I work as a Pedi ARNP. Since having my DS, I feel like such a fraud. For years I have been giving medical advice, very textbook, to new parents who have tons of questions. What I have found is that I don't have an EFFING clue! This baby stuff is no joke and it seems the textbook obviously does not apply to all. So help me out, as a FTM and an ARNP.
Have you ever gotten bad advice from the pedi or advice that just didn't work for you? What did you do instead?
Post by somebabiesmom on Jan 23, 2015 8:36:17 GMT -5
Don't be too hard on yourself. Textbook advice is great. And it's as much of a skill to read your kid as it is to know how to address it.
I have to say La Leche League always gave me the worst advice. Pretty sure that was b/c they had an agenda to get the whole world breastfeeding (men and adult children, too).
My pedi was really into asking how often/for how long I was breastfeeding at the time- she advised me not to "use my boob as pacifier," so I was obsessed with trying to set nursing limits, thinking that DD would never give it up if I didn't set these limits. I wish I just would have relaxed and enjoyed the process more.
Post by theborg7of9 on Jan 23, 2015 9:03:08 GMT -5
When my first was born, he was gaining weight, but it was not quite as fast as the charts said it should be. He was happy, sleeping well with plenty of wet and dirty diapers. But because of his weight they were asking me to come in every 3 days for weigh ins. It was extremely stressful. After a couple weeks, I put my foot down and said I was sure my baby was fine and I'd be back in 8-9 days. They caused me a lot of stress, like my stomach was in knots all the time. But it was totally unnecessary. N is just a baby who doesn't eat much. And he's fine.
My second baby is a giant chunk who eats a ton, but I didn't do anything differently. So, that goes to show that you can't control what a baby does.
My pedi (whom I love for the medical stuff) gave me bad advice on breastfeeding. He said if I still want to BF after 1 I need to pump and give a bottler or the kids will be spoiled. I ignored that advice entirely. I'm now going to another practice because we moved and my main Pedi is a CRN (childless) and she is fantastic. She is very relaxed with all the non-medical stuff (breastfeeding, not sleeping through the night, potty training) and very good on the medical stuff. There has been plenty of times when she said "there is no one right answer for every kid" or "I'm not sure - I'll research more and follow up" and I only think more highly of her for that.
Car seats! It seems like every pedi here says kids can be forward facing at 1yo. Drives me freaking insane. I wish pedis were better educated on proper car seat safety because people listen to them.
In general I think its important to differentiate between medical advice and parenting advice. I trust my pedi as a doctor, but ignored the little parenting advice he offered (sleep training, food etc). But most doctors throw out parenting opinions like its medical advice and that bugs me.
We love love love our pedi. But it's because he's just so practical. He isn't textbook on much except sleeping in a crib, which happens to really work for us. And even with that, he's sensible. Like when DD at around 8 mos started getting upset when we put her in her crib, he told us to give her a lovey. When we went, "But SIDS!!!" he said "don't give her a big lovey or one that she can't lift. Or so many stuffed animals that she can build a pile to climb out of her crib. But a little teddy bear is not going to attack your baby." DD still sleeps with that lovey. And indeed I have never caught it trying to kill her.
Also, he's laid back, which I really need. He just doesn't get excited about much.
I LOVE our family Dr. and honestly, she hasn't really ever given us any parenting advice. She made a few suggestions regarding how long to allow DD to have bottles vs. sippy cups that I basically ignored and did what felt right for DD.
Honestly, I think we have had such a great experience because the practice philosophies are basically in alignment with our own. We vaccinate, we don't bed share (but do room share), they were totally non-judgmental about feeding choice, we kept DD rear facing until well after 2.
She's very laid back and really only chimes in on medical stuff. Since she doesn't have children of her own I think that keeps her from sprouting out too much non medical advice.
