jenn_unplugged | Time for a new pediatrician. :-P

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Time for a new pediatrician. :-P

This morning Carter had his 6 month well baby visit with his pediatrician, Jill Nichols of the Austin Diagnostic Clinic. Up until today, I've been happy with Dr. Nichols. But this morning she told me he was old enough to start sleeping through the night, and that I should start cutting out his night feeds. When I told her it wasn't a problem for me, that I didn't mind nursing him twice at night (for ten minutes each time), she lit into me. I argued back, because after all I've actually read a lot of the research that contradicted what she was saying. We went around and around about cosleeping: she thinks Carter sleeps in a cosleeper sidecarred to our bed (I started lying about that one after the first visit when she made her opinion on bedsharing clear), and she thinks that's bad because OMG he might still be sleeping in our room when he's two!; nursing at night: she said it would cause tooth decay, despite the fact that there's not much evidence to support that for breastfeeding infants; pushing him to sleep through the night: she thinks I'm doing him permanent damage by "conditioning" him to wake up to eat overnight, despite the fact that research suggests human babies NEED to eat overnight, and so on.

When it became clear that I wasn't going to back down, she said, "Well, I'm very anti-attachment parenting. I think it's a horrible way to parent and produces children who are clingy and far too dependent on their parents." At that point, my jaw dropped, and I stopped talking. I decided there was really nothing more I could say to her. She checked over him, but I only nodded or shook my head at her from there on out. She came back and apologized before we left,
and said she had strong opinions and understood that I might disagree with them, but I still left the appointment thinking this was no longer the best pediatrician for my family.

I will only see her for a few minutes every few months, but I don't feel like I can be open with her now. I'm afraid I won't be inclined to tell her things I probably should, because I'll be concerned that she's judging my parenting. So I think it's time to move on. (I posted about this on a local AP group, and already have several recs for new peds, all of whom are much closer to my house anyway.)

But still, yuck. You know? I'm completely confident in my parenting choices, but it's still no fun to be confronted in that way. I'm thinking I might send her an email when we transfer to explain (in a very reasonable way, of course) why I'm leaving the practice. Or should I just quietly slink away?

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No, leave and let the practice itself know why. None of these things will change until enough customers complain, so to speak.

You deserve a ped who you can work with, one you can be honest with, and one who will be happy and proud of you for what you are doing with your son, which is fabulous!

I know, that's sort of what I was thinking. She needs to know that AP is a valid parenting choice, one that works and works well for many families, whether it would have worked well for her own children or not.

Holy cow! Yes, I agree that you should find a less judgemental paediatrician.

Ugh, seriously. I hate that sort of confrontation, too. :-P

Yeah, you don't need that. Just so you know: we were very happy with Dr. Ross Prochnow, who's off of Metric. He was very hands off, extremely supportive and OK with every decision we made, and generally a dream to work with.

Is Metric the same as 183? Do you remember the name of the practice, by any chance?

I was wrong, it WAS on 183, like in a grocery store strip mall kind of thing - kind of a weird place, but handy! His ARC page is here: http://www.austinregionalclinic.com/find_a_doctor/index.asp?view=Name&ID=135

At the time, there were a decent handful of AP moms seeing him; don't know if he's still a hot property among that community, though. Does Austin still have a strong API chapter? API and LLL always have good skinny on pedis.

I go to LLL, but I haven't head of an API chapter. I should look into that. :-)

Holy shit! You definitely deserve better, and so does Carter. I would write, and not in email, either -- a physical letter to the office explaining why you're leaving. You might not change the minds of anyone at the office, but it'll raise questions that apparently no one else in the office is asking!

Yes, that's what I was thinking: an actual paper letter, and maybe cc the other doctors in the practice. It's not that I want to embarrass or scold her so much as I want to let her know that I know there are many valid ways of parenting, and that I want a pediatrician to work with me, not try to argue with me that my way is wrong.

