Should I Vaccinate My Baby?

Disclaimer: this blog does not constitute medical advice. Please contact your doctor for advice. The names of the patient and mother have been changed.


One afternoon, on a busy winter day, I saw a patient in my partners practice. She was a 15 month old healthy toddler named Emma. Kate, Emma's mother, tearfully explained to me that Emma had had a raging fever of 103, for 3 days. Kate was upset because the fever would not go away, and now Emma was developing a rash which was worsening. Emma was becoming more irritable and miserable.

Emma was so uncomfortable, that she would barely let me examine her. 15 minutes and all of my energy later, (and all of poor Emma's too), I was able to coax her into a quick check. I discovered that Emma had chickenpox.

Kate, proceeded to explain to me that Emma had 2 other siblings at home, a 10 and 13 year old. Kate had chosen not to vaccinate them hoping they would get the chickenpox "naturally". Kate assumed chicken pox was harmless and could not develop into a severe illness. After seeing Emma miserable and suffering, Kate tearfully regretted her choice not to vaccinate her kids.

Because of Kate's decision not to vaccinate, Emma was ill. Although severe complications of chickenpox are rare, they do occur and include neurologic and skin infections.

Given the option to prevent the possibility of these complications Kate now felt that her own reasons for choosing not to vaccinate her children were unclear even to her.

This is a common scenario in the office. Parents choose for one reason or another, not to vaccinate their child. Sometimes, it is the mythical link between autism and vaccines, which has been repeatedly been dis proven by science, and now by the courts. However, these myths plant the seeds of fear into the minds of many concerned parents. And like all myths, the voice of one misinformed parent can cause panic and replace actual facts for many other parents.

So when parents and friends come to me for my advice on the subject I talk to them about the disease in the pictures below. These diseases are real, and sadly do still occur in other parts of the world.

I talk to them about how they feel about the picture below: a young child with tetanus

or this: Two young boys with polio:

or what little Emma could have been facing: A complication of Chickenpox (varicella)

Many of us are fortunate enough that our kids have access to vaccines. We are lucky, we have a choice. A choice which allows us to prevent the spread of these types of debilitating diseases. Many kids in the developing world have no choice. They are faced with the possibility of these illnesses daily.

It is important for parents to remember that these are the diseases that vaccines prevent. Many children and parent don't have a choice. We do.

Choose facts, not fear.

For more information, talk to your child's doctor. Please check out the links below.

Websites:

www.aap.org

www.vaccineinformation.org

www.vaccinesafety.org

www.cdc.org

Top Ten Dont waste your money on!

I love to shop. But I don't like to buy anything unless I know I need it. So when I was pregnant with my little girl, I decided I would shop, but only if the item was functional, practical and necessary.

So here are my TOP TEN ITEMS you DON'T need.

Happy Shopping.

1.) Video Monitor

Parents often think they want to know every move their infants makes.

But, what I know as a pediatrician is that when baby sleeps it is time to give yourself a break.

A video monitor only increases your anxiety.

So enjoy yourself, relax, sleep or watch TV instead!

If your walls don't allow noise to permeate then an alternative is to invest in a sound only baby monitor.

2.) Ear Thermometer

Plain and simple, they are not accurate. We use them in clinics out of convenience, but if I really want to know what temperature my child is, I use a standard digital thermometer. If you are not sure how to use it, check with your doctor.

3.) Baby Scale

Your pediatrician should be monitoring your baby's weight. If your doctor is concerned ask them about the need for a scale. Otherwise, save your money. The one thing your baby will do naturally is gain weight! And you will notice, because the babies grow rapidly their first year, doubling their birth weight by about 4 months. 

4.) Wipes warmer

Not much to say here except, no you don't need this at all. Put the 20$ in a college fund.

5.) Sleep cushion for babies back

Unless your pediatrician recommends it, I don't think this is useful.

6.) Baby Mirrors Car

My daughter cried and cried in the car. We finally figured out that a specific song would sooth her. I bought various baby mirror (at least 3), they don't work! You can hardly see your child and in between you are trying so hard to find her in the mirror, it affected my driving.

7.) Boppy pillow for nursing

I got a hand me down, and I used it for about 1 week. Then it went into the closet.

A regular pillow works fine and doesn't cost more money or clutter.

