After Charlie was born, our pediatrician became our first line of defense whenever we encountered a problem we couldn’t solve on our own. That was ideal whenever Charlie spiked a fever or came down with a rash… but over time, we started to realize that there might be some holes in our pediatrician’s knowledge.
Like the time Mrs. Bee was struggling with supply and asked our pediatrician what he thought of Fenugreek… but he had never heard of it before. Or the time that Charlie struggled with constipation, and our pediatrician suggested Miralax… without mentioning that Charlie might be coming down with functional constipation (or exploring diet changes beyond going off dairy). And then there was the time that we asked for advice on Charlie’s sleep, and got the advice to “cry it out.” Which was fine – that’s what we eventually did after more research – but a little more guidance (books/websites to check out? pros and cons?) would have been really helpful.
Olive is 5 months old in the left picture and Charlie is 3 months old in the right. Both were bad sleepers at the time.
Our pediatrician eventually moved to his own practice, and we found that the other pediatricians in our practice were similarly inclined. They were great at figuring out our kids’ medical problems, and great at making certain referrals, like when Olive had 2 back-to-back ear infections and our pediatrician said if she had a third one, he’d refer her to an ENT. But we found that the pediatricians we’ve had have been not as good at advising on less acute conditions. And their advice on stuff like constipation, sleep and milk supply seemed to draw heavily on their experience with their own kids, as opposed to drawing from their training and/or continuing medical studies.
Over time, we’ve come to realize that there’s a whole range of professionals that can supplement our pediatrician’s excellent medical care! Here’s a partial list:
Nursing/Supply – An experienced lactation consultant can really help here. Mrs. Bee wrote up her experience with an LC home visit here.
Child sleep issues – If books and blog posts aren’t doing the trick, you can consult a sleep program or consult with a “sleep doctor.” Mrs. Superhero wrote about her experience with the Sleep Sense sleep program here and Mrs. Stroller wrote about Moms on Call here; if you’d like one-on-one help, there are doctors that specialize in sleep that do consults in person or over the phone/email.
Developmental delays – We know several people who were told not to worry about a developmental delay by their pediatrician, and later discovered that there was cause for concern. One person we know was given incorrect information about how the state’s Early Intervention program worked – information that almost prevented them from applying for state services! I was excited to learn that there are pediatricians that specialize in developmental, learning and behavioral problems (Developmental-Behavioral Pediatricians). They specialize in this stuff and are probably best equipped to assess delays… or alternatively, you could also contact your state health department about Early Intervention services.
Serious constipation – We’ve written before about our son’s struggle with functional constipation, and how Dr. Tom (child psychologist and guru on childhood constipation) cured him quickly. The real surprise to me was that several pediatricians we consulted knew so little about what is a fairly common problem with kids! Dr. Tom is a genius, and literally wrote the book on childhood constipation (The Ins and Outs of Poop).
Eating – If your child is having problems with breastmilk, formula or food, it may be worth consulting an allergist to work with your pediatrician. Mrs. Jacks wrote about her experience with an allergist and MSPI here and Mrs. Superhero wrote about her allergist here. More on allergies here! (A nutritionist may also be helpful, once allergies and other medical conditions have been ruled out.) Allergists can also be helpful with environmental issues, like pet dander or dust mites.
Behavior problems – If your child is acting up, a child psychologist can be extremely helpful in diagnosing possible causes. When we talked to Dr. Tom about Charlie’s constipation, he casually mentioned several things we could do to help with Charlie’s horrific bedtime and they made a huge difference! Now that I think about it, why had I been asking a pediatrician for help with a psychological issue? I’d never ask my GP for advice on how to handle depression or anxiety!
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If you aren’t able to consult with a specialist, it helps to remember that pediatricians are best at solving acute medical problems – and may not have expertise on things like sleep, constipation, nursing, and developmental delays. If they do, that’s wonderful – and definitely avail yourself of that expertise! But if not, make sure to do your own research and consult other specialists too!
For us, pediatricians are an essential part of raising a healthy child. It took us time to learn that pediatricians are just part of the full team we needed to raise our kids… now that we’ve realized that, we’re much more able to tap the full power of our whole team (including our pediatrician) to raise our kids!
