The time has come for the hallmark rant about the pediatrician. Don't get me wrong, I like Leila's doc. I think this is a reflection of the larger issue that is U.S. healthcare. I'd also like to preface this with the fact that I work with a lot of physicians and understand that their position is crammed right between the rock and the hard place. The rock: patient well-being and leaving no stone left unturned (wow, what's with all my geological references?). The hard place: making money and satisfying insurance companies. At our last visit, I had what felt like a proverbial finger waving in my face about Leila's growth stats. For those who are interested, Leila has dropped from the 90th+ percentile to the 5th in a matter of a few months. Hubby and I were prepared by the docs at Children's for the steroid-induced stunting and have since embraced the notion of raising a wild, little smurf until the treatment is completed (at which point her growth will rebound to where it should be). Back to our 8-month checkup. I felt a reaction of disbelief and quiet judgment coming from the pediatrician that we haven't been feeding Leila solids at least twice a day, if not three. I'm immediately feeling embarrassed and a whole lot guilty. Is that something everyone knows? How could I NOT know that? Shit. (I know, I know, you're sitting there thinking, "duh." Whatever, smarty pants.) Anyway, I then got internally defensive. At our last visit, it was recommended that we introduce solids at one meal a day to see how she does. If we wanted to, we could go ahead and give her more, but the message I heard was that the goal is to get her interested and to get her practicing. Ok, now I take some responsibility for not scouring the internet for a feeding schedule for my baby. But, I also expected that the pediatrician would help us out with this one - and, no, not a sheet printed from the internet with general milestones. I'm talking about one that is specific to Leila, who has been on a steroid regimen (which affects her appetite) for the past 5 months and who consistently deals with reflux and bouts of constipation. Did I mention the milk protein allergy? With all that is going on in life, that pinto brain of mine has been sputtering along just trying to stay within the lines - it doesn't have time to be proactive, much less common sensical about something. Plus, if you've read my earlier blogs, you know that I've tossed the kooky baby books. There's such a thing as an oblivious first time parent! ::hand raised high in the air:: How was I to know? Communication gets faulty. Misunderstandings happen. I get that. But I think this touched a nerve and is a sign of what things have come to with managed care. I would prefer to receive guidance and support throughout this daunting process, not a boatload of judgment followed by a request for a copay. Appointments have to be shorter, patient questions need to be succint, and responses are rapid-fire. You would be scratching your head feeling as though you've missed something, but you can't because you have an appointment card in one hand and a heavy, cumbersome car seat drooping in the other as you're quickly shuffled out the door. Again, I can't fully blame the pediatrician - I'm perfectly capable of researching things and, bottom line, I dropped the ball. But, given that I have the memory of a 90-year-old Alzheimer's patient, remind me of what I'm paying the pediatrician for? All snarkiness aside, I guess we learn from our mistakes. I just wish I didn't have to feel so inept in the process. We'll chalk this up to Mommy of the Year Moment #37.
One of the prime reasons we quit our old pede was because of her extreme attachment to the growth charts. She was going to refer us to a pediatric gastroenterologist for the first kid and wanted me to feed the second kid junk food to get her to gain weight! The current pede could care less what they weigh as long as they are healthy. I've spent the past 20 years obsessing about my weight, I will not allow my children to do the same. Johnny also had a milk protein allergy and he outgrew it eventually.
ReplyDeleteMy neighbor's pediatrician just suggested she test her son for dwarfism because he's not up to par on the growth charts. They gave her the name of specialist and sent her out, crying, freaking out. He is of course fine, and not a dwarf, just a little small for a sixth month old. She was lectured about not enough food. UG. That's why we switched to a naturopath. It's an entirely different approach to wellness and I love it.
ReplyDeleteOh and as far as solids, don't beat yourself up. There is no set schedule for solids. I have friends who didn't even start them until closer to a year. I had one baby who loved cereal and one who hated it. All those stupid books say a baby's primary source of nutrition for the first year should come from breast milk or formula anyway. And gaining weight from carrots? Forget it. Been there. Not enough calories.
ReplyDeleteWhat Kayris said. :-) If she needs to gain more weight, then her formula is way more calorie-dense than any solid you're going to feed her. (The first foods we give to babies? Pears, carrots, bananas? They're the foods adults eat when they want to LOSE weight!) I'm freaking out about Rachael's growth right now because she has pretty much stalled, and I've gotta say--I think I know why it stalled, I think it's probably about to come back up again, and I wouldn't be all that worried about it, but Rachael has her nine-month checkup in a couple of weeks, and I'm worried I'm going to get yelled at, too! Bottom line--you can offer your kid formula, breast milk, solids, and whatever else all day long, and the kid is going to eat what the kid wants to eat. I don't think there's much else that you can do, and as long as she's healthy, I wouldn't worry. (Says the mama who just admitted to worrying . . .)
ReplyDeletethanks for the reassurance, ladies! it's funny because leila sucks down 6-oz bottles of nutramigen, that's why josh and i weren't worried about her weight. since her appetite has been, erm, hearty (she's definitely our kid!), it has to be related to the steroids. after the look of mocking surprise the pediatrician had on her face about us not giving her a lot of solids, i brought up the role of steroids, which she wasn't convinced was the sole cause of leila's poor growth. well, i'm no pediatrician, but i do know that specialists have told me to expect her growth to be stunted, and the fact that her growth has fallen off only during mid-late course of the steroids says something.
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