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Can This Pediatrician Relationship Be Saved?

Can This Pediatrician Relationship Be Saved?

By Amalah

Dear Amy,

I’m writing because I’m at my wits end. I have a 1.5 year old little girl. She was small when she was born (5lbs 8oz full term) and she’s been growing steadily since birth but has flattened out a little over the last few months.

She eats pretty well but can be picky and immediately stops eating the minute she feels unwell- this winter has been a battle as every two weeks she got an ear infection or a cold- nothing serious but enough to make her want to drink every meal and forget about things that are high in protein and she absolutely hates Pediasure.

Anyways, my concern is not about my daughter, but about our relationship with our pediatrician. When my daughter was born, they made it clear to me at the hospital that her low birth weight was my fault- the doctor told me that “obviously she wasn’t getting good nutrition in utero so now you really need to focus on fattening her up.” That was the first of so many comments about my child’s low weight and now they come from her doctor constantly. When we go to the office, she’s deemed totally healthy except she’s small. At her 1 year check-up, the doctor told me to feed her butter on everything she ate to increase the calories so she would gain more weight. I’ve told him that the babies in my family are smaller and my husband’s side is very small (babies and people). But he continues to prod me about what I’m feeding her every time we go in to the point now that I just feel attacked and on edge. On days that we have pediatrician appointments, I’m a mess. Now he’s ordered blood tests and the results came back normal (albeit the prealbumin levels a bit low) but we’re still getting so much pressure to force feed her ice cream and butter products. If he says to me one more time “focus on high fat high protein foods” I will go insane. What does he think I’m doing?

I don’t doubt that our pediatrician is doing what he thinks is right. He obviously feels that she is too small and that it is important for her to gain weight. However, I’m concerned that his constant attention to her weight is a red herring and that the focus is not just wasting our time and money as a family, but is killing our relationship to our pediatrician and the medical system in general. I’ve spoken to other parents with children of similar size and growth patterns. I had assumed that our pediatrician’s concerns meant that she was an anomaly but I meet parents every day that say their kids were/are the same. Some of them said that they were actually worried but their pediatricians said it wasn’t a big deal.

So here’s my question: Should I change pediatricians? How important is our relationship to this doctor? I never really had a pediatrician as a child or a family physician so I’m concerned that I don’t understand how important this relationship is to my daughter’s health. Is it just a thing where we go in and see the doctor occasionally and grin and bear the fact that we don’t love him? Or will this relationship just get worse over time?

I just can’t help but think that my frustration about the issue is a) now stopping me from being objective and b) not going to get better.

Any advice about pediatrician woes would be much appreciated.

Change pediatricians.

I mean, what else is there to say? Your daughter is fine. She’s just small. Your pediatrician has essentially CONFIRMED that she is fine and is just small thanks to extra check-ups and tests. But clearly his bedside manner is driving you bonkers and that alone is a perfectly justifiable reason to change pediatricians.

What the hospital told you (“it’s your fault”) was complete B.S., and a horrible thing to say to a new mother — who OF COURSE is going to take that deeply to heart and worry that she’s already failed her child for life because AS WE ALL KNOW, people LOVE to tell pregnant women everything and anything they are eating or drinking is wrong and bad and why aren’t they thinking about the baaaaaaaaby instead of their selfish craving for a hot dog.

But I don’t doubt for a second that the hospital said that, because they said essentially the same thing to ME about my 9 lb, 15 oz, full term but not overdue baby. “We have to test his blood sugar,” the nurse told me. “Babies aren’t supposed to be that big.” When I insisted that I’d passed my gestational diabetes test, she actually snorted a laugh at me. “We’ll see,” she said, super condescendingly.

His blood sugar was FINE. He was FINE. He was just BIG.

So I don’t doubt that your daughter is also just fine and you’re doing the best you can to get calories in her, the way parents of picky-but-typical-weight-babies do. (My huge baby gave me more feeding/weight gain stress that EITHER of my two 7-pound babies did, by the way.)

