Sneaky Chemical Exposures - the Nursery

Baby's on the way.  You're busy nesting.  Painting the nursery, buying the crib, the dresser, the glider, the toy chest.  It's an exciting time.  But, the hundreds of decisions that have to be made regarding exactly what to buy can be stressful.  Well, add another stressor:  between flame retardants, formaldehyde-laced particle board, and volatile organic compounds (VOCs) in paint, you have a lot of chemicals to try to block at the door of baby's room.

Paint
VOCs are what gives paint that terrible chemical smell.  The EPA lists the following as side effects of exposure to VOCs:  "eye, nose, and throat irritation; headaches, loss of coordination, nausea; damage to liver, kidney, and central nervous system, as well as cancer.  Granted, the health effects of VOCs vary by specific compound (some compounds are not known to have any side effects) and by length and route of exposure to the compound(s).   Pregnant women and young children may be especially sensitive to VOCs.  You can find more information on VOCs here and here.

Photo by Dave Matos; downloaded from Flickr without amendment

Fortunately, paint has come a long way.  There are now plenty of low- and no-VOC paints on the market.  Taking the VOCs out not only means your house doesn't stink to high heaven while you're painting and for days afterward, but also that you and your family are not sucking in hazardous chemicals all day and night.  These paints vary in price, just as high-VOC paints do, and are not necessarily more expensive.  Quality and performance can vary, just as they do with high-VOC paints.  So you'll want to research these matters.  Also, there doesn't seem to be a lot of oversight to the industry, and it seems some low- or zero- VOC paints do still put out that smell, leaving me to wonder if they are mislabeled.  So you'll need to research that as well.  When you're painting the room baby will spend half of his life in, it's time well spent.

Furniture
Flame retardants and formaldehyde are the big ones to be aware of here.  Exposure to both has been linked to serious health problems. 

Flame Retardants are found in upholstered furniture, mattresses, carpet, and children's items such as car seats, changing pads, infant sleep positioners, nursing pillows and strollers.   

Photo by Joel; downloaded from Flickr without amendment

The following list references those problems that have been directly studied and shown to be linked to flame retardant exposure:

• Thyroid problems in pregnant women
• Depression of learning and memory (rat study)
• Attention span; attention span, cognition, fine motor development, lower IQ
• Advanced puberty
• Neurotoxicity
• Cancer: see this NCBI report and this report from the California EPA; or this study on abnormal pap smears

Formaldehyde is found in composite woods including MDF, plywood, and particle board; paneling; and some insulation.  

The following list references those problems that have been directly studied and shown to be linked to formaldehyde exposure:

• Asthma
• Eye, nose, throat irritation, Bronchitis
• Possible menstrual disorders
• Possible cancer: see this EPA report and this National Cancer Institute report

Other
Unfortunately, a blog on home safety would not be complete without a discussion of lead, radon, and air freshener.

Photo by Steve Snodgrass; downloaded from Flickr without amendment

Lead is found in the paint of old homes (pre 1978).  It can also be found in your soil, if the outside of your home was ever scraped or sanded improperly.  Most landlords tend to gloss over the lead clause of their leases, saying something like, "don't lick the walls."  There are two problems with this attitude.  One is that if you live with kids, they just might lick the walls, and eat the paint chips.  The other is that lead turns to dust easily.  That dust falls to the furniture and floor.  Your children then end up with that dust on their hands and lick them.  Also, everyone breathes in the dust.  Lead is the most problematic where paint is chipping and where doors or windows rub against wood frames causing lead paint to turn to dust.  If you have lead in your soil outside, your children may play in the dirt and thereby ingest it, or you may grow edible plants that may absorb it.  

Lead exposure in children can lead to decreased IQ; neurotoxicity; behavioral problems; anemia; liver and kidney problems; hearing problems; developmental problems; and in extreme cases, even death.  It can cause a multitude of problems in adults as well.  See more from the US EPA.

Radon is found in some homes and causes cancer.  It's quite easy to test for and can be an easy problem to fix.  See more from the US EPA.

According to the National Resources Defense Council (NRDC), air freshener may contain allergens, VOCs, and phthalates.  A study done by UC Berkeley found other harmful chemicals, as well as some which may be benign on their own, but react when sprayed to form such chemicals as formaldehyde.  Phthalates are associated with reproductive and fertility problems, possible insulin problems, possible weight gain and possible cancer.

Photo by Emi Moriya; downloaded from Flickr without amendment

Action
So what can you do to decrease your child's exposure?  

