Justin, Junior

Monday, February 28, 2011

Doctor Knows Best...right?

Mmmmm...chocolate.
I’m paranoid about taking my son to the doctor. Sounds funny, right, since those of you who know me know that lately we’ve been checking out Children’s Mercy like we’re looking to move in or something. But the thing is, I am paranoid about it. What if the doctor sees that bruise on my son’s butt, the one he got from pulling a large decorative plate off a shelf, flipping it over, then falling down hard on the rim of it? Or the chipped front tooth that he got in the bathtub? And lately, we’ve been having penis issues - which necessitated a trip to the Emergency Room, because this Mama does not mess around when it comes to her little boy’s penis. I was terrified that the doctor would think it was because I didn’t bathe my son or something, and that social services would be called in.

My son doesn’t make this any easier on me - whenever we have an appointment, he always seems to get a runny nose, resulting in a crusty face - or, this last time, he had a bad bout of diarrhea 2 days prior to his appointment, which resulted in a slight diaper rash. Or I notice in the waiting room that his fingernails have magically grown ½ centimeter and that he has earwax in his left ear - any of which I become certain will be grounds for the doctor to call in Child Protective Services to question me.

I don’t know if this is normal or not. My husband seems to think it’s not, but he knew I was neurotic when he married me, and, unfortunately, motherhood seems to, in many ways, magnify that neurosis. I think it boils down to this: I adore my son beyond reason. I love him with great depth and without boundaries. And sometimes I think that I will never measure up to the task of keeping him safe and raising him well. I’m certain that someone - probably medical, and certainly official - will point their accusing finger at me and cry out, “That woman has no idea what she’s doing!”

So far, though, so good. The penis issue? Pretty common in little boys, certainly not my fault, and had not been caused by lack of hygiene but had, rather, been exacerbated by the multiple bubble baths we had been taking together. Lesson learned. The earwax? That’s a good sign, it means his ears are doing what they’re supposed to be doing. The diaper rash? The doctor didn’t even see it until I had pointed it out, and then he commented that his wife always said their own children never have a diaper rash unless they’re about to go to the doctor. So, even doctor’s kids get it.

Last week, I was finally able to take my son into his one-year checkup…7 weeks late. I felt that horrible guilt again. My first excuse was that my son’s birthday falls 3 days before Christmas, and I did not want him cranky from his vaccinations on the holiday. The next week was his birthday party. And then two appointments were cancelled due to fevers he decided to run, and a third was cancelled because my mother had scheduled eye surgery on the one Monday that I told her not to, of course. I was pretty sure the new pediatrician we were seeing would want to check my son’s sippy cup for Coca-Cola or something.

Junior checked out well - I had no worries there. My husband and I briefly basked in the praise of our son - how strong he is, how dexterous (he’s already jumping, for God’s sake), how utterly perfect he is. And then the lecture began.

“You may want to think about baby proofing. Things like electrical outlets should be covered, cabinets should be locked.”

Yeah. We know. He started crawling at 6 months and walking before 10 months…we’ve pretty much got that covered, thanks. Shoot, we even keep things like knives and guns out of reach, for the most part.

“It may seem silly, but you should start reading to him now. Reading is important.”

We’ve been reading to him since he was in utero.

“You should never leave your son unattended in the bath.”

Uhhh…yeah. We know that. He’s 14 months old. He’s never unattended, period.

I glanced at my husband to see how he was taking this. Maybe I was just being too sensitive, but no - his brow was furrowed and his jaw was set.

“How does he eat?” the doctor asked.

“Often,” I replied, back on confident ground. I’m pretty proud of my son’s diet - it’s well-rounded and varied. I pay careful attention to all the food groups…but I’m not going to lie, we like Chef Boyardee and the occasional chicken McNugget. “Three meals and two snacks a day.”

“Plenty of fruits and veggies?”

“Yup, as long as we serve the veggies first,” I replied.

“What about milk?” he asked.

“Well, that depends on what he’s eaten,” I said. “If he’s had cheese or yogurt or both, then he gets less. But he loves milk, and drinks it whenever we give it to him.”

“Well, he needs more milk. It doesn’t matter what he’s eaten, he should have at least 15 to 20 ounces of milk a day.”

But I had researched this plenty when we switched him to milk. Everything I read, and all the moms I talked to, said that too much can be a bad thing. Too much calcium can make the absorption of other vitamins and nutrients necessary next to impossible - it particularly inhibits the absorption of iron. Also, milk fills my son’s tummy. If I give it to him with meals, then he won’t eat.

“And now that he’s a year old and weighs 23 pounds, switch your carseat to forward facing.”

“No, we’ll wait,” I said.

“There’s no reason to wait.”

