Follow Your Gut- Tips for Discussing Your Baby’s Digestive Concerns with the Pediatrician
Over the years I have heard time and time again, “I brought this issue up to my pediatrician several times before today”, or “the doctor said there isn’t anything wrong and she’ll grow out of it”, and of course “his doctor told me lots of babies spit up which made me feel I wasn’t right about my own child”. Naturally, calming fears of the unknown and ‘normal’ versus ‘not normal’ is part of any pediatrician’s job and a very important one at that. However, I believe parents should be encouraged to follow their gut when an issue continues to be of concern. Sometimes this means requesting to see a specialist when general strategies do not alleviate the issue. This is not a dig at physicians' or health care professionals’ knowledge or expertise, but an emphasis on parents knowing their child and having spent the most time with their child. Parents and caregivers are the true experts of their children.
Tips for Having “The Discussion”
Many times a detailed account of the history gleans important information when determining where the source of a problem stems. Only a parent or primary caregiver can provide this type of information. Too many times to count I have evaluated children with severely picky eating, only to find out they had significant discomfort and vomiting all throughout infancy. If you have ongoing concerns, be prepared to provide objective information which you have tracked and documented. For example, instead of “my baby is spitting up a lot” you will be able to report “my baby is spitting up mostly large amounts every feed and he cries and arches during these episodes” or “my baby becomes inconsolable after feeds, but only when I lay him flat” or “my baby hasn’t stooled in 4 days”. Another example includes an accurate measure of how much volume the baby is taking. Are you measuring by water volume before mixing or total volume after making a bottle? (Hint, measure intake by total volume). This is not a good example for primarily breastfed babies, but breastfed babies are generally less likely to be overfed given no underlying supply conditions. When you can provide details and clues to a potential issue, it is much easier for a pediatrician to offer solutions or send you to the right specialist.
Any time a recommendation is provided, a health professional should be able to tell you why they are recommending it and the outcome they are aiming for. If they are unable to have an open discussion with you (even if it includes acknowledging that we cannot always know the exact answer) then remember it is within your right to seek a second opinion. Additionally, if you feel unheard, it is within your right to seek a second opinion. And of course, if you feel uncomfortable or that a recommendation is not right for your child, it is within your right to seek a second opinion.
Beware of the Interweb (a.k.a. Internet)
When it comes to second guessing recommendations and taking on the responsibility for knowing the unknown, it’s easy to get caught in what I like to call “the interweb”. This is when we fall into the never-ending black hole of searching for answers on the internet. Unfortunately, we can rarely confirm what we find on non-vetted websites as fact or myth without the aid of an experienced professional. For natural-born questioners like me (thank you Gretchen Rubin for that term) this can create a never-ending search for which there is no final answer. Or worse, some information can be downright dangerous. What’s the harm you ask? Some web suggestions are not proven safe for infants and children and may cause actual physical or emotional harm. It also comes when we over-trial and throw too many variables into a situation, muddying the water and making it difficult to find a clear solution. Examples of this include finding home remedies to add to an infant’s diet or changing formulas too frequently (both of which can be hard on a young gut). I am all for educating yourself to be an advocate and asking about alternative solutions to the standard options; just remember the higher the number of variables, the more difficult it is to sort out an etiology.
Where to Turn
The best advice I can give to parents is to follow your gut, if you suspect something is wrong talk to your pediatrician. Seek information and education, but don’t fall down a fear-led rabbit hole where things become even more confusing. If you don’t feel satisfied or heard by your pediatrician, ask to speak to a different doctor or request a referral to see a specialist. Hearing similar recommendations from multiple professionals may put your mind at ease. Inversely, a different opinion or diagnosis can provide clarity to the situation and comfort that your concerns are not irrational. Other parents are great resources for finding good providers, especially if multiple families have had a good experience with one. It often just takes finding the right professional that has the key to unlocking your concern. And if you have a true concern, listen to your gut.