In my early days as a pediatrician, I felt a little bit at a loss when parents asked specific parenting questions. Of course, I could offer them advice and refer resources but it was as a physician unaware to the nuances of parenting.
The tactile temperature
When talking about a fever, it is common for a parent to answer, ‘yes, at least 102F.’
Now, a thermometer gives one measurement not a range. So how were they measuring a fever? To clarify, the parents responded, “I could feel it. My child felt really hot, not like a 99F fever but closer to 102F fever’. Ah, the tactile temperature.
After becoming a parent, I found that there is some merit to the tactile temp. One can differentiate various levels of “feeling hot” although it may not always correlate with a fever. The tactile temperature is not a replacement for a measured temperature, of course, but it does give a sense of whether the child feels warm enough to bring out thermometer. Knowing now that sometimes parents can associate tactile temps as fevers without the child having an actual fever (100.4F or more), I find these are good educational points to review about fevers, when to treat and when to watch, the importance of monitoring fever curve with recorded temperatures confirmed on a thermometer. This way, we are all on the same page and child receives the proper treatment.
So many ways to feed a baby: breast, bottle, pumping, formula, triple feedings. Let’s take breastfeeding. The benefits are many and well documented. Prior to having a baby, it is told to moms to be about how wonderful, natural, and amazing it is, especially to build a bond between the mom and baby. All true. But, does anyone tell you how freaking hard it is? And that the desire or willpower on mom’s part may not be enough for exclusive breastfeeding? A mom can be recovering from an c-section, baby not latching, delayed milk production, a combination of factors can lead to excessive baby weight loss and approach has to be modified for the health and safety of mom and baby.
I was empathetic before I had my own kids but now having experienced some of the challenges with feeding, I now take extra time to tell the parents, especially moms, that they are doing a great job and to hang in there. I want moms to know that this is going be a few rough days, not to give up on breastfeeding if that is their goal, and that it is ok to supplement with formula. Wait–did you say formula, you ask. Yes, I did. And here’s why: breastfeeding is best but formula is a friend too and it can help reach goal of breastfeeding despite an initial rocky start. When it comes to feeding–or parenting, or anything really–no need for extremes.
“Not a good sleeper”
Oh so much information on sleep. Letting a baby self soothe when waking up in the middle of the night? Putting kid to bed drowsy but awake in crib and she should drift off to a peaceful slumber? Oh that is funny! Someone please let my kids know about these things because they had different ideas on sleep. They hated their crib but loved their toddler beds. Go figure.
After experiencing the adjustments that each kid requires, I make sure to tell the parents of my patients not to worry if their child isn’t following ‘the rules’. It doesn’t mean that something is wrong with their child.
Generally, I have found that kids respond to a predictable bedtime routine and it is ok to soothe the child as well. If the child is crying, it is because he or she needs something, even if it is just your presence. As we know, parenting doesn’t end at bedtime. Regardless of whether parents choose to safely cosleep/room share or let the child sleep in an independent room, I like to empower parents with safe sleep options to give the child the closeness he or she wants and still allow the parents to get some sleep too.
The meaning of being tired
I thought the sleepless nights of residency were tough. And then I had children where one is on call 24-7 and no sick days or post call days to rest. I think back to my fellow residents and attendings who were pregnant or had little ones in residency and I wish I had known to bring them a cup of coffee with an extra shot of espresso.
Being chronically sleep deprived and having to function pleasantly and proficiently is no easy feat, regardless of if one is working at a job or as a stay at home parent. In any case, if you are a parent or a caregiver of a child, I commend you for doing a great job of taking care of your family.
I recommend that parents try not to add to their tiredness by over-scheduling or trying to do too much during the day. Try to rest when the baby rests. Though it may seem that using nap time (or bedtime) to squeeze in extra chores or catching up on work adds to efficiency, it really just compounds the exhaustion. And then when baby wakes up with energy, you are just more tired and cranky.
Yep, I’ve been there and two kids in, I’ve come to realize that making time during the day for little breaks of parental rest is very important for well-being. I use their nap time to have a little me time, whether it doing a quick yoga session, reading a book, or taking a nap with the kids. Then, I feel rejuvenated when the little one(s) wake up. I recommend making these little changes during the day if possible. Nap time doesn’t mean time for more work, it means scheduled break (guilt free) for yourself. So, do something fun or something relaxing. It is your time. Enjoy it.
Finding work life balance
Easier said than done. Most of us are struggling to do it all and to do it all well. That is not easy. We are pulled in so many directions and there seems just not enough time in the day for everything. I want to be an amazing doctor/parent/spouse/friend/sister/daughter/etc. I’m sure most of you have similar lists. Most days, I just straight up forget to put myself somewhere on the list. If I did remember, I’d be way on the bottom or as an addendum.
To prevent burnout, I’m trying to make myself more of a priority. As the saying goes, you can’t pour from an empty cup. So, really, taking time for self care helps the other people in your life, at home and at work.
Every Day is a Learning Experience
Of note, having kids is not a prerequisite for being a good physician. Nor does the choice to not have kids take away from being a good physician. For me, kids have been the impetus for personal and professional introspection.
I appreciate on a deeper level the interplay of factors and challenges in caring for a child, especially parental preferences on how to approach child rearing. These different parental philosophies affect how readily a pediatrician’s advice is accepted or the challenges at finding common ground if there is difference of opinion. I knew variations existed before I became a parent but I didn’t really know what each entailed.
From attachment parenting, Ferberizers, anti-vaxxers, formula vs breastfeeding, helicopter vs free range, gentle parenting, modified versions of these. There are a lot of parenting decisions to make. I appreciate the depth to which parents try to make the best choices for their kids and family. Working together as a team is of utmost importance for the health and happiness of the child and their caregivers.
Of all the encounters, my favorites are the ones where parents ask questions and discuss parenting strategies. I love being able to educate and empower parents to take the best care they can of their child. I’m right here with the family, both as a pediatrician and as a fellow parent. It’s a learning experience and I am glad we are in it together.