Has your pediatrician been helpful when your LO struggles with sleep, constipation, eating or other day-to-day issues? Do you have any other specialists on your and your LO’s team?
honeydew / 7589 posts
Fantastic post! Pediatricians are so important, but they aren’t the be all, end all.
blogger / eggplant / 11551 posts
I agree! At J’s 4-week checkup I expressed concern that he was constantly sputtering and de-latching and fussy while I tried to nurse him, making our nursing relationship very frustrating… and I said I didn’t think it was reflux because he rarely spits up and was gaining weight like a champ. The pediatrician still thought it might be silent reflux, and said if it doesn’t improve to look into options like putting rice cereal in his bottle or zantac! I didn’t say anything at the time, but those were not what I had in mind and would be a last resort if anything – I’d rather pursue dietary changes first.
After doing my own research, I discovered that we had an issue with oversupply, and I was able to remedy the problem by suggestions I found via the net.
I’m sure going to a lactation consultant would’ve been more appropriate than my pediatrician for that issue.
coconut / 8498 posts
Yes! While I LOVE our pediatrician, and she is fairly knowledgable about the “softer side” of parenting, I need to do my own research as well, then seek advice from pros in that area. Now if only I could get my doctor happy friends to realize the same…
pomelo / 5628 posts
My ped has been great so far and we also we OT and EI. The OTs in particular always talk about their own children and it really frustrates me. I wish they would speak in terms if all the kids they have worked with since it is a much better norm than one child.
persimmon / 1135 posts
This in an area where I think the UK has a really good thing going, structurally. I’ve seen a pediatrician one time- just before we were discharged from the hospital. Unless something is seriously wrong, you don’t see one. Health Visitors are assigned to new mothers (and visit you in-home during the early days). They are generally specially trained nurses who focus on issues like breastfeeding, starting foods with babies, identifying PPD, etc. Of course, like always, some are better than others.
GOLD / apricot / 341 posts
@MegWag: We have a similar system here in Sweden. We see a doctor every 4-6 months through the first year but have very regular check-ups with an experienced nurse who supports us with everything that comes up with healthy children (breastfeeding, sleep, introducing solids, behaviour, adjusting to a new sibling etc etc), simpler medical questions, vaccinations, and also is there with us when there is a real medical issue. Our first child was born in the US and while it was great for our peace of mind to have him seen by a doctor so often, we did miss the support on the softer issues.
olive / 62 posts
We switched to a family physician when our first son was about 3 months old for the above listed reasons among many others. Many of the pediatricians we visited were young, inexperienced, or just not knowledgeable in other areas surrounding parenthood. While there’s absolutely nothing wrong that pediatricians specialize in child care ONLY, we just felt more comfortable with a family doctor that could answer more questions and diagnose a larger range of illnesses. Not to mention, our family doctor is much more understanding of our alternative parenting style (homeopathic medicine before conventional, etc). We were condemned by every pedi we visited because we didn’t practice mainstream parenting. One last comment and I promise I’ll stop rambling. Our family doctor is the father of 5. All of whom were breastfed and BLWed. He has been a constant source of information during my BFing and BLWing journey and I feel so much more comfortable and at ease knowing that my children are under his care.
pea / 7 posts
I can relate to this issue. We stopped seeing our first Pedi because they were a “baby factory” and were just in the business of giving shots and getting as many babies in and out as possible with little interest in being personal. The combination of that issue and some questionable practices (they didn’t look at our daughter’s chart for her first shot which said we wanted shots broken up and gave them all to her) led us to find a new pediatrician. We like our current pedi a lot more but came to the same realization that while she is better she still is good for health issues of the medical variety and when it comes to sleep issues (which we have plenty of!) we shouldn’t depend on her for the most through answers.
apricot / 340 posts
Thank you for this post. It’s so educational and really helps me set my expectations when looking for a pediatrician.
