Speaker 1: Who baby a baby belof I need you, Oh hell,
Speaker 1: I need you. What to Expect is a production of
Speaker 1: I Heart Radio. I'm your host Heidi Murkop and I'm
Speaker 1: a mom on a mission, a mission to help you
Speaker 1: know what to expect every step of the way. Getting
Speaker 1: ready to welcome your baby bundle, then get ready to
Speaker 1: start shopping not only for that crip, that car seat,
Speaker 1: and all those impossibly tiny and precious outfits, but also
Speaker 1: shopping for a pediatrician. The right pediatriction can see you
Speaker 1: and your little one and later you're not so little
Speaker 1: one through eighteen years or so of checkups and unizations,
Speaker 1: runny noses and fevers, tummy bugs and boo boos of
Speaker 1: all varieties. Help you troubleshoot feeding problems, navigate napstraight, resolve rashes,
Speaker 1: document your baby's amazing growth and development. So today we
Speaker 1: are talking about how to find the baby doctor that's
Speaker 1: right for you and your baby. And joining me today
Speaker 1: is Dr Lauren Crosby, a board certified pediatrician here in
Speaker 1: Los Angeles and my personal go to for all things baby,
Speaker 1: not to mention full disclosure, pediatrician to two of my
Speaker 1: favorite babies, Lenox and Sebastian. Welcome. Dr Crosby. Hi, hi ki,
Speaker 1: thanks for having me. First of all, we have talked
Speaker 1: a lot on what to expect about pregnancy and parenting
Speaker 1: during a pandemic, and there's a lot to talk about.
Speaker 1: But how has the pandemic changed the way that pediatricians practice.
Speaker 1: That's a good question. So in a couple of ways.
Speaker 1: One is the way our office runs is different. You know,
Speaker 1: you're not going to have like tons of little kids
Speaker 1: running around the hallways anymore, and just the stroller parking
Speaker 1: lot that we're trying to have it not crowded. This
Speaker 1: is are doing video visits or i tele medicine visits
Speaker 1: or what they call it telehealth, where certain things can
Speaker 1: be done that way where you don't even have to
Speaker 1: leave your home and we can set up times with
Speaker 1: people where we can look at certain things that way.
Speaker 1: Like I've had very successful office visits for things like
Speaker 1: beastings or allergic reaction type rashes that they thought were
Speaker 1: that or you know, like ezema or rewards, or you know,
Speaker 1: discussing medication changes. The next best thing to be in there, right, Okay,
Speaker 1: let's say you're expecting your first baby and you don't
Speaker 1: have the slightest clue on how to find the pediatrician
Speaker 1: that you know you're going to need. Stat When is
Speaker 1: the best time to start looking for a pediatrician? Really,
Speaker 1: anytime during pregnancy, except for not maybe the last few weeks,
Speaker 1: and even maybe before like thirty five, thirty six weeks,
Speaker 1: like given at least a month or marek because you
Speaker 1: don't know how long it's going to take, or maybe
Speaker 1: you want to interview a bunch of people and you
Speaker 1: want to have plenty of time, and it has to
Speaker 1: match your schedules. Sometimes we play a lot of phone
Speaker 1: to bag. So I think early is always good, definitely,
Speaker 1: essentially because there's always a slim possibility your baby might
Speaker 1: come early surprise you. So you want to be all set.
Speaker 1: How do you start? What are the first things to consider?
Speaker 1: And I would imagine the first first first thing is
Speaker 1: deciding if you're going to use a pediatrician or family physician,
Speaker 1: you know, I think that that decision depends on the
Speaker 1: family physicians experience. You know, pediatricians are specifically trained and
Speaker 1: only trained in the health, development and illnesses in children,
Speaker 1: and that's very specific. So there are lots of things
Speaker 1: that we scream for you know. Now I've done this
Speaker 1: for twenty years. You know I can eyeball stuff and
Speaker 1: be like that's okay, that's not okay, you know, things
Speaker 1: like that. So some family physicians deal a lot more
Speaker 1: with older kids or maybe more adults. So it depends
Speaker 1: on how much of their practice is really real true
Speaker 1: general pediatrics. I think that matters um And then to
Speaker 1: actually find a pediatrician, you do want someone who is
Speaker 1: board certified. It will say after their name, after the
Speaker 1: M D or the d O, it will say f
Speaker 1: A a P. So that's Fellow of American Academy Pediatrics,
Speaker 1: which means they're board certified. Now some people don't put
Speaker 1: those initials after their name, but you can always call
Speaker 1: their office and make sure their board certified or look
Speaker 1: them up even online. Often it's the will be a
Speaker 1: lot of times it makes the initial recommendation or will
Speaker 1: give a list of people. Call these offices, talk to
Speaker 1: these people. Yeah, that's how Emma found you. In fact,
Speaker 1: was her be recommended you? And you can also ask
Speaker 1: friends or coworkers. Definitely very helpful because you may have friends.
