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How to find a Pediatrician?

When should a newborn see the pediatrician for the first time after discharge from hospital?

a newborn just released from the hospital will usually go to their first well visit with the pediatrician in the first 2-3 days. The American Academy of Pediatrics recommends a checkup with a doctor at least 72 hours after the newborn has been discharged from the hospital.  This is why it is important for the parents and caregiver to start searching for a pediatrician before the baby is born.

What is the role of a pediatrician and what do they specialize in?

A pediatrician is  a doctor that that has special training with infant, children and adolescent. They have completed college, medical with a pediatric residency of three years. After this they take a test and get certified by American Board of Pediatrics.

When should a pregnant women start looking for a pediatrician for their unborn child?

Pregnant women should start their search for a pediatrician between 28-36 weeks. It is good to do this early because once the baby is born the mother will be busy with caring for the baby and the last thing on their mind should be looking for a pediatrician.

A study done by Evaline Alessandrini  a pediatrician at the Children’s Hospital in the city of Philadelphia, which co-authored found that babies who have the same doctor for the first six months of their lives are more likely to have important health tests run on them  before they turn the age of two.

How do I start looking for a pediatrician?

  1. Word of mouth. Ask family and friends. Many may give you good references on a pediatrician based on their experience and interaction with them.
  2.  Start early. You should really be looking for one at 24-36 weeks. This way you can take your time and be able to decide on several doctors and make a quality selection.
  3. Look into the American Association of Pediatrics website http://www.healthychildren.org for a list of board certified doctors that you may want to consider. 
  4. Ask your OBGYN  physician and hospital of delivery for assistance. They might be able to locate a doctor and provide a referral for a doctor that is affiliated with the hospital
  5. How often should a newborn see a pediatrician?                                            After the first visit the baby will have well visits at one month, two months, 4 months, 6 months, 9 months 12 months. This does not include the unexpected illnesses like fever and colds.                                                                                                                                  But you should see a pediatrician before the baby is born. True or False                                                                        The American Association of Pediatrics suggests that pregnant women should have a prenatal visit with a pediatrician that they are considering for their unborn child. This might be helpful for pregnant women who face a high risk pregnancy, experience complications, expecting twins or adopting a child.
  6. During this prenatal visit, the pediatrician can discuss with you about safety of the newborn, car seats, how the baby should lay down to sleep on their backs not their stomachs, an other issues and concerns. This is an opportunity to discuss breastfeeding, immunizations circumcision and how to bring up an healthy child.

    What should I look for in a pediatrician?

    • Check credentials.  Do your research. Make sure they are certified by American Board of Pediatrics.Where they went to medical school? Where did they do their residency? Check how many years have they been practicing and what other experience do they have for example emergency room experience. Are they affiliated with a hospital?
    • Check how they run their practice. Do they have a free consultation session where you can meet them? Are they taking new patients? Do they accept your insurance? How long is the wait time in the waiting room? How can they be contacted in case of an emergency? What happens if your baby gets sick in the middle of the night? Do they make house calls? What are they hours? Do they have extended hours, late or weekend hours? Do they offer same day sick appointments?
    • The relationship. Are you comfortable with asking questions without feeling guilty or embarrassed. Is the doctor patient with you and respects your decisions about the care of your child without being judgmental. How does the doctor feel about breastfeeding, circumcision or you deciding not to vaccinate your child.
    • This is for once the baby is born and meets the pediatrician for the first time. How do they interact. Does the doctor interact well with children and your child?
    • Ask Do they read academic journals and what academic journal do they read?

      This is an important question because according to a study done by Doximity, they found that 75% of physicians alter their practice because of something that they read in a medical literature journal. For example, in 2015 a clinical study called  LEAP. published results that early introduction of peanuts actually  reduce the rate of peanut allergies. Before this study pediatricians were advising parents to wait to introduce peanuts to children until the age of three.

      What do pediatricians do?

