Strollerderby : pediatrician poll

Pediatrician Poll: Nanny vs. Daycare

editors — Fri, 16 May 2008 16:00:00 GMT

Q: Which is better for kids (if economics aren't a factor) — nanny or daycare?

Nanny: 35%
Daycare: 12%
Depends on the child's age and circumstances: 53%

"Nanny before age two. Daycare is better after that, because children are social little beings and love to be around other kids." — Kim Gush MD, FAAP. Chapel Hill, NC

"There are pros and cons for both. With a nanny, you have the convenience of being at home, more flexibility with hours, less exposure to illness; with daycare there's more opportunity for social interaction with other children and more adults around monitoring each other, but also more exposure to infection." — Julie Luttinger, MD, FAAP. NY, NY.

"That is so individual; it really depends on family circumstances." — Lawrence Rosen, MD, FAAP. Old Tappan, NJ.

To obtain these results, Babble randomly called 300 AAP-approved pediatricians in 50 states, then tallied the answers of the 20 who called back. Pediatrician Poll appears in Strollerderby every Friday.

Pediatrician Poll: Behavioral Problems

editors — Fri, 02 May 2008 16:00:00 GMT

Q: What is the most common behavioral problem you see?

Tantrums: 35%
Discipline problems: 29%
Sleep problems: 12%
Attention problems: 12%
Fighting: 6%
Anxiety and stress: 6%

"Parents worry a lot about tantrums, which aren't really a problem but are seen as one." — Erik Cohen, MD, FAAP. Greenwich, CT.

"Children not being taught how to sleep, or not getting enough sleep — a lot of things come out of that." — Lisa Kaufman, MD. NY, NY.

"Many parents have questions about discipline. What to expect of a child at a certain age when it comes to following directions, doing chores, stuff like that." — Patricia McGuire, MD, FAAP. Cedar Rapids, IA.

Pediatrician Poll: Common Questions

editors — Fri, 25 Apr 2008 16:00:00 GMT

Q: What is the most common question parents have for you?

Feeding and sleeping questions: 48%
Safety of immunizations: 17%
"Is he growing okay?": 17%
Pooping: 12%
Can't answer, it varies too much: 6%

"Two major topics are sleep and nutrition. Sleep is a big issue, especially these days in my practice in Manhattan, also discipline issues and how to deal with children at different ages." — Lisa A. Kaufman. MD. NY, NY.

"Questions parents have vary with the age of their child. Feeding questions are most common, followed closely by stooling. People are worried sick about their children's poop, we are anally hung up." — Charles I. Shubin, MD, FAAP. Baltimore, MD.

"Feeding concerns are common, when to start solids. When kids get to 18 months they stop eating. Questions about development and questions about potty-training and constipation are also big." — Erik Cohen, MD, FAAP. Greenwich, CT.

Pediatrician Poll: Child Spacing

editors — Fri, 18 Apr 2008 16:00:00 GMT

Q: What is the ideal spacing between children?

One to three years: 47%
Three to five years: 24%
Whatever feels right for the family: 29%

"At least one year, but the decision lies with the family. If the sibling is under three or so, you just have to accept the fact that you have two babies; they can't be expected to be big kids and give up the nurturing and attention that they need at that age." — Ann Kellams, MD, FAAP. Charlottesville, VA.

"There is no ideal spacing. This is parental preference. Some plan what they think is ideal spacing for them, but then it doesn't happen that way." — Eugenia Marcus, MD, FAAP. Newton, MA.

"I've seen all kinds of spacing between kids work out great. If I wasn't under the gun of a biological clock, I'd love to have 3 years between children." — Julie Luttinger, MD, FAAP. NY, NY.

Pediatrician Poll: Antidepressants

editors — Fri, 11 Apr 2008 16:00:00 GMT

"Prozac and many of the SSRIs have shown themselves to be safe. They can also help against postpartum depression. The benefit of allowing the mother-child bond to form properly can outweigh the negative. Many of my patients are on anti depressants." — Erin Thelander, MD, FAAP. Brooklyn, NY.

"Safe is relative but, by and large, we don't want to take chances in those situations." — Charles I. Shubin, MD, FAAP. Baltimore, MD.

"It's a balancing act. If the mother needs medication it is much better for her to have it." — Patricia McGuire, MD, FAAP. Cedar Rapids, IA.

