The Parent-Pediatrician Relationship
|Photo Credit: dmason on flickr|
Those of you who know me well know that I lean more toward natural medicine. I had a hospital birth, but I was very careful to prepare so that I could still birth unhindered, with minimal intervention. Since Annabelle was born, I have successfully treated two eye infections with breast milk alone, and having come down with strep throat myself, managed to bounce back by taking plenty of garlic and grapefruit seed extract. I avoid pharmaceutical drugs wherever I reasonably can. Still, I take Annabelle to all of the regular “well-baby” visits with the base pediatrician.
Many who take a view similar to mine when it comes to medicine choose to avoid seeing, or taking their children to an MD or a Pediatrician. Some feel that doctors are only for the sick, and don’t replace these “routine” visits with anything at all. Still others choose to see a chiropractor, or another type of practitioner. Personally, when I was single and uninsured, I saw an ND (Doctor of Naturopathic Medicine), and that would be my first choice if I had a wide variety of options. Now that I am covered by military insurance, as is Annabelle, and we’re in a location with limited options, for me the family practitioner is the best bet, and for her it’s the pediatrician. I feel fortunate that we have access to this resource, and I don’t hesitate to take advantage of it.
While I know Annabelle best, and I pay careful attention to her growth and development, her pediatrician knows how the “average” child should be progressing at Annabelle’s age, and is aware of a wide array of potential issues that I would not know to watch out for. I have plenty of confidence in our ability to take responsibility for Annabelle’s care as parents, but I welcome the screening tool that we have in her pediatrician. I don’t see this tool as a substitute for being well-informed myself, but simply as another source of information, to be checked against the others I have access to.
The pediatrician alerted me to the fact that Annabelle has labial adhesions and, while I chose not to take the doctor’s advice regarding treatment, I am thankful that she took note of the condition and that I now know what to watch out for. I see the pediatrician as another resource in my journey as a new mom.
I will admit, however, that I have found myself frustrated with this model of care on more than one occasion, and navigating the parent-pediatrician relationship has been a huge learning experience. If I were asked to advise new parents as they choose a care provider, I would certainly recommend that they look for one with whom they share some core values. I have only one option here, so I have taken what I can get, and it’s not all bad, but it’s a challenge at times!
I went to Annabelle’s four month visit happy as a lark, and about as confident as a new parent can be. I left fuming mad. I was nursing when the doctor came in to the room, and he was very good about it, gauging the situation to make sure I was comfortable with his being there, and continuing with business as usual when he realized that I was. A good sign, I thought. I got too comfortable, however, and made the mistake of indicating the fact that we coslept. He jumped in with, “Well, you do know that cosleeping increases the risk of SIDS!?” I calmly replied, “Yes, but there are those who would argue that it actually decreases the risk.” He looked at me like I had at least half a dozen heads and quickly corrected me. “No, it INcreases it.” I smiled, and waited for him to move on, since he clearly was not interested in the other side of the issue. Later, he went through the list of topics that I suppose are standard practice to cover: “Do you use a car seat in the car?” and the like. The whole thing felt patronizing, yet I know he was following the ‘standard of care.’ In any case, it all rubbed me the wrong way and I was very glad when the visit was over.
Fortunately, we won’t be seeing that particular doctor again, and since that unpleasant visit, I have learned a few things. First and foremost: I’m the mama. While the pediatrician is the expert on norms, I’m the expert on my daughter, and the one who ultimately has to live with any decisions made regarding her care. I appreciate the valuable expertise doctors can provide, but I believe that they should be my collaborators, not directors of my decisions as a parent.
Additionally, I have learned that pediatricians are medical experts, but not all can be nutrition and parenting experts as well. Annabelle’s pediatrician suggested months ago that I night wean. If you’ve been around this space for awhile, you can probably guess that it took a great deal of restraint on my part to avoid uttering a loud, “Pffft!” at that particular recommendation. This was just one example of a suggestion offered based on norms. In the doctor’s words, “At her age, she shouldn’t need to eat during the night.” Fortunately I know my daughter, and I know that, age aside, she does need to eat during the night, so four months later, we’re still night nursing. Having read plenty on the subject of breastfeeding and infant sleep gave me the confidence necessary to quietly blow off this particular piece of advice.
Another suggestion that was pushed, this one several times, was the introduction of rice cereal. It was implied that Annabelle would turn out horribly iron deficient without it. I knew that rice cereal is a pretty lousy choice as first foods go, so it was easy for me to disregard this advice, but with my tendency to have low iron levels, I was a bit worried about that particular issue. Not wanting to be irresponsible, I requested that Annabelle’s iron levels be checked at nine months instead of waiting until the twelve month mark, as is the standard here. You see, I was borderline anemic early in my pregnancy, and have had low iron in the past, so as Annabelle’s primary nutrition source, I wanted to ensure that she was getting enough. Her levels were perfectly normal, and at the time she was eating very little in the way of solid foods. My confidence in our feeding decisions was reinstated.
Overall, I value the resource that we have in Annabelle’s pediatrician and I feel extremely fortunately to have such easy access to medical care. More and more every day, however, I’m finding that there is no substitute for informed parenting.
What are your thoughts on “well-child” visits? Does your family use an MD, or do you go the alternative medicine route? What factors have you considered in making your decision? How do you navigate the parent-care provider relationship?