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I'm a pediatrician by training with an undergrad degree in journalism. I spend my days teaching and mentoring future pediatricians. My wife and I spend our evenings and weekends keeping up with very active twins. This blog will chronicle my thoughts on current children's health care issues and trends, trials and tribulations as a parent and husband mixed in with a lot of life experience.

 

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photo William Stratbucker, MD
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Tuesday, March 30, 2010
The Decision to Vaccinate
by William Stratbucker, MD at 09:06 AM

The long overdue retraction by the British Medical Journal Lancet of a 1989 study linking injection of the MMR vaccine to autism should reassure parents that this important vaccine is safe and will protect their children from life threatening disease.

 

Not only is the original study that tried to show an association between the vaccine and gastrointestinal symptoms completely discredited, but the subsequent studies which investigated the safety of MMR have all shown the vaccine to be safe.

 

Now, parents who have to decide whether to vaccinate their child against measles, mumps and rubella can feel good that the combination shot saves the child pain (one shot versus three), saves time (one visit instead of three), and is safe.

 

Much damage to the perception of vaccine safety was done by Dr. Wakefield and his unethical "study." In recent years the folks who wanted to believe in this theory have inappropriately extended their concern to preservatives like thimerosol and now to the H1N1 vaccine. As a result, a percentage of our population is either partially vaccinated or totally unvaccinated.

 

When you decide not to vaccinate your child, you put your child at risk of getting that illness and you also put all children exposed to your child at higher risk of getting that illness.

 

Let me explain. If a child is not vaccinated for a particular illness, they obviously are at an increased risk as there is no way their immune system has any way of fighting off the virus or bacteria. When a child receives a vaccine, there is a small chance that their immune system will not make a response, leaving this child susceptible to the offending organism should it ever come around. This non-responding child is at a higher risk of coming across the organism when around unvaccinated children. The more unvaccinated children, the higher the risk for the child whose parents tried to make her immune.

 

As a parent of two kindergartners, a part of me wants to know if their classmates are fully vaccinated. I don't know if they are vaccine responders or not. Doctors don't typically check to make sure. I don't want my fully vaccinated kids or other kids to be at a higher risk of coming across a vaccine-preventable illness. Perhaps, if there were unvaccinated kids in their classroom, I would insist that I know my children's immune status. And, perhaps, if it showed that they did not respond to a vaccine, then we could try again to see if they would respond.

 

I endorse the recommended vaccine schedule that is published each year by the American Academy of Pediatrics and Centers for Disease Control. Yet, I see and hear many things in the media and popular press that annoy me as they are comments that are not fully grounded in up-to-date medical science or even common sense.

 

As a pediatrician I've received too many digital alerts from the American Academy of Pediatrics. You see, these alerts are about deaths. The AAP is now routinely sending out urgent emails to us when they are informed of more deaths of children in the U.S. from vaccine-preventable illnesses.

 

We are all trying to do what is best for kids. I have both a medical education which has taught me to stay current in scientific study and I have, at least, a sufficient amount of common sense (although my wife might argue this one sometimes). Here is what I know for sure:

 

  1. Children should not die in the U.S. (or anywhere for that matter) from vaccine-preventable diseases.
  2. Causes for many medical conditions, including autism, are not yet discovered.
  3. Vaccines that are currently recommended for all children in the U.S. have been tested to a degree that makes me comfortable with their safety.
  4. The benefits of vaccinating children and adults against disease far outweigh the known side effects.

 

When deciding whether to fully vaccinate your child, you are deciding whether to put other children at higher risk of injury or death. Hemophilus Influenza Type B (HIB), is the bacteria that causes meningitis or brain infection. HIB kills unvaccinated children, partially vaccinated children and those who are vaccinated but happen to not have responded to the vaccine.

 

I want to stop getting e-alerted that children are dying in the U.S. from HIB. I want to stop hearing outdated, factually inaccurate medical advice in the media, on websites and in the popular press. I want our limited resources to be going toward just some of the much more urgent needs in our society. One urgent need is to have available the appropriate developmental resources for those children who have autism or another form of developmental delay. I feel the pendulum of vaccine fear swinging back toward the reality of the need to protect our children from many illnesses that we truly should fear. Doctors and medical scientists have the best interest of children at heart. Those who are opposed to recommended vaccination have been quite vocal and it is time for those who choose to vaccinate to be heard. I want our families to trust medical science. I want all children to have a medical home where they can be taken to a doctor. I want all children to be fully vaccinated.

 

I want to hear from you on this important public health issue.

 

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Monday, March 01, 2010
12 Tips for Parents
by William Stratbucker, MD at 01:26 PM


My colleague Pat Crum, parent educator with the Helen DeVos Children's Hospital Center for Child Protection, pointed out March is parenting awareness month. There are many worthy recognition months but parenting awareness is particularly important to me as the father of twins and a pediatrician.

Parenting is a full time job. I would actually argue it's one of the hardest jobs in the world. Here are Pat's 12 tips to help us be the best parents possible.

1. Take care of yourself. It is easier to meet your child's needs if you take care of your own. Over-commitment and fatigue are two of the greatest distractions from positive parenting. Take time to relax and enjoy the company of your children.

2. Speak calmly and firmly to your children when they misbehave. Tell them what they have done and what would have been a better choice. Respond to disruptive behavior immediately, consistently and decisively.

3. Realize it is okay for your child to say "no". Parents feel challenged when children say "no" or question authority. Disagreeing respectfully is a skill that must be learned and one parents can teach. Keep in mind that you want them to have the skill to say "no" to peer pressure and inappropriate situations.

4. Allow your child to practice being powerful in useful and appropriate ways. Show them a positive way to make a contribution. Let them know their actions count. Most parents want to raise a child who will be a self-reliant adult, who can make good decisions and who has the confidence to be whatever he or she chooses.

5. Give your children a voice in family rule making and the consequences for breaking rules. Fewer rules are better and should be clearly understood before a problem arises.

6. Focus your attention on what children are doing right, and you will see more of that. What you pay attention to is what you get more of. Children feel safest when the limits are firm and consistently enforced. Otherwise they may constantly push and test the limits. Children of all ages have a strong need for attention and will repeat behaviors that get a strong reaction, whether positive or negative.

7. Be patient. Being rushed is not compatible with a child's natural rhythm. The dawdling, which is sometimes seen by parents as a challenge to their authority, is normal for children. Time runs much slower for kids than the hectic pace of working adults.

8. To manage the behavior of young children, use distraction and lots of supervision. Discipline calmly. Don't assign consequences when you're angry.

9. Young children are developmentally programmed to explore. Tell them what they can do instead of punishing for what they can't do. For optimum learning, create an environment that is safe for exploration. Give them plenty of interesting things to do.

10. Put problems on your family meeting agenda and let kids brainstorm a solution. Kids are more likely to cooperate when they are involved in the solution.

11. A sense of humor is a valuable tool in working with children. A silly or playful attitude will often ease a tense situation, end a power struggle and invite children's cooperation. Laughing together is a great way to strengthen family bonds.

12. Respect others and children will respect you. We model respect through our daily interactions with others. Our children learn respect from what they observe and receive from us.

What is your best piece of parenting advice?

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