Stupid doctors
Jun 2, 2004 Parenting
(The following is a personal rant; read at your own risk.)
I forgot how much I hate well-baby checks. If I could, I’d skip ‘em or at least cut way back. Well-baby checks have their place but I’ve got 47 million books here on child development and I know what she “should” be doing at this age and she’s doing it and she’s healthy as a small pony so I don’t see much point. However, since the agency will have legal custody of Madison ’til October — per Ohio law — I have to go so there I went yesterday to answer nonsensical questions such as, “How much does she sleep at night?” Me: “I don’t know. I don’t look at the clock when she wakes up.” And then I face the pursed lips when the doc figures out that we’re co-sleeping.
We got in an argument (or shall I say, discussion colored by vehemence) about how much Madison eats. I have no idea how much she eats so when the doctor asked how many ounces, I made a wild guess and said, “I don’t know, I wash bottles, what, twice? And there are four or five bottles in a load? And we put 4 oz in a bottle so I’ll take a guess and say 36 oz but she always leaves at least an ounce in every bottle so maybe 27, I’m not sure.” I mean, really, I have no idea how much she eats; we’re feeding on demand.
So the doctor looks at chubby old Madison lolling about gleefully on the exam table and announces that we’re over-feeding her. And I, of course, start arguing and she, of course, plays her “I’m the doctor and you’re a housewife” card and starts quoting studies about “life-time obesity.” And I say I’ve read the fucking studies (only I don’t say fucking because that’s a sure way to make doctors not listen to you) because I just wrote an article about childhood obesity and then she says, condescendingly with false sympathy, that parents often think a child is hungry and stick a bottle in the kid’s mouth “and it may make then stop crying but then the parent isn’t really meeting the baby’s needs.” I was livid. And suddenly horribly guilt-stricken because she’s basically accusing me of neglecting my kid and I don’t think I am but what if I am and don’t know it?
The doctor said that Madison shouldn’t be eating more than 20 ounces a day, which is absolutely nuts (as I told her) seeing as how 20 ounces a day was what they told me she should be eating in the hospital when she was 8 lbs. One can assume that she should be eating more at two months. “Well then,” the doctor reluctantly amended, “24 ounces.” For a 15 lb baby, no less. 15 lbs 2 oz, to be exact and 23.5 inches, although her head was a bit tilted and I’m betting she’s taller. (Noah, I must add, was 11 lbs 11 oz and 23 inches at that age, which was exactly 50th percentile making him alarmingly average.)
That’s the thing about well-baby visits. I can intellectually know that the doctor is insane but still whatever they say goes into my brain and rattles around shaking up my confidence.
I remember when Noah was 9 months old and he quit gaining like he had been. He’d also started walking and babies stretch out when they move. He was totally NOT into solids because all he wanted to do was fuel up at the breast and then run around like a very small lunatic. The doctor said he was too skinny and that I better “butter his broccoli” to fatten him up. I said, “He doesn’t eat broccoli or anything else so buttering it isn’t going to help any.” Besides, I pointed out, Noah was following his very tall, nicely built father’s growth curve exactly. (Brett, being the first-born, had a meticulously kept baby book, which came in handy, let me tell you.) The doctor didn’t believe me and told me to supplement him with formula to fatten him up.
I switched doctors that time, too.
Madison is in the 90th percentile for height and a little over 100th percentile for weight. Which means that she’s tall and chubby. Babies grow up and out and the height/weight proportion aren’t wildly out of sync so I’m not concerned. Also, her birth mom was a big baby (breastfed, I found out too, so she was meant to be big) and her birth dad is currently the size of my refrigerator so it’s not beyond imagination that he was a big baby, too.
Anyway, I was pissed so I came home and spent the last 24 hours carefully logging how much Madison eats. That meant dumping out the left-overs from her handy-dandy collapsible bottles into the easier-to-read regular ones to monitor what she was getting. And the result? 24.5 ounces. But here’s the thing, according to the American Academy of Pediatrics, whose review book I have right here and whose name was invoked in hushed, reverent tones by the stupid doctor, the recommendation for formula fed babies is 2.5 ounces of formula per pound of body weight, up to 32 oz a day. Meaning that the docs recommendation of 20 ounces was insane and that we are apparently underfeeding her since it’s appears to be scientifically impossible that she has the caloric support to grow. A fact I can happily deny by pointing to her copious rolls.