And really, changing pediatricians is not a decision you need to justify to me or anyone else. This guy drives you nuts and won’t drop this one issue and you’re having ANXIETY about visits. Move on, really, and don’t worry about it. I remember feeling so pressured during my first pregnancy to OMG FIND A PEDIATRICIAN and it felt the same as picking a daycare — super momentously important and also permanent, like I wasn’t allowed to change my mind if it didn’t work out.

Ha ha yeah mom-of-three now and I’ve changed pediatricians multiple times. Once because the practice dropped our insurance. Another time because they repeatedly failed to correctly diagnose my child’s UTI and we ended up terrified and at a specialist’s office because of the misdiagnosis. I’ve also switched between doctors within the same practice for a variety of reasons: This doctor thinks Cry It Out is appropriate for newborns and won’t stop suggesting it. That doctor tends to interrupt you a lot and doesn’t fully listen to your questions. That doctor is really chill and I like him while that other doctor gets mad if I tell her that no, sorry, my kids refuse to drink skim or 2% milk so I let them drink whole milk and I’m sticking with that decision, okay, lalalalalala?

Our current pede practice has eight different doctors. I see us now as having a relationship with the practice and not necessarily with any specific doctor. I trust that I can always get an appointment if my boys are sick. They will be operating on time and will bill our insurance correctly and fill out forms when we need them. My kids will get their vaccinations as needed and the doctors and nurses will work hard to make visits as pleasant and non-scary as possible. And they will give me good advice and recommendations without making me feel defensive, judged or panicky.

Your doctor isn’t working out on that last one.  Go back to the parents of other fine-just-small babies and children and ask for pediatrician recommendations. Stick up for yourself and your own instincts.

Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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Nancy
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Nancy

please change doctors! or practices if necessary. my 5 year old has rocked the 5th percentile in height and weight from day one. it is obviously genetics. Our current doctor is very comfortable with her weight and makes me feel comfortable with her being so tiny.

Ally
Guest
Ally

Both my girls are super tiny (never on the charts). Our pediatrician has never been concerned. He always says if they stay on their own curve they are good to go. He tends to be more concerned with dramatic changes. Having a pediatrician that you really like is such a great thing. I didn’t care for some that we have seen, and now I just stick to one in particular. 

IrishCream
Guest
IrishCream

Change, and don’t look back! If you’re feeling judged or attacked by your pediatrician, it’ll make it harder for you to bring up the random questions and concerns that you will have over the years. It sounds like your doctor is, frankly, kind of awful. You’ve been a saint to put up with that bedside manner this long, and you’re entitled to move on and find a pediatrician with whom you feel comfortable and whose judgment you trust. I also have tiny but healthy kids who’ve gone through long periods of no weight gain. All I had to do was… Read more »

Melissa S.
Guest
Melissa S.

Hi IrishCream, your child did have times of no weight gain? I ask because my son has gone 4 months now and he’s been stuck at 19.5 pounds (he’s 2). We’ve gone to so many specialist and they haven’t really helped. We’re about to give up but I still have this nagging feeling because he hasn’t gained. I get him being below the charts, but no gain is scary. Should it be? 

SusanEm
Guest
SusanEm

Both of my kids are pretty small (5th or below). My 2 year old son has had no weight gain in the last few months. My 5 year old daughter gained a whopping half pound in the last year. They are getting taller, just not heavier. All other development is normal and nobody’s worried about it. (nobody that I’m listening to anyway)

IrishCream
Guest
IrishCream

Melissa, she has had several periods with no weight gain. She’s a fits and spurts kind of kid. She went about a year without gaining a pound between 3 and 4 years (but did grow taller). She was otherwise energetic, developing normally, eating small but consistent quantities of healthy food, so I wasn’t stressed. (And nor was our doctor.) My three siblings and I were all 5th percentile for height and weight until after puberty, and went through those same periods of slow or no weight gain. We had a different family doctor by the time my little sister came… Read more »

Melissa S.
Guest
Melissa S.