We try to break out the parenting advice from medical advice. Our pedi is great - he's well educated, he's friendly, and we trust him for anything medical related. He's also about 65 years old, and comes from another generation. His parenting advice is pretty mild - around 9 months, he asked if she was STTN yet, told us she is physically capable of it now and doesn't need MOTN feedings. He recommended letting her cry - either she'll break first or we would. We tried his method for a few nights and realized that it wasn't doing any of us any good.
The thing that bugs me the most is when the pedi dismisses the notion of "Mom knows best". I see my child everyday. You see a small snippet. When I feel that something is wrong, don't be dismissive.
In the same vein, I repeatedly give new parents the advice that "Mom knows best. If you think your concerns are being brushed off, go to a specialist or get a second opinion." I love my pediatrician but going around her to get further treatment for allergy/asthma as well as an ENT was the best decision.
Also, medical doctors really have no place in giving parenting advice. And if they do give parenting advice, give well rounded advice with options and qualify that it isn't the only way.
There is no one size fits all. For example, sleep... It's more helpful to say "There are several methods to help with sleep. I highly advise reading up on them to help decide what works best for your kid. In the meantime, here are some things you can try... they may not work as every kid is different."
Basically, have empathy and understanding that there is no textbook answer and encourage and guide parents in finding what works for their child.
Post by sassypantzz on Jan 23, 2015 10:33:07 GMT -5
I have the best pedi ever. It also helps that her son is 3 months older and my daughter. So basically she has done it. Like just done it. She is a perfect mix between mom advice and medical advice. I adore her.
We moved and switched peds. We left the "new" ped after less than a year and found a "new new" ped we love (a year later).
I think most parents are OK with advice that doesn't 100% match their style/thinking. It's good to have perspectives. For me, the problem arises when the practitioner does not listen and respond as if they listened. If you are discussing BF and someone complains about reverse cycling and you respond with the amount of food a baby needs in a day then move to a new topic, that is too textbook. As long as you pay attention to what the parents are REALLY asking and respond to that - even if it is to say "there are several things that could work..." or "this might be a phase" that is much better than presenting facts and figures without connecting.
We also didn't want an RX every time we turned around - that was very offputting.
The thing that bugs me the most is when the pedi dismisses the notion of "Mom knows best". I see my child everyday. You see a small snippet. When I feel that something is wrong, don't be dismissive.
In the same vein, I repeatedly give new parents the advice that "Mom knows best. If you think your concerns are being brushed off, go to a specialist or get a second opinion." I love my pediatrician but going around her to get further treatment for allergy/asthma as well as an ENT was the best decision.
This is one thing I LOVE about our family doctor. During DD's first year we had two major concerns, she took them both seriously, but at the same time calmed us off our FTP mini panic. She advised us to keep an eye on the issues until our next well baby visit, or to contact us if things got worse. Then she actually asked us about the issues, and followed up at the next visit. When we still maintained the same concern she gave us great referrals to specialists. In the end DD didn't end up having any major issues. However, the way our Dr. listened, took us seriously and trusted the information we were giving her, is one of the primary reasons we love having her as our Dr.
Also, I really love the family doctor approach. She is very focused on us as a complete family and is asking questions and making sure we are all healthy every time she sees one of us.
Post by queenbabee on Jan 23, 2015 11:22:27 GMT -5
Thanks guys. This is exactly what I'm talking about. Basically parenting advice vs. Medical. I get a ton of questions and usually respond the best I can, but obviously nothing compares to life experience (of which I still only have minimal). I do let them know when I don't "know" something. I only ever try to advise when asked. Otherwise, it's super straight forward medical concerns.
The best conversation I ever had with a ped was at our 3 month appointment. The doctor looked at our tired, worn out faces and told us that she was happy to offer advice but there really is no right way. She said whatever you are doing is OK and we need to figure out what works for us. Those might not have been the exact words but that was the gist of what she said and I remember walking out and telling my husband I loved her.
