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   Thursday, February 01, 2007  

Mommy Wars at the Doctor's Office

On Monday, the lowercase had his 15 month well-baby visit. Because our pediatrician now considers him a "normal" child, his visits are on the rotation with nurse practitioners seeing him every other time.

The NP came in and looked over the information the RN had gathered -- developmental questions, questions about our parenting and his environment, and his height, weight and head circumference.

I asked her if I should be worried that his weight has fallen from it's high of 13th percentile (at 9 months) to the 4th percentile. She looked at me as if I had sprouted a second head. "He's still gaining weight," she snapped. Ok then. He's 15 months old and he weighs 20 lb 3 oz, up about 1/2 lb from 12 months. Which would lead me to believe the percentiles mean nothing -- except that if they truly meant nothing we wouldn't even discuss them or look at the growth curve at every freaking appointment.

He has gained only 1/2 inch in height since his 12 month checkup. He is now 30.5" tall. This dropped him from the 60th percentile curve down to the 33rd percentile. Again I asked if this was a problem. The lovely NP told me that I should expect my son to be short because I am (extremely so...I'm not 5'1 yet and at 6 months before my 30th birthday, I really don't think I'm going to grow much more). I pointed out to her that while I am quite petite my husband is 6'4 and built like a linebacker. To which she did some crazy calculation to tell me what she thought my son's adult height would be. Good to know, but I was just concerned about the fact that, you know, he appears to be losing ground compared to his peers.

She did mark on the chart in the concerns category "slowed growth rate." After lecturing me about the fact that he will only gain about 3 lbs in total between 1 and 2 and that I shouldn't be concerned. Forgetting the fact that we are still playing catch-up from his premature birth.

After that, she asked me how much milk he drinks and what kind (roughly 24 oz/day, whole cows milk).

"I assume this is all from a cup?"
"For the most part. He does drink from a bottle at bed time and if he's really sleepy and fussy before some naps."
"You need to stop that. NOW."
"Um....ok." (Thinking whatever, bitch.)
"And how does he sleep...does he sleep through the night?"
"Do you put him in his bed awake?"
"No. He cries too much so I hold him until he falls asleep and then put him down." (Obviously I saw where this was heading and didn't mention that we're co-sleeping at the moment and neither Mr. W nor I see any real need to change that right now)
"You need to ignore him. Just let him cry."
"I can't do that. He cries until he makes himself physically sick. It's awful."
"When he throws up from crying, just go in, pick him up, clean him and his bed quickly and quietly, and put him back in it. You just have to do it until he learns."
"Um...ok." (Right. That'll happen.)

She closed the appointment by saying, "Ok, so you're going to stop giving him bottles, you're going to put him in his bed the minute he appears drowsy and you're going to ignore him."

I told my friend (who uses the same doctor) about this appointment and she agreed with the nurse and all but told me that I'm being too protective/coddling him.

I'm not saying that CIO is wrong (wrong for me, yes, but whatever -- you do with your kid what you will)...I'm not saying that a less joined-at-the-hip child-rearing technique wouldn't work well...But here are my immediate examples of both.

My mom breast-fed me until I was somewhere close to 3 years old (at bedtime and naps only at that point). My parents divorced when I was 2. Mom converted our second floor to an apartment and rented it. The 3 of us lived in the 1 bedroom on the first floor and all slept in one bed. Every night, she read to us, held me close against her and rubbed my brother's head until he fell asleep.

We are both extremely connected to our mom. We each speak to her at least once a day (my brother lives in the same town, I live 10 hours away). We consider her to be one of our best friends and closest confidantes. She knows what is going on in our lives -- including the things we know she would disapprove of. We hide nothing from her. We value her opinion but we don't let it rule the decisions that we make.

On the other hand...Mr. W and his younger sister were bottle fed (I am not saying it is bad...my brother was bottle fed). His mom let them cry until they learned to sleep on their own. They were put in their playpens frequently during the day so she could get things done. Obviously, she read to them and played with them, but not to the same extent -- they were left to amuse themselves more from a younger age. When they went out, the kids were in their strollers until they were old enough to walk and were not held and carried. They never took naps cuddled with their parents -- always in their own beds or playpens. (For the record, the MIL also tells us that we should be doing all of these things because our child is too "clingy" and he'll "never learn" if we always hold him -- not sure what it is that he'll "never learn")

Thirty years later...neither Mr. W nor his sister like their mother much. They don't want to visit her. They talk badly about her to each other (and everyone else). Mr. W has already said that when the time comes he will "see to it she's put in the finest nursing home that HER money can buy."