Yes it is helpful! We’ve seen a cardiologist, and gastrologist (sp), all to no avail. The gastro thought he was back up…..but for 4 months?! I’m going to give up for now. He’s totally normal otherwise. Thanks for the responses!

Carolyn Allen Russell
Guest

Yes, change doctors! Because this one sounds awful, and what if something DID happen where you needed important medical advice from someone you trusted? You clearly don’t trust this guy! And that would be a terrible time to try to find someone new that you like. I’m not super picky about my doctors (we were randomly assigned a pediatrician and he just happened to be wonderful, so we got really lucky! It’s not like I went and interviewed anybody or put a ton of thought into it) BUT it’s important to me that I feel comfortable asking questions and confident… Read more »

Melissa S.
Guest
Melissa S.

Yes it is helpful! We’ve seen a cardiologist, and gastrologist (sp), all to no avail. The gastro thought he was back up…..but for 4 months?! I’m going to give up for now. He’s totally normal otherwise. Thanks for the responses!

Kendra
Guest
Kendra

Change your Pediatrician! My daughter isn’t even on the weight charts at this point and our doctor isn’t concerned. She is obviously growing so he said she is healthy and we would only need to worry if she stopped growing. And I was even smaller than her when I was her age so obviously genetics. Those charts are total crap.

Victoria
Guest

Absolutely change. Now, rather than later. I had the EXACT SAME experience when my daughter was born, where she was small and not on the charts. She breastfed fine, was a great eater – until we started getting the same advice. Add butter and cream to everything, add chocolate to her milk, as much cheese and nut butters as she will eat. We had already been to specialists for bloodwork and a terrifying Cystic Fibrosis test, so we listened and fed her all the fatty extras. Then, when we tried to get back to healthy eating – it was not… Read more »

Shannon
Guest
Shannon

Listen to your doctor…really listen to him before you change pediatricians. It sound like you have concerns about the message and how it was delivered

.

The message is that your doctor, who is an expert in children’s, health is telling you there is reason to be concerned about your daughter’s weight. Spend more time learning about those concerns. Ask for a referral to a nutritionist. Then, if as a team, you all agree she is healthy and small and you still don’t like the way the messages are delivered…then change docs.

MR
Guest
MR

No, I’m sorry, but as an “expert” in children’s health, this doctor needs to know that the delivery of the message is just as important as the message itself. This doctor is rude and condescending and flat out saying things that are false. Stating that it was obvious that baby wasn’t getting adequate nutrition in utero?? That’s total crap, and a good doctor knows that mother shaming is not going to deliver the message. This OP absolutely needs a new doctor IMMEDIATELY. There is absolutely no need to stay with this doctor at all. If there truly is a problem… Read more »

MR
Guest
MR

OP, one more thing – there is also one more simple point I learned in our process with our daughter – a child who is not getting enough to grow will not continue to meet milestones. They grow physically first, then they grow mentally. So, if your daughter is continuing to meet her milestones developmentally, then she is just small. If she is behind on her milestones, it is possible that she needs more calories. My daughter had a health issue that was contributing to her weight issues, and once we started supplementing, she grew significantly in only a few… Read more »

Cheryl S.
Guest
Cheryl S.

First, while pediatricians might be “experts” on the books, they should also know that every child is different.  They don’t know everything.  (Believe me, my daughter had a sinus infection as a baby for approx 6 months.  Until I insisted that she be put on a long course of antibiotics — 3 weeks– the “expert” kept telling me she just had the sniffles and I should calm down.) Even if there is a problem (weight or anything else), if you can’t discuss that problem with the doctor, you need a different one. OP is having anxiety just having to go… Read more »

IrishCream
Guest
IrishCream

I’d have more concerns over the fact that the doctor has not given her a reason for his concerns. All tests have been normal and she’s a healthy toddler…if he has specific reasons for his concerns, that’s great, but small size and slow but consistent growth are not in and of themselves a medical issue.

If she finds a new pediatrician and after an exam and family history, they too are concerned, then absolutely, she should learn more, see a nutritionist, etc. 