8.) Bassinet: Oh, how I wanted one. They are so sweet looking. But! But,

if you have one or have a hand me down great you are lucky, use and recycle. But don't go out and buy a new one. They cost around $100 and your infant will grow out it so quickly. A pack n Play is a more practical alternative which can be used for multiple purposes as your child grows.

9.) Baby Einstein and baby DVD's

If you don't have them, you wont need them. if you start using them, it will be taught to survive without them. Contrary to popular belief, they don't help you baby learn.

10.) Bouncy seat:

Useful if you don't purchase a swing, buy realistically, you don't need both. Pick one. I preferred the swing, it was a more expensive, but your baby can use it longer.

The Top Ten on My Baby Registry

Because I am a pediatrician,  everyone assumed that I knew exactly what I needed when my baby was born. 

Part of that was true, I had seen so many versions of car seats, strollers, toys, and bottles. And I knew which items were gimmicks, (which I will get to at my next post).

But as a mommy to be, I too felt like buying cute baby stuff I knew I did not really need. However, with the help of my baby daddy I stayed true to my "needs" list, not my "want" list.

So here are my picks!       

      

                             1.) Graco Snap and Go Stroller 

Say forget it to those amazingly expensive strollers. I too, liked the look and feel of them, but really, how necessary are they? 

Do they really make a difference in the long run?

 No, your kid wont remember what you toted him around in.

This stroller was practical and easy to use.

It is inexpensive, portable, lightweight, durable, has a coffee cup holder for those java addicts and it fits with most standard car seats.

2.) Medela Breast Pump- FREESTYLE

This breast pump is like a blue tooth headset, you can type, talk on the phone,even make dinner, without having to hold the annoying breast pump to your chest. 

And, for you wild women, you could double pump at the same time, hands free. This is a bit pricey, but if you know you will breast feed for a while, and you have to go back to work, this is definitely worth it. 

Added bonus, lightweight, compact and can operate 

on a battery. I took this to Vegas in my purse.

3.) Organic Crib Bedding and Mattress

This is a more pricey option than the conventional crib mattress and bedding, but babies spend so much time sleeping. Because of that, the crib mattress and sheet seem to me to be the most important thing to buy organic. So be frugal on organic clothes and other stuff, because your child will grow out of it, but you know the extra dollars will last longer with the organic mattress and crib sheets.

I purchased mine from the store listed below, they were fast, efficient and so far the mattress has worked out great. There were many other options online, but this was the best bang for my buck.

www.daxstores.com/v-snq-crib.html

4.) Breastfeeding Cover-up

Oh, how I needed this. 

I love to wear short skirts, but I was never into nursing in public.

This cover-up allowed me to feed my baby, pay attention to her and actually leave my house!

www.rightstart.com/global/store/product-item-9199-dept-feeding.html

An inexpensive version of this is also available at Target, or if you are creative, you can stitch one yourself.

              

  5.) Activity  Mat

All infants love this and it is portable and easy to clean and assemble. Great for vacations, if you are luck enough to have one!  Go to google and type in infant activity mat and you will find this priced around 30-40$.

6.) mypublisher.com

OK, this doesn't go on your registry, but it is so important I could not wait until I do my blog on the best websites!

Upload your pictures fast and easily. You can create great photo books, calendars etc. 

My favorite feature, they have great sales and discounts at Costco.com 

7.) Favorite Book!

"My Friends", by Taro Gomi

I love this book, my daughter loves it too. Great pictures, easy to read, and will entertain as they get older. Most people love Goodnight Moon, but this was my favorite.

8.) Colic Woes?

Harvey Karp's, "Happiest Baby on the Block is awesome, the DVD is great for those who don't have time to read, but what got us thru many many rough colicky evenings was his White Noise CD- called the "Super-Soother" White Noise.

My daughter would be screaming and as soon as we turned on "Rain on the Roof" she would stop. Thanks Dr. Karp!

Cheaper option:

I tell my patients to use a vacuum cleaner or hair dryer to create the same effect, but when you are in the car, on vacation, or just strung out, the CD by Dr. Karp works wonders.

go to www.thehappiestbaby.com

By the way, it is best to know about colic before it happens, so if you have the extra cash, get the book/DVD before the baby arrives. If your baby is colicky, this book will save you a few trips to the pediatrician and the stress of not understanding the screaming.

