Choosing the right doctor for your child is one of the many important responsibilities you have as a new parent.  The anxiety and stress this decision causes is not without reason.  Your child’s pediatrician will partner with you in your child’s medical care for the next 18 yrs.  Whether your child is healthy or has been diagnosed with a serious disease,  all parents strive to have a highly qualified doctor treating their child. My oldest is almost 18 yrs old and has had at least 3 pediatricians. I’ve also navigated Dylan’s care with pediatric hematologists and other specialists.   Here are some tips/questions I put together as an experienced mom of 3 boys to help with your search.

1.How long have they been practicing? 

I prefer to have a doctor who has years of experience, but stays up to date with new research and findings.  This can be a challenging breed of doctor to find.  Many experienced doctors are stuck in routines and don’t challenge these routines with new paradigms.  New doctors don’t have the hands on experience the text books can’t teach. Knowing how long the your doctor has been practicing is valuable in understanding their approach to medicine.  I would also research where they went to school.  Remember this is your partner and having as much information about their background will give you some insight to their thought process.

2. How diverse is their patient population?

Different communities are affected by different medical trends.  In the African American community we are not heavily impacted by lice, while the Caucasian community is not impacted by Sickle Cell Anemia.  Your pediatrician should understand disease states that may affect your child and your family. Understanding with anecdotal experience vs textbook experience is completely different.

3. Do they offer same day/walk in appointments?

Schools and daycares are cesspools. If your child is not in a protective bubble chances are they are going to be infected with something.  Your pediatrician should be accessible for those emergencies.  I don’t like dragging sick babies to the ER and try to avoid the ER at all costs.

First, an Emergency Room visit is pricey.  Especially if you don’t have insurance or a high insurance deductible your visit could literally cost thousands.  Second there are tons of bacteria festering in the ER.  Chances are you will leave with something you didn’t bring with you. Who are these ER doctors anyway ? Most of the times they are students practicing on your child and even if its an experienced doctor you have no idea about their philosophies and medical approach. Lastly, continuity of care is crucial.  This strange doctor has no clue about your child’s medical history and relies on your ragged memory to provide details that help them make medical decisions.

Some parents decide to choose Urgent Care instead of the ER for emergencies. They are cheaper and you’re not waiting as long to see a physician. My only issue is I don’t have a relationship with the urgent care doctor.  My other concern is continuity of care and keeping all of my children’s medical information in a central location.  When you have one child this may not be such a big deal, but when you have 3 and 1 with a serious illness this is crucial for my sanity.

4. Are they available after hours?

Accessibility is key.  I need to be able to speak to someone in the middle of the night if there is an emergency.  As a new mom you’ll discover the middle of the night is when things go wrong.  Fevers spike, vomit is spewed and nasal passages are blocked.  It never fails that nights are when things go awry for sleep deprived parents praying for a full night of rest. A call to your pediatrician should ease your fears or alert you when there is a need to seek immediate medical attention.

5. Do they have a child friendly bedside manner?

My oldest sons 2nd pediatrician had a horrible bedside manner.  She had resting bitch face and never made attempt to make him feel more comfortable in her office.  This is probably why he was deathly afraid of needles and getting blood drawn.  I liked her because she and I had similar philosophies about antibiotics, but when we moved I quickly switched pediatricians even though I still shopped at the supermarket near her office.

Pediatricians should at the bare minimum attempt to make your child feel less anxiety in their office.  Some people are not built to deal with children and they should not be teachers, pediatric nurses or pediatricians.

This will be difficult to assess without actually seeing the doctor interact with a child.  My suggestion is to get referrals from mommy/daddy friends and ask them this question.


6. What hospital are they affiliated with?

If possible you should choose a physician affiliated with the hospital where you’re delivering.  It makes the transition from birth to first visit seamless.  They will be able to visit the baby in the hospital and have access to their medical records via their digital records system.  Trust me my pediatrician is NOT affiliated with the hospital we typically go to for Dylan’s care and it can be a nightmare keeping her in the loop with hospital stays and lab work.

7. Do they treat children who are not vaccinated?

Many parents are opting out of vaccinations because of their link to autism and other side effects.  Some doctors are choosing not to accept these patients.  Even if you decide to vaccinate and then change your mind at some point you should know where your pediatrician stands on this issue.  Also if you’re not sure about vaccinations you don’t want your pediatrician attempting to convince you to make a choice you’re not comfortable with.

8. When do they prescribe antibiotics?

There is a very lengthy discussion that needs to be had about over prescribing antibiotics, but I wont dive into that pool here.  Find out specifically when they prescribe antibiotics.  Some doctors prescribe antibiotics more freely because patients come into the office with symptoms and demand treatment.  They prescribe to satisfy the patients and not because antibiotics are truly warranted. Understanding the philosophies of the practice is key when making your decision.