Speaker 1: They know you, they know your style, they know that
Speaker 1: you're either a worried about certain things, or you're not
Speaker 1: and they may be able to go this is a
Speaker 1: good fit for you. Yeah, and I wouldn't necessarily go
Speaker 1: by online reviews as much as those no, because sometimes,
Speaker 1: like even like for our yell page, they'll put a
Speaker 1: one star because the person was mad, because our office
Speaker 1: doesn't take people who don't vaccinate. So you given you
Speaker 1: went on yelp and give us a one start, gotcha? Yeah,
Speaker 1: so you know what I mean. It's extremes. It's either
Speaker 1: super happy or like super mad. So clearly some parents
Speaker 1: are going to have more of a choice than others
Speaker 1: because of insurance coverage or because of their location if
Speaker 1: they're in a rural area where there are a few choices.
Speaker 1: But if you have the choice, would you suggest um
Speaker 1: having an interview, consult with a potential candidate, or would
Speaker 1: you even suggest two or three? Yes, I think it's
Speaker 1: good to kind of get a list of people and
Speaker 1: maybe narrow it down. You could narrow it down by
Speaker 1: how many other friends you know that go there and
Speaker 1: I'm happy with them, or how far is the schleft
Speaker 1: to the office, you know, especially in a city like
Speaker 1: l A where it could take you like an hour
Speaker 1: to not even go that far, so traffic, office location
Speaker 1: and hours and all of those things do matter, and
Speaker 1: then it is good to do a visit. We used
Speaker 1: to bring pregnant women into the office and we would
Speaker 1: sit down and meet with them. Now we're not, so
Speaker 1: we're doing it either virtually on a video and visit
Speaker 1: or via phone call too. And I feel like you
Speaker 1: might miss a lot in a phone call if you're
Speaker 1: not you know, making eye contact, at least for me,
Speaker 1: I feel like a video call would be, if possible,
Speaker 1: would be prefercent. That's what we do. Yes, and even
Speaker 1: if you've made your decision without a console, do you
Speaker 1: think it's important to have one call or video visit
Speaker 1: before the delivery so that you're all kind of all
Speaker 1: set about what's going to happen, what you can expect. Typically,
Speaker 1: what I always did when I did those was I
Speaker 1: also would talk about what's what's going to happen at
Speaker 1: the hospital even during that. So I usually say so
Speaker 1: once the baby's out, they call our office right away,
Speaker 1: and then we come see the baby, and we kind
Speaker 1: of give them that, but they should call if they
Speaker 1: still have more questions. For sure, you make it sound
Speaker 1: so easy once the baby's out just you know, just
Speaker 1: like that. Let's let's dig into some of the topics
Speaker 1: you'll want to cover with a potential pediatrisian. I imagine
Speaker 1: some of these you could just go over with the
Speaker 1: office off when you make your call for the appointment.
Speaker 1: Hospital affiliation does that matter? I mean, we like to
Speaker 1: see our newborns right when they come out, like we
Speaker 1: enjoy going in the morning and seeing the new babies.