And then I look at the difference in parenting styles and I have to say that based on my study (sample size: 2 families) my more AP style of parenting is definitely the right way. Obviously there are other family dynamics involved in each and my husband turned out ok (his sister however...well...she's a mess. Her life is...well, that's a whole other blog and not one that I feel at liberty to discuss). But he measures his success as a parent in how much better/how differently he handles things than his own parents did.

Yet the NP and the entire pediatric group think that I'm wrong. That I'm doing my child a disservice. That I need to change how I do things and do them "right."

It's bad when even medical professionals focus on this instead of the fact that I am raising a bright, happy, well-adjusted child who is extremely healthy despite his prematurity.

I honestly think that in this country, we have become too focused on what the "experts" say and we've let that change our instincts. Why is co-sleeping wrong? In tribal societies, they obviously do not have cribs -- where do those infants/toddlers sleep? I don't know it to be fact, but I'd say it's a safe bet they sleep fairly close to their parents. Co-sleeping seems pretty natural to me.

Why is it "better" to put your child in a stroller? What's wrong with carrying the child? How many societies did it before (Asian women working in agriculture, the Native American "papoose")? Why is it "spoiling" your child to carry them?

And why should a doctor care how a child goes to sleep and how he drinks his milk if he's healthy? How is the way we do things going to "make it harder to break the habit" as he gets older? As I see it, when he's bigger and in his own bed, which he will naturally begin to want, what's wrong with a mother sitting beside him, rubbing his head and cuddling him until he goes to sleep? What's wrong with him taking comfort from drinking from a bottle/using a binky at bed and naps? Again...these are things that I feel he will naturally leave behind as he grows and no longer needs them. It comes down to a difference in parenting philosophy. And neither my mother-in-law nor the NP are going to change mine.

   [ posted  @ 9:11 AM ] [ Post a Comment ] [ View Comments (14) ]
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  Comments about my post, "Mommy Wars at the Doctor's Office":
If YOU are happy w/your son's bedtime routine (being walked/rocked/etc.), don't change it. My first son was JUST like this, and because he slept thru the night just fine, we didn't bother to EVEN try and get him to go to bed on his own until he was 2. Who cares! I LOVED the nighttime bonding time!
Now w/my second, because he didn't know how to put himself to sleep, he couldn't get himself back to sleep if he woke up in the middle of the night, so we had to teach him to put himself to bed at night (which we did a "gentle" CIO, where we laid down next to the crib w/him)... but would've kept rocking/walking, just like we did w/the first except the nighttime wakings were killing us.

You do what you feel is right. The nurse is not the mommy.
Alice-That NP is lucky she had you. I would have walked out of the visit, told the office that I was to NEVER see that NP again, and complained to the medical board. She seriously lacks compassion.

Also, since when is ferberizing your kid the only answer? Yeah, my mom did it with me, but it worked with the person I am. I have a friend with a small one who, like yours, would not take to ferberizing at all. She also co-sleeps.

I'm all for breastfeeding until they can walk up and ask for it using a complete sentence. At that point, feel free to keep giving the kid breast milk, but use a pump. I'll probably stop directly breast feeding around age 1, but since I'm not there yet, I'm hardly going to say that's set in stone.

When she said "Okay, you're going to..." I would have come back with "And you're going to work on that bedside manner and tone, right?" in the same bitchy tone.

Wow...how did you not punch her?
You said yourself that your son is happy, healthy and thriving despite a premature birth. Whatever it is that you are doing is working out just fine for your family. Do not let a NP "drive-by" spoil that.

We sort of co-slept. Azure was not in our bed, but in a bedside bassinet connected to my side of the bed. I LOVED having her right next to me. Just this week she has moved to her crib in her own room, more out of safety than anything. She is too mobile for the bassinet to be safe now. I put her down awake and with a binkie. Sometimes she fusses and sometimes she konks right out. She does not CIO. I have a distinction between being fussy and crying. They are NOT the same.

Have you ever gotten this anti-AP feeling from your actual ped? If it is only this particular NP maybe you could request not to see her next time?

Blue :0)
My line in this situation is "I believe that's parenting advice. I came here for your medical opinion. I don't believe my choices are harming my child so at this point I choose not to take the parenting advice you are giving me."

Bitch NP!
I have your exact same "problem" (note the sarcasm in that word, please!). We put our daughter to sleep with a bottle of milk every night, and before she weaned herself (shock! to let a child wean herself instead of making her wean!) I nursed her to sleep. I've gotten a million comments from family and friends about this, mostly to the tune of "You're spoiling her, you need to get her into good sleeping habits!". Which I just don't understand; she's been sleeping through the night since 2 months and it's 12 months later. :)

You do exactly as you please, and PLEASE speak up to the NP next time. Sometimes they really need to hear it from parents who disagree with them.