9. Do they have the ability to run labs in their office? 

This is about more than convenience.  If the office does not run basic labs they will have to send out your child’s “sample” and wait 24-48 hrs for results. In the case of strep throat and antibiotics are needed two scenarios will play out. The doctor will prescribe antibiotics in anticipation of a positive test result.  Or they will wait for the result and prescribe antibiotics the next day when a positive result has been confirmed.  Either scenario doesn’t sit well with me.  Should I be preemptively giving my child antibiotics without a confirmed diagnosis? Or should I be waiting 24 hrs while the bacteria festers untreated? If they are able to test in the office I receive the results immediately and can proceed with treatment accordingly.

10. Do they listen when you voice your concerns? 

This is another reason to get referrals.  Some doctors are programmed in the way they see patients.  Many of them are overbooked and only have 15 min to spend with each patient or less. Your mommy/daddy friends will be able to tell you if their pediatrician is rushing in and out of the room barely listening to the symptoms the child may be experiencing.  My personal physician asks tons of questions and listens closely to my responses.  He also poses very well thought out follow up questions.  I truly love his approach to my care and I never feel rushed in his office.  Choose a pediatrician who makes you feel comfortable discussing your child’s needs.

A pediatrician is there to help you assess a myriad of issues throughout your child’s life including developmental delays. sickness and even behavioral concerns.  Choose wisely.

Choosing a Pediatrician – 10 Questions to Ask Before You Decide

5 Folic Acid Facts You Didn’t Know

Dylan was officially diagnosed with Sickle Cell Anemia at 5 weeks old.  We left our appointment with 2 prescriptions, one for Folic Acid.  The doctor explained that Folic Acid will assist in red blood cell formation, which is crucial for sicklers whose red blood cells die faster than normal red blood cells.  I didn’t do much research on it at first because I thought, like everyone else,  that it is a vitamin and harmless.  However, after doing some research on Sickle Cell Anemia, the potential harm of Folic Acid started surfacing.  The risks increase especially in high doses over a long period of time.  Sickle Cell patients take 1,000 mcg of Folic Acid daily for their entire lives.

1. Folic Acid and Folate are NOT the same

Folic acid is the synthetic form of Folate.  Its manufactured to mimic Folate.  Folate is a water soluble B9 vitamin that is naturally present in leafy green vegetables, beets and citrus fruits to name a few Folate rich foods. Folic acid is added to foods like cereal, bread and rice.  Folic Acid and Folate are used interchangeably by the medical community. You will hear doctors and nutritionists talk about Folic Acid and Folate as if they are exactly the same.  I recently read one article where the author uses both Folic Acid and Folate with noting any differences.

2. Folic Acid is Metabolized in the Liver

Why is this important? The MTHF enzyme required to metabolize Folic Acid has a low capacity, leaving unmetabolized Folic Acid in the blood stream to wreak havoc. Some people do not even produce the MTHF enzyme at all.  Folate is metabolized in the mucosal lining of the small intestine.

3. Folic Acid Increases your Appetite 

Folic Acid is often given to increase your appetite.  This may actually explain why pregnant women have insatiable appetites as they are directed to supplement with Folic Acid to prevent NTD ( Neural Tube Defects) in their growing fetus.  During my 1st pregnancy I gained 70lbs.  I incessantly ate fast foods and supplemented with Folic acid as directed by my physician. During my last 2 pregnancies I gained less weight due to me being more health conscious.  My <a href="http://Prenatal Vitamins” target=”_blank” rel=”noopener”>prenatal vitamins also included Folate and not Folic acid. Who knows if this is the reason for the difference but its definitely something I consider.  This doctor certainly thinks there is a link between over eating and folic acid fortification in foods.

4. Folic Acid may cause Cancer

Data from two Norwegian studies that included almost 7,000 heart patients treated with B vitamin supplements or placebo for an average of three and one-half years between 1998 and 2005.

During treatment, blood folate levels among patients who took 0.8 milligrams a day of folic acid plus 0.4 milligrams a day of vitamin B12 increased more than sixfold.

Folic acid and B12 supplementation was associated with a 21% increased risk for cancer, a 38% increased risk for dying from the disease, and an 18% increase in deaths from all causes. (1)

a) Increased risk in lung cancer

b) Increased risk in breast cancer in postmenopausal women (3 )

c) Increased risk of prostate cancer with daily supplementation of 1mg of Folic Acid.  (2 )

5. Folic Acid may cause Seizures

This has not been definitively proven, but what they know is there is a link between Folic Acid and Seizures.  One school of thought is that the risk is only for patients who have a history of seizures.  But WebMD lists seizures as a general side effect when taking doses greater than 1,000mcg daily.  Please consider if you take 400mcg in addition to eating cereals, rice and bread fortified with Folic Acid you may easily creep past the 1,000mcg mark daily.  Sickle Cell patients start at 1,000mcg and are presumably well above if eating fortified foods.

