I had great plans to write something meaningful this weekend. But time change + potty training regression = exhausted mommy... I'm heading to bed as soon as I get Petunia's milk ready for tomorrow.
If anyone out there knows why an almost 3 year old who clearly can control her pottying (since she does so at day care and was doing so at home) would now choose not to do so at home, please tell me. My current theory is that my daughter is trying to drive me insane.
Sunday, March 14, 2010
Wednesday, March 10, 2010
A Mechanism for the Effects of Vitamin D on Immune Function
Our pediatrician is a big proponent of vitamin D supplementation, and thanks to her, everyone in the family regularly takes vitamin D. She referred us to the GrassrootsHealth.org website for more info about her recommendations. I did some PubMed searching, too, and decided that I agreed that the available evidence suggested that vitamin D supplementation might be a good idea- or at least that it wouldn't be a bad idea. We all know that vitamin D is essential for strong bones (this is because we can't absorb calcium without it), but one of the other things that vitamin D is supposed to help is your immune function.
I submit that "improves immune function" will be irresistable to just about any parent with a child in day care. And indeed, after we started giving Pumpkin vitamin D, I noticed a drop in the number of illnesses in our family (most of our illnesses come home from day care, and Pumpkin is the first one to get sick). However, she had also been at day care for awhile, and presumably built up some immunity to various things, so I considered this suggestive, but nothing more.
This week, I cam across a recent article in Nature Immunology by von Essen, et al, which adds support to the idea that vitamin D is essential for proper immune function. (You can read the abstract of the original paper without a subscription. Here is a write up of the paper, too.)
The paper looksat the function of one type of immune cells, called T cells. T cells are far more responsive to antigen after they have been "primed"- i.e., exposed to antigen once. The current model to explain this involves the fact that T cell activation can occur via two different signaling pathways. The first pathway dominates in "naive" T cells (T cells that have never been exposed to antigen), while the second dominates in T cells that have previously been exposed to antigen. The second pathway is far more efficient than the first, which explains why primed T cells are more responsive than naive ones.
But how do the primed T cells switch to the second pathway? That is where the new paper comes in. The researchers show that the expression of one key protein in the second pathway, phospholipase C gamma1, is increased by the combination of vitamin D and its receptor (cleverly called "vitamin D receptor", or VDR). The expression of VDR, in turn, is increased by the activity of the first pathway. So, the T cells turn on the second, more active pathway using the same pathway that they use to respond to antigen the first time they "see" it- but only if there is sufficient vitamin D around. The researchers even showed that T cells isolated from people with low serum levels of vitamin D were less responsive to antigen than T cells from controls with normal levels of vitamin D.
Maybe it is because my background is in biochemistry and biophysics, but this is the sort of study I like to see when I'm trying to evaluate the benefits of a supplement. Correlative population studies are all well and good, but I'm always a little suspicious of them. Human beings aren't lab animals- it is very hard to control for all of the confounding variables in how we live our lives. A population study indicating a correlation between levels of some vitamin and a certain outcome is a nice story, but it is only the outline of the story. A biochemical mechanism adds some satisfying detail to the story.
And here is the ironic twist to this story- as I write this, my nose is blocked with the second or third consecutive cold I've had this season, which just goes to show that no supplement can guarantee you perfect health.
------------------------------------------------
I am not a medical doctor. This post should not be construed as medical advice. I read the entire paper, but as an interested scientist, not as a careful reviewer. If you're wondering about whether or not you or your children should take vitamin D supplements, all I can really tell you is to talk to your doctor and/or do your own research.
I submit that "improves immune function" will be irresistable to just about any parent with a child in day care. And indeed, after we started giving Pumpkin vitamin D, I noticed a drop in the number of illnesses in our family (most of our illnesses come home from day care, and Pumpkin is the first one to get sick). However, she had also been at day care for awhile, and presumably built up some immunity to various things, so I considered this suggestive, but nothing more.
This week, I cam across a recent article in Nature Immunology by von Essen, et al, which adds support to the idea that vitamin D is essential for proper immune function. (You can read the abstract of the original paper without a subscription. Here is a write up of the paper, too.)
The paper looksat the function of one type of immune cells, called T cells. T cells are far more responsive to antigen after they have been "primed"- i.e., exposed to antigen once. The current model to explain this involves the fact that T cell activation can occur via two different signaling pathways. The first pathway dominates in "naive" T cells (T cells that have never been exposed to antigen), while the second dominates in T cells that have previously been exposed to antigen. The second pathway is far more efficient than the first, which explains why primed T cells are more responsive than naive ones.