Speaker 1: But it doesn't always work out. Sometimes their insurance doesn't
Speaker 1: cover the hospital that were so at least if you
Speaker 1: know we'll see them within usually forty eight hours after
Speaker 1: going home, then that's also good because they do have
Speaker 1: people who will cover and sometimes the OBI who delivers
Speaker 1: that the hospital has a pediatrician they work with really well,
Speaker 1: and we'll recommend to see your baby until you come
Speaker 1: to our office. Do you think there are benefits to
Speaker 1: going into there's probably fewer than ever. But solo practice
Speaker 1: as opposed to group practice or a practice that combines
Speaker 1: a nurse practitioner or physicians assistant. Some it depends on style,
Speaker 1: Like I know there's parents, Like we have five doctors
Speaker 1: right now in our practice, UM and so we have
Speaker 1: a busy practice and a busy office. Not prouding anymore
Speaker 1: though at least, but we do really have a good
Speaker 1: number of patients that we see. So for us, if
Speaker 1: you want an appointment at a certain time, like for
Speaker 1: the check up, make it on your way out, because
Speaker 1: an office that is on the busier side, their availability
Speaker 1: maybe a little bit tighter um to get you in
Speaker 1: at a time that you want, whereas a smaller office
Speaker 1: maybe with one or two doctors, depending how busy they are.
Speaker 1: You can find out those kind of things like how
Speaker 1: long is the way time to get an appointment, same
Speaker 1: day appointments, all of those things, and then you know
Speaker 1: if you have qualified nurse practitioner. You know, typically pediatric
Speaker 1: nurse practitioners are quite good, intend to know their limitations,
Speaker 1: and they are also supervised by a physician as well.
Speaker 1: It does depend on what's available in your area. I
Speaker 1: will say. One other thing is that in our practice
Speaker 1: I have found it's nice to have several doctors there
Speaker 1: at one time. There's always like two or three of
Speaker 1: us because also we'll talk to each other, run things
Speaker 1: by each other, or I'll say, look, I'm not going
Speaker 1: to be here tomorrow, but when you come back, I
Speaker 1: want you to see doctor so and so. So I'm
Speaker 1: gonna bring her in so you can meet her. And
Speaker 1: now way tomorrow you come back for us to look
Speaker 1: at the wound or the cut or listen to the lungs.
Speaker 1: You'll know who it is and she'll be able to
Speaker 1: know what's going on. But there's definitely a benefit to
Speaker 1: seeing generally this same pediatation for every world baby check
Speaker 1: up as possible. Yes, and you do want to know
Speaker 1: who's covering you know if that doctor, especially in a solo,
Speaker 1: practices on vacation because us we always have multiple ones
Speaker 1: of us around. You're not allowed to have vacation, right,
Speaker 1: be off, it's not like we're going anywhere, No exactly,
Speaker 1: say cation. Um. So the phone calls when parents have questions,
Speaker 1: should you ask how those are handled? Typically? Are there
Speaker 1: call in times or is it a free for all
Speaker 1: and you wait for a callback. Some doctors do have
Speaker 1: call in ours where people can just call UM. A
Speaker 1: lot of them take a message and the return the
Speaker 1: calls like we return the calls usually between twelve fifteen
Speaker 1: and one fifteen and then after five of it's a
Speaker 1: specific call where they need us. But we do have
Speaker 1: trained nurses who do phone calls and often are the
Speaker 1: first ones on the phone triage because a lot of
Speaker 1: times they can tell you, you know what, you need
Speaker 1: to just come in. I'm going to give you an appointment,
Speaker 1: or that is totally fine, and that is going around,
Speaker 1: and if that fever is still there by tomorrow, we'll
Speaker 1: just call in the morning. We'll get you in. They know.
Speaker 1: I get messages, like yesterday, I got a few. The
Speaker 1: nurse put them right in my box. She said, this
Speaker 1: one you need to call, or this one really would
Speaker 1: prefer to just talk to you, and that's fine, and
Speaker 1: we just call them mat and protocol for emergencies. And
Speaker 1: I think it's kind of like a Murphy's law of
Speaker 1: sick kids. But it's always like Saturday night at three am.
Speaker 1: Did you ask about that as well. Yeah. It's also
Speaker 1: like who's covering and who handles the after hours calls.