Pediatrician Poll: Cord Blood Banking

editors — Fri, 04 Apr 2008 16:00:00 GMT

"I tell people it is still a rather new science and that it is expensive. The chances of needing the cord blood are pretty low. If I myself was going through it today, I probably wouldn't do it. It's a bit like having meteor insurance — it is beneficial should anything happen, but it is so rare that you will need it that it is not necessarily worth the money. It can't hurt, though." — Kenneth Saul, MD, FAAP. Thousand Oaks, CA.

"This is a new procedure which, so far, hasn't proven its worth or longevity. But if you want to spend the money (it's not cheap), you have only one chance to make the decision, which is when your baby is born. If it proves to be life-saving later on, it will pay for itself many times over. But we don't know that now." — Eugenia Marcus, MD, FAAP. Newton, MA.

"It can be life-saving, but it's very expensive and the likelihood that you will ever need the cord blood is very low. If money is not an issue, I always tell people to make sure the bank has been around and is reliable. Some banks have fallen under and people have lost their cord blood." — Erin Thelander, MD, FAAP. Brooklyn, NY.

Pediatrician Poll: Television

editors — Fri, 28 Mar 2008 16:00:00 GMT

"Under the right supervision, TV is okay. It really depends on what they watch. In general it's not harmful, but there is a lot of misleading information on TV that kids can't process." — Erik Cohen, MD, FAAP. Greenwich, CT.

"TV should never be a babysitter. But if a parent sits down with their 18-month-old and together they watch an educational and stimulating TV show, that can be quite healthy." — John W. Waidner, MD, FAAP. Jacksonville, FL.

"We don't know definitely that it is bad, but we do know it has no benefits. That includes videos, DVDs; all screentime." — Kim Gush MD, FAAP. Chapel Hill, NC.

Pediatrician Poll: Vaccinations

editors — Fri, 21 Mar 2008 16:00:00 GMT

"Yes, I do accept patients who don't immunize. My opinion is that every child and their parents deserve the best pediatric care available. My job is to educate. If those are their beliefs, I don't hold it against them." — Kenneth Saul, MD, FAAP. Thousand Oaks, CA.

"We are very, very pro-vaccination. All of our vaccines are thimerosal-free. I try to do all I can to convince parents that they are taking a much greater chance not vaccinating than they are doing with vaccines. We do have a handful of parents who, despite our best efforts, choose not to vaccinate. We continue to see those children, but we insist that the parents sign a waiver we have indicating that we are 'agreeing to disagree' on this issue and having them accept full responsibility should their child contract one of the diseases in question." — John W. Waidner, MD, FAAP. Jacksonville FL.

"We do not accept parents who totally refuse to vaccinate; however, we have parents who customize their children's vaccination schedule." — Andrzej Klos, MD, FAAP. Hoboken, NJ.

Pediatrician Poll: Organic Food

editors — Fri, 14 Mar 2008 16:00:00 GMT

"I'm not an organic foods fan. I think there is a degree of fraud in the organic business. That's not to say that there aren't problems surrounding the way we eat, but I don't think all organic is the answer." — Charles I. Shubin, MD, FAAP. Baltimore, MD.

"I think organic food is good. But it isn't possible to get away from all toxins. There isn't enough evidence that all organic is healthier in the long run, so I encourage organic food, but I don't push it." — Kenneth Saul, MD, FAAP. Thousand Oaks, CA.

"The FDA has a list that shows which vegetables are particularly exposed to toxins and hence more important to buy organic. Apples are one of them. If money is an issue, you can look at that list. It is important to lower exposure to toxins." — Erin Thelander, MD, FAAP. Brooklyn, NY

Pediatrician Poll: Lollipops

editors — Fri, 07 Mar 2008 17:00:00 GMT

"Not balloons, but lollipops, stickers and rubber duckies. We have a treasure box with age-appropriate treats." — Kim Gush MD, FAAP. Chapel Hill, NC.

"No, we have stickers, fake tattoos and bracelets." — Robert D. Saken, MD, FAAP. NY, NY.

"Absolutely no. We have stickers and child-safe toys, a bowl of fruit and water." — Erik Cohen, MD, FAAP. Greenwich, CT.