But how do the primed T cells switch to the second pathway? That is where the new paper comes in. The researchers show that the expression of one key protein in the second pathway, phospholipase C gamma1, is increased by the combination of vitamin D and its receptor (cleverly called "vitamin D receptor", or VDR). The expression of VDR, in turn, is increased by the activity of the first pathway. So, the T cells turn on the second, more active pathway using the same pathway that they use to respond to antigen the first time they "see" it- but only if there is sufficient vitamin D around. The researchers even showed that T cells isolated from people with low serum levels of vitamin D were less responsive to antigen than T cells from controls with normal levels of vitamin D.
Maybe it is because my background is in biochemistry and biophysics, but this is the sort of study I like to see when I'm trying to evaluate the benefits of a supplement. Correlative population studies are all well and good, but I'm always a little suspicious of them. Human beings aren't lab animals- it is very hard to control for all of the confounding variables in how we live our lives. A population study indicating a correlation between levels of some vitamin and a certain outcome is a nice story, but it is only the outline of the story. A biochemical mechanism adds some satisfying detail to the story.
And here is the ironic twist to this story- as I write this, my nose is blocked with the second or third consecutive cold I've had this season, which just goes to show that no supplement can guarantee you perfect health.
------------------------------------------------
I am not a medical doctor. This post should not be construed as medical advice. I read the entire paper, but as an interested scientist, not as a careful reviewer. If you're wondering about whether or not you or your children should take vitamin D supplements, all I can really tell you is to talk to your doctor and/or do your own research.
Monday, March 08, 2010
High Stakes
A very sad couple of stories have been dominating the news over the last couple of weeks here in my home town. A 17 year old girl was attacked and killed while out jogging. She was missing for a couple of days before her body was found. They have arrested a 30 year old man who has previously served time for attacking a young teenage girl. And now, they have found the skeletal remains of a 14 year old girl who went missing on her way to school just over a year ago. The same man is a "person of interest" in that investigation.
These stories hit harder now that I am a parent. I look at my two beautiful little daughters and can barely comprehend the pain that the parents of those two young women are feeling.
But I find that I spend a lot of time thinking about the other parents in this story- the parents of the little boy who grew up to be a rapist. I think they must be feeling a lot of pain right now, too. I do not in anyway blame them for these attacks. Their son is a grown man now, and surely, at some point, we have to be responsible for our own actions, regardless of what mistakes our parents make. To say otherwise would be an affront to the many people who go on to lead perfectly normal lives despite bad childhoods.
I am also not saying that this man's parents necessarily did something wrong. There are surely people out there who had idyllic childhoods and still go on to commit crimes.
But clearly something went wrong here. And clearly we, as a society, have an interest in figuring out what goes wrong in cases like this and determining how we can prevent these things from happening.
There are many people in my community calling for the death penalty, or saying that after this man's first offense he should have been locked up for life. I don't think either of these things provides an answer. Yes, executing this man will ensure that this one man never commits a crime like this again- but there will be other men who do, and I think the evidence is pretty clear that they won't be deterred by the thought of the death penalty. And yes, a longer prison sentence would have prevented these crimes- but it would not have prevented the first crime.
So I come back again to the parenting. It seems to me that the only way to stop these crimes is to prevent little boys from turning into men who could commit such an act. This man's parents will never know if there was something they could have done differently that would have changed the outcome for their son. From what has come out about his background, it does not seem that there was any obvious warning sign, any clear point at which his parents should have intervened. There was just an average boy, perhaps a little more troubled than most, trying to find his place in the world. If there was anything his parents could have done differently, it is buried in the mundane details of raising him- in how he was disciplined and how he was praised, how he was taught to respond to disappointments and what he was taught to expect from the world. In short, it is in the sum of all the everyday decisions that parents make, while they are also trying to keep food on the table and hold their own lives together.
And that is what has me stuck thinking about this story, reading every new little update that comes out. It is a reminder that parenting is such a high stakes game, and one with very delayed feedback. We muddle through as best we can, but won't really know the outcome for at least 20 years.
For such a high stakes game, we play it with very little support from society. We are presented with unrealistic images of what parenthood will be like, and society frowns on frank discussions of things like the fact that some children are harder to parent than others. We isolate new parents by creating a fiction that the tight knit nuclear family should be able to handle it all, and show images of the joy of parenthood without fully acknowledging the frustrations. How easy it is to think that you're doing it all wrong. How easy it is for new mothers to slip into depression (which studies show can lead to an increase in aggression in the child) and how poorly prepared we are to catch it. I had prenatal appointments every week by the end of my pregnancy- but my first post-partum appointment was six weeks later. A lot can happen in those first six weeks, and a lot can happen after that one post-partum appointment is past. Why does it fall to pediatricians to try to catch the signs of post-partum depression? Why don't we follow up with the women directly, rather than via the proxy of their babies?