Speaker 1: So some people have on call centers that take over
Speaker 1: and then only reach out to the actual doctor if
Speaker 1: it's something that the on call nurse system doesn't handle. Um,
Speaker 1: whether it's through the medical center they're affiliated with or
Speaker 1: a company they hire for us, it's one of the
Speaker 1: five doctors which take turns each night on call and
Speaker 1: so after hours, it's our same phone number and it
Speaker 1: gives two options. If it's the emergency, you press this
Speaker 1: and leave a message and we get paged right away,
Speaker 1: versus I have a question that I need to know tonight,
Speaker 1: but I don't have no right to second. Then we
Speaker 1: call back in about one and after two hours. On
Speaker 1: those I'm sure you have the parents who think everything
Speaker 1: is an emergency. We do. That's okay, we know, and
Speaker 1: you know all those basics are super important, you know,
Speaker 1: and you can ask about how billing has done all that,
Speaker 1: all those logistics, But I think even more important than
Speaker 1: that is making sure that pediatrician is on the same
Speaker 1: page as you when it comes to certain philosophies and
Speaker 1: points of view immunizations. I know that's a non negotiable
Speaker 1: in your office, like every parent needs to accept immunizations
Speaker 1: for their their baby. What would you say to a
Speaker 1: prospective parent who comes in and says, I am really
Speaker 1: nervous about this whole vaccination thing. I heard this or that.
Speaker 1: As you know, it's also become like a huge topic.
Speaker 1: So I do like to give them perspective because what's
Speaker 1: happened now is because these parents are not seeing polio
Speaker 1: every day, and they're not seeing measles, and they're not
Speaker 1: seeing newmaccocklemaningitis and hidmeningitis with children with hearing loss and
Speaker 1: brain damage, and you're not seeing it because of these
Speaker 1: fabulous vaccines. That you need to realize that these diseases
Speaker 1: come back when we stop vaccinating. People travel all over
Speaker 1: the world. There are countries that don't have access to
Speaker 1: the vaccines, and we are lucky that we have them.
Speaker 1: So I do go through my years of experience what
Speaker 1: I have seen, how all of us have kids. We've
Speaker 1: all vaccinated our kids with everything. They're all totally fine
Speaker 1: and healthy, and we just really want them to know
Speaker 1: that it's benefits benefits benefits much outweigh the risk exactly,
Speaker 1: and everyone around your baby should be up to date
Speaker 1: on other refinings. Absolutely true breastfeeding. You're not gonna find
Speaker 1: pediatricians who are not pro breastfeeding. Of course they're pro breastfeeding,
Speaker 1: but should you ask about how much hands on guidance
Speaker 1: you will be able to receive in the office, for instance,
Speaker 1: are their knowledgeable nurses or even a certified lactation consultant
Speaker 1: on staff. Because breastfeeding is the natural process that doesn't
Speaker 1: always come naturally, so it depends how much trouble people
Speaker 1: are having. And I have found that the nurses at
Speaker 1: the huspital I'm affiliated with have just become better and
Speaker 1: better and better, and they have great lactation consultants. So
Speaker 1: we really like to make sure before we actually they
Speaker 1: walk out of the hospital that they really at least
Speaker 1: have seen someone who really can get them to latch,
Speaker 1: and that they feel at least like they can latch
Speaker 1: that baby before they get home. Now, sometimes it goes
Speaker 1: off the rails once you're home, right the hospital, everything
Speaker 1: seems to be fine, and you get home and you
Speaker 1: can't latch her baby, and all bets off when the
Speaker 1: mail comes in right right, yes, exactly, and then you're
Speaker 1: dealing with all of those things. So um, when they
Speaker 1: come in a day or two her and we check
Speaker 1: in and we see how they're going, if they are
Speaker 1: having a lot of problems, I will make a bunch
Speaker 1: of suggestions like let's try this position, let's do this,
Speaker 1: let's try this, maybe pump a few minutes just to
Speaker 1: pull the nipple out and then stop and put the
Speaker 1: baby on, and we give them lots of things they
Speaker 1: can try There are some lactation consultants that we work
Speaker 1: closely with and they always give them their card. Nowadays,
Speaker 1: they do a lot of virtual visits, but there are
Speaker 1: those cases where they might need like up close hands
Speaker 1: on just to get the baby on and then they
Speaker 1: back away and have their masks on and stand back,
Speaker 1: and that's very short and probably low risk, and they're
Speaker 1: very careful. On the flip side, say mom is planning
Speaker 1: to for whatever reason, formula feed, should she mention that
Speaker 1: just to get sort of a gauge of whether she
Speaker 1: might be judged for that decision. Definitely should. I mean,
Speaker 1: hopefully they're not being judged for that. We understand there
Speaker 1: are certain personal decisions. For some people. That's a very
Speaker 1: personal decision. Some can't rest feed because they have medical
Speaker 1: reasons or they're on medications, or they've had surgeries on
Speaker 1: their breast that it's not gonna work, and they know
Speaker 1: that and it's fine, you know, and we definitely help
Speaker 1: them through it. And some women just really don't like
Speaker 1: the idea, or they're going back to work in two weeks,
Speaker 1: so there's a lot of reasons. So no judge. So
Speaker 1: you want to find a pediatrician who is supportive of
Speaker 1: whatever you decide to do ultimately, whether it's breastfeed for sure,
Speaker 1: time a long time now, nutrition and supplements, Right, if
Speaker 1: you have strong feelings about that, is that something you
Speaker 1: should talk to the pediatrician about for sure, because there
Speaker 1: are a lot of them, and you're gonna hear a
Speaker 1: lot of things, and there are only certain ones that
Speaker 1: really we feel are safe to use wild breastfeeding, because
Speaker 1: there's no studies on the impact of any of these
Speaker 1: on newborn babies, So there's a lot we don't know,
Speaker 1: And you certainly don't want to risk anything any kind
Speaker 1: of danger of toxic the allergic reaction, anything like that.