Our Choice:

After weighing the long term risks of Dylan taking 1,000 mcg of Folic Acid daily, We decided to switch him to this brand of <a href="http://Folate” target=”_blank” rel=”noopener”>Folate .

We also are relentless about checking for Folic Acid in any multi vitamin, and foods we consume as a family.  Reading food packages have become a way of life for us.  We realize that it is impossible to remove all toxins from our environment and foods, but we make the best effort to reduce the amount we consume.  Especially for Dylan because Sickle Cell Anemia compromises his immune system making bacterial infections potentially lethal. His liver is also overworked removing dead red blood cells and other toxins from his blood.  Our goal is to minimize the impact of foods and supplements on his body even if it requires me to spend all my days and nights researching.

No Mom Should Receive Devastating Medical Results Over the Phone

“Your child has tested positive for strep. A prescription for antibiotics has been sent to the pharmacy for him to start today.”  This is a pretty common phone call for a parent to receive when they have small children.  Daycares and schools are bacterial war zones and kids are constantly bringing home unwelcomed viral and bacterial guests.  Its convenient for doctors to unload this type of medical information over the phone to busy parents.  In fact as a mom of two small toddlers I welcome this kid of consideration for my time.  When I have a doctors appointment for my 3 and 4 year old I’m anxious just thinking about getting a parking space close to the office and then schlepping the boys into the office and back to the car.

When I took my first HIV test many years ago it was a huge deal to come in to get your results.  Even though the results were negative I had my sister there for support.  The social worker was present to counsel me before and after the results.  This type of support is warranted for these types of life altering medical results.  However, this is not the support I received when my 5 week old son was diagnosed with Sickle Cell Anemia.  This debilitating disease is known to cause life long pain and numerous health issues which include stroke, organ damage and death.

My car desperately needed to be washed so I stopped at the car wash quickly before heading back to my new baby.  Dylan was 5 weeks old and I had just shared a photo of him on my social media.

Dylan 1st Pic Face.jpg

At the car wash my phone rings and I answered an unfamiliar number not knowing the life altering words I was about to hear.  I wonder how many times the woman on the other end has had to deliver heart wrenching news in her career.  How does she handle the guilt of literally ripping parents’ hearts straight out of their chests?  She said it so matter of factly.  You delivered a baby on  **.  His newborn screen came back positive for sickle cell anemia. We need you to bring him in ………….I had an outer body experience at this very moment.  Watching myself react to what literally was the worst possible news that I could hear.

I don’t really recall what I was feeling.  The tears started forming automatically and on cue.  What? You must be mistaken.  He has the trait right? I have the trait.  He doesn’t have sickle cell disease? Right?

No-one should receive news like this at a car wash 5 weeks post delivery.  This is standard procedure I’m assuming, but I had to come in for my HIV results because of the possible emotional impact of the news. Why is it acceptable for a new mother to receive this type of news on the phone and alone.

I’m sure the employees were wondering what had just happened.  They looked at me strangely as I drove off crying hysterically.  I’ve never cried so much in my life.  My thoughts were scattered all over the place.  Literally my pregnancy and delivery 5 weeks ago flashed before my eyes.  My sweet 9lb hairy baby, no seriously Dylan was the hairiest baby I had ever seen.  He was born with a head full of hair and hair covering his arms and back. I remember laughing in the delivery room at how hairy he was.  For the first 4 mos of my pregnancy I swore Dylan was a girl.  What does a boy need with all this hair? I thought looking at his head.

I knew I had the sickle cell trait.  When I was pregnant with my oldest son I was tested and was informed then I had the trait.  My mom told me it was her dad who passed his trait on to his children and now grandchildren.  I had no idea Dylan’s father had the trait.  I was healthy my entire pregnancy and there were no signs of any issues.

When I got home I cried some more as I nursed my baby who has now been identified as a Sickle Cell Warrior.  What would his life be like? Would he be in pain his whole life? Would he die at a young age? There were too many thoughts flooding my mind for me to process any of them.  Tears were the only answer.

This story would be completely different if the phone call would have been simply to schedule a new born screen follow up appointment.  The diagnosis would still be the same, Dylan would still have Sickle Cell Anemia.  However, my questions could have been answered, my fears calmed and I could have been equipped with information on how to protect my sweet little hairy baby.