If Madison was a giant breastfed baby, I would have had no trouble rolling my eyes at the doctor because I know now that however breastfed babies grow — provided that they’re nursing at the breast on demand and providing the requisite number of wet diapers — it’s absolutely perfect. Skinny Noah was perfect, my friend’s 19 lb 3-month old was also perfect. It’s a bit more difficult with formula fed babies because sometimes they want to suck but not to eat. A breastfed baby can change his/her sucking to get exactly what they want — fluttersucking for comfort, shallow sucking for thirst-quenching foremilk or deep sucking for tummy-satisfying hindmilk. Formula fed babies are at the mercy of their bottles. Brett and I have had to learn how Madison signifies wanting to eat versus wanting to suck but we’ve figured it out now because we are attentive parents and don’t stick bottles in her mouth every time she squeaks, despite the doctor’s assumption otherwise. I really resented the implication that we might be pacifying her with food instead of meeting her emotional needs because we’ve worked hard NOT to do that.
Oh gosh, I have no way to wind down this rant. I’m going to go squeeze on my squishable daughter.
June 2nd, 2004 at 12:23 pm
Oh, Dawn, I know how much these visits suck. There’s always something that they say that goes against how we want to raise our kids, or something that they don’t say so that when you find it out later you start to furiously wonder whether or not it’s important … You are well-read and intelligent, you care so very much about your daughter - if your doctor has medical concerns about illnesses or disabilities, of course you’ll do the right thing! And you’re smart enough to know that you being with Madison, every day, gives you a better idea of who she is and what she needs than a doctor who sees her chart once every few months. Please don’t get down on yourself. Madison is in a wonderful place, with loving parents - lots of them! *hugs*
June 2nd, 2004 at 1:02 pm
{{{{Dawn}}}}
I hate well-baby visits too. I still remember every annoying aspect of the one that made me switch doctors 6.5 years ago. Just try to put it out of your mind.
June 2nd, 2004 at 1:20 pm
Ugh ugh ugh. I really do despise most doctors for their superior bullshit. Sorry about the wracked nerves. Question authority!! Fight the power!! Screw ‘em!!
June 2nd, 2004 at 1:29 pm
You’re doing great. Doctors are very often stupid.
I’m just glad that you do so much research and you can come and rant to us… It scares me how many people never question the word of someone in a white coat.
June 2nd, 2004 at 1:37 pm
The AMA has told docs they should be worrying about kids’ weight and counseling parents and looking for contributing factors to obesity like having obese family members. My girl hasn’t been since her first well visit (she’s 3). Even though she’s small for her age and not chubby, I’ll bet I’d get a talk about her diet because I’m fat.
I actually had a friend take her very healthy, ten year old jock son to the doc for a respiratory problem. She got a bunch of questions about his diet and a lot of long advice about his weight. The doc forgot to deal with the respiratory thing which turned into pneumonia! Yeah! And the thing is, this boy might be on the heavy side, but he’s one of the tallest kids in his grade too. He grows really fast- a couple sizes every year- as opposed to my kid who goes up one size. I think kids who are very fast growers tend to keep on a little extra weight when they’re young.
Your doc sounds like an ass. I hope you can find a new one who isn’t a fat phobic jerk.
June 2nd, 2004 at 1:48 pm
You know, there are some really good pediatricians out there. But there are some really bad ones, and some really stupid ones. You clearly have the latter. Go find a really good one. You won’t believe the difference in how you feel about well-baby (or, for that matter, sick-baby) visits if the person you’re seeing is a partner in caring for your child rather than an adversary.
(And yes, I know that’s easier said than done, but it can be done. My personal strategy is to look at an academic medical center or a children’s hospital, and see which doctors work there. But then again, I work in PR for an academic medical center which has an affiliated children’s hospital, so it was kind of easy for me–all I had to do was call the children’s hospital PR office and ask them who they would recommend. But it’s worth the effort, because I have never loved another woman the way I love my kids’ pediatrician. ;-))
June 2nd, 2004 at 2:34 pm
Argh, I *despise* well baby checks. We just plain don’t do them, but am always worried that will come back to haunt me because we selectively vaccinate. I just find the visits stressful. By the way, even though you already know they’re wrong, I am certain that the recommendation I got when Logan was bottlefed was 2 ounces of formula for each pound of body weight, because my ped. always lectured me because he was small and assumed I was underfeeding.
I think fat phobia is behind it too. I have a friend who’s a pediatric nurse and she said she’s noticed that the doctors are more likely to lecture moms of big babies when the moms are overweight too - presumably because if the mom eats too much, she will feed the baby too much also. I think it’s a crock, personally. (says the overweight mom of two babies who were 14 lbs at a month…then 20 pounds at a year!)