Pediatrician Poll: Pacifiers

editors — Fri, 29 Feb 2008 17:00:00 GMT

"Pacifiers can be detrimental in the first few days of life before breastfeeding is established. After that and up until six months I am for them, as recent data shows pacifiers may help protect against SIDS." — Ann Kellams, MD, FAAP. Charlottesville, VA.

"I have been for pacifiers even without the academy coming up in favor. The main reason I like pacifiers is because they can be controlled. You can't cut off a thumb, but you can take away a pacifier." — Charles I. Shubin, MD, FAAP. Baltimore, MD.

"Once breastfeeding is established, I have found that most infants can use a pacifier without adverse effects. New data suggests that pacifier use might actually decrease SIDS cases as well." — John W. Waidner, MD, FAAP. Jacksonville FL.

Pediatrician Poll: Circumcision

editors — Fri, 22 Feb 2008 17:00:00 GMT

"We always tell parents there is no medical reason to circumcise, but we respect cultural obligations." — Kim Gush MD, FAAP. Chapel Hill, NC.

"I am for circumcision. New evidence shows less transmission of AIDS in circumcised men. This is a world-wide issue." — Eugenia Marcus, MD, FAAP. Newton, MA.

"In my opinion, this is more of a social/religious decision than it is a medical one. I discuss the pros/cons with parents and let them decide." — John W. Waidner, MD, FAAP. Jacksonville, FL.

Pediatrician Poll: Attachment Parenting

editors — Fri, 15 Feb 2008 17:00:00 GMT

"I'm not sure what that means. I would hope that all parenting is attached." — Patricia McGuire, MD, FAAP. Cedar Rapids, IA.

"I'm neutral. There is no one parenting strategy that works for everyone." — John W. Waidner, MD, FAAP. Jacksonville, FL.

"I'm neutral, except for sleeping in the same bed, though a co-sleeper is OK." — Robert D. Saken, MD, FAAP. NY, NY.

Pediatrician Poll: Spanking

editors — Fri, 08 Feb 2008 17:00:00 GMT

"Neutral. I think that time out is often equally effective, as are other behavioral modification techniques. There are some children for whom spanking, done appropriately, is effective and safe. I am a very well-adjusted, successful professional who was spanked by my mother, whom I still love dearly to this day." — John W. Waidner, MD, FAAP. Jacksonville, FL.

"I'm against spanking. It sends the wrong message that violence is an acceptable means of conflict resolution." — Eugenia Marcus, MD, FAAP. Newton, MA.

"I am anti for the most part. I think there are other forms of discipline that are effective." — Julie Luttinger, MD, FAAP. NY, NY.

Pediatrician Poll: Swaddling

editors — Fri, 01 Feb 2008 17:00:00 GMT

"With colicky newborns, swaddling simulates the womb experience. However, it is bad for babies with hip dysplasia." — Erik Cohen, MD, FAAP. Greenwich, CT.

"Swaddling is good if it comforts the baby. Some babies won't tolerate it and shouldn't be forced." — Robert D. Saken, FAAP, MD. NY, NY.

"It is a good way to soothe newborns, as long as the blanket doesn't get too close to the face." — Ann Kellams, MD, FAAP. Charlottesville, VA.

Pediatrician Poll: Breastfeeding

editors — Fri, 25 Jan 2008 17:00:00 GMT

"That's a personal decision. I have no problem with parents making a decision not to breastfeed. If you can get to six weeks, I think you've done a great job. Longer than that depends on the individual family's circumstance." — Julie Luttinger, MD, FAAP. NY, NY.

"As long as she can. Even past a year if possible." — Tamar Magnas, MD. NY, NY.

"One year is always optimal, but a lot of women have to go back to work, and that makes it difficult. At least six months can be a more realistic goal for most. That can help minimize food allergies." — Erin Thelander, MD, FAAP. Brooklyn, NY.

Pediatrician Poll: Potty-Training

editors — Fri, 18 Jan 2008 17:00:00 GMT

"There is no ideal age. You do it when the child is ready and that's more of a range. With girls it's two to two-and-a-half years, with boys two-and-a-half to three years. 'Training' is a misnomer. You can't train kids. They do what they're ready to do." — Charles I. Shubin, MD, FAAP. Baltimore, MD

"I usually start talking about it at 18 months, but it's not completed until the child is about to start preschool. I always let the child initiate the process." — Erin Thelander, MD, FAAP. Brooklyn, NY.