• Buy zero-VOC paint from a reputable source
• Don't buy composite woods
• Buy products known to be free of unnecessary chemicals
• There's not a lot of regulation here, so an "organic" or "natural" label may not mean it's 100% safe
• Buy products from a reputable source, or those that have been studied and proven safe
• Check out Healthy Child for further guidance
• Vacuum frequently with a HEPA filter
• Wash hands frequently, especially before eating
• Damp clean floors and surfaces frequently
• Test your paint, inside and out, for lead
• Test your soil for lead (note that this is controversial, and can lead false negative results) 
• Avoid the use of air fresheners, even those labeled "natural"

For more information:
Healthy Child on Formaldehyde
EWG on Flame Retardants
Surprising Health Hazards in Your Home
Flame Retardants are Everywhere
Hazards in Berkeley Homes
Four Lessons About Formaldehyde
Furniture and Flame Retardants
Radon Resources
NRDC on Air Fresheners
NRDC on Air Fresheners
Science Daily on Air Fresheners

Sneaky Chemical Exposures - The Garden Hose?!

It's a tough world to navigate.  Parents make hundreds of choices a day; all of which can potentially impact their children's health.  No pressure.  Unfortunately, some of the choices we make are ill-informed.  The worst is when you don't even realize you're ill-informed.

The other day, my son was happily filling his pool with the garden hose.  When the obvious next thing happened and he drank from the hose, I was hit by a powerful "ick" factor.  However, when all the other adults found it hilarious, my son did too, and kept it up for the sake of performance.  I wanted to stop him, but I just couldn't bring myself to crush his joy.  Reassuring myself with thoughts of how many people have drunk copious amounts of hose water during endless summers, I allowed him to continue, stifling my gut reaction.

 Photo by Mark Turnauckas; downloaded from Flickr without amendment

The next day, I told the story to my friend.  Feeling it was a stupid question since she was talking to her doctor friend (yours truly) who happens to be quite proactive about chemical exposures, she asked anyway: "your hose is lead free, right?"  Well, I should have known this, but it turns out, many of the garden hoses sold in the United States right now do contain lead, as well as BPA and phthalates.

The good news is that, according to a study by HealthyStuff.org, the number of hoses containing lead  did drop from 2012 to 2013.  However, even in 2013, 14% of the hoses they measured contained greater than 100 parts per million of lead.  When no amount of lead is safe for any living being, particularly a child, this is 14% too many.

And, for someone who assiduously avoids plastic, letting my son drink from a BPA- and phthalate-ridden hose was a major lapse in judgment.

Photo by Marc Lagneau; downloaded from Flickr without amendement

So, how can you save your children from the garden hose?  Buy a lead-free hose that is food grade polyurethane or rubber, "drinking water safe," and outfitted with non-brass fittings, such as nickel, aluminum, or stainless steel (brass may be okay if it is certified lead free).  Also, be sure to store your hose in the shade, and let it run for a few minutes before watering edibles or filling the kiddie pool.

Find more information on garden hose safety at:
HealthyStuff.org
Time Magazine
The Environment Report

Find more information on the problem of lead exposure at:
CDC
Kids Health
Mayo Clinic
Bioscience Technology

Find more information on the problem of exposure to BPA and phthalates at:
WebMD
Medscape
CNN
WebMD Fetal Exposure to Plastics and Asthma Risk 

Summer!

Summer is upon us, even in the Pacific Northwest.  And with it come adventures and great fun.  But let's keep those kids safe, healthy, and intellectually stimulated also.

Keep Them Safe
A little caution goes a long way toward a great, safe summer.

