to OCA2 does not, however, turn off the gene entirely, but rather limits its action to reducing the production of melanin in the iris – effectively “diluting” brown eyes to blue. The switch’s effect on OCA2 is very specific therefore. If the OCA2 gene had been completely destroyed or turned off, human beings would be without melanin in their hair, eyes or skin colour – a condition known as albinism.

Variation in the colour of the eyes from brown to green can all be explained by the amount of melanin in the iris, but blue-eyed individuals only have a small degree of variation in the amount of melanin in their eyes. “From this we can conclude that all blue-eyed individuals are linked to the same ancestor,” says Professor Eiberg. “They have all inherited the same switch at exactly the same spot in their DNA.” Brown-eyed individuals, by contrast, have considerable individual variation in the area of their DNA that controls melanin production.

Professor Eiberg and his team examined mitochondrial DNA and compared the eye colour of blue-eyed individuals in countries as diverse as Jordan, Denmark and Turkey. His findings are the latest in a decade of genetic research, which began in 1996, when Professor Eiberg first implicated the OCA2 gene as being responsible for eye colour. Nature shuffles our genes

The mutation of brown eyes to blue represents neither a positive nor a negative mutation. It is one of several mutations such as hair colour, baldness, freckles and beauty spots, which neither increases nor reduces a human’s chance of survival. As Professor Eiberg says, “it simply shows that nature is constantly shuffling the human genome, creating a genetic cocktail of human chromosomes and trying out different changes as it does so.”

Blue eyes and red hair

http://www.wellcome.ac.uk/Professional-resources/Education-resources/Big-Picture/All-issues/How-We-Look/Articles/WTD041629.htm

The genetic basis of blue eyes and the classic Celtic look - red hair and pale skin - has been discovered. Both are linked to the production of melanin.

Although eye colour used to be considered a simple Mendelian recessive trait, the genetics of human eye colour are surprisingly complex. Eye colour depends on pigments in the iris (principally eumelanin), and many subtle shades exist. A key factor seems to be variation in the OCA2 gene, which is mutated in a form of albinism.

This is not just of cosmetic interest. Variation in OCA2 also affects freckling and skin pigmentation and is a risk factor for skin cancer.

Surprisingly, blue eyes result not from changes in OCA2 but in a nearby gene, HERC2, which regulates OCA2. In January 2008, several groups identified HERC2 mutations - in fact, all present-day examples of blue eyes may have their origins in a single change that occurred 6-10 000 years ago, during the expansion of humans in the Stone Age.

Why did it persist - blue eyes seem to offer no selective advantage? Perhaps it was chance. Or perhaps blue eyes were particularly attractive to Stone Age women…

Low melanin levels is also a feature of the classic ‘Celtic’ look - red hair and pale skin. It is a feature of people with two inactive alleles of the gene for the melanocortin 1 receptor (MC1R), who need to be particularly careful about sun exposure, as they are more vulnerable to UV radiation and at increased risk of skin cancer.

MC1R codes for a receptor found on pigment cells, melanocytes, which make skin pigments - eumelanin and the lighter phaeomelanin. Variation in MC1R affects the ratio of eu- to phaeomelanin and hence the depth of colour in the skin. Redheads produce almost no eumelanin.

Interestingly, analysis of two Neanderthal remains revealed variation in their MC1R gene sequence, suggesting that Neanderthals too showed variation in hair and skin colour pigmentation.