What? There are lots of reasons to wait. I won’t go into all of them, but the prevention of decapitation is high on my list of reasons to wait. The one-year / 20-pound mark is a minimum guideline…you know, kind of like when you get a “D” on your report card you still pass, but an “A” is so much better. (You can read more here:
http://childcarsafety.adcouncil.org/)

“We’ll wait,” my husband said.

“No, no reason to wait,” the doctor continued, and then, “I am going to assume he’s off the bottle and no more formula, right?”

“He was breastfed,” I said. And then, “He still is, once or twice a day.” Honestly, I should have known better, but usually nurses and doctors congratulate us on this. Only 22% of breastfeeding moms make it 12 months, and there’s a reason for that - it ain’t always easy. Just a few weeks prior, when, due to a horrible bout of stomach flu that necessitated an IV being placed in my son’s arm for dehydration, the pediatrician said it was awesome that I still breastfeed, that it was the best thing for him, especially while he was sick.

“Oh, there’s no need for breastfeeding anymore. At 12 months, the benefits he gets from breast milk decline sharply.”

Huh? That’s news to me. Now, I have no intention of breastfeeding my son throughout toddlerhood or (God help me) beyond, but at 14 months, I’m pretty sure that breastfeeding is still beneficial. The American Academy of Pediatrics recommends that you breastfeed for at least the first year, and the World Health Organization states that breastfeeding through the second year is beneficial. It goes back to that minimum standard thing. Plus, I checked my boobs thoroughly and there’s no expiration date on them as far as I can see.

Anyhow, he finished with his lecture and sent the nurse in to give my son his vaccinations (and yes, I vaccinate…please don’t get me started on that) and we left.

Once in the car, with our son safely strapped into his rear-facing carseat, my husband said, “What the ____? ‘Don’t leave your baby unattended in the bath.’ Does he think we’re morons?”

“Maybe,” I said. “He is a doctor, after all. Probably we all seem like morons to him. He was thorough, at least.”

My husband looked at me in complete disbelief. I think he was expecting me to hyperventilate or something - after all, we had been questioned about our parenting abilities, something I obsess over unnecessarily. Usually I am tripping over myself to prove to any medical personnel that we’re good parents, we do our best, we read all the books.

But, strangely, I was able to shrug this off. We went home, and I breastfed my cranky son, who was noticeably less cranky afterwards. (Pretty beneficial, I think.) Because we learned that our son is only 3 inches away from reaching the height limit on his carseat, we started researching for a new one, which will allow him to remain rear facing until at least 40 pounds. (Why not? It certainly can’t hurt, and it certainly might help.) And since my son ate an entire grilled cheese sandwich for dinner (along with a serving of broccoli and half a banana), I withheld milk from him for that meal.

We go back in 3 months in order to get another round of vaccinations. Justin wondered whether we should go to another pediatrician, and I thought about it for awhile, and I’ve decided no, I like this doctor. For one thing, the office is 2 minutes from home. I know several of the women who work there, and if I need an appointment, I never have to wait. The nurses are great. And the doctor? Well, he’s obvious, obviously, but I started to think about all the people he must see, and maybe to some of them, not leaving your baby unattended in the bath is a newsflash. So maybe, rather than assuming we know the obvious, he just trots it out there in the open. And maybe next time he’ll say something that I didn’t know, and that could be helpful. I think I would rather have a pediatrician who belabors what should be done than one who just assumes we already know, because I’ll be the first to admit that there’s a lot we don’t know. We just learned last week that the difference between infant Tylenol and Infant Motrin is that the first helps with pain and fever, while the second helps with pain, fever and inflammation. We didn’t know that. That was helpful. And his time-consuming lecture took time. He wasn’t rushing on to the next patient - he wanted us to know these things. And I appreciate that.

See, oddly enough, rather than making me question my parenting decisions, I left that office feeling more confident. Motherhood is no longer a huge, scary territory to me all of the time (I mean sometimes it still is, and I imagine it will be when my son’s 14 years old instead of 14 months old). I know enough now to question what the pediatrician tells me, to take his advice with a grain of salt, or modify it with my own concerns and beliefs, or ask my sister and sister-in-law or my mom-friends what they think, because hell, they’re in the trenches with me. I am certain enough of the decisions I make to say, “I don’t agree with that,” on some points, and confident enough to say, “I think you’re right, let’s do that,” which is why I elected to have my son get the flu shot along with his immunizations. And I was confident enough in the parenting choices my husband and I make to not argue with the doctor when he spouted off about weight limits and breastfeeding. Six months ago, I would have been spouting off statistics and studies in a superhuman effort to appear informed and competent. But the truth is, I am informed and competent, and I don’t need a stamp of approval from a pediatrician to know that.

The doctor may know a lot, but as far as I’m concerned, Mama knows best.

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