"When a child shows that they are interested — before age five." — Erik Cohen, MD, FAAP. Greenwich, CT.

Pediatrician Poll: Injuries

editors — Fri, 11 Jan 2008 17:00:00 GMT

"A lot of accidental touching of things like fire and hot water." — Patricia McGuire, MD, FAAP. Cedar Rapids, IA.

"Falls with bruises. Kids' bones are really hard to break and they should run around and fall down, but when they are toddlers they don't really watch what they're doing." — Charles I. Shubin, MD, FAAP. Baltimore, MD.

"Head injuries, with toddlers or infants falling out of their parent's arms, or falling at the playground. Burns are also common." — Erin Thelander, MD, FAAP. Brooklyn, NY.

Pediatrician Poll: Illnesses

editors — Fri, 04 Jan 2008 17:00:00 GMT

"URIs (upper respiratory infections) are the most common, and I think in the total picture, gastrointestinal problems. Ear infections have really been cut back since the introduction of pneumococcal vaccine." — Charles I. Shubin, MD, FAAP. Baltimore, MD.

"We see a lot of upper respiratory infections, variations on the common cold." — Kenneth Saul, MD, FAAP. Thousand Oaks, CA.

"The illnesses I see most often are: the common cold, stomach viruses, ear infections, sinus infections and strep throat. Also we see a lot of allergies, asthma and eczema." — John W. Waidner, MD, FAAP. Jacksonville, FL.

To obtain these results, we randomly called 300 AAP-approved pediatricians in 50 states, then tallied the answers of the 20 who called back.

Babble Poll: Doctors Not So Into Spanking

Kelly Mills — Mon, 07 May 2007 18:54:00 GMT

The results of the Babble pediatrician poll are in, and not very shocking. Doctors don't think much of spanking as discipline. Interestingly, when Babble polled dominatrixes, the results were exactly opposite: 88 percent were pro spanking, and 12 percent neutral. I think maybe the 12 percent were feeling some career angst.

Here's my favorite rule of thumb for discipline: the long term goal is to teach life skills, so I try not to practice anything with my child that we adults wouldn't tolerate in the grown-up world. If someone disapproved of my actions and swatted me, I would probably call the police. Yelling is also not generally effective for getting people to change their behavior (though I'll be the first to admit I've done this one with my kid on bad days.) However, time-outs are actually a helpful strategy for adults as well as kids--when I get really pissed and I'm using my outside voice or whining, it really does help to have some alone time to pull myself together. I don't have a naughty seat for myself, though the closest thing would be sitting on the throne in the bathroom (um, lid down, it's not that kind of story) taking deep breaths in my own special time-out corner. Many of us adults have learned that if we can't be responsible with our toys, the repo man or the credit card company will come and take away our privileges. And if we really can't behave, or neglect all responsibilities, we get grounded. In short, I think discipline ought to be more like the natural consequences of our choices, real world kind of stuff, and less like, "Mommy said so, now behave, or I'll give you something to cry about!" C'mon, I'm not making this up, there's books on this.

Though I'm not sure if the pediatricians are on board with all of that. Or the dominatrixes.

Television Before Two? Babble Finds Out.

Patti — Mon, 19 Mar 2007 22:21:00 GMT

As parents and as bloggers, we love to talk about television around here. The bad, the good, the ugly, the useful, how much, if at all. We're all products of our generation, with a healthy background in pop culture and so television, frankly, interests us both in and out of the context of childrearing. Several of us probably wish we could marry our Tivos, or maybe that is just me.

But the Strollerderby bloggers' observations of what other people are saying about television and our own interpretations thereof are just the ravings of people who happen to have kids. For a look at what card-carrying experts are saying about the question of whether young children and babies should be exposed to television, Babble didn't come to the blogging staff, but instead went to actual pediatricians for the scoop. And it breaks down just about how it does every time I get cornered into a conversation about television on the playground, so possibly being a pediatrician doesn't make you any more of an expert on television than being a parent does.

I notice that the quote from the "con" side of the television question admits that television isn't necessarily bad (although we know it might be), just useless. That is a pediatrician who has never ridden for eighteen hours in a Volkswagen Jetta through the barren Southwestern desert with two children under the age of two.

The American Academy of Pediatrics' official statement on television can be found here.