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Your Pediatrician Isn’t Your Parenting Expert

Everyone hates unsolicited parenting advice, and it seems as if there’s been an upsurge of it coming from a very confusing source.  It’s not Facebook. It’s not a parenting magazine. It’s from your pediatrician.

Scroll through your local mom’s group, breastfeeding group, play date group, etc. and you’ll likely see something moms are questioning related to infant sleep, infant feeding, and/or discipline that they were told to follow strict guidance about at their well-child visits.  The weird thing is, most of these topics can’t be generalized.  Yes, kiddos need to sleep, gain weight (by healthy sources), and need discipline. Duh. But, no one knows your kid better than you do, and if you have questions (outside of the medical realm) related to things like infant sleep, infant feeding, and/or discipline, you would likely benefit from educational materials and support groups that are evidence-based, unbiased, and non-judgemental.

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I’ve switched peds a few times because we were told to do things that we weren’t comfortable with, and we honestly had never asked about!  If your ped makes you post on Facebook, “You’ll never believe what my ped said!!” then you should consider switching peds.

Over the years we’ve heard these quotes from our (former) pediatrician:

“There’s no benefit for kids in car seats to rear face after 1 year old.”

“Your baby is using you as a pacifier.”

“Babies should be sleeping through the night by (insert made up age here.)”

“Don’t pick up your baby every time they cry or they’ll learn to manipulate you.”

I will tell you, there are LOTS of risks to switching baby to front-facing in a car seat before the height and/or weight limit. My baby was NOT using me as a pacifier. There’s lotsandlotsandlots of benefits to nursing after age one! My first baby was most definitely not ready to sleep through the night until closer to 2 ½, because sleep training just didn’t “work” for her.  Our second and third kiddos, just like I do, sleep through the night…sometimes.  There is absolutely no research that supports that a baby will be clingy if you “give in” to them crying.  Spoiler alert: Little ones cry to tell you that they need you. They’re not manipulative A-holes (all the time, anyway).

When I want parenting advice, I can look in every direction and at any point in time, and I’m bombarded with it. The last thing that parents need is a healthcare professional passing along their personal parenting allegiance and masking it as healthcare advice.  Parents often do what their peds recommend EVEN if it’s not what the ped was trained to talk about.  As a different type of healthcare professional (I’m a lactation consultant), I know that they generally have veeeeery little training about breastfeeding, yet…how often do you hear about peds giving breastfeeding advice?  Telling a mother that “It’s normal for breastfeeding to hurt,” that “Baby shouldn’t nurse for more than 10 minutes on each side,” or that “Baby shouldn’t nurse at night.”  AHHHHH!!! Those are the moms/babies that I see on the reg for treatment for tissue breakdown and/or totally crashed milk supply.

If you’re wondering how to keep your conversations on-topic (when baby is otherwise doing fine, growing, meeting developmental milestones, etc.) here are a few tips:

When they ask, “How does he sleep?” Answer, “Like a baby.”

When they ask, “How often does he nurse?” Answer, “When he needs to.”

When they ask about solids, “What does he eat?” Answer, “Food. A bunch.”

When they ask, “Questions?” Answer, “Nope.”

Find the parenting styles that work best for you, but know that it’s rare that you need more than gentle guidance and support here.  You are the best thing for your baby, and there’s no one-size-fits-all advice, especially the kind that makes you question if it’s the best fit for your family.

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Thankfully, we’ve hit the goldmine of lack of unsolicited advice with our current ped.  I love, love, LOVE her.  She greets us all, asks the older siblings how they’re doing, asks if we have any questions (the answer is usually ‘nope’), and then asks the kids what kind of stickers that they’d like. Short and sweet. We hit the ped jackpot.  I trust that she’s knowledgeable about all things related to taking care of our kids when they’re sick, and that’s what she’s there for!  Find a ped that relates to you, that knows all things in their scope of practice related to optimal growth…and that meets you where you are with parenting.  That’s your best match!


