Saturday, April 7, 2012

Might be time for a new pediatrician

When we moved here from Virginia Garrett was three months old. I looked up pediatricians in the phone book and took the next available appointment with the next available ped when it came time for his 4-month check up. We've stayed with the same ped even though there are times she has really annoyed the fire out of me.

Now, fast-forward three years and I'm taking my 4-month old daughter to the same ped. It was deja vu all over again and I realized again why I was thinking about switching three years ago and just too lazy to do it.

Pediatrician: "How is she sleeping?"
Me: "Great! She only wakes up once or so to nurse and then she goes right back to sleep." I specifically through in "She easily sleeps five to six hours straight," because as a pediatrician she should know that "clinically" 5-6 hours of uninterrupted sleep is one of the three criteria considered "sleeping through the night." 
Pediatrician: "I think you need to wean her from that. She doesn't need to nurse during the night and she's essentially using you as a pacifier and relying on you to put her back to sleep. You need to wean her from the night nursing."

I've mastered the art of smiling and nodding while standing up and screaming, "NO!" inside. If Olivia is healthy and growing well and we are happy, well-rested and enjoying the arrangement why should we have to change it? I greatly enjoy nursing her and being close to her at night, especially on the nights I have to go to class and I see no reason why I should change that. From a medical stand point there is no medical reason to change our arrangement either. 

We moved on to food.

Ped: "How is she eating? Is she eating any baby food?"
Me (rather proudly, I might say): "She is still exclusively breastfed."
Ped: "I recommend starting some solids at four months. She doesn't need them but at four months she's lost the tongue-thrust reflex and can start eating solids. You can mix some rice cereal with breast milk if you'd like and feed that to her. It will also help her learn to accept a spoon."

This was the same speech she gave me when my son went in for his four-month check up.

My facade must have cracked and I think even she could see my disdain through my tense smile and nod.

Now, I'm no doctor but I am a mother and I like to think of myself as educated and versed on the needs of my growing children. I am a fanatic when it comes to breastfeeding, having breastfed my son for one year, eleven months when he weaned himself. I did not start my son on solids until he was eight months old when he got his first teeth and started showing genuine interest in other food. I also have a fantastic and healthy breastfeeding relationship with my daughter despite being back at school. She is growing beautifully and is perfectly healthy!

I know the American Academy of Pediatricians (AAP) recommends exclusive breastfeeding for the first six month with supplementing with breast milk up to a year. According to the CDC the risks of childhood obesity decrease the longer you breastfeed, specifically if you exclusively breastfeed to at least six months. For every month you breastfeed, according to the CDC, your child's risk of obesity is decreased by 4%. There may even be health benefits to delaying solids and new research presented in the breatfeeding and baby food classes I took in 2008 suggests one sign a baby's intestines are ready for solids is the introduction of the baby's first teeth.

Either way, my 4-month old shows NO signs she is ready to start solid food. She cannot sit up on her own. She does not reach for food or bring things to her mouth on her own. She also has no pincher grasp.

I've also read many articles that suggest a child eating solids too early can mess with sleep patterns and entice him or her to start nursing more during the night.

I remembered the battles I had with her when at Garrett's 6-month check up he was still exclusively breastfed and how she warned how he would have a problem using a spoon. We battled it out again at his 9-month appointment when he was only beginning a few solids and feeding himself, not being "fed" by me with utensils.

Well, when you are using the baby led weaning method, why does it matter if he (or she, in this case) can tolerate a spoon or not?

Then she got a crooked smile on her face and said, "Are we doing any vaccines today?"

She knows my answer to that question. She's been my son's pediatrician for three years and we have yet to give him a single vaccine. Before I get crucified on the cross of pro-vaccination I must say that I am not anti vaccines. I am anti so many vaccines at such young ages when there is low or no risk of the disease being contracted. I have told many people, many times, that if the diseases we commonly vaccinate against were to start coming back due to individuals not vaccinating against them I would be the first in line to get my children vaccinated. If polio started a come back you'd better believe I'd get my kids a polio vaccine. Yes, there has been a slight come back in some diseases such as pertussis and even measles but the risks in our family are exceptionally low. They do not go to day care, they stay at home with me in a closed environment. All in all we really don't have much to worry about.

I shook my head. "No," I said.

"You'll have to sign the vaccine refusal form."

They must have a dozen of those refusal forms from me.

I'm not trying to be difficult and I'm sure that she had 3-dozen patients who have gone through her model of growth that are alive and well to tell the tale about it. I have my own style and opinions and research to back up my parenting decisions regarding my child's sleeping, eating and vaccinations. I have not felt disrespected for my decisions, but I have felt that condescending disapproval that says, "I'm the doctor, I know best."

I don't want to have to be geared up for battle every time I go to the pediatrician's office. It might be time to make a switch. But, to who?