9.) California Baby Body Wash

Gentle, non-toxic and bio-degradable. All words you want to hear when you apply something to your babies face. Added bonus, easily available at Target.

10.) AAP guide to your child's first year.

Order it before your baby arrives so you might actually get to read it.

Another tip- ask your pediatrician for a copy, I always hand this out to my new families for free!

That is all for now. Stay tuned for the top ten what not to buy list.

Breast Feeding 101

Many nursing mom's switch to this.





Without judgement, I completely understand why.


Although I am a pediatrician, I did not want to breast feed my baby. I know, having learned over and over again in medical school and then again in residency all of the reasons why women should breast feed.
I had heard the mantra "breast is best" over and over. Many of you know that breastfed babies have better immunity, tend to "bond" with their mothers and the books say, it is easier than formula feeding!

Regardless of all of this information, I had decided in my mind, at some point in medical school that I hated the thought of "me" breast feeding. I wanted everyone else to do it, all my patients and my friends. But, me, breast feed-- No Way! I mean no thanks. But, before my baby was born, I promised my baby's daddy (also a pediatrician) that I would at least try to breast feed.

The day arrived unexpectedly, and so did my first true test.

Day 0, hour 1 of my daughter's first day. I lay awake and asleep in my hospital bed to find my precious little daughter in my arms. It was time for her to eat.

She latched. She sucked, She drank. We did it! To be honest, the first time around, I was so dough eyed in love that I didn't really know what was going on.

And then, we got home and it started to sink in. She cried with hunger, she cried with exhaustion, I breast fed. But, I was exhausted and in pain from surgery. I was also overwhelmed by the new person in our home, yet for some reason I continued to breast feed. My little daughter lost weight the first week and was jaundiced. I worried she was not getting enough to eat, and despite that I continued to exclusively breast feed.

There it was. I had not given her any formula. Hip Hip Hooray!

But I still felt, well, not comfortable with breast feeding.

Despite that,I marched on. I continued to love, love and love my little daughter. But the breast feeding all I could express to others was, "they say, "breast is best."

so, at 3 months post partum I felt like this:

What job can only one person perform every 2hours, for 20-30 minutes at a time, 24 hours/day, 7 days a week for months and months at a time.
Breastfeeding. Only a mommy can do that.

This is what no one talks about. The challenges of breastfeeding. No coffee breaks, no bathroom breaks and certainly no meal breaks. How does anyone manage to take a shower, answer a phone call, or have a coherent thought in the middle of all of this. And I did not even mention the middle of the night feedings, diaper breaks, dirty laundry, oh yes, and grabbing a bite to eat yourself.
With all of this, it is no big surprise that most woman in the US don't do breast feed for long. Most women give up or wean before or around 6 months post partum.

All the while, that powdered white formula is sitting there, like a tiny while bottle of evil, calling my name, enticing me to pick it up and use it.

Some of my colleagues, wondered why I didn't give my daughter the occasional bottle of formula. But they just didn't know me in that special way. My obsessive compulsive tendencies weigh in and prevented me from going for the formula. If I was going to do something, I always do my best. And then was the other simple truth about me, if I tried the bottle of evil, a quick and easy shortcut, would I even be able to go back to breastfeeding?

So, I trudged on. Exhausted, and waking up every 2-3 hours to feed her all day and night.

As a mommy who has been exclusively breast feeding her baby for 10 months (no formula yet). I can say it ain't easy.

So why did I keep going? Because my daughter was thriving, and she was thriving so beautifully I did not want to give her any less than my personal best. I'd be lying if I didn't tell you there were many moments where I loved being the one person who she needed the most, for love, attention and her meals, but it went beyond just that. Something I just can't explain. With the combination of sleep deprivation and breast feeding, somehow, perhaps with the help of all of the maternal hormones still surging thru me, I was able to manage to wake up every day and be excited about seeing her and breastfeeding her.

In the end, I think that if someone had told me how much work the breastfeeding was, I might have been better prepared. Now, I hope you might be. But realistically, I don't think anyone can know, until it really happens.

As far as I can tell, I just passed my first test of motherhood, with patience, dedication, hard work and lot of love. Now, only many many more years to go.

A Doctors Guide to Choosing Your Child's Doctor

How to pick a pediatrician?