Jeannie
Guest
Jeannie

I, too, have a small daughter — she is heading towards five and last year grew three inches and gained a SINGLE pound. She also took over three years to triple her birth weight, something that should take a year. But! My doctor has always been fine with it. She grows on her own curve, she eats, she’s meeting all her milestones no problem. I’m not a huge person either, so my doctor is apt to just shrug and say — it’s just genetic if she eats ok and is growing at her own pace. As for the doctor issue… Read more »

Ashley
Guest
Ashley

I completely agree – Change docs ASAP! Doctors opinions can vary widely, even in the same practice. Our first doc told me that at 2 months old my baby was “obese” because of the difference in percentiles between height and weight even though he was born large and never lost weight. We changed immediately. The next doc we saw from the same practice said he looked great at his 3 month appt and his weight was due to “the miracle of breast milk.” MUCH more my style 😉 It’s so important to know and trust your ped. Don’t stay with… Read more »

Sara
Guest
Sara

Just to provide a slightly different perspective…I am a pediatric health care provider (full disclosure). I agree you should have no hesitation to change providers if you do not feel comfortable with the one you have. Going to a check up is anxiety-provoking enough for our children, we don’t need parents to be upset as well! So by all means, doctor shop. It won’t hurt your kiddo as long as you are getting records transferred so she doesn’t miss any important vaccines or follow ups. That being said, I think it is important to keep your daughter’s growth on the… Read more »

Jeanne
Guest
Jeanne

Isn’t it so reassuring to hear everyone agree with what you’ve been intuitively feeling?! Definitely change peds. Our Ped is really fantastic – my daughter was 38W, born at 4 lb 15 oz. Like many of the bebes in the comments, she didn’t even hit the charts at her first visit. She’s growing fine, and isn’t eating butter 🙂 

Always trust your intuition!

c
Guest
c

Have you considered a family practice? My OB is also a family physician, so she sees my son too.

Lisa R
Guest
Lisa R

Change.

If it truly is a problem (being a mother of a small girl who grows almost not at all makes me think it isn’t a problem) then another dr will notice and can make you feel comfortable even when dealing with it.

I had a very similar thing, and luckily we moved so we had to get a new dr. Not even one word about weight at our new place! Love it.

Operation Pink Herring
Guest

My daughter is also super tiny. I celebrated when she hit the 3% at her last well vist. My regular ped, who i really like, has always been pretty concerned about her weight, to the point of giving me a handout from the 80s that suggested adding Karo syrup to her milk and lacing all her food with margarine. Yeah, no thanks. i didnt worry as much because she’s my second, and my first is a very picky eater who has gone weeks eating essentially nothing and is still always in the 75-90%. Shes just big. Second is just small.… Read more »

turbocharger
Guest
turbocharger

God yes, change doctors! And to be on the flip side, I have an abnormally large, but otherwise healthy baby and had a doctor suggest we put her on a diet. At 3 months old. And she was exclusively breastfed. She was 10lbs 8oz at birth and just kept growing on the 98th percentile until around a year and now she’s begun slimming out. Doctors don’t know everything, and the relationship that you have with them is incredibly important. Picking a daycare was similar to what Amy said, I agonized over it, and after 2 months it simply wasn’t working… Read more »

A doc
Guest
A doc

I think either you bring yourself to ask the doctor why he is so concerned and really listen to the answer, or you find someone you can ask that question of more comfortably.  Your relationship with your doctor matters, as does his/her with you; if you don’t trust him, it shows, and it will affect how you are treated.  Because we are all human. I have to comment on the last paragraph – the 8 doctor practice sounds lovely but you are being very naive if you think that any primary care practice, however well run, will always run on… Read more »

Caroline
Guest
Caroline

Oh, definitely change doctors. Thing is, this will come as a major shock, but there is no actual law that you have to see a paediatrician regularly… There are certain times it’s recommended (6 months, 1 year), but for regular vaccinations, a nurse can give those, or any regular GP… ideally a slightly older GP who is, let’s say, not obsessed with obsessing on ridiculous things… My youngest baby was 5.2kilograms or 11lbs8oz. Yes he was. No, I did not have diabetes, nor did he. He was just… ridiculously big. My older 2 were both over 4.5kgs so I have… Read more »

Cheryl S.
Guest
Cheryl S.

