I didn’t give much thought to choosing a pediatrician, other than finding one that was near our house. I got a recommendation from a friend, called them about 6 weeks before I had Maggie, and that was about it. My philosphy was that once I had the baby, I’d go to them for the first few appointments, and if it didn’t work out and I didn’t like them, then I’d switch to someone else.
Last Thursday, when we were still in the hospital, Maggie had jaundice. Her bilirubin levels were high enough to warrant her undergoing light therapy overnight Thursday night and most of Friday. So instead of being released on Friday morning as scheduled, we spent the day staring at her in an incubator. It was heartbreaking, but we knew that it could be something much much worse.
She was allowed out of the incubator only to eat, and had to be on a bili blanket while I was feeding her. We had to start supplementing with formula so that we could get as much food in her as possible in an effort to get the bilirubin out. With her being a bigger baby, it would take more than my body could produce at the time in order to flush out her system. By early evening on Friday, her levels were low enough that she was able to be released but had to come back for bloodwork on Saturday. The pediatricians at the hospital were fantastic to deal with and spent a lot of time with us. And the OB that was on rotation that day was kind enough to NOT release me until Maggie was released so that there wasn’t a chance that I would have to go home without my baby.
On Saturday morning, we went back to the hospital for the bloodwork, and got a call a few hours later that her levels were up again and that we’d have to have more bloodwork done on Sunday as a precaution. Of course, being first-time parents, we were a little freaked out. All I could think was that the bilirubin levels would get high enough to cause brain damage, and that something as “ordinary” as jaundice would escalate to something much much worse.
We went back to the hosiptal on Sunday to get additional blood drawn, and Mike and I decided to hang out in the cafeteria for the hour until results were available. Just in case something was wrong and she would need additional treatment or to be readmitted, we didn’t want to drive the whole way home just to have to turn around and come back. The pediatrician called us to tell us that the bilirubin levels were still high, even higher than the day before, but not quite high enough to treat with a bili blanket or additional light therapy. I talked to her for about 10 minutes, asking questions about the likelihood of a problem with her liver and other questions I had about jaundice and what to expect/look for over the next 24 hours until we saw our pediatrician for the first time.
It was then that I really began to appreciate a good pediatrician. We had been released from the hospital 2 days prior, but this woman was willing to spend as much time as necessary with me. Technically her “job” was done since we were no longer patients at the hospital and she could have easily blown us off with “Your regular pediatrician will answer any questions when you see her on Monday.” But she didn’t. She cared about us even though her obligation had already been fulfilled.
We went to Dr. F on Monday for Maggie’s 1 week well baby appointment and also as a follow up for the jaundice. I liked her immediately. In addition to having 2 children of her own–the youngest only 10 months old–she goes to the same OB as me and delivered at the same hospital. She also has a great personality and really listened to what I was saying, and I felt so at ease with her.
She spent a lot of time with us, answered the big list of questions I had, told us that the jaundice was clearing up and to keep doing what we were doing, and reassured us that we weren’t making a big mess of this whole parenting thing.
Maggie’s birth weight was 10 lbs 2 oz. When she was discharged last Friday, she was at 9 lbs 2 oz. At her appointment on Monday, she was 9 lbs 6 oz. Dr. F was very pleased with the rebound in her weight gain at only 6 days old. She asked us to come back on Friday just for a weight check and to further monitor the janudice.
We went back yesterday expecting to just see a nurse for the check. When the nurse weighed her, she was down an ounce from Monday, when she should be gaining half an ounce to an ounce a day. Dr. F made a point of coming in to talk to us, asked a lot of questions about how often she eats and how breastfeeding was going (not great so far, but that’s a subject for another post), and how much formula we were supplementing with. She could sense that we were struggling before we even said anything. Maggie had been sleeping in only 20 minute increments for the past day or so, crying a lot, was struggling to eat but acting ravenous at the same time.
Dr. F mentioned that her youngest had been the same way, told us how she personally had dealt with it, gave us additional suggestions, and most importantly, she asked us how we felt and what we were aiming for. I explained that ideally I’d prefer her to be breastfed exclusively. But since her blood sugar was low at birth and she had to be fed immediately in an effort to avoid the NICU, and then having to supplement with formula to get rid of the jaundice, that was shot from the beginning. Even now that my milk is in, I’m still not yet producing enough for her to maintain her weight, let alone gain any. She was able to reassure me that once Maggie gets back to her birth weight, I should be producing enough to support her needs and gave me some suggestions to help with switching between breastfeeding and supplementing to make things easier for both Maggie and me. All of this without having an appointment with her.
With her suggestions, today has been such an improvement on the past few days. Maggie is eating more, eating well, and sleeping so much better. We actually had to wake her up to eat a few times, which we haven’t had to do before (because she was always awake!). We go back to Dr. F on Tuesday and we’re hoping to get her weight up 4 to 6 ounces by then. If the next few days are anything like today, I don’t think that will be a problem.
The past week has taught me the value of having a good pediatrician. When we leave her office, all of my questions are answered and I feel confident that we’re able to take care of Maggie. With all of the stresses that go along with being a parent, it’s great to know that we have such a caring doctor!