Amanda

I wouldn’t rely on death certificates for this information. They are an afterthought typically in health care, and not particularly standardized. When my grandmother died in 2021, the doctor filled one out without having been present or examined the patient or done an autopsy or tested for covid. It was probably roughly correct, but it was no gem of data accuracy. And it was absolutely typical. It’s paperwork that doctors have to do but often rush through, and it’s not done in the interests of data or science.

Question on teacher student ratios: how do you figure out if they are directly comparable? They don’t seem to be the same thing as class size. They often see to include staffers other than classroom teachers. Are they calculated the same everywhere?

As a parent I’ve found it basically impossible to assess a school without being physically in it myself. Which makes it challenging to select a school for my kids. Just last week I was in a music class with my kid and was horrified. Our district was ranked the best in the state in music for several years running, which sounds very impressive. But by listening to my kid and then seeing it for myself, I realized that the class is horrendous and a complete waste of time. I still have no idea how to figure out things like that about schools I might potentially like to switch to, particularly if they are not hyper local to us.

I don’t see a way to comment on the doula article directly. Maybe this is the correct place??

I think it’s great for everyone to be allowed to bring an emotional support person to labor. I think it’s great if a quick online training helps those people be good support people. But I don’t think everyone wants or needs a doula. I certainly did not want a friend or doula at my labors. My husband was the only person in the room I’d accept (aside from medical folks). I’d find pressure to get a doula 100% as annoying as the browbeating about breastfeeding. It’s not for everyone.

Agree. I don’t understand what they were hoping to achieve with this change. I don’t know if ohhihellothere will see this; I no longer receive notifications when people like or respond to my comments.

It does make me reconsider reupping my subscription.

2 comments on colon cancer screening:
First, it’s one of the cancers most avoidable based on individual decision-making. Diet matters immensely here. Many cancers seem pretty random; colon cancer is within your power to avoid in many cases, by comparison.

Second, colonoscopies didn’t used to be done with anesthesia. They still don’t have to be. Some places will do them just with sedation (eg valium), and this is preferable for most to total anesthesia. The unpleasant prep and the risk of a serious complication are the same, but sedation is a great way to go and should be considered if intubation and the risks of GA are putting you off.

Question: Do we have any idea how many kids get flu shots at annual visits, vs elsewhere, vs not at all?

Our ped was spectacularly unhelpful with flu shots. We could only get them during the school day at specific times in very badly timed flu clinics. No thanks. But we always get them. Plenty of kids don’t even have peds, or don’t visit the month of their bday (we are often unable to schedule within months of the bday nowadays.)

I always think of germs as a great thing for babies (unless it’s a fever before 3mo). Hygiene hypothesis! With our kids I don’t know how you could have isolated older sibling vs daycare as the source, as our younger started at 3mo. Do siblings start child care at a similar age, on average? Siblings AND daycare friends are petri dishes. Also parents are even more tired and run down and apt to catch germs themselves and pass them on. I’m still wondering about the causality here.

On the vitamin issue, you likely do not need to supplement with folic acid later than the end of the first trimester. By then the defect either exists or not. It doesn’t form later.

If you want DHA supplementation but are vegetarian, there are pills from the algae that the fish eat, that apparently can work to supplement as well.

When we were weaning our kid off the bottle (way past 14mo) we started watering the milk down gradually so it became less satisfying. He mainly used it as a pacifier at bedtime, not ingesting very much. Over time he did forget about it.

We feed our kids dairy but I’m not sure it’s true that they have to have it. Vegan kids and kids with dairy allergies do OK with alternate nutrient sources as far as I know.

Can we also talk about the environmental effects of all the crap kids get for rewards? Not infrequently my kids will bring home 10 plastic gizmos that get lost, broken, or chewed by the dog in short order, and they know they got them as some sort of reward but they don’t even know for what. Add them to the pile of cheap plastic crap they get just for going to the dentist. Arrgh.

I’m not against rewards, but it seems like kids get them all the time and it’s not linked in their heads to behavior necessarily. Kids with ADD supposedly do better with reward charts, and we use them sometimes, but I don’t like them getting plastic trinkets or sugar so much as the reward.

I think that this discussion of trampolines does not adequately distinguish between trampolines and trampoline parks. Jumping in a foam pit isn’t necessarily similar to jumping on a trampoline of the sort some have in their yards. My own kids sometimes spend time at trampoline parks getting pizza or doing the arcade, among other things. So I can’t infer much about the safety of trampolines from data on time spent in trampoline parks.

What I do know is that any ER professional will tell you that trampolines are a top cause of pediatric injuries that bring in kids. And it doesn’t even have to be from misuse, like carelessly crashing into another kid. A kid I know broke her leg as a 3yo just from bouncing up and down on one. The force itself is the problem.

We would never allow our kids to have a trampoline, but we do take them to places like Urban Air. The places for jumping there don’t allow you to spring as high or as hard as your typical backyard trampoline, and plenty of the time spent is on aerial rope courses, slides, arcade games, snacks, and other things that aren’t what we consider risky.