A pediatrician is a critical part of your baby’s health. That doctor will likely be taking care of your child from birth through their teenage years, and may be providing guidance as soon as the baby is born. He or she will address your child’s physical, mental and emotional needs over the years and answer any questions that may arise, as well as diagnose and treat illnesses. But how do you find the pediatrician who’s right for you?
In this episode of San Diego Health, host Susan Taylor and guest Dania Lindenberg, MD, a pediatrician at Scripps Coastal Medical Center Hillcrest who at the time of taping was about to give birth to her fourth child, discuss what soon-to-be parents should consider while choosing a doctor to care for their child.
Dr. Lindenberg recommends starting the pediatrician search several weeks to a couple months before birth because the doctor will need to see the baby a day or two after being released from the hospital. Ask trusted friends or colleagues for recommendations.
Also, consider the office’s location and availability — you’ll be there a lot, at least initially. Research the doctor’s care philosophy, which can include anything from their stance on antibiotics to how much time they spend with a patient, and make sure you have a good rapport.
I see myself as a team member, as part of a team with you, your baby and whoever else cares for your child. I help guide you in those early days, to care for your child's health needs, your emotional needs, help guide you through breastfeeding, answering any questions that may come up, really guiding you through those early days and later caring for the health of your child.
I always say: "No question is a bad question.” New parents are going to have questions. Even parents who've had babies before have questions. And that's my job, answering those questions. And then as the baby gets older, it's advising about immunizations, taking care of the child if there are any medical issues that come up, being able to diagnose and help get a child through any illnesses or challenging times in that child's life.
Any advice from very trusted friends or colleagues as to who their pediatrician is and why they like them is very helpful. Location of the practice, initially especially in the first couple of years is critical, just because you are going to be coming a lot initially.
You want to find out if you get along well with that doctor, their care philosophy, how they feel about antibiotics and immunizations, how they approach you, how much time they take with you and if that meshes with how you like to be treated.
[Other pediatrician interview questions to ask]
- Are they part of a group? Are they a solo practitioner, which is becoming less common? Do you like their colleagues?
- Is there general availability for same-day appointments if you need it? Is there somewhere you can call for advice after hours during the day?
- What happens on weekends? What happens after hours in terms of care?
- Where can you be seen or where are you directed? What kind of services they use for referrals for pediatrics? All these things are important things to consider before you choose.
Also, you have to make sure they accept your insurance.
If you have a gender preference, that's absolutely important. If there's a certain language you're more comfortable in, does that practitioner feel comfortable doing the interview and the visits in that language? I can do visits in Spanish as can some of the others in my group and that's very helpful for some patients.
In the first year, initially, we see the baby about one to two days after hospital discharge. I like to follow babies at least weekly until they're back to their birth weight. Sometimes it's more often, depending on if they're having feeding issues, or jaundice or if parents are very anxious. Then we see them at a month, 2 months, 4 months, 6 months, 9 months and a year. Those are the minimal. That's just the well checks. If they have any other issues, they come in more often.
It's important to ask about office hours in case there are late hours that will work for you whenever you have to take your child in, or if it means you're going to have to miss work or they're going to have to miss school.
If they don't offer weekend hours, what are the alternative places they may send you? Is there at least a phone triage on the weekends? Those are things that are worth asking if you are a working parent or have limited hours when you can come in.
In case of an emergency, you want to find out if there is someone you can talk to. Is there a physician on call at all times? That can be reassuring for a parent, to know that they can always speak with somebody about their child's issues.
Aside from the 15 to 30 minutes that a physician schedules, there are immunizations. I would say leave a good hour for that visit, even though the time with the physician may be only 15 to 30 minutes.
The recommendation now from many health organizations is two years or until mutually desirable.
I really try to encourage parents to do what works for their lives and for them. If they can make it through the first year with breastfeeding, that is incredible. I saw a recent study on one of my pediatric sites that most people don't even make it six months with exclusive nursing. Most people start nursing their babies, but don't do it exclusively for very long. So any breast milk that a baby can get is wonderful. It provides additional nutrients, antibodies and bonding with the parents.
Breast milk is definitely the best food. That being