blogger / coconut / 8306 posts
One of the reasons why I love our pediatricians practice so much is that they are so quick to recognize their own strengths and weaknesses, both as a practice and as individuals. They have an LC on staff, though I did ask my OB for an LC referral and saw a private practice instead. Our pediatrician doesn’t hesitate to speak up, though, if she thinks we’re better off seeing a specialist. She has offers us websites and book recommendations, and several solutions to problems we address with her (like sleep issues).
pomegranate / 3314 posts
@MegWag: My sister-in-law is a visiting nurse in the UK and when she described her job to me I was so jealous that we don’t have anything similar in the US. It really does sound ideal.
guest
Agreed, agreed, agreed. I’m in healthcare and when you are sick is when we can help you the most. I struggle between being either praised for my conservative management or yelled at because I didn’t give their child any medicine. So maybe it is important to remember, that just like *you*, I have my own philosophies on how things should be treated. (This, of course, is based on my knowledge and the literature, but medicine is not black and white and I do not have supernatural powers. Almost everything we treat requires information first and then choices.) I would never recommend anything to the detriment of a child, but I also would never, ever hesitate to recommend another practitioner if the parent felt uncomfortable. If your doc doesn’t or wouldn’t do that for you, then find one who will listen to you.
I’m definitely checking out that poop book, ha! More info on managing constipation w/ or w/o Miralax would be great.
papaya / 10560 posts
Great idea for a post. Although we love, love, love our pedi as a physician, she isn’t a parent and sometimes freaks out a little over parenting type things. It’s easy to forget pedis aren’t always the go-to for parenting issues.
pomelo / 5866 posts
Pictures of babies sleeping=ooooo, ahhh, soooooo cute!! Yes, we love our ped. even more now that LO is older and when it comes to the ‘big’ stuff.
apricot / 274 posts
Don’t forget your pharmacist! My trusted pharmacist (aka my sister) recommended probiotic drops for my newborn who had painful gas. What a great recommendation! It worked so much better than simethacone drops.
wonderful pear / 26210 posts
Switzerland has a great service as well, it’s basically parent consulting, where they address all these things and then some. It is a free service offered through the school years and you can make an appointment every month if you want to, which we did during my son’s first year. They look out for things you might not notice, like flat head.
cherry / 224 posts
I agree with you many times over. My DH is a pediatric pulmonologist and I can certainly relate. Our DS has his own pediatrician and my DH is like his backup ped when I need clarifications. Our son’s peds have been in the field for 30 years and she is very knowledgeable and have tons of experience with children whereas my DH has been in the field for about seven years with more up-to-date medical knowledge. Even between them, I noticed that there are slight differences in how they medically treat children. While I do not know the medical aspect of dealing with children, I know a lot about the developmental aspect of working and studying about children. It is interesting how between the pediatrician, my husband and I, we don’t always see eye-to-eye.
As for searching for a pediatrician, I looked long and hard. I wanted someone who would have more knowledge and experience compared my husband but on the other hand I knew that my husband was more up-to-date on his medical knowledge in treating children so it was about finding a balance.
apple seed / 4 posts
Agreed! While I get asked tons of parenting questions this is not the stuff we learn in medical school and we receive very little training about these parenting issues in residency. Most of my parenting knowledge comes from my own experience as a parent and research done on my own or from patient experiences. Usually there is no right or wrong answers and a lot of it comes down to parental [ersonal preferences on how to resolve these issues. In searching for a pediatrician look for someone who is well-trained and also someone who is an AAP member (there will be a FAAP besides their name which stands for fellow of american academy of pediatrics). Sorry. I know that i’m biased but in general pediatricians are going to be the best type of primary care physician for your child since they have the most training/experience with pediatric medicine.
persimmon / 1255 posts
I agree, pediatricians and doctors in general only know what they’ve been taught so I always take their advice with a grain of salt. My own personal opinion is that most doctors tend to over-prescribe (probably for liability reasons and because that’s what’ they’ve been taught) so I’ve learned to do research on the web as a second opinion.
For example, my LO went in with an ear infection and the doctor immediately prescribed antibiotics. A quick search on the net, however, revealed that most ear infections go away on their own in 2-3 days…..so I filled the antibiotic prescription just in case but waited 2 days. Her ear infection cleared up in 2 days , no antibiotic needed.