I think that makes perfect sense. I think it's perfectly okay for people to have different views on parenting -- everyone does. But, a pediatrician needs to be a partner to families in their child's health, not an adversary.

I'm also surprised by the vehemence in her response to you when you said you didn't mind continuing to feed Carter at night. I'm not a doctor (obviously), but even if you were not as well read and researched as you are on many things related to parenting, simply the fact of the circumstances related to Carter's birth as a premie and such might make me (as a pediatrician) see that a mom might just relish the time and bonding that comes from continued nursing at night. But, meh. Am not a mom yet.

Go, you.

I've read a lot of books about babies and sleep in the last few months, and all of them (written by pediatricians and parenting experts, mind) say that the key is to find what works best for your family, and that there is no one "right" way. I told the doctor that much today, and she completely dismissed it. It seemed clear that it was her way or wrong, and that's just not going to work for me, you know? :-P

Wow, different ped for sure. I would also write the letter if I was you to let them know why you left and found a new ped to take care of Carter.

I'm thinking I will be writing that letter now. :-P

I suspect telling her why you're leaving will help you more than her. It means you can leave as a reasonable adult, explaining that since you both have such different views on how to raise Carter, it would be better for you to find someone who will support your choices. However, I'm sure that she will just think "crazy attachment parenter" and think no more of it. I doubt it will change her mind or her behaviour.

I have a similar issue with my OB - she believes that natural childbirth is a dman silly idea, and that episiotomies are pretty much required. I will not have another baby with her, and I suspect I will switch to another doctor for my general care as well.

Yes, you're probably right. That was why I bit my tongue and didn't say anything when I left; I was afraid I would come off as a crazy AP person. I figured a little time and space would make me seem a bit more reasonable.

Dude, I would be finding a new OB too, wow. Episiotomies required? :-P

Ewww. That sounds like a very uncomfortable situation. It's horrible to feel like you need to lie to your doctor. I think I would be looking for a new doctor too.

I will just put in that my experience with Amber was that no one ever thought to mention baby bottle tooth decay because they knew she never took a bottle. They never asked about how I nursed her at night. They just assumed that I got up and nursed her and then put her back to bed. Since we shared a bed, she had free access to nursing when ever she wanted through the night, it was really easy to just roll over, offer her the nipple and fall back to sleep.

When she was two and she had to have extensive dental surgery because her teeth were all rotting, the dentist said that it baby bottle tooth decay isn't dependent on the baby getting formula or even taking its meals from a bottle but rather the act of sleeping with the teeth bathed in the sugars of the milk.

That's a good point. What I've read is that it's much less likely for BF babies to have the teeth issues because they have to actively suck to get milk out, whereas a bottle would just drip milk into their mouths. I guess if the baby is comfort nursing all night and not swallowing, it could have the same effect. I keep thinking this is something I don't need to worry about until he actually gets teeth.

I agree with an above poster who said it's fine to disagree, but she needs to partner with you instead of arguing with you. If Carter is developing well and is healthy and growing, how you parent is none of her business. Sorry you had to deal with such an adversarial conversation when it should have been a pleasant appointment.

Yes, exactly. While I'd love to find a ped who agreed with me 100%, I know that's not likely. Not everyone can have Dr. Sears as their family's pediatrician. But it's not too much to ask that my views be given some respect. :-P

I would definitely write a letter. I'm sure you're not the first that has left for similar reasons. I know I hit the jackpot with Emma's ped and it was purely luck. You definitely need a doctor you can talk honestly with and one you feel comfortable with.

I'm not the first, as I learned from someone in a local parenting group. She said she left for the same reason. I think I am going to write that letter...

Wow. It's ok to have a difference of opinions but she took it too far. Brooke is nearly 8 months old and still gets up 2-3 times a night to nurse. Every baby is different, she should know that. She should trust that you know your child best and what works for your family. You certianly aren't doing anything to harm him! You shouldn't have to dread going to appointments with her; see if you can find a new doctor.

