A young, hip expectant couple comes to interview me. Armed with a checklist downloaded from the internet, they settle into the love seat in my office and begin to size me up. Am I the right doctor for their baby?
Expectant parents might not fully understand why you pick a pediatrician before the baby is born. The reason is that the person you choose will come to the hospital within 24 hours of the birth, examine your newborn, discuss test results and newborn vaccines, and talk to you about the first few days of your child’s life. Additionally, your doctor will write the order to discharge the baby home and hopefully develop a relationship with your family for the next 18 to 25 years. Daunting, but if it’s the right match, you’ve met the person who will help you navigate parenthood.
Based on my training and experience as a pediatrician combined with my experience as a mother, here are the topics I think are the most important and that concern parents in the first year of their child’s life.
Feeding: We all know that “breast is best” and there is plenty of breastfeeding support available. Doulas, lactation consultants, friends, and family who have breast-fed, and your pediatrician can offer advice and support. But if breast isn’t working for whatever reason, don’t beat yourself up. Your baby will grow, develop and thrive on formula. Breastfeeding unto itself doesn’t make you a better mother.
Sleeping: Until the day your baby was born you held her for 24/7, and that’s what she knows. For the first few weeks she will be happiest in your arms, listening to a human heartbeat and feeling the movement of human breathing. For the short periods of time that you put the baby down to sleep, she will be swaddled and on her back. The first months are a weaning process as the baby adjusts to sleeping on her own. I recommend sleep training when babies are 3-4 months old and are losing their newborn startle reflexes and beginning to reach or swat with their hands.
Growth: At each baby check-up, your child will be weighed and her length and head circumference will be measured. There is not one best weight at a given age. Pediatricians follow the growth trends and being at the 90th percentile is not always the best. If a baby is feeding well, growth is mostly determined by genetic factors; we all come in different packages.
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Development: Infant development is highly variable, for example the normal range to start walking is 8 to 18 months. Other milestones have narrower ranges. The ones I feel are most important are smiling by 2-3 months, reaching or swatting by 4-5 months, and making consonant sounds by 5-7 months. Some babies have better social or verbal skills and others have stronger motors skills. By one year old, most babies are either walkers or talkers (I had one of each), so rather than lament what your child is not doing, celebrate what they are doing. Soon enough they will be able to do it all. There is no race to the finish line here.
Vaccines: It’s important to be educated about all aspects of your child’s health, including vaccines. I am a pro-vaccine doctor and feel that it’s important to spend the time answering questions about the recommended vaccine schedule. I want parents to feel empowered and informed so they can make their own decisions.
Overall parenting: Each new family I meet reminds me that parenthood is a unique journey that is mostly amazing, sometimes heartbreaking, and guaranteed to change you. Parent is its own job title. Nothing truly prepares you for it. I was a working pediatrician when I had my daughters and my professional training made parenting a different type of challenge. I knew too much! I overthought and overanalyzed everything, so I’m certainly empathetic when new parents have questions keeping them up at night.
These days I am more of a big picture person. Babies, and the rest of us, come into the world as who we are. You get what you get. I find joy in being more of an observer and less of an instructor. Good parenting is a combination of acceptance of who you are, acceptance of who your child is, knowing that you will not always know what to do, making mistakes, and allowing others (partners, grandparents, friends) to share the journey. It will take a village.
So, what do I say to the cute couple in my office and to all of you? I already know this is going to be a loved and nurtured child, so trust your instincts, ask questions, file away the answers, and ultimately do what works for you.
Dr. Lisa Stern, a pediatrician, did her internship and residency at Children’s Hospital LA, later to join Dr. Harvey Karp in the little house on Pier Ave. They merged with Tenth Street Pediatrics where she is now a partner and remains in private practice full-time. Dr. Stern loves seeing the breadth of pediatrics from newborns through to college graduates. At the office she engages children in conversations about what it means to have a healthy, balanced lifestyle and is a walking encyclopedia of wacky home remedies.
