Can This Pediatrician Relationship Be Saved?

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.