1. Drowning, Dry and Wet:  Drowning typically occurs quietly and with little commotion.  A child can simply slip under the water and not come back.  Also, drowning can occur hours after the initial scare; this is usually referred to as "dry" or "secondary" drowning.  If you notice that your child is coughing, has chest pain or difficulty breathing, is fatigued, or is acting strange, consider secondary drowning and call your doctor, 911, or go to the Emergency Room.  For more information on drowning or secondary drowning, see my post, or this WebMD article.
2. Sunburn:  Sun damage, especially sun burns, in childhood increase the risk for skin cancer later.  Sun damage can be prevented with a few steps.  Use an adequate amount of sunscreen with an SPF of 30 or higher with "broad spectrum" protection (UVB protection as well as UVA), and be sure your sunscreen is not expired.  Apply at least 15 minutes before going outside and reapply frequently (time depends on the product).  Experts recommend staying out of the sun between 10 and 3, and wearing protective clothing and UV blocking sunglasses when you are in the sun.
3. Hydrate:  It's pretty easy to get behind on fluids, especially when you're a kid on the run in the sun.  Be sure your children always have a water bottle them, and figure out a way to make sure they drink from it even when you're not around.  Push fluids first thing in the morning, and whenever you have the opportunity.  We do lose electrolytes through sweat, so be sure to replenish these too.  However, you do not have to use major brand name sports drinks (they are high in sugar, and contain high fructose corn syrup and other ingredients I don't love).  Coconut water, miso soup, vegetable and chicken or beef broth all have great electrolytes.  You can simmer carrot or celery chunks in water for 30 minutes to make your own electrolyte rich vegetable broth.  Finally, there are some natural products on the market that you can buy (effervescent tablets or packets, and liquids); just be sure you read the labels!
4. Concussions:  Obviously this is one to think about all year long.  Anytime a child is on any sort of moving vehicle, whether it's a bike, a balance bike, a scooter, or a skateboard, he needs a helmet, fastened, at all times.  Of course, concussions can happen any time; with a simple fall, or an injury sustained despite the helmet, or while playing sports.  If your child sustains a head injury, even if it seems minor, go see the doctor.  Concussions can be very serious, and education is very important.
5. More summer safety articles can be found on MedicineNet, Baby Center, and Parents. 

Photo by Guillermo Viciano; downloaded from Flickr without amendments

Keep Them Moving
Not everyone gets extra time off over the summer.  This can mean the kids are at home while parents are at work.  It can be challenging to keep the kids stimulated while you're concentrating on work just as much as ever.  As a result, many kids actually gain weight over the summer.  I firmly believe in the importance of keeping kids active and intellectually stimulated (see "Keep Them Learning," below) throughout the summer.  One of the best solutions here is to sign up for summer camps.  Parent Map has a good list of camps; I especially like the "Camps In a Class By Themselves." Seattle Parks and Recreation also offers a wide range of camps, as does the YMCA.  Other solutions are to exercise or play as a family after work and on weekends, to start a "get moving" program in the family, and to limit access to screens and cars or buses.  Fortunately, most day cares and summer camps do include physical activity in their programming, but if the kids are home with a nanny, be sure you set the expectation for physical activity with the nanny.

Keep Them Learning
We know that all kids who do not participate in educational activities over the summer experience the "Summer Slide;" they lose math and reading skills, and perform more poorly on standardized tests at the end of the summer.  Kids from lower socioeconomic brackets experience even more of a slide than those from the upper brackets (another volunteer opportunity).  So be sure you continue your daily routine of reading with your kids every day throughout the summer.  And find some time to add in museums, summer camps (see links in "Keep Them Moving," above), and visits to the library.  (The Seattle Public Library has great summer reading and education programs). 
 

Photo credit Pratham Books; downloaded from Flickr without amendements

Keep Them Eating
Unfortunately, summer is a time of hunger for countless children. Some of the free meal programs are not available over the summer. If your family is more fortunate, you can benefit greatly by volunteering. Volunteering brings family together, strengthens family bonds, and exposes kids to other socioeconomic groups, along with empowering them to instigate change. So, why not find a place to volunteer this summer? Make it part of your weekly routine. Here's a great Seattle's Child article with more information including volunteer opportunities, and how to access summer eating programs for your own family.

Happy summer!  Be safe, and have fun!

I have no affiliations to disclose.  This post does not constitute medical advice.  If you have medical questions or concerns, call your doctor or 911.

My Top 10 Avoidable Physical Dangers for Kids

As a naturopathic doctor, I don't see a lot of emergency cases. Parents tend to know when they need to go to the ER, so I generally see kids for their follow-up care. But, as a mom who is also a doctor, I ponder questions such as: what do I worry most about for my child? Here are the physical dangers I worry about most for my baby, his buddies, and my patients, that are preventable, or at least whose damage can be mitigated.

1. Drowning
2. Accidental Gun Shots
3. Unrecognized Respiratory Distress
4. Accidental Marijuana Ingestion
5. Alcohol Poisoning
6. Accidental Over the Counter Medication Overdose
7. Falls From a Window
8. Obesity
9. Car Accidents
10. Vaccine Preventable Illness

Here are some suggestions for avoiding these, or mitigating their damage.

