Your pediatrician is not a god. They work for you. Remember that.
I am so grateful for the access to medical support and expertise I am afforded and I gratefully utilize my pediatrician in times when I decide their medical knowledge and access to medication would be advantageous for my child. This is not a piece speaking out against pediatricians. This is written to empower you within the relationship with your pediatrician.
There seems to be some confusion wherein parents walk into the exam room offering their baby at the feet of the omniscient pediatric deity. Unquestioning acceptance of every word out of her mouth as The Word of MD, going to the pediatrician seeking approval for parenting decisions, accepting the advice of pediatricians on topics beyond their scope, and asking permission are all mistakes parents make that distort the reality of the relationship and perpetuate a grossly skewed power differential.
So, what’s the problem? The problem is that it invalidates and denies your wisdom. It leads to you being herded into parenting choices that you might know are not right for your baby. It is your job as a parent to do your research (any moderately intelligent adult can read the same studies and literature to which doctors have access on any particular issue) and combine that with your expert knowledge of your baby. Your pediatrician’s advice is just one voice in this internal conversation. And the weight of that voice varies depending on the topic of that conversation.
Parents frequently seek out the advice of pediatricians, and pediatricians frequently offer unsolicited advice, on topics beyond their scope. The scope of a pediatrician includes all of the things on which she has been thoroughly trained as a pediatrician. For example, did you know that pediatricians receive virtually no training on breastfeeding? Mind blowing, right?! Medical issues should be within the pediatrician’s scope. My son has an allergy that was giving him gastrointestinal problems and we elicited the help of his pediatrician, then a gastroenterologist in helping us diagnose and find treatment options. We were grateful for this resource. I once had a pediatrician mandate a monthly date night with my husband. After 3 appointments, which all ended in a prescription for my (very healthy and never discussed by me with her) marriage, I said, “Excuse me, but that is way beyond your scope of practice. As a Marital and Family Therapy associate, it is within my wheelhouse and I would never make a presumption that that was in someone’s best interest without knowing anything about her marriage.” She responded by saying that it was just based on her personal experience after having her baby. “Then please don’t present it as a medical prescription for my baby’s well being.”
Non-medical aspects of nighttime parenting (how your baby sleeps), for example, would also fall under this category. A surprisingly great deal of parenting advice that goes from pediatrician to parent is based on personal experiences and preferences, not medical training (read the Sage Sleep book if you want evidence-based guidance on sleep). My recommended response filter is: “Based on what?“
“By 8 weeks you should cease all night feedings. He no longer needs that and you are setting up bad habits. He is capable of sleeping through the night.”
“Based on what?”
“Well … he just doesn’t need it.”
“So you don’t have actual medical science to support those recommendations? Do you have specific training in breastfeeding or nighttime parenting that informs that recommendation or is it just your personal opinion?
You need to know that as your child’s parent, all of the decisions regarding your child are YOURS to make (unless you are harming your child, in which case any mandated reported would be required to intervene (doctor, therapist, teacher, etc.)). In a conversation about shots, I explained in a class full of parents and their infants that I hold and breastfeed my babies when they get a shot and they hardly notice. One mom jumped up and exclaimed, “I asked if I could do that and they said no!” Stop asking permission to parent your child! “I’m going to nurse him while he gets the shot.” If you are confident they will usually go along. With 3 kids and several pediatric offices, I have had 1 nurse protest.
“No, he has to be pinned to the table. It’s our policy.”
“It’s no different for you but if you feel you lack the experience to competently inject a baby in this position, let’s have a more experienced nurse give him his shot.”
“I’ll have to go speak with the doctor.”
“Please, thank you.”
She came back a few minutes later with a more experienced nurse who happily demonstrated how to give a shot with the baby in arms.
One common form of this disempowerment is when a pediatric office tells you, “It’s our policy.” Bullshit! When you hear this you should see a big red flag. It’s like your parent telling you, “Because I said so.” If you believe something that is “policy” to not be in your child’s best interest, respectfully ask the pediatrician to explain (and back up) his concerns, and you can make suggestions to mitigate these concerns. Using the above example, you could secure your baby’s leg with your free hand, ensuring no movement or you could sit on the table, if they prefer the height.
You don’t need to be intimidated by your pediatrician. After asking about using a modified vaccine schedule and being told, “No, that is against our policy”, one mom confessed, “Who am I to question someone who went to school for this stuff?” Who are you? You are her parent! You are her lifelong advocate and the one ultimately responsible for her wellbeing. You should carefully consider, research, and weigh every decision, choosing a conscious and well-informed course of action. Your pediatrician will walk out of that room after 5 minutes with your child and not give her another thought. You will take that baby home. By all means, use your pediatrician for that expertise. Ask her why that is the policy and gather any other information you can from her that you feel would help you in your decision-making process and then YOU make the decision. If your decision is not compatible with this pediatric office, it is time to find another one.
Ultimately, you have to remember that your pediatrician works for you. They are not a god, beyond question. They are a resource for you in the care of your baby. When you walk into that office, you set the tone for the relationship you will have with your pediatric office. I am courteous, respectful, informed, and assertive. If I am there, it is because I am seeking his wisdom, but not offering my baby up at his discretion. I will be the one nursing that baby that night. I will be the one holding his hand 5 years later. I will be the one watching him launch into his own life as an adult. And I will be confident that I gave him every advantage at a healthy, happy life by advocating for his best interest at every step along the way.