Don’t even get me started on pediatricians who invoke the AAP and don’t even know their own organization’s guidelines…
June 2nd, 2004 at 2:46 pm
hey, i popped in to see if you had any pics of the backyard theatricals. but no, instead, a missive which pushes so many of my (swollen to bursting) anti-allopatic buttons.
anyone who sees your fabulous daughter can not think anything but THRIVING and delicious. except, apparently, that idiot doctor.
well, fuck her.
June 2nd, 2004 at 2:49 pm
I so lucked out and had a laid back old hippie doctor- hard to find in Idaho- he used to reasssure me about everything I was doing by saying “The baby looks great, keep trusting your gut.” He is a gp and I prefer them to pediatricians. I have learned with other doctors to temper my answers- I tell them only as much as they need to know. Damn, I have four kids and so far nobody is obese, anorexic, or has taken to a gun tower because of emotional problems. My two year old just went for a well child, but for the most part, we only do a physical every couple of years. I can see my kids are fine. Find another doctor Dawn. Madison looks great- feed on demand. My bottle fed babies were fatter than my breast fed babies. The oldest one is a skinny 13 year old now and the the 2 year old is in the 50% on everything- they were “fat little rabbits” as my grandma called them. Its not like you are giving her fries and Coke. She will thin out once she starts moving and eating solids. You are doing great, blow off the doctor.
Lisa
June 2nd, 2004 at 2:49 pm
Don’t worry! When my girl was tiny, all she would do was breastfeed. Demand feeding, 24-7. I had not a clue how much or how little she was eating. At the time, she was small for her age. (at 1 year, she was only 18 lbs.) My Mother and sister in law insisted I had to be starving her because she was so small. We were concerned because compared to other humongous bottle fed babies, she did look tiny. We had a wonderful Doctor who told us not to worry, yes, she was small (her Dad and I are average sized) but she was very healthy and developing faster than normal. (she walked alone at not quite 9 months) he encouraged me to breast feed her as long as possible, even when she was 10 months old and still refusing solids. She eventually started eating solid food (not jar baby food, by then she was so old with a mouthful of teeth, she went straight to grown up food). Today? She just turned 16 in April, she’s 5′6″ and a svelte 109 lbs. Her brother refused the breast at only three months, didn’t much care for the bottle either, and was chowing down on anything at 6 months. Every child is different. I can’t believe there are some Doctors that make such a fuss over how much/when a kid eats. Just keep doing what you’re doing, Madison is fine.
June 2nd, 2004 at 3:34 pm
Boy, it’s just never too young to start dieting, is it? Screw up Madison’s body chemistry and self-image before she ever has a chance. Nothing builds a secure parent-child bond like starving your infant.
I’m really surprised that no weight loss companies have jumped into what must surely be a huge potential market of parents who’ve been driven to obsession about their child’s body size by moronic medical “professionals.” Slim Fast baby formula, anyone?
June 2nd, 2004 at 3:40 pm
Gah, I hate pediatricians! Mine attributes everything to Alena’s adoption. She’s naturally a tall, thin child, so we’ve gone from feeding her too much formula to not enough to everything in between. I can’t even go into the battles we’ve had over us cosleeping for her first year. I honestly don’t think it’s bottled formula that makes a baby fat, thin or whatever - it’s genetics. Madison sounds like she’s doing just fine…tune out the doc while you search for another.
June 2nd, 2004 at 3:53 pm
Argh argh argh!
I think you should photocopy the page from the AAP book and highlight the part about ounces pe pound and send it in to her with a little note saying she’d better watch out before she counsels parents to starve their children. And threaten to let her malpractice insurance carrier know she’s giving dangerous advice to parents that could cause failure to thrive. And then report her to the Better Business Bureau. And then get Julie to go mess with her car.
June 2nd, 2004 at 4:37 pm
My 9 lb boy was 22 lbs at 3 months. My ped told me they develop all of their fat cells before they are 2, and I needed to stop feeding on demand. Stupid me-I listened for a month and put us all through hell until I decided I’d rather he be fat and happy and know someone was listening to him that be miserable and thin. He is now 16, 6 ft, and scrawny as can be-just like his dad.
June 2nd, 2004 at 4:39 pm
The first pediatrician I took my first born son to berated me for the entire appointment for not having him circumsized, he insisted I had to set up an appointment to have that done immediately. I was a 20 year old mom, but I knew enough and had read enough not to listen to him.
A called around a bit, asked good parents I knew for their ped., and found out about the Dr. who has taken care of my kids ever since–for nearly 20 years now. I adore her. If she could be my doctor, I’d go to her, too. I’d never miss one of my kids well appts. if only because it is so nice to see her.