Drowning: a far too common cause of death and disability in children. Since it is entirely preventable, the onus is on us to beware the water. Remember, drowning does not only occur with swimming; it can occur in a few inches of water if the child is too young to move his head. Always supervise swimming and bath time. Do not leave buckets of water unattended around young children.  Keep toddlers away from the toilet unless they are supervised, or install a lock on it. Talk to your teenagers about drinking and swimming. Help them understand that drinking or doing drugs and swimming (especially cliff diving!), are not a good combination. Be aware of "dry" or "secondary" drowning.  If your child chokes on water, or has any sort of "near drowning" event," he is vulnerable to drowning at a later time.  Watch for coughing, trouble breathing, chest pain, changes in behavior, or fatigue.  If you notice anything unusual, even hours after the event, call your doctor or 911, or go to the Emergency Room.  If you do not already know CPR, take a class. You could be the one to save your own child's life, or someone else's. 

Photo by Lotzman Katzman; downloaded from Flickr without amendments

Accidental Gun Shots: if you decide to have a gun in your home, keep it locked in a safe, preferably unloaded. Ensure that the safe will not be accidentally opened by someone who does not know the gun is there. Hiding a gun is not sufficient to protect children. They are curious, persistent, and know no boundaries. There is no reason to think that your child, your child's friends, or your child's caregiver won't stumble upon it at some point. No matter your view on gun control, make 100% sure that your child and his friends are 100% safe.

When your child begins visiting other people's houses, especially if he will be there without you, ask the parents if there is a gun in the home. If there is, ask where it's kept and if it's loaded.

Unrecognized Respiratory Distress: respiratory distress is not always as obvious as you might think. Whether it's a viral infection in a baby, asthma developing in your older child, or a child with an inhaled foreign body, you could potentially miss it. Here's what to look for:

• fast breathing
• abdominal breathing: either the space where the ribs meet the belly or the V where the ribs, top of the belly, and xyphoid process all meet is sucking in with each breath
• retractions: the muscles in between the ribs are contracting with each breath, or the spaces just above the sternum or clavicles suck in with each breath
• nasal flaring: nostrils flare with each breath
• shoulder shrugging: the shoulders move up and down with each breath
• wheezing: this is generally only audible with a stethoscope, but you might hear it on the outbreath
• leaning forward, open mouth breathing, drooling
• unable to talk or walk normally
• cyanosis: blue lips or fingertips 

Image and more information on respiratory distress available here

If you notice any of these signs, call 911 or your doctor immediately. For more information, read this article.

Accidental Marijuana Ingestion: recreational marijuana is licensed in Washington State and Colorado now. I would expect more states to follow suit. This means that marijuana is more widely available. People who never would have used it or possessed it before, now do. Which means that when you go to a party, you need to find out exactly what's in the cookies. And the brownies. And the lasagne. It brings a whole new meaning to the question, "Mommy may I have a cookie?" Be sure to speak with your child's friends parents about this one too: find out if they have it, and if it's kept away from the children at all times.

Alcohol Poisoning: people have different ideas about how to raise children with a healthy respect for and a reasonable relationship with alcohol. I won't get into that here. But I do want to make sure that your child, whether a toddler or an adolescent, never gets alcohol poisoning. For toddlers this may be as easy as keeping it out of reach. Until of course they can reach it, which will come sooner than you expect - on the day they learn to move a chair over and climb on it. Also when your child starts going to other people's houses for play dates, find out where their alcohol is.

Obviously this may be easier said than done for adolescents, but think about it, research the options, discuss it with the family, choose a strategy, and most importantly, address it. Do NOT think that because your child hasn't brought it up with you that she's not being faced with it at school. And do NOT think that because your child is: obedient, an athlete, a straight A student, etc; that she is not thinking about using alcohol. For more guidance, here's a good place to start.

Photo by Daniel Lee; downloaded from Flickr without amendments

Accidental Over the Counter Medication Overdose: kids are curious. They will get into medications, supplements, essential oils, you name it. Iron is a big offender here. Ensure that all of your medications are stored in their original child-proof containers. Supplements and essential oils can be harder to deal with as they usually do not have child-proof caps. Store them out of reach and periodically ensure that your child has not gained the height or skills necessary to reach them.

Adolescents and child care providers may get into these substances too, very much on purpose. Have an idea of how many pills you have in any given bottle. Keep especially attractive / addictive medications like pain killers locked in a safe. If you have left-over medications, especially pain killers, take them to a drug take back location; do not save them for "next time."

Falls From a Window: this may sound crazy, but it does happen. If a child can get to the window, he can climb out of it. So leave them either closed and locked or open only enough that he can't fit through (as long as you're sure he can't open it further). Remember to think and act like a child. It might not be obvious that he can get to it, but if he climbs that and scoots under this, he's there. Be especially careful of windows that are elevated, but remember that even if he doesn't hurt himself going out the window, he's still now on the loose without you knowing it. Finally, know that kids have flown out of windows after bouncing on the bed, or rough housing in some way.