I would definitely change docs.  If there is an issue with your daughter’s weight the new doc will deal with it as well.  

You should not be getting anxious just to take your kid for a well visit. Get out of there and get a new doc.

Mona
Guest
Mona

My sons are on the opposite end- always over 95% for height. They also weigh more than my peers’ children, though they are not heavy at all. I’ve asked our pede about their size several times- he assures me each time that they are just BIG, and proportional. As a chubby kid, I guess I just need the reassurance, and he always makes me feel comfortable that they are growing well, appropriately for their (giant!) size. I feel like your pede should help reassure you that things are as they should be- it’s stressful enough being a parent. Change doctors,… Read more »

christina
Guest
christina

Change Drs…. my son is also on the low end of the charts. When I asked my dr if we should be concerned, his answer was perfect. “They are just charts, someone will always be in the 90th percentile and someone will always be in the 10th” If she is growing and happy, I’d say thats one healthy little girl.

Natalie
Guest
Natalie

CHANGES DOCTORS FAST. What a dick, first off. Secondly, pediatricians, although equipped with much more medical knowledge than the most of us, thanks to their medical school education and general experience, are still getting paid by YOU for their OPINION and service. You are in control. You are the mother. You wouldn’t continue to pay/use a mechanic that insulted you because you don’t wash your car enough or some stupid opinion based argument of theirs….it amazes me that we as a country (including myself up until recently) continue to allow doctors to question our abilities as parents. Every doctor is… Read more »

Jenn
Guest
Jenn

Another pediatrician chiming in here, and I have to echo what Sara said above. By all means, if this pediatrician has poor bedside manner and is not explaining things well and is making you stressed out, switch pediatricians. BUT, you mentioned several red flags in your question that would justify concern and medical evaluation for your daughter. Small but growing is different from small and not growing. Dropping percentile lines (while maintaining the same weight) is a concern. If you are not getting enough nutrition, weight flattens out first, then height, then head/brain growth. You want to catch it and… Read more »

Kat
Guest
Kat

Really cool to see two experts weighing in (Sara and Jenn). We actually don’t have a pediatrician, we have a “family doctor” who sees me, my husband, and our three year old son. He is the same doctor who provided my prenatal care (and connected me with specialists when we needed them towards the end of the pregnancy), he was there when our son was born and he continues to be a great resource between visits. The key for me was finding someone who would care for our whole family, and was confident and comfortable in calling experts when we… Read more »

Jenn
Guest
Jenn

And, Amy, I think the problem with your nurse was also an issue of tone rather than message. Big babies are definitely at risk for low blood sugar, even if the mom didn’t have documented gestational diabetes. It can be missed. If there is concern, better to check a blood sugar than have a newborn with hypoglycemic seizures or brain injury. It happens. Most doctors/nurses are trying to do the right thing for you and your child, even if their bedside manner is lacking.

Christy
Guest
Christy

These percentiles create so much stress! If your child is in the 5th percentile for both weight and height, isn’t that perfectly proportioned?  My two year old is actually skinny, 99th percentile for height and 20th for weight. This is out of proportion and all my pediatrician said was basicly get her to eat whatever she will but keep it healthy, don’t feed her junk just for the calories. My pediatrician is awesome.

s
Guest
s

We also had Dr. Issues but we asked for referrals for continued genetic low growth. My son had severe reflux and would stop eating when sick. This was treated with medication for years. My son eventually had a bone age done, two years behind chronological age through pediendrochronolgy at a children’s hospital. This is after being followed by Pediatric gastro from before your daughters current age, allergy, ent, audiology. I also called birth to 3 for a feeding evaluation with an occupational therapist. There are feeding resources through American speech language hearing association. We also had an evaluation done through… Read more »