Stressed out. Sleep deprived. Tired. Excited. Getting the nursery ready, checking off your "before baby arrives" to do list. Seeing old friends and relatives and working overtime to get extra time at home with baby once she arrives. Sound familiar? If so,you'll find this guide to the "Pre-Baby Basics" helpful.

I was so excited before my baby was born, but it felt like life was chaotically in limbo. And I still had not picked the pediatrician.

Take it from a pediatrician, choosing your pediatrician can be a daunting task.

So here I am, a pregnant pediatrician, ready to become a mommy, but not ready to become a mommy either. It just happens to be that my baby's daddy is a pediatrician also. So the task of finding our pediatrician seemed even more challenging.

All of my friends, and family assumed with my unique situation that I, or my husband would be our baby's pediatrician.

No way, I thought!

Here's why: You want your baby's doctor to remain objective. Anytime I give advice to family members about their kids, I find myself wanting to tell them what they want to hear. I find myself wanting to give them advice I would never give to my patients. The best doctors remain objective about the situation. It is difficult to remain objective about a child who is part of your friends and family network.

For example, my baby had terrible reflux in her first few months of life. On many occasions, my husband and I wanted to treat her condition, but I knew that I would advise my patients not to do anything in this situation. Yet, I could not watch my daughter suffer with it. I could not be objective. Thankfully, we found a doctor who was objective.

That said, how did we find our pediatrician?

Take it from a mommy who loves to shop. The first rule for shopping, buy something only if you LOVE it! Finding the right pediatrician can be similar to finding a pair of shoes you could live in forever. So, in order to get it right, you may have to meet a number of different doctors until one "feels" right. What do I mean by, "feels right?" There are many issues that go into that "feeling".

For me, it meant finding a doctor who really listened to me. Someone who not only listened to what I said, but actually heard me. When my daughters reflux worsened I called my pediatrician. He was out of town. So, I decided to speak to the on call physician. The on-call pediatrician knew I was a pediatrician, yet,he talked down to me, and further went on to tell me- "you already know your options." In reality, he was right, I did know my options for my daughter's condition. And I also knew how I would approach a patient with a similar issue. But, what I needed at that moment, was a doctor who could realize my fears as a mom. A doctor who could say, "Wow, that situation sounds scary know, but here is what I think, here is what you should do and this is why everything is okay."

As a pediatrician, some doctors may assume that I already know everything. But, my daughter has taught me that being a parent means. It means on occasion all rational thoughts vanish. So, find someone who you can ask the silliest and most embarrassing questions. You will be surprised what questions you may have for your doctor in the future.

Some other important tips to find the pediatrician that is right for your family.

1.) Is he/she board certified in pediatrics?

2.) Find out who takes calls after hours and on weekends.

3.) Find out what their weekday schedules are. Many pediatricians work part time, so find out if their schedules fit your families needs.

4.) Meet the other doctors who work in their office, chances are, you may see one of them on occasion.

5.) Ask where you go for labs, x-rays and in emergencies, much of this is dependent on your insurance, but it is still important to know.

6.) Oh yes, this may seem basic, but find out how far they are form your home? When your child is ill, you want to be close by. I ended up picking someone 20 minutes away, but when your baby is ill, that feels like a long drive.

7.)Ask the pediatrician questions about what is important to you. Examples may include their philosophy on child rearing, vaccines, co-sleeping,antibiotics and anything else that may be important to you.

8.)Ask how they keep up with medical advances.

9.) Word of mouth is important. Talk to other mothers locally and get their feedback.

10.) If you don't know any moms, you can always check the local mom's groups for opinions.

Most importantly,if you choose someone and later on it doesn't "feel right", its not too late. You can pick someone else and you won't hurt any-one's feelings. You are your child's advocate so follow your instinct. And remember, before your baby arrives, go meet the different pediatricians. Comparison shopping is best to do before your baby arrives.

"Never Say, Never"--- trite or true?

"Never Say, Never"--- trite or true?

For the many years my husband and I were known as DINKS-- (double income, no kids).
This meant we like 2 single people who just happened to be married. We would work hard during the week, both of us, full time pediatricians.
The weekend would roll around and we morphed into adult toddlers, enjoying breakfast, lunch and dinner out with friends, weekends spent where ever and however, and vacations traveling to exotic destinations. And oh yes, my favorite part, guilt-free, no need to discuss it with the hubby, shopping.
Yes, we lived like a "Sex and the City" episode, only happily married,sans kids.