Photo by storebukkebruse; downloaded from Flickr without amendments

Obesity: all too common these days, and not necessarily because parents are overweight. It's an epidemic; one with terrible consequences. And despite the fact that we know how bad it is, how rampant it is, and what contributes to it, we as a country do not change our practices. So it's up to us as parents to bring our children up in a way that fosters healthy weight and healthy body image. Here's what to do:

• Avoid juice and sugary drinks (and artifically sweetened drinks - more on these in a future post).
• Avoid sugar except for occasional treats.
• Limit processed food, junk food, and white flour.
• Encourage fruits, veggies, and whole foods.
• Encourage physical activity. I don't use the word exercise with kids for 2 reasons: they naturally love to run and play outside in a very physical way; I think this wording encourages them to embrace that. I also think using the word "exercise" too much can make it sound like a boring adult activity being forced on them.
• Promote outside time - because fresh air is important for physical health, for mental / psychological development, and because if you're outside, there's a good chance you're moving your body.
• Foster good sleep. Poor sleep is an independent risk factor for obesity, so practice good sleep habits with your children.
• Limit total screen time. Do not allow screen time within an hour of bed; do not allow any screen in the bedroom. 

Car Accidents: can be hard to avoid. I'm sure you already do everything you can to decrease your risk (avoid alcohol and drugs, don't drive tired, no fiddling with the radio, no talking on the phone or texting). But since accidents happen, consider how to mitigate the damage. Wear your seat belt and make all of your passengers wear theirs too. Every time. Place your child in his car seat and lock the harness. Every time. Ensure your car seat fits in your car properly and that your child fits in the seat properly. Ensure that you are using your car seat properly.

Photo by Bradley Gordon / bradleygee; uploaded from Flickr without amendments

Vaccine Preventable Illness: I have many posts coming soon that address vaccines in detail. But for now I'll just make this plea: if you decide not to vaccinate, or to delay vaccines, be completely sure you understand the diseases your child is at risk for. I don't want any child coming down with meningitis or tetanus induced respiratory depression because of a lack of information. Be sure you are familiar with the course of the disease, the complications, and how it's contracted. Be sure you understand the risk you are taking by not vaccinating before you make your final decision.

Remember in medicine, the best policy is usually prevention.

I have no affiliations to disclose and no financial interest. This post does not constitute medical advice. If you have medical questions or concerns, call 911 or speak with your doctor.

Healthy Eating for Kids - Meals

I went to a diner this weekend whose kids menu included a sandwich, cheetos and a soda.  Why do restaurants all seem to have the same concept of kids food: peanut butter and jelly, grilled cheese, (fried) chicken fingers with french fries, macaroni and cheese and juice or soda?

At what point did we give up on kids eating nutritious food?  As I asked in a previous post, why do we swap pureed good-for-them baby foods for salty, not good-for-them, kid foods?

Photo by Rupert Ganzer; downloaded without amendments from Flickr

Yes, I am aware that kids go through a picky phase.  But you can minimize the impact of this phase.  You can continue to offer nutritious foods after your kids are finished with baby food and until you are no longer feeding them.  If they never know foods like mac and cheese and french fries, or if they are largely unfamiliar with them and know them only as treats, then they won't fight you (or they'll fight you less) on the roasted chicken with green beans and potatoes.  

Of course, kids, like adults, have their likes and dislikes, and some kids just don't like green beans.  For those kids I say, don't offer green beans (provided of course you've offered them 10 times in a nonchalant, no-pressure way as I mentioned in a previous post.)  And for the kids whose list of dislikes is more extensive, here are some suggestions: 

Photo by Luis Tamayo; downloaded from Flickr without amendments

Tips for Picky Eaters

1. Persistence:  Continue to offer the foods they don't currently like on an occasional basis in a nonchalant, no-pressure way.
2. Creativity:  Expand your own food horizons by offering them vegetables and other healthy foods that you are not in the habit of cooking, and that are not on their list of dislikes.  Use variety in spices and cooking methods.  Some kids just want variety (as do most adults). 
3. Emotion-free eating:  Remember everything I mentioned in "Growing Healthy Eaters." Release your emotional attachment to their eating.  Keep providing varied healthy food, in a non-attached, nonemotional way. One day, they will surprise you. 
4. Rules:  Don't be a short order cook.  Set the expectation that the whole family eats the same meal.
5. Reliability:  Make sure the family meal includes some foods they do like and will reliably eat.