And then there are the pressures on working families. Women get a guilt-trip regardless of what choice they make about whether to go back to work or not- and many women don't really have a choice, anyway. But any attempt to require more family-friendly workplaces is met with cries of how it will destroy jobs, or of how unfair it is to the people who do not have children. I think cases like these show that policies that degrade our ability to parent are risky for all of society, not just painful for the families in question.
I look around my community, and I see a patchwork of programs and organizations trying to plug these, and the countless other holes in our support network for families. They are constantly underfunded, and usually overlooked. It must be difficult work. I suspect their success stories are not always easy to recognize, because you're looking for an absence- an absence of depression, an absence of abuse, and absence of troubled children- and how do you know that the program caused that absence? In some ways, this work is like the work of parenting. Its difficulty is underappreciated, and its importance is hard to pinpoint because it is so all-encompassing.
I don't know what to do to try to fix this mess. So I give a little money to the programs I think are trying to address the problems, I try to reach out to other parents where I can, and I hug my little girls a little tighter, and I hope for the best for all of our kids.
These stories hit harder now that I am a parent. I look at my two beautiful little daughters and can barely comprehend the pain that the parents of those two young women are feeling.
But I find that I spend a lot of time thinking about the other parents in this story- the parents of the little boy who grew up to be a rapist. I think they must be feeling a lot of pain right now, too. I do not in anyway blame them for these attacks. Their son is a grown man now, and surely, at some point, we have to be responsible for our own actions, regardless of what mistakes our parents make. To say otherwise would be an affront to the many people who go on to lead perfectly normal lives despite bad childhoods.
I am also not saying that this man's parents necessarily did something wrong. There are surely people out there who had idyllic childhoods and still go on to commit crimes.
But clearly something went wrong here. And clearly we, as a society, have an interest in figuring out what goes wrong in cases like this and determining how we can prevent these things from happening.
There are many people in my community calling for the death penalty, or saying that after this man's first offense he should have been locked up for life. I don't think either of these things provides an answer. Yes, executing this man will ensure that this one man never commits a crime like this again- but there will be other men who do, and I think the evidence is pretty clear that they won't be deterred by the thought of the death penalty. And yes, a longer prison sentence would have prevented these crimes- but it would not have prevented the first crime.
So I come back again to the parenting. It seems to me that the only way to stop these crimes is to prevent little boys from turning into men who could commit such an act. This man's parents will never know if there was something they could have done differently that would have changed the outcome for their son. From what has come out about his background, it does not seem that there was any obvious warning sign, any clear point at which his parents should have intervened. There was just an average boy, perhaps a little more troubled than most, trying to find his place in the world. If there was anything his parents could have done differently, it is buried in the mundane details of raising him- in how he was disciplined and how he was praised, how he was taught to respond to disappointments and what he was taught to expect from the world. In short, it is in the sum of all the everyday decisions that parents make, while they are also trying to keep food on the table and hold their own lives together.
And that is what has me stuck thinking about this story, reading every new little update that comes out. It is a reminder that parenting is such a high stakes game, and one with very delayed feedback. We muddle through as best we can, but won't really know the outcome for at least 20 years.
For such a high stakes game, we play it with very little support from society. We are presented with unrealistic images of what parenthood will be like, and society frowns on frank discussions of things like the fact that some children are harder to parent than others. We isolate new parents by creating a fiction that the tight knit nuclear family should be able to handle it all, and show images of the joy of parenthood without fully acknowledging the frustrations. How easy it is to think that you're doing it all wrong. How easy it is for new mothers to slip into depression (which studies show can lead to an increase in aggression in the child) and how poorly prepared we are to catch it. I had prenatal appointments every week by the end of my pregnancy- but my first post-partum appointment was six weeks later. A lot can happen in those first six weeks, and a lot can happen after that one post-partum appointment is past. Why does it fall to pediatricians to try to catch the signs of post-partum depression? Why don't we follow up with the women directly, rather than via the proxy of their babies?
And then there are the pressures on working families. Women get a guilt-trip regardless of what choice they make about whether to go back to work or not- and many women don't really have a choice, anyway. But any attempt to require more family-friendly workplaces is met with cries of how it will destroy jobs, or of how unfair it is to the people who do not have children. I think cases like these show that policies that degrade our ability to parent are risky for all of society, not just painful for the families in question.