I can't think of a time that my pediatricians have given out any parenting advice that I didn't agree with. My hematologist on the other hand...he randomly brings up things his wife does as though it is parenting law. I usually just smile and say "I'm glad that worked for you."
Before I was a parent I taught a parenting class. It was a mandatory component of a social skills group and a lot of the information was common sense/basic safety. Looking back, I realize now that I have first hand parenting experience I would be able to facilitate more helpful group discussions about how to handle stresses of parenthood.
I think being able to recognize that parenting doesn't have one size fits all solutions makes you a better provider and not a fraud at all!
We moved a year ago and got a new pedi when DD was 18mos. At her 2year appt, new pedi told us DD was a little overweight and we should watch what she eats. I'm still upset about it!
1. She's not overweight. She was mismeasured by a nurse who gave no fucks about proper measuring and marked her down as an inch shorter than she is. When I made the pedi re-measure her, DD came out on the very top of the normal growth curve.
2. She's been a big kid since the day she was born. Never has she been below the 95th percentile in height or weight.
Our old pedi probably would've known that. If our new pedi had looked at her growth history, I hope she wouldn't have said anything. I know childhood obesity is a big deal but I seriously disagree with introducing weight concerns to a 2yo who isn't overweight.
On a positive note, our last pedi ended every exam with "she's perfect." It may have been cheesy but it always made me feel very reassured.
I'm on my 3rd pedi and finally found one who actually listens to my concerns and isn't radically in procedures. I just wish when it was time to examine my daughter or give shots she wouldn't ask me to hold her down. I refused at her 3 year appointment and told the pedi she could talk to DD about it and explain what she needed to do and why but I wasn't going to forcefully hold her down. Pedi was pretty annoyed at me and just skipped checking her vagina and bottom. This was the same visit that DD told the pedi that she couldn't touch her patella's and was covering both her kneecaps and the pedi mouth dropped to the floor and was like okay I won't. So in my book DD probably would have listened and responded to the pedi explaining things.
I had a pedi when my oldest was a baby who kept blaming all my son's constipation issues on normal baby stuff and his pain from it on colic. I switched pedis. The new one found blood in his BM. Turns out he was MPI.
My new pedi has given me tons of bad BF'ing advice.
My own personal GP gave me some terrible TTC advice.
I guess I look at it like Dr.s/nurses are human too. Every baby is unique. Moms should trust their gut and do their own research so they can make an educated decision with their doctor's input instead of blindly trusting their pediatrician.
For what it's worth I like my medical professionals to give me textbook advice. Then I can take it and combine it with my knowledge of my kiddo and whatever else I read/hear and make a decision. So, don't beat yourself up. Live and learn.
Our pedi told us when we could physically do cry it out (like he weighed enough and didn't need to eat in the middle of the night anymore). I didn't (not against it, just found another way that worked for us), but I didn't take it as bad advice and she didn't push it. It was helpful to know that in her medical opinion it was a safe option at that point if we needed it.
I don't really ask for much parenting advice from our pedi, but would always listen to what she said if she offered and take it into consideration.
This. Our pedi is great with medical advice, and would give parenting advise when asked. He has two young kids too, so he's pretty laid back with a lot of stuff, like when DS was a baby we talked about sleep training a bit and he gave a few options, same with some behavioral stuff, nothing pushy. My only problem ever was with breastfeeding advise, which, while they never gave BAD info they just never were as helpful as I needed in the beginning. But...live and learn I guess.
For what it's worth I like my medical professionals to give me textbook advice. Then I can take it and combine it with my knowledge of my kiddo and whatever else I read/hear and make a decision. So, don't beat yourself up. Live and learn.
Our pedi told us when we could physically do cry it out (like he weighed enough and didn't need to eat in the middle of the night anymore). I didn't (not against it, just found another way that worked for us), but I didn't take it as bad advice and she didn't push it. It was helpful to know that in her medical opinion it was a safe option at that point if we needed it.