Also, yes, I have met the child who can go for days surviving on one bite of peanut butter toast and an orange.  I've heard them called air-etarians, or air-ivores.  It can be very stressful for parents to feel that their child is not eating enough.  But trust me, kids will eat when they need to.  Of course, there are exceptions to every rule, and if you have a child who has any sort of special circumstance or need, or if your gut tells you something is wrong, then please, make an appointment with your child's provider for an evaluation.  Otherwise, here are some suggestions for the child who just doesn't eat:

Photo by Patrick Feller; downloaded from Flickr without amendments

Tips for Food Avoiders

1. Persistence:  Continue to host meals at the table, at routine times, away from the TV.  Have as many family members as possible at the table for meals.  The more the family all eats together, the better.  I don't believe a child should feel tortured by having to sit at the table, so make it engaging for them.  Talk about how everyone's days went, and include her in the conversation.  Talk about the food you're eating and where it came from.  Talk about gardening, farming, ranching, and the culture and history of the food you're eating.  (Note: for older children, doing a little research before dinner into these subjects can trigger interest and more fruitful conversations).  You'll have to find the balance that works for your family as far as how long your child should sit if she's not hungry, and how far to go to make it engaging for her.  I do not advise bringing books or toys to the table.  Keep it about food and family.
   
   Photo by US Dept of Agriculture; downloaded from Flickr without amendment
2. Nutritious Snacking:  Snacks are an important part of a growing child's life, but they can blossom out of control.  Make snacks part of the daily routine.  Once or twice a day, sit down with your child at the table (or at the picnic table if you're at the park), and have a nutritious snack.  Do not let your child wander around or play while snacking.  Minimize snacks eaten in the car or otherwise on the go.  Do not fill her with empty calories.
3. Swapping Meals For Snacks:  In regards to #1 and #2, if your child is consistently jumping up from the table at meal time claiming she's not hungry, only to come back 45 minutes later for a snack, then some trouble-shooting needs to occur.  She needs to eat that meal rather than that snack, so start by altering the schedule.
4. Reliability:  At meals and snacks, offer foods you know she likes (as well as some she doesn't, as mentioned in the previous set of suggestions).  Be creative to maximize variety.  New spices, new foods, and new cooking methods can be very helpful.
5. Involvement:  Continue to involve her in food shopping, food preparation, and food culture (see below).

Photo by Jaro Larnos; downloaded from Flickr without amendments

Ways To Involve Your Child In Food

1.  Food shopping:

• Set yourself up for success:  go at a time of day when you both are at your best, not tired, and not in a rush
• Make shopping fun: go to a farmer's market, a produce stand, or a store you don't always go to
• Ask your child what he wants to buy (while you're in the produce section, not the candy section!)
• Give your child a choice: e.g. "We need a vegetable for tonight, would you like to pick it out?"

2.  Food preparation:

• Have your child sit down with you on Sunday and plan the week's meals together; then make the grocery list together
• Place your child in charge of clipping coupons, or looking online (supervised of course!) for good deals of the week
• While cooking, have your child stir, dump foods from a bowl into the pan, tear lettuce, cut soft foods with a plastic knife, operate the salad spinner, etc.
• Garden with your child (even if it's just growing basil in a pot in the window) 
• Make it fun: make your own pizza night, pasta bar, etc - prep everything together in the kitchen, and bring it all out for everyone to assemble as they like (don't forget to include veggies!)
  
  Photo by Coqui the Chef; downloaded from Flickr without amendments

3.  Food culture:

• Go to food events like the Bite of Seattle or the Herb and Food Fair at Bastyr University
• Go to Farmer's Markets, the Pike Place Market, You-Pick Farms, Pea Patches or other community gardens (sometimes they have fun events at the gardens) 
• Discuss and celebrate the culture of origin of your dinner (afternoon project: research the culture and find a fun fact)
• Wear sombreros at taco night, wear saris for Indian night 

Sneaking Nutrients In
Sometimes you may want to experiment with stealthily boosting your child's nutrition. Most kids will reliably eat marinara or pizza sauce, so puree some vegetables and add them in.  Find other sauces you know they will eat and do the same.  Make zucchini bread instead of banana bread.  Add raw greens to a smoothie (as long as they will tolerate a green smoothie!)  There's a book called Deceptively Delicious that you might want to sneak a peek at.  