(In case anyone is looking in my area–she is Dr. Catherine Slota-Varma of Milwaukee. She rocks. She also does a lot of work with student doctors–I hope enough of those are out there now, following her lead.)
June 2nd, 2004 at 4:47 pm
Because I relate things to myself….
Here is what I would have done. Is the doctor in a practice? Write a letter to the practice explaining the poor handling and nasty customer service you received by this physician. I’d cc: the letter to the local licensing board as well. (It won’t really do much but it looks good!)
I would call the agency (as Madison is legal custody there by law) and let them know that you will be seaching a new physician out because this one has made you uncomfortable.
What a jackass! I picked my physician, and as you know, I’m not nearly as “earthy” as you are, because she listens. When I say to her “something just isn’t right”; there is not a need to immediately dismiss what I’m saying. The whole concept of doctoring is to HEAR what the patient is saying not to JUDGE the patient.
Just my two cents.
-d
June 2nd, 2004 at 4:48 pm
Oh yeah, and I’m sorry about the jackass comment…. I’m having a bad day!
June 2nd, 2004 at 5:10 pm
Jackson’s first ped gave me all kinds of trouble about overfeeding him because he was topping out the percentiles (nevermind that his birthmom was very tall and had been a large baby). I fed him on demand and I’m doing the same with Janie. Jackson was a delightfully fat baby with rolls on his rolls. He slimmed down right away once he started walking and I miss his little leg rolls more than I can say. Janie, so far, is more long and lean with chubby cheeks. She takes a similar amount of formula as Jackson did at her age. They’re just built differently.
And just for reference, Janie is eating roughly 28 to 32 ounces a day and has been for the last month (she’s 3 months old now). If she can eat more than Madison but not have the rolls, it seems to me that it’s all about the individual baby’s body type.
June 2nd, 2004 at 6:44 pm
I was about to give you all kinds of advice and reasurance, but you did the research yourself and proved this doctor doesn’t know her head from her ass (sorry, strong language from me, but I feel it’s warranted). 20 oz a DAY? For a 1 day old, MAYBE!
Sorry. ; )
When you said “I found a new ped. then too”, does that mean you’re looking for another new one? Because it might be a good idea. This ped was way out of line, and has no sense of boundaries. Sheesh, I hate my HMO, and most of the docs, but our ped, even though he disagrees with many of our parenting practices, at most suggests what information he thinks is useful (informed consent), and then respectfully honors our decisions. I love him.
I really hate the whole dr/G-d thing. I wish medical schools would stop encouraging it.
June 2nd, 2004 at 6:47 pm
O-M-G. I just saw Madison’s picture. This is what the Dr. is freaking out about?
Puh-leeze.
What a lovely daughter you have.
June 2nd, 2004 at 7:24 pm
I’m sorry you had to go through this. I’m with Lisa in recommending general/family practitioners. I had an experience with a ped once that might make you laugh, although at the time I thought I might kick her in the shins. She asked if I owned a playpen, to which I replied that I did not. She then said that my children were all underweight (built like Daddy, 6′ and 140#) because I let them run around all the time. She said I should confine the smaller one in the playpen and put the older one in front of the TV more, because I was making them hyperactive. You have to wonder how a “fellow of the AAP” thinks that hyperactivity is caused by lack of playpen use or lack of TV watching. Needless to say, I never went back to this sad excuse for a doctor again.
June 2nd, 2004 at 8:04 pm
Dawn,
I do not have children yet, but I do have a good friend who is newly minted as a pediatrician. By coincidence, he called right after I read your post. Before he could say 2 words, I interupted and said, “Promise me that you will not tell a mother of a 2 month old that her baby is on the road to obesity.” I made him swear it! What a terrible thing to happen to you. Doctors can be such egomaniacs. I should know, I’m a lawyer.
Best wishes to you and your beautiful family.
June 2nd, 2004 at 8:23 pm
F**K that doctor.
I freaking hate meeting with our pediatrician. We had absolutely the best ped ever when we lived in San Francisco (Dr. Jane Anderson at UCSF, if you live in the area). She was 100% willing to work with us to figure out what would work best with our family…cosleeping, vaccinations, etc.
Then we moved here and our current ped is a total ass. She really believes we have our daughter on a delayed vacc schedule because we don’t want her to get too many needle sticks. THEN, I had to practically BEG her to give my daughter her lead screening (we live in a really old building that was recently renovated) which involves a blood draw.
If you find a new ped who you like, let me know. We are in the market for a new one. I was waiting until we buy our new place to find one who is nearby, but I will drive forever if I can find someone who doesn’t make me spend the entire following week grumbling.