I don't really ask for much parenting advice from our pedi, but would always listen to what she said if she offered and take it into consideration.
Medical advice, yes.
There is no such thing as textbook parenting advice. And sleep really is more parenting than medical. Pediatricians, particularly older ones, have very outdated sleep training info.
ETA- I realize my sleep statement seemed directed at you. It wasn't.
The thing that bugs me the most is when the pedi dismisses the notion of "Mom knows best". I see my child everyday. You see a small snippet. When I feel that something is wrong, don't be dismissive.
DD's first pedi dismissed a lot of my concerns because he assumed it was just me being a crazy, overprotective, young mother. Also, that whole office treated me differently once I switched DD to medicaid (single mom, insurance through work was too much for me to afford). And, btw, I only look young. I'm 30, but up until our last visit, he was apparently under the assumption that I was 22. Which doesn't make a difference here or there when it comes to any concerns I have about my child.
Another thing he told me: Because DD was so big at 15 months, he "highly recommended" we put her in a front facing booster. Uh... No.
There was another pedi at the office who was always on call whenever DD spiked a fever and I brought her in, this doctor had absolutely no interest in anything I had to say. I'd ask a question and then she'd talk to me as if I never asked anything.
Post by librarychica on Jan 23, 2015 15:06:33 GMT -5
Our first pedi kept insisting that DD1 wound grow out of her reflux. His own partner was shocked and wrote her a prescription when I came back a third time. I don't want to over medicate, but my kid was clearly in substantial pain.
A nurse in that office also gave me a "how wonderful you're staying home/selfish moms work" speech because I said I didn't need daycare paperwork. I work full time. Awkward.
It has been a while, but our first Pedi was okay, except for the time she told me when DD was about two months old that I was spoiling her by responding to her cries all the time, especially in the middle of the night. I think she was trying to comfort me in a way, but that didn't happen. We moved and now have a new doctor for her. She is a general practitioner and I LOVE her. I think she truly adores my daughter, which feels pretty awesome, and she definitely is very attentive. She will even stay around to help comfort my DD during vaccinations.
Post by thenetwork on Jan 23, 2015 22:33:10 GMT -5
My only upsetting pedi experiences have been regarding breastfeeding. At the hospital right after DS was born, the pedi there was adamant that I needed to supplement with formula from the get-go because of jaundice and that if I chose to exclusively breastfeed DS would not gain enough weight. I'm so glad I pushed back. His jaundice cleared in 2 days with a light bed, and DS has always been in the 99% for weight.
In general though, I have learned to just disregard parenting advice I don't agree with, even coming from a doctor.
Post by toratoratori on Jan 24, 2015 11:31:54 GMT -5
I second what somebabiesmom said about getting bad advice from lactation consultants. I asked about supply issues before I gave birth and essentially got told "that's not a thing, you're doing it wrong." Then my baby showed up, and guess what? I was producing less than 2 oz. a day. I didn't find out until she was 10 days old that she was basically starving to death. We started supplementing immediately and eventually switched to EFF, but I spent the next three weeks in a depressed haze and still feel guilty about not realizing sooner.
Post by clarkebar1013 on Jan 26, 2015 15:10:17 GMT -5
We love DS pedi, but there was one time I do remember we didn't follow her advice. My son had to go to the NICU the morning after he was born, however, it was only for his bilirubin levels. He was jaundice, but other than that he was a healthy 7 pound baby. When he went for his yearly checkup, she recommended he have his hearing tested. I forget the name of it exactly, but the lady at the outpatient center asked me to verify with DS pedi that she meant that test b/c he would need to be under anesthesia for it. When I asked his pedi, she replied with "since your son was in the NICU, it's something that we recommend be done at this age..." I talked with my husband and we couldn't think of any reason to put our son under if he seems to be hearing fine from what we can tell. So we decided not to do it. Luckily, his pedi hasn't mentioned it again or anything.
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