Most importantly, breathe.  Take my suggestions, but make changes slowly; don't stress yourself or your family out.  There's enough stress in life; I do not want to add to yours.  But I would be so happy to see restaurants change their kids menus to include healthy choices because consumers start demanding it!

I have no affiliations or financial interests to disclose.

The Principles of Naturopathic Medicine, or How Red Sorrel Taught Me What I Already Know

I was recently diagnosed with a serious problem: red sorrel in my yard.  I knew it was there; I watched it spread from the parking area last summer to my yard this spring.  I saw those blades of beautiful red flowers waving in the breeze all over my yard.  But I had no idea that I had a problem.  When my neighbor came over and gave me the diagnosis, I tried not to panic.  I did what any good patient does - I got on the Internet.  I found some optimistic and cheery sights touting its great culinary and medicinal uses.  But mostly I found sites that were frightfully useless.  They were all about the same: a description of the weed and a picture (thanks, but I got that part), a description of where it likes to grow (anywhere and everywhere), and an explanation of how to manage it (you can't - just forget it; give up before you even try).  These web sites always mentioned that you could try this or that weed killer, but only in spot treatments.  I'm not certain what constitutes a "spot," but I'm pretty sure it's smaller than half my yard.  You could probably guess that I'm vehemently anti-weed killer, but these guys are telling me that even if I were up for using it, I can't because it's only a spot treatment?  So do I have any options?  Should I sell my house?  Rip up the top 2 feet of yard and start over?

Red Sorrel: Photo by Jacob Enos; downloaded from Flickr without amendments

Alas, I have not found a miracle cure to rid my yard of the dreaded red sorrel. But, being certain that I didn't want this noxious, invasive weed taking over the rest of my yard and the strawberries I just planted, I decided I had to maintain hope.  Why am I telling you this story?  Because this terrible weed is reminding me of valuable lessons I already know about life and medicine.

Again, like any great patient would, I looked deeper into the Internet. (Do you hear the sarcasm in my voice?  Maybe soon I'll write a post about Dr. Google and its followers).  I hit the jackpot: two different blog posts outlining attempts to kill red sorrel organically.  One says the only thing she did was add nitrogen to her soil and the following spring, problem (almost entirely) solved.  The other says she's about to try adding sawdust and manure mulch, which she has heard can work.  Sadly, this one gave no follow up posts, and has not replied to my inquiries.  No matter; I will believe.  I will continue my quest with vigor.  I will dig out the sorrel, replenish the soil, plant native plants, and start nurturing my yard (something that has not happened in at least 2 years since I've been busy with other parts of my life).  I will believe that I can get past the sorrel fiasco, even if the Internet tells me otherwise. 

This story of restoring land health is strikingly similar to that of restoring human health.  It follows the principles of naturopathic medicine and the therapeutic order of healing so well that I just had to write about it. 

Photo by Sean Mason; downloaded from Flickr without amendments

Principles of Naturopathic Medicine

The Healing Power of Nature
Naturopathic medicine believes that nature, and the human body, have an innate healing power.  Given the proper foundations of health, and the appropriate support, the human body has the ability to heal itself of illness.  Someone who is ill and eats a diet of strictly processed foods, drinks nothing but diet soda, and lives with an abusive spouse may not experience this power.  But if that same person begins to eat fresh vegetables, drink clean water, and amend emotional health, nature may now be uncovered and allowed to work toward healing.  I believe that once I provide my lawn with the foundation of health (water and nitrogen) and the appropriate support (strong native plants), that it will heal itself of the red sorrel. 

Western Trillium:  Photo from Mount Rainier National Park's photostream; downloaded from Flickr without amendments

Identify and Treat the Cause
We NDs don't just say "well you've got constipation, here's a prescription for a laxative."  We dig into the root cause of the constipation - why is your body responding this way?  Is it diet?  Is it emotional? Is it a genetic syndrome?  Is it an anatomical malformation? 

Why do I have a sorrel infestation?  Because I wasn't paying attention.  I let it grow without finding out what it was.  I was focused on everything in my life other than my front yard.  I was putting it off for later, when I had time.  My yard was not watered once last summer.  It was about half grass half dandelions and moss at the time the sorrel came to town.  I planned to dig it out and replace it with native plants one day.  But in the mean time, I was completely ignoring it.  Just as we so often ignore our health.  We know one day we will start exercising, increase our veggie intake, or start making time for ourselves.  But when does that day ever come?  Often it comes when there's a major problem.