We've heard a lot of anti-AP sentiments at our ped's, and have decided that the next comment gets our full-on assault tactics of lectures and research on the benefits of extended breastfeeding, not CIO, co-sleeping, and AP. Hey, if they can dish it out, they should be able to take it...right?
Have you thought about changing pediatricians? That NP was way out of line. We take a fair amount of what's said at our ped appointments and outright ignore it, but at least it's delivered respectfully.

I like some of the other commenters' suggestions for responses to the NP.

Trust yourself. You've been doing a great job with the boy.
it must have been hard for that NP to see with her head shoved so far up her ass.
My son will be 3 in June. We have always co-slept. Others, family, friends, strangers, nurses have made me feel guilty and question this decision all my sons life. I finally decided that maybe I need to figure out how to get him to sleep by himself. He is almost 3. So, I got the book "the no-cry sleep solution" by elizabeth pantly. (I tried the cry it out thing once when he was a baby and he threw up and I never did that again.) I read about why sleep is important, how much a child at a given age should get and why it is important for mom and dad to get sleep too. Then she went on to help you decide if you do or do you not have a sleep issue. She said that if you and your family are getting the right number of hours of productive sleep then it does not matter where or how that sleep is achieved. I brought the book back to the library and decided that my family is happy and we get enough sleep and I am not going to trade in the joy of co-sleeping because others don't like it. Now, if anyone has anything to say about it I tell them that how and where my family sleeps is none of their business. And when my nurse says I have to teach my son to sleep in his own bed I say....okay and smile. My doctor says if it works for us then don't fix what isn't broken. Keep on doing what feels right in your heart because 99.9% of the time that is the best option.

Oh...and I am sure you are well aware of this...but your son is so cute!!!!
You are right.

The dumb nurse bitch is wrong. Sorry, there's no other phrase that describes her appropriately. God. I hate that whole old-school, terrible way of parenting. And the idea that there is only ONE way to do things is JUST FREAKING WRONG. I'm so sorry you had that horrible visit, and if I were you, I'd find a new place to go and spread the world about how awful she was.
I just wanted to echo the comments before me. That's parenting advice, not medical advice. So, in my opinion, totally inappropriate. Wow. It's obviously up to you, but I would consider whether you might want to ask not to be seen by her again. It's hard to imagine that you'll feel comfortable in the future asking her about things that might be a health issue but about which you're unsure (like the growth issue) or that might reveal the parenting methods of which she disapproves. I know how I would get around somone like that. Closemouthed and defensive. Which is a counterproductive way to be around your healthcare professional, for sure.
While I'm not sure that your concern about the fate of your future relationship with lowercase rests solely on this issue, I *do* second (or third) the others who said that you need to do what you think is right for YOUR CHILD and your family.

If it's working, don't fix it.

BTW, this is coming from a kid whose parents did do CIO and we still have a close, loving, connected bond. ;-)
Our daughter will be 3 in May and we've hardly let her cry at all when going to sleep (maybe a few minutes here and there). We never let her "cry it out" because there are good reasons for her tears (and words). We feel that our connection to her shines through when we leave her to go to work or out -- she's never cried because she knows we are coming back. I still rock her for about 30 seconds before bed because we both think it's funny and sweet. There have been difficult moments to be sure, but it's worked for us. She is learning, though, that we love her and that she can trust us. We used to have friends who told us that she needed to learn who is "in charge" but I don't think this is the way for most children.
Yes, do what you want and need to do and find a practice of doctors who support you.
Ignore that bitch of a nurse.

The only issue re: milk bottles at bedtime is the one connected to tooth decay, but if you give him water in his bottle instead, there's no problem.
Hmmm... I wonder how many preemie children that NP has of her own?

I've had so many doc appointments that went the same direction as your did, over the past 8 years. Specialists are the worst.

My daughter slept with us for the first 15 months. It was easier because of her apnea monitor. Hubby and I decided that we needed a little bit of our life back (wink wink) and put her in her own room. We let her cry it out. It only took one day (and she only cried for an hour). She is the best sleeper in the house (she is 8 years old)! But, just because it works for one person, doesn't mean it should be shoved down the throat of every parent!

When our son came along (May, 2006) he had severe reflux. We let him sleep with us, on his stomach. Can you just imagine all of the comments we got from docs! He is now 10 months old and in his own room. CIO worked for him too.

But, when either one of them is sick, mom and dad's bed is where you can find them!

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