Now that I look back on all of our visits, I can see that this had been her attitude all along. I suppose I should be glad she showed her true colors this early on, so I can move on now. I just don't do well with people who believe their way is The Right Way, with no room for other views -- even when there is evidence for them. :-P

Ow. That sucks. Writing a letter is a good idea - but then, I don't plan on telling my pediatrian why I'm not going to be returning to him!

There must be a story there...

For me? Oh yeah. Like, he never remembers from one appt to the next that Sam has eczema, and keeps recommending cetaphil. And while he's not nasty like your ped was, he definitely thinks he knows best about things. And he keeps giving me prescription for antibiotics for ear infections, when Sam shows no symptoms. Plus, he slurs his words together in a way that I can barely understand what he says. But the eczema thing is the straw that broke the camel's back.

I can tell you when patients leave the doctors office that I work for the doctor needs to know why you are leaving. It may help another individual who has to deal with her in the future. It sounds like she is telling you how to raise Carter based on HER experience as a parent and how she has raised her child, not what she learned in med school. She definitely does not have a good bedside manner in my opinion. I would have left crying for sure! No doctor should ever be that way with a patient or parent. You should never feel like you need keep information from a doctor just because of fear of getting lectured or reprimanded. Something very important may need to be told or missed.
I am so happy you are so confident in the way Carter is being raised. The doctor would have probably made me doubt myself.
I hope you find a doctor you can create a doctor/patient relationship with soon. There are more doctors out there who really care and are not so judgmental.
Personally, I think you are wonderful mother and have already been through a lot. Carter is such a sweet, healthy, bundle of joy!!!!!! You can tell that he is loved and well taken care of. Books, TV, etc cannot tell you how to raise a child it is advice ONLY! I really believe that Mother intuition is a reliable source!
Good luck search for that new ped doc.
Love,
Julie

Right, it really does seem like she's convinced that her way to parent is the best way and she's presenting it to her patients as The Right Way. People don't work that way. There isn't a single way to teach something that works for everyone, or to learn something, and everything I've learned about child development contradicts so much of her attitude.

I'm definitely going to write her a letter!

Followed you here from your Austin Mama's post about blogs, and when I read this, I felt awful for you. Even if a pediatrician doesn't agree with a parenting choice, as long as it's not clearly, legally defined abuse, they really have no business being judgmental about it.

Plus, she's really, really, really wrong.

I was so worried about a lot of the AP stuff I was doing naturally because it felt right, but all of the conventional advice was how doing those things meant my kid would never learn to do things on her own. My MIL said not to listen to that crap because, as she put it, "They figure it out long before college, trust me." She raised 4 kids who are all independent, well-adjusted adults, two with PhDs and a third on the path to it. A lot of what she did would be considered AP stuff today.

Do what's best for you and your baby and find doctors who are at least supportive, even if they personally disagree. It's okay for people to disagree, but they have to be polite and civil about it.

Oh wow, a local person on LJ! *friends*

That's great that you had someone so supportive of your parenting. Most of the people I know practice AP to some degree, whether they are aware of it or not. I really like the idea of trusting your instincts about your child, and there is a research base for it, which makes it all the better. :-)

I hope you are able to find someone better. I go to one down south at the ADC on James Casey and we just love her!

I think it's just this one doctor, and not representative of the practice. But still, I'm moving to another practice. I just need a clean break. :-P

Hey, found your LJ from a parenting101 comment...I'm in Austin too, and here's my $0.02:
dump the doc. Now. If you like ADC and don't want to go through a record-moving hassle, I recommend checking out Dr. Juan Guerrero, he was at the Far West clinic and now at Mopac & Parmer (they moved the office). I don't know how he feels about AP, but he's pretty reasonable, listens, good with kids, and actually knows what not to do with an intact penis (apparently, those are rare species in Texas).

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Time for a new pediatrician. :-P

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http://myutopias.blogspot.com/

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