First Do No Harm
Drugs?  This is a question I ask a lot when I see patients.  Will they help?  Will they harm?  Are they immediately necessary or can we try something else first?  Sometimes, drugs are immediately necessary; often they are not.  Drugs, as well as any intervention, can cause harm.  The question should always be, do the benefits outweigh the potential harm? 

Weed killer?  My 2 year old plays in this yard, digs in the dirt, rubs it on his face, breathes the air that comes off of it, and sticks his fingers in his mouth before we can get inside to wash them.  Do I really want residue of something designed to kill left on this lawn?  And what about the watershed?  Weed killer runs off our lawns and straight into our rivers and streams.  This is not an insignificant problem (see links below).

Photo by Fletcherjcm; downloaded from Flickr without amendments

Doctor as Teacher
You better believe I have become the greatest anti-invasive plant evangelist there ever was.  Sometimes I think I just might have the time and energy to pursue a side career in landscaping specializing in native plant restoration. 

Treat the Whole Person (Yard)
Rather than seeing a patient with symptom X and prescribing drug Y, we NDs like to get a list of all the symptoms, determine why the body is expressing these symptoms, and address the root cause of these symptoms with natural interventions.  So, for constipation in a child, I don't jump to prescribe a laxative.  I find out what the child eats and drinks; I ask about emotions and emotional support - is this a child who can't let go of anything, or who can't use a public bathroom?  I ask about other symptoms.  I might prescribe increased water consumption and diet improvements.  I might prescribe counseling.  I might uncover emotional stress at school and prescribe cooperating with teachers to address it.  The prescription will be individualized and address the child as a whole person.  What I've found with the dreaded sorrel is no different.  I can't solve this problem with a single solitary action.  I'm going to have to remove the offending agent, nourish the health of the soil, add strong native plants that can fight off the sorrel (probiotics?) and continue to promote health in the future. 

Prevention and Wellness 
Generally, the best way to prevent illness is to promote wellness.  A well fed, well watered, happy, emotionally attached, cared for human who exercises, gets lots of fresh air, and relaxes and sleeps well, will typically be healthier than one who does not, and will often be sick less often, less severely, for less time.  Apparently, the same is true for my lawn.  A lawn that goes an entire summer and then some without water, that is growing in soil that has never been nourished, seems to be a bull's eye for a hostile take-over.

Photo by Lindsey Turner; downloaded from Flickr without amendment

The Therapeutic Order

NDs prefer to use the lowest intervention possible for each patient's treatment plan.  Here is the order: 

• Determinants of Health - Are the following needs being met for the patient: adequate clean water, fresh air, exercise, adequate nutritious food, emotional and mental health?
• The Healing Power of Nature - Is something preventing the body from healing itself?
• Tonify Healing Systems - E.g. series of structured sweats, hydration, and increased exposure to fresh air.
• Correct Structural Integrity - E.g. is the gut lining damaged by years of exposure to a poorly tolerated food?
• Symptom Based Naturopathic Treatment - A specific natural product that treats a specific symptom of illness without addressing the root cause; e.g. licorice for heart burn or calendula for mouth sores.
• Symptom Based Pharmaceutical Treatment - A specific pharmaceutical that treats a specific symptom of illness without addressing the root cause; e.g. Ibuprofen for headaches.
• High Force Interventions (e.g. surgery)

Echinacea: Photo by Nomadic Lass; downloaded from Flickr without amendments

With each patient, we choose where we need to come in on the Therapeutic Order, based largely on the extent of the illness at hand, but also on the patient's abilities and desires.  

With my red sorrel, I considered, for about a half a second, coming in at symptom based pharmaceutical treatment: weed killer.  But, I learned it wasn't an option, and I would have been unwilling to do it in the end anyway.  So, I'm coming in at determinants of health, the healing power of nature, and correct structural integrity. 

Sadly, you can't always cure a disease.  Some patients will die of their diseases, and some will live with them chronically.  But you can always help a patient, if you seek the opportunity.  At this moment, I have to believe that I will cure the disease, that I will beat the sorrel, that I won't still be battling it in 5 years.  But I may be.  And at least, the patients (me and the lawn) have been helped.  I think it's obvious how my lawn has been helped (sparkly new plants!)  As for this patient, I've seen how the idea of foundational health applies to the earth.  And I've been reminded of the tantamount importance of these foundations of health for the wellness of my family, my friends and their families, and the globe.  Okay sorrel, lesson learned.  Thank you, you may go away now!


Resources:
Roundup linked to health problems
Roundup's inert ingredients kill human cells
Weed killers in our water
Pesticides as Water Pollutants

I have no affiliations or financial interests to disclose.