I look around my community, and I see a patchwork of programs and organizations trying to plug these, and the countless other holes in our support network for families. They are constantly underfunded, and usually overlooked. It must be difficult work. I suspect their success stories are not always easy to recognize, because you're looking for an absence- an absence of depression, an absence of abuse, and absence of troubled children- and how do you know that the program caused that absence? In some ways, this work is like the work of parenting. Its difficulty is underappreciated, and its importance is hard to pinpoint because it is so all-encompassing.
I don't know what to do to try to fix this mess. So I give a little money to the programs I think are trying to address the problems, I try to reach out to other parents where I can, and I hug my little girls a little tighter, and I hope for the best for all of our kids.
Thursday, March 04, 2010
Quality Day Care for All
I'm going to do something that I don't normally do... I'm writing this from my lunch break. I'm bending my rule about no blogging at work because this is important.
Awhile back, I signed up for the MomsRising email list. A lot of their stuff I don't necessarily agree with, but I'm 100% with them on the need for better policies to support working families. They are running a campaign today to get people to write to their congressfolk in support of the proposals in President Obama's budget that support access to quality child care and early education. Here are some specific items, which I confess I am just cutting and pasting from the MomsRising email:
I have written here before about how I am a happy working mom. The single most important part of the arrangements that make me a happy working mom is the excellent day care I can afford to purchase for my daughters. I firmly believe that this should not be a privilege reserved for well off families. All mothers should have access to affordable, quality child care if they choose to work.
If you agree, don't just tell me about it- here is the link to send emails to your congressfolk. You can customize what you say, and you can cancel out of this if you decide that this is not something you want to do.
Updated to add: Here is a write up in Slate with more details about the proposals.
Awhile back, I signed up for the MomsRising email list. A lot of their stuff I don't necessarily agree with, but I'm 100% with them on the need for better policies to support working families. They are running a campaign today to get people to write to their congressfolk in support of the proposals in President Obama's budget that support access to quality child care and early education. Here are some specific items, which I confess I am just cutting and pasting from the MomsRising email:
- $1.6 billion increase for the Child Care and Development Block Grant (CCDBG). This would be the largest increase in funding for the program in more than 20 years. CCDBG directly helps families afford quality childcare
- $989 million increase for Head Start and Early Head Start helps ensure that low-income and at-risk children have access to quality early learning opportunities
- The reauthorization of key programs like Child and Adult Care Food Program, which would ensure that millions more children across our country have access to healthy foods.
I have written here before about how I am a happy working mom. The single most important part of the arrangements that make me a happy working mom is the excellent day care I can afford to purchase for my daughters. I firmly believe that this should not be a privilege reserved for well off families. All mothers should have access to affordable, quality child care if they choose to work.
If you agree, don't just tell me about it- here is the link to send emails to your congressfolk. You can customize what you say, and you can cancel out of this if you decide that this is not something you want to do.
Updated to add: Here is a write up in Slate with more details about the proposals.
Tuesday, March 02, 2010
Another Blindingly Obvious Post
Petunia is doing great at day care. She did fine her first day, but ate a lot less than usual, and frankly, she seemed a little freaked out by it all when I picked her up. Her eyes were open even wider than usual, and when I took her from the teacher who was holding her, she grabbed onto my shirt and leaned back so that she could keep looking at me while I gathered up her things.
They had taken her to visit Pumpkin at one point, which I imagine helped. She clearly loves her big sister. Pumpkin can almost always get her to smile, and usually can get her to laugh.
Today, Petunia ate more- still not as much as usual, but at least 3 ounces more than yesterday, and seemed pretty content when I got there. She was finishing off her last bottle in the arms of one of the teachers. She immediately gave Pumpkin (who insists on coming in to the baby room with me, even though she is required to stand against the wall by the door while I pick up Petunia) a huge grin. In short, she seemed like her normal self- a smiley, happy little baby.
I've made it out of the house on time both of the last two days. We got dinner on the table a little late, but not terribly so. We even had time for a family walk around the block today. The girls looked so cute sitting next to each other in their double stroller.
So, it is all going to be OK.
But you already knew that.
They had taken her to visit Pumpkin at one point, which I imagine helped. She clearly loves her big sister. Pumpkin can almost always get her to smile, and usually can get her to laugh.
Today, Petunia ate more- still not as much as usual, but at least 3 ounces more than yesterday, and seemed pretty content when I got there. She was finishing off her last bottle in the arms of one of the teachers. She immediately gave Pumpkin (who insists on coming in to the baby room with me, even though she is required to stand against the wall by the door while I pick up Petunia) a huge grin. In short, she seemed like her normal self- a smiley, happy little baby.
I've made it out of the house on time both of the last two days. We got dinner on the table a little late, but not terribly so. We even had time for a family walk around the block today. The girls looked so cute sitting next to each other in their double stroller.
So, it is all going to be OK.
But you already knew that.
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