Speaker 1: So you definitely don't want to take something without checking
Speaker 1: with your doctor completely. And I think it's just probably
Speaker 1: good to get all of these issues on the table.
Speaker 1: You don't want a parent to hold back about anything. No, definitely, definitely. Okay,
Speaker 1: So you've covered the nuts and bolts of what is
Speaker 1: important to look for in a pediatrician, But then there
Speaker 1: are some intangibles, right, don't you think for Emma it
Speaker 1: was so important to have a doctor who wasn't an
Speaker 1: alarmist um and so her non alarmists obstetrician referred her
Speaker 1: to you a non alarmists pediatrician who just as importantly
Speaker 1: was able to take her concerns seriously while also offering reassurance.
Speaker 1: For me, it was all about empathy and a sense
Speaker 1: of humor. I feel like a sense of humor takes
Speaker 1: parents far and pediatricians far in the relationship listening. I
Speaker 1: was just gonna say, it's exactly like my my little
Speaker 1: list is like, a sense of humor definitely helps. Listening
Speaker 1: skills are super important, and also being able to give
Speaker 1: the parent perspective too. You know, it's super important to
Speaker 1: go look and even sometimes from my own experience with
Speaker 1: my son's I'll even go, look, Luke broke his arm
Speaker 1: in multiple places and we had to have surgery and
Speaker 1: they had to put a ran or whatever, and we
Speaker 1: got through it. And I've been there and this is
Speaker 1: gonna be fine, and this is what we're gonna do,
Speaker 1: or whatever it was. I'm able to reassure that it's
Speaker 1: it's gonna get better, it's gonna go wait. I promise you.
Speaker 1: You know, so, is that actually something you should put
Speaker 1: on your checklist like that? The pediatrician is also a
Speaker 1: mom or a dad You know, it's interesting because I
Speaker 1: have friends who practice in one runs a clinic in
Speaker 1: York and he doesn't have kids. H he's you know, fabulous,
Speaker 1: you know, brilliant and fabulous, so like you can't. It's
Speaker 1: funny you think that, oh, well they have to have children,
Speaker 1: but not necessarily so interesting. But I think the perspective
Speaker 1: is often really helpful because you've been in the trenches
Speaker 1: and world perspective, like, remember, there's this many millions of
Speaker 1: kids who have done this or been through this or
Speaker 1: whatever and they're fine now. So yeah, what about exam
Speaker 1: table manner? Like that's going to be super hard to judge,
Speaker 1: you know, until your your baby is on the table.