I heard that Dr. Plachta at some OSU related peds clinic(shamrock? leprechan? blarney? something Irish sounding) in dublin is not bad. Not super flexible about vaccs, but maybe that isn’t your thing anyway. I don’t have any personal experience with her though. Avoid Dr. O’Brien at OSU in grandview.
June 2nd, 2004 at 10:01 pm
They say that a “mother knows best” and in this case I think it definitely rings true.
June 2nd, 2004 at 10:19 pm
My pediatrician is a stickler for weight as well. With our recent foster daughter, who is only two, she told me to watch her weight as it was a little high compaired to her height. Well, I told her that this poor child came from a home where there was no utilities and NO food. She foredged on the floor and ate pocorn kernels and anything else she could find and I had to teach her that we do NOT eat off the floor, we eat at a table. And if she is hungry I’m going to feed her. She came to me with a bloated stomach and stick thin arms. Now she has filled out arms and legs and her belly is just barely rounded, but perfectly rounded for a healthy toddler. She didn’t say much after that. I’m not going to monitor her intake when she has basically been starved before she came to her. I do give her healthy food and drinks and figure that is what she needs.
Go with what is good for your child!
June 2nd, 2004 at 11:14 pm
>I do give her healthy food and drinks and figure that is what she needs.
Exactly! I figured if there was more focus on not filling children with soft drinks, cakes, candy etc. and more emphasis on healthy eating and lots of running around outside (and what was with Heart’s ped? put them in front of the TV to *stop* them getting hyperactive?) childhood obesity wouldn’t be such a problem.
If you feed on demand and offer healthy choices they will learn good habits. Says the mother her follows her skinny-as-a-rake-still-breastfeeding toddler around trying to get him to eat *something*. He’s been below the bottom of the charts since he started walking at 10 months, but my GP says he’s fine, and his Dad is 6 foot and 65 kilos (that’s what, 140 pounds?). I love my GP, but it took some hunting to find him.
But, here in Australia (well, this part of it) our well baby visits are with nurses at the baby clinic, and I went to one - and never went back.
June 3rd, 2004 at 9:20 am
OMG, I am so livid on your behalf. It’s one thing that they pull this obesity epidemic crap on adults, but on a two month old baby?
June 3rd, 2004 at 9:57 am
Oh yeah, and as for the healthy food. My case manager told me that when our foster daughter was at her visitation, she has her healthy snacks in her bag I pack for her and when the case manager offered her a cookie, she said no. I didn’t tell her “no” is her favorite word, but still, she chose fruit snacks and pretzals over a cookie. So take that doctor!
June 3rd, 2004 at 10:02 am
My #1 Daughter was off the charts in height and weight and the doc tried to get me to put her on a diet. Right, a breastfed baby on a diet. She is of course now a gorgeous, tall and just right pre-teen. As will be Madison.
I’ve kept my ped all these years but I just never took her advice re: cosleeping, weaning, discipline, etc. And to her credit she never really gave me much grief about it either. I need a doc to help me when my child is sick not to tell me how to parent, thank you very much.
June 3rd, 2004 at 10:18 am
There are no words for how pissed i am about this doctor, Dawn. I really hope you are able to find a pediatrician who knows what the fuck she’s talking about, rather than one who seems to thrive on proclaiming superiority.
Are doctors even AWARE that they are providing a SERVICE? That they are, in fact, being EMPLOYED by us? They are up there with government officials on the hubris front.
June 3rd, 2004 at 10:22 am
Pissed
this woman’s work: Stupid doctors So the doctor looks at chubby old Madison lolling about gleefully on the exam table and announces that we’re over-feeding her. And I, of course, start arguing and she, of course, plays her “I’m the…
June 3rd, 2004 at 10:49 am
You know you’re doing fine. You know it deep inside. It’s just the damned physician’s job to make us feel like we need them. There are a few good ones out there, but mostly they suck, suck, suck. Squeezing your squishy baby is the best medicine!
June 3rd, 2004 at 1:27 pm
We had a check-up for Logan this morning. He’s not quite 16 mos old, and is in the 90-95% for height, weight and head size, which to me would say that his weight was proportionate to his size - he’s not chubby but he is a big kid. We were told that he should not be eating more than 16 oz of milk, period. In all other ways he’s advanced, smart, physcially capable and obviously happy - so that’s good - but we need to watch his milk or he’ll end up fat? 16 oz is only 2 feedings a day …
June 3rd, 2004 at 1:49 pm
I think you should trust your instincts on this and find another doctor as well. Your daughter looks like a healthy infant and her height and weigh percentiles don’t vary widely. Most of the brain growth in children takes place in the first two years of life, so you are literally feeding her brain right now.