Then, with a dramatic and unplanned C-section our beautiful little girl arrived and turned our lives upside down. Most people expect that. What I didn't expect was re-learning everything I knew about being a parent and a baby doctor.
So, this blog is about me, Dr mommy, and everything that comes with a little knowledge and deconstructing the "rules". No medical advice dispensed , just my mommy opinion.

Before, I became a mommy, a good friend said, "never, say never" when it comes to your kids. Well, I wasn't so sure. After all, there are so many "nevers" when it comes to kids. At work and home I believe in moderation, but really ..there are some good nevers out there-- never talk to strangers, never talk back to your parents, never yell at the kids... etc....
As a one week old infant, my daughter behaved like a typical textbook baby. She lost weight the first few days, became jaundiced, nursed poorly and kept us up all night for fear that we were not feeding her enough. Ok, I could handle that. I had a comic hero style supportive husband who keeps life light and fun. Plus, I am fortunate to be blessed with devoted parents and parent in-laws too! The sleep deprivation did not seem so bad at first, all the hormones I suppose.
By 6 weeks, the family and their helping hands returned to their own homes. Baby daddy went back to work. Which left me and my little dhingaloo (hindu slang for precious baby doll) all alone at home.
Day one by myself, I thought, "I can do this mommy thing alone." I thought-- I have been around kids my entire adult career (8 or so years), I take care of 30 patients and their families a day. I dispense medication, counsel families and keep up with my medical journals. I never thought, all day at home with a baby would be too hard. Actually, I thought I might have free time while the baby slept to enjoy some of my hobbies.
But, day one, without family, I was still in my pj's at noon. I had been up since 8am and sleep deprived (after many middle of the night feeds). I hate being in my pj's until noon because I just feel dirty. Pre-baby I went to the gym, showered and dressed within the hour. I am one of those. The kind that makes the bed as soon I as I jump out. Yes, it is a compulsion, probably what allowed me to get thru medical school.

Anyway, I think I was in my pj's the whole day. I would never do that, not even if I was sick. All alone, trying to figure out how to bathe, pee, eat and make dinner between the 4 daylight hours left after breast feeding and diapering the dhingaloo. I had to call baby daddy who was busy at work for advice on how to do these things. I never thought I would have difficulty figuring out these tedious issues. Finally, I had to resort to calling my friends (most of them are mommies already) for advice. I slyly asked them how they managed to pull these chores off. Of course, I didn't want to let on that despite being a pediatrician, I had never thought about how a new mom takes her 6 week old infant grocery shopping. I mean I had seen a ton of infants at the store, but never paid attention to how they were toted.
Why didn't anyone tell me that being a mommy was hard mind numbing work?

As a pediatrician, at work, we often joke about how so many parents should have obtained a license to procreate. And here I was, MD and all, wondering, if I am so overwhelmed, with a loving husband, supportive family and tons of friends, how crazy are my patients lives?

And why, why didn't anyone tell me that breast feeding is harder than medical school? I mean, every 2 hours, from start to finish only leaves you an hour between feeds after a 30minute feed, burping and diaper changes!

So here is my advice to new and old parents:

1.) Definitely, "never, say never"-- especially not to your kids.

2.) Use your family and friends for whatever help they offer ( previously, I never wanted help/interference)

3.) Never discount anyone advice, if it doesn't apply yo you discard it. (Most advice from mom's I have found useful in some form)

4.) I never thought I would pick up a dirty pacifier from the floor and hand it to my child, but you do what you have to sometimes.

5.) I never thought I would still be breastfeeding at 6 months post partum. ( I am a pediatrician, I know its great for the baby, blah blah blah,)
But here I am, 9 months later, still doing it. Not sure that I enjoy it, and not sure that I don't either.

As I write this, I am filled with conflicting emotions-- Mostly, I love being a mom, but sometimes I am so exhausted I need to scream.

That said, my daughter is 6 months old now, and I can see myself doing it all over again, and loving every minute, but realistically only a minute later.

So here I am, the beginning of my re-education.

Confession of a Dr Mommy