Speaker 1: So what would you look for? You know, it is
Speaker 1: hard to tell. But I think when you do do
Speaker 1: the interview, like you said, if you can get a
Speaker 1: video one that at least it's helpful. I mean, I
Speaker 1: like to talk to the babies. That's how I can
Speaker 1: do my part of my developmental assessment is I just
Speaker 1: let them stare at me and see what happens, you know,
Speaker 1: and and the back and forth with the baby and
Speaker 1: I dangle my step and so I kind of spend
Speaker 1: time with them. So I can see if they're reaching
Speaker 1: and grabbing, if they're trying to roll for things, and
Speaker 1: and just staring at the baby is important to let
Speaker 1: them look at your face. And I watched them, and
Speaker 1: I watched their eye contact and the social skills. So
Speaker 1: and you know what, as you and I know what
Speaker 1: is better for a baby's social and language development than
Speaker 1: people talking to them eye contact, singing, talking, narrating your day. Right,
Speaker 1: So I also believe in mom gut and I feel
Speaker 1: it's important for doctors to respect it. Remember when Emma
Speaker 1: had lenox with the local site was infected and she
Speaker 1: had the mom got something wasn't right, and she persevered
Speaker 1: and sure enough he ended up very rare case, but
Speaker 1: ended up, you know, with a staff infection. So what
Speaker 1: are your feelings on mom cut. Obviously it's not gonna
Speaker 1: be a but right. I think that it's very different
Speaker 1: with first baby Mama and third baby momat too. But
Speaker 1: we know that and that's fine, but we always want
Speaker 1: to address it whatever the concern is. You know, at
Speaker 1: least take it seriously and say, you know what, I
Speaker 1: see why you're saying that, or you feel this way.
Speaker 1: But here's X, Y and Z to explain why this
Speaker 1: is okay, or you know what, you're absolutely right, let's
Speaker 1: do this like you're right, I think the formula isn't
Speaker 1: agreeing with the baby, and let's take the poop for
Speaker 1: blood or you know, so you at least do something
Speaker 1: to address it, and sometimes just to alleviate those worries
Speaker 1: and concerns. And most of the time the baby is fine,
Speaker 1: vast majority of time, but when in doubt, check it out.
Speaker 1: It's just better. Now, it's better. And that actually brings
Speaker 1: me to my final point. The way I see it,
Speaker 1: the relationship with your pediatrician, just like your obie or
Speaker 1: your midwife, should be a partnership. So you as parents
Speaker 1: will contribute what you know best, and that's your baby.
Speaker 1: And first time parents out there all saying, what do
Speaker 1: you mean, I don't know anything about my baby, But
Speaker 1: in fact, you see your baby every day, every night,
Speaker 1: and so you will get to know your baby, and
Speaker 1: you will know your baby best. And then the pediatrician
Speaker 1: contributes to that partnership what he or she knows best,
Speaker 1: and that's all the medical expertise and experience, and then
Speaker 1: you put that together and and it's a beautiful thing.
Speaker 1: But what's your best advice for building a good relationship
Speaker 1: with the pediatrician that you do choose. I think listening
Speaker 1: on both sides is good, you know, I think that's important.
Speaker 1: I think that make ensure that you do ask your
Speaker 1: questions and that they are willing to answer them so
Speaker 1: that you don't feel brushed off or rushed is good.
Speaker 1: And also, you know, on the on the parents side,
Speaker 1: you know, making sure that you know you show up
Speaker 1: on time for your appointments and that you kind of
Speaker 1: follow a lot of the stuff that we suggest that
Speaker 1: will actually help you. And if you disagree, I want
Speaker 1: to know, you know, I'll be if or if you
Speaker 1: tried it and it didn't work, fine, let's talk about
Speaker 1: it and make clean b So communication that's the key
Speaker 1: to any good relationship, including the relationship between parents and pediatrician.
Speaker 1: And you will spend almost as much time with your
Speaker 1: pediatrician as you will with your partner, so you want
Speaker 1: to make this relationship work. So I want to thank
Speaker 1: you Dr Crosby for joining us and walking us through
Speaker 1: how to find the best pediatrician. Thank you, thanks for
Speaker 1: having me say love my baby love. I need you,
Speaker 1: Oh how I need you. Thanks for listening remember, I'm
Speaker 1: always here for you. What to Expect is always here
Speaker 1: for you. We're all in this together. For more on
Speaker 1: what you heard on today's episode, visit what to Expect
Speaker 1: dot com slash podcast. You can also check out What
Speaker 1: to Expect when You're Expecting, What to Expect the First Year,
Speaker 1: and the What to Expect app. And we want to
Speaker 1: hear from you. Connect with us on our community message
Speaker 1: board or on our social media. You can find me
Speaker 1: at Heidie Murkoff and Emma at Emma Being w t
Speaker 1: E and of course at What to Expect. Baby Love
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