      1. They administer medications
      2. They detect problems early on.  Developmental and behavior problems
      3. Diagnosis of common illness

      * flu

      * fever

      *cold

      4. promote health by informing the caregiver on nutrition, developmental delays, growth.

      5.  work with other professionals psychologists, social workers ect..

      The first contact with a pediatrician for a newborn is in the hospital 24-48  hours after they are born. Newborns are given an apgar score. This tests checks for the heart rate, muscle tone, reflexes, skin tone and other medical care needed. The test is given in the first minute the baby is born and then is repeated again after five minutes after delivery.

      Other test done on newborns is two types of hearing tests. The American Academy of Pediatrics (AAP) does recommends hearing screenings for all newborns

    •  This is necessary because 1 out of 3 in 1,000 babies born have difficulty hearing

      The (ABR) Auditory brain stem response provides information abut the softest level of sound the newborn can hear where sounds are placed on their head to detect response.

      The second test is the (OAE), the Otoacoustic Emissions  test where it measures the sound waves in the inner ear. This test is administered by placing a probe inside the baby’s ear canal. Tones are played in baby’s ears and it measures responses.

      If these tests are done early enough and a hearing problem is detected they can be enrolled in early intervention to start treatment.

      Another test done to baby’s that are just delivered is a newborn metabolic screening. This helps rule out PKU, sickle cell and other genetic disease.

      What should you expect during the first visit with your newborn and pediatrician?

      During the baby's first checkup the pediatrician will check their eyes, ears, nose, skin and limbs for any abnormalities. They will check their weight also

    • Be aware that babies lose weight right after discharge but by the second week they start gaining weight steadily.

      They will inspect the umbilical cord to see if it is healing properly

      If a boy has been circumcised the pediatrician will check to see if the penis is healing properly and see if there is any kind of infection.

      If the baby has developed jaundice. This is a temporary condition when the baby’s skin is yellow.

      First developmental milestones. Does the baby move their arms and legs. Are able to focus on a object 8-15 inches in front of them. Are they able to lift their heads for a brief moment on their tummies.

      They check to see if the baby has certain reflexes.

      1. The Rooting Reflex. This reflex occurs when the corner of baby’s mouth is stroked or touched. Then the baby will turn their head in the direction of the stroking. This reflex helps the baby find the breast or bottle to feed. This reflex lasts about 4 months

       2. Suck reflex. This reflex starts about the 32nd week of pregnancy and is not developed until about 36 weeks. When the roof of the baby’s mouth is touched the baby will start to suck.

      3. The Moro reflex. This reflex is often called the startle reflex. It only occurs when a baby is startled by a loud noise of movement. The baby will throw back their head extend his arms and legs, cry then pull arms and legs back in. This reflex lasts for about 2 months after baby is born.

      4. Tonic neck reflex is when a baby’s head is turned to one side, the arm on that side stretches out and the opposite arm beds up at the elbow.  It lasts for about 5-7 months. It called often the fencing position.

      5. Grasp reflex is when one strokes the palm of baby’s hand and the baby closes their fingers in a grasp. This reflex lasts about 5-6 months.

      *Babies have a similar grasp in their toes. This last 9-12 months*

      6. A Steeping reflex. This reflex lasts for about 2 months. The baby appears to take steps of dance when help upright when their feet is touching a the ground or a solid surface.

      These are some tips and advice from pediatrician to make your experience better at the doctor’s office better for you and baby

      1. Ask questions. Questions should be encouraged. The engagement increases and makes a better relationship with the doctor.
      2. When you make an appointment schedule it in the middle of the week.
      3. Keep visitors to a minimum during the first 8 weeks of newborn’s life. This helps them increase their immune system.
      4. have the family member or person touching the baby to wash their hands because their immune systems’s are weak.
      5. make sure there is nothing inside their crib. Only a fitted sheet. This reduces the risk of SIDS
      6. keep your wellness appointments. These appointments. This will help the doctor diagnose physical and developmental issues that may intervene with the child’s development.

      Please download your checklist on the top ten questions parents and caregivers should ask the pediatrician

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