 

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15 COMMENTS

  1. I think there is a lot to this article. I have noticed that pediatricians a tend to give advice even if not medically related. However, your article does the same thing. Instead of offering hypothetical responses from parenting views of all spectrums, you offer the advice of your parenting style. (Sleep training is bad; you should breastfeed past age 1; you should pick up your kid every time they cry). Not a knock – just pointing out that maybe pediatricians try to give the “best” advice they believe they can give from thei perspective and opinion. Probably similar to what you did. I don’t think you are purposefully trying to do the same thing that your former pediatricians did, and yet you did. I guess my point is that maybe it is hard to talk about anything baby-related without putting your own view in it. And maybe those pediatricians were just trying to help — like you are.

    • I’m so glad you mentioned this! I should have asked for more insight from parents in this time and place. I also should have mentioned that these were things we heard before our kids met these milestones and we didn’t find our parenting “fit” until much later.

    • I’m not getting the vibe that Jen is trying to give you parenting advice…what I’m hearing from the article is that parents should be informed consumers when receiving parenting information from health care practitioners because that’s not their role and it’s typically not evidence based information. And, as an IBCLC, Jen is well within her scope to be able to discuss best practices for breastfeeding in this article.

      “The weird thing is, most of these topics can’t be generalized. Yes, kiddos need to sleep, gain weight (by healthy sources), and need discipline. Duh. But, no one knows your kid better than you do, and if you have questions (outside of the medical realm) related to things like infant sleep, infant feeding, and/or discipline, you would likely benefit from educational materials and support groups that are evidence-based, unbiased, and non-judgemental.”

      In my opinion, it can be dangerous for doctors to get into these things because of the nature of how we perceive physicians as a culture–many people take what information they give without question instead of finding out more information. This can be very problematic when a healthcare practitioner is speaking outside of their scope of practice.

  2. I did not get the impression that Jen was offering parenting advice, as her responses were void of “should” statements. My impression was to be aware of advice regarding non-medical topics from well-meaning doctors, because it is just that- advice and nothing more. There are “two sides to every coin,” as Jen pointed out :-). Great post!

  3. This is extremely biased and possibly dangerous advice to be recommending, especially to new parents. While I agree you are the expert on your own baby and you find what works best for you, pediatricians give evidence based personalized recommendations to keep your baby healthy.

    Are you suggesting that parenting blogs, Facebook posts and people who have never met you or your baby can give better advice than a board certified pediatrician who has studied for years on child development and has met and examined your child?

    I’m sorry that you had a bad experience but unfortunately you can’t always find the right Doctor the first time. And no one is infallible. Suggesting that parents be purposely obtuse with their child’s doctor and avoid answering questions leads to a hostile environment that helps no one and potentially causes harm. Express your concerns/disagreement in an adult manner or find a new doctor.

    • Thanks for commenting!
      The goal here is definitely to point out the difference between actual evidence based info…and the not so much, and I gave examples of those.
      My suggestion would be to point to evidence based research regarding infant development, local therapist run groups, and/or mom-to-mom support groups that consult with legal and medical advisory boards.
      As a consumer, find the best fit. Pediatricians are invaluable for their expertise, but sticking to expertise is the kicker.
      I appreciate your comments!

      • Actually you gave examples of a few bad pieces of advice you’ve gotten from doctors and how you determined via evidence based research done by….doctors (I know, shocking!) that those comments were wrong.

        As a healthcare professional I would think that rather than bashing the doctors on Facebook you would consider educating them on topics you have more expertise on.

        • It sounds as if you’re pretty familiar to the research that I’m referring to. Surprisingly, often research related to optimal infant development isn’t done by doctors (like a few of the examples that I referenced).
          I get the gist you feel that I don’t dig doctors…which isn’t the case. I work closely with many practitioners locally. I believe that healthcare providers should stay within their scope of practice, and give appropriate referrals for care when they’re not the expert.
          Like here, I’m the expert in what I wrote, and meant. I think you may have missed that.
          Thanks for reading (and re-reading)!

        • It is my impression the author did not bash doctors, but instead provided accounts of well-meaning doctors providing suggestions not based on evidence, but personal experience. In many other fields, a practitioner can loose a license for doing so. Also, much of the evidence the author provided was indeed the source of doctors, but those holding Ph.D.s in fields relevant to the topic. Medical doctors study medicine, and it is important to make a distinction between medicine and other forms of science. Medicine treats ailments, illnesses, and diseases related to the physical body. Much of the research referred to by the author is conducted in fields other than medicine, such as child psychology, physics, biology, ethnopediatrics, and anthropology -to name a few. Those physicians who are experts in fields related to research she mentioned often do a fellowship in said field and are not typical pediatricians conducting well-visit exams. Did you know the world’s leading expert on infant/mother sleep, Dr. James McKenna, is NOT a pediatrician? He is a biological anthropologist :-). Pretty cool, right?! I think every parent walking into their pediatrician’s office deserves to know this!

    • Unfortunately, physicians receive almost zero training regarding child development in terms of behavior, sleep, breastfeeding and the like. They are well-trained in medicine- meaning illnesses and diseases related to the physical being. Their work in this field is highly valuable. Folks trained in fields such as ethnopediatrics, psychology, physics and anthropology have a MUCH better understanding of the topics the author mentioned. It is my experience that this is not a well-known, and it seems the author was simply trying to convey this message in a light-hearted manner. Much love on our parenting journey :-).

  4. I’m married to family practice physician and his brother is as well. I’m also a nurse and I can absolutely tell you that we are given parental /child-care recommendations in our nursing and medical education that are absolutely lacking evidence. Are they the most harmful recommendations, generally not, but they aren’t the most up to date. I’ve discussed this with fellow healthcare providers (Physicans and nurses alike) and they usually shrug it off as its not a priority in their scope of knowledge to stay up to date on the latest evidence that effects parenting because their primary concern is making sure nobody is going to die immediately in front do them. This was also stated in regards to the breastfeeding knowledge that is lacking in healthcare education. My husband received 30 mins of breastfeeding education and I received none in nursing school despite focusing on Pediatrics during my internship, my brother in law luckily has some knowledge in breastfeeding but only because his wife breastfed 5 babies prior to him going onto becoming a physician.

    While everyone is glad that we healthcare providers want to make sure nobody is dying right now, parents appointments aren’t just about that and IT IS important to not undermine healthy parental practices since nobody has cancer at this moment. Preventative medicine and health care IS still important.

    • I want to also add that when my husbands colleague and close friend became a father for the first time at the age of 37 years old, they both laughed about how they had no clue about parenting advice until they became parents themselves. They gave examples of this poor advice they heard and repeated over and over again and how they would leave the room to ask other nurses with children to be able to answer the question. That sums it up right there, they couldn’t say “I’m sorry I don’t have any experience potty training.” Or “some parents seems to report having luck with xyz method” or “i don’t know”

      Great article Jen!

  5. I”m a recently graduated RN and almost mother of two and we had a decent bit of training in breastfeeding, so it surprised me when you said that a doctor said it was ok for breastfeeding to hurt…What?! No, I can’t believe he told you that! I do agree that doctors should stick to their scope of practice and not give out advice unless sought out by the parents, but if the doctors are asking questions, I think it’s perfectly fine to give them an detailed answer on how you do things, and if they try to turn you away from your method, you have the option of telling them that you agree to disagree and maybe even going to a different pediatrician. I don’t think you should be friends with your pediatrician, but I think it’s perfectly fine for your doctor to be asking how your child is doing with those things and for you to give more than an answer like he/she “sleeps like a baby.” For me, I want to feel like my doctor has an interest in my child and that the child isn’t just another name to cross of the list of appointments. I think it’s ok to get a little personal, but we, as the parents need to do our own research, just like you did, and make decisions based on what we believe is best, which is what you suggested. I just don’t necessarily agree that it’s not ok for doctors to be asking questions about breastfeeding, sleeping, or the likes. Yes, there can be a danger in them putting in their own opinion, but in the end, that’s what we as parents do anyway. We look at educational material and judge what we deem to be most correct. In the end, we are all human, not infallible to human error, and we have a brain that we can use to help guide us. I do feel that your article came off sounding like we shouldn’t trust our pediatricians and I think not giving somewhat detailed answers to their questions may inhibit the relationship, especially if we really are struggling with a child who doesn’t sleep well or whatever the issue may be. They may actually have good advice that you can use or they may tell you something totally ridiculous. In the end, the parent always has the final say in how they can care for their child. Sifting through well-meaning advice that may or may not be good is just part of the experience.

    • And I did reread the article again and noticed that your suggestions of things to say to your doctor was to keep things on point if the child was already hitting the milestones, but I would hope that you were going to a doctor you felt like would steer you in the right direction and would want advice from regardless if your child was doing good or bad when it comes to milestones.

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