interveiwing a pediatrician

[stcelia]

DH &I are inyterviewing a ped on wed. Since there are no peds who will come out and say they've been bought out by the formula industry, what questions can I ask to determine his real views on BFing? We're hoping to find someone really supportive & natural minded.

FWIW, we are leaving our current ped, because 1)she is very condescending, 2)doesn't seem to take me serious when I ask questions 3)talks to us as if we fell off the turnip-truck we hitch-hiked into town on. We're into natural medicine, try to avoid antibiotics except when really necessary, we are vaxing, but it makes me nervous and I want someone who will answer my questions. So we are switching, but I don't really know how to ask the right questions, the right way so as to find out this guy's real way of practicing. KWIM, Questions can be leading, and answers can not really tell much if the question wasn't asked properly.

I've asked around, but my friends love the lady we are leaving. I'm sort of a fish out of water around here. None of my friends breastfed more than a few days/weeks, none of them really question the what their drs tell them, etc. So, I could really appreciate help here.
TIA, Jenn

[knaidel]

Hi Jenn,
Totally with you on this one. We had a similar problem.
First off, I hope no one on this board takes this the wrong way, but a pediatrician who is younger and serves a higher socioeconomic population is where you might get lucky. (I have no idea about your current ped). At our first ped, the nurse at every visit would ask, "Which formula do you give your DS?" as it was a given that our kid gets formula! This practice takes Illinois Public Aid, so there were unfortunatley many patients who were totally in the dark about breastfeeding....and the nurses assumed everyone was like that!
I think the best question is to ask "How do you feel about extended breastfeeding?" Gauge the peds attitude by that answer. Also, you might say, "We have had positive experiences with complementary medicine. How do you feel about alternative treatments before resorting to antibiotics?" Something like that...make sure you sound like you know what you're talking about, and the dr. is more likely to take you seriously.
Also, I highly recommend you check out "Tribal areas" over at www.mothering.com/discussions. There, you can find other moms from your area and people are ALWAYS asking for recs. for a AP/BF friendly pediatricians. Also, you might want to cross post your ?? to the lounge, because there is a lot more traffic there.
Hope that helps!

[DebbieJ]

Where do you live?

I think the best way to find a pediatrician is through referrals from other people. To find one that fits with your philosphy of care, I would attend a La Leche League meeting and ask the other moms where they go.

Any ped can say they support BFing when in practice they may recommend something entirely different.

~ deb
DS 12/03
And a niece or nephew arriving in early August!

http://www.windsorpeak.com/dc/user_files/10029.gif

[Rachels]

I second the suggestion to ask on MDC. Also ask local LCs or homebirth midwives for their suggestions. Honestly, though, I was incredibly rigorous about interviewing, and still wound up with a ped whose practice was a whole lot different than what she led me to believe. The pressure to supplement was enormous. I wound up leaving for a different (acutally bf-knowledgeable) ped when Abigail was three weeks old, but it was torture until then. As a new mom, you're VERY vulnerable, much more so than anybody tells you. It's very hard to go against a doctor's advice when you're in that state, even if you're sure the advice is total crap. In retrospect, I would have made things a whole lot easier on myself if I had given myself permission before she was even born to change peds. I had worked so hard making my choice that I felt really terrible about having made the wrong one, if that makes sense. If I had allowed myself the knowledge that there was really no way to know until my baby showed up what her ped would truly be like and to know I'd change at the first sign of trouble, I would have spared us all a lot of agony.

That said, ask a few questions about normal newborn weight loss, breastmilk jaundice, and nipple confusion. If the word "formula" comes up quickly with any of these topics, consider it a red flag. You're not right out of the starting gate anymore, but it helps to know how a ped treats mamas who are, kwim?


-Rachel
Mom to Abigail Rose
5/18/02
New baby coming in October!
(Holy smokes, it's a boy!!!)


"When you know better, you do better."
Maya Angelou
http://www.gynosaur.com/assets/ribbo...ethyst_36m.gif
Nursed for three years!

[murpheyblue]

Perhaps you can pose some, 'what would you do/say/recommend if . . ' questions. Such as what would you recommend if a BF baby was on the low end of the growth chart. See if the answer is BF more or supplement.

For me, I didn't need to have someone who subsribed to everyone of my beliefs about child rearing (sure, it would be nice). I'm nt raising DD the way the ped would/did raise her own but she's always been very open to my parenting style (co-sleeping, no CIO, BFing). Despite DD practically falling off the charts for weight she never told me to supplement her or give solids early or questioned me as if I was doing something wrong.

I hope you find someone you love!

[JTsMom]

I'm stealing the following from the book So That's What They're For!
I'm just going to put down some highlights, but if you have access to the actual book, try page 56.

-You can simply ask, though 90 percent of doctors are initially supportive of breastfeeding.

-Male Dr. w/kids- ask if his wife bf and for how long (or if female, if/how long she did)

-What % of moms in his/her practice bf, and what % still bf at 1 yr.

-Ask what is important about bf?
-How much bf education do you have?
-Is anyone in your practice board-certified in lactation?
-To whom do you refer bf difficulties.

Look out for answers like "it's not for everyone"

Hope this helps. We are going to have to find a new ped too, so I feel for you! Good luck.

[KrisM]

I ask open ended, non-leading questions. For example, instead of asking "How do you feel about extended breastfeeding", I would ask "How long do you think a child should be breastfed". In the first question, the ped is going to know you're interested in extended BFing and probably answer with something you want to hear. You might still get that with the 2nd way, but may get something more honest.

[Sillygirl]

I know you're quoting from the book, so this isn't directed at you but rather at the author. I think quizzing the doctor about their own or their family's BF choices is out of line.

It's weird, because doctors have to ask you about all sorts of personal stuff about your sex life and bowel movements and everything else. Perhaps that's why it's so important to have strict boundaries. I don't discuss my personal life with my patients and if someone asked me that sort of question I would deflect the discussion to more general terms. Even though I know a lot about my patient's personal lives, that's my job. There isn't a quid pro quo. Of course, patients who feel strongly that they need to know these things about me probably are going to feel more comfortable in someone else's practice. But I know my feelings on the matter are not unique to me - a lot of my doctor friends share them.

JMO. The other questions are fine.

[tarahsolazy]

I think those questions are actually not bad ones to ask, about the ped's personal experience with BF. As a neonatologist who deals with new parents every day, I have become to believe that its caregivers with positive BF experiences that are real assests to new BF families. I'd assume that its the same in primary care peds. I have heard a couple of our nurse practitioners say, "I didn't have enough milk for my big baby", or "she lost interest in the breast at 7 months, and really, she had teeth already", and "formula is not the end of the world", or a nurse who said to me when she learned that I was "still" BF my then 11 mo old, "oh, you're one of THEM". My old male partners are all pro-BF as well, in their owm opinions, but "a formula bottle here and there can't hurt".

Moms are very vulnerable in those early months of BF, and thereafter, who wants to argue with your doctor? The MDs, RNs, NPs that people have contact with can really influence their choices. All the men and women who I describe above would say that they are very pro BF, BTW. I would be happy to share my personal experiences with patients, if they felt that information was important to our relationship.

[Sillygirl]

I don't mind offering it if I feel comfortable and if I think it would help a patient having a difficult time. In fact, I've done that. I just don't like the idea that patients are entitled to ask about my personal life and expect me to share those things as a matter of course. I would find it off-putting in the course of an informational interview.