Help! I feel Like I'm Pestering My Pediatrician..
John P. Sotos, M.D.
This is one of the most common questions I receive from new parents and my response is always the same. First, as a Pediatrician, I expect numerous questions from my new parents. In fact I would find it worrisome if they didn't ask a lot of questions! I always tell my parents, “ If you don't know the answer, it is not a stupid question. So don't ever hesitate to ask.” New parents are usually concerned about not doing something “the right way”, or fear that they may “miss” something that leads to actually harming their child. They can receive conflicting advice from numerous sources: grandparents, in-laws, neighbors, TV shows, the internet, and when coupled with the inevitable sleep deprivation it's no wonder they're confused and start second guessing their second guesses. My job as a pediatrician is in part to alleviate this confusion and provide guidance during this most challenging of times. Although we at River's Edge Pediatrics, Inc provide educational links on our website and offer suggested readings (see below), no one can foresee all circumstances and thus we prefer to err on the safe side and have our parents call us with any questions or situations that they feel need our helping hand. This being said, there are a few general guidelines one can use to start to assess the situation.
Infants have four “jobs” in life: eating, sleeping, peeing and pooping. Odds are if these four things are going okay, then the child is okay. Newborns should vigorously feed every 2 to 4 hours and should awaken to feed on their own. If they continually have to be awakened to feed and have a poor suck, this could be a sign that something is wrong. Newborns usually don't sleep longer than 4 hour stretches without feeding during the first several months. Once they “sleep through the night” , they may sleep 8 hour stretches or more. Wet diapers occur every three to four hours at a minimum. Bowel Movements can be after every feeding or up to several days apart. Some breast fed babies so totally absorb the breast milk that it takes several days to build up enough undigested substance to produce a bowel movement. Stool consistency can vary from watery to toothpaste consistency. Constipation is when an infant has hard pebble-like stools to dry clay consistency and strains to have a bowel movement.
Temperature is a concern for many parents. There is a saying in pediatrics, “Treat the child, not the temperature.” What this means is I am going to be more concerned about a child that is acting lethargic, unresponsive, etc. with a temperature of 100 degrees, than I am about a child with a temperature of 103 who seems just a little puny. The one caveat is I want to know about any child with a temperature that is less than 6 to 8 weeks of age (Rectal temperature > 101.5) no matter how they're acting.
There is a medical study which found one of the most sensitive indicators as to whether an infant is ill is the parent's perception. So if something doesn't seem right, trust your gut and call your pediatrician.
For further research on specific items one can search the following:
www.riversedge-peds.yourmd.medfusion.net.
Your Child's Health by Barton D. Schmitt, MD; www.whattoexpect.com ; Caring for Your Baby and Young Child, Birth to Five years, as well as other titles provided by the American Academy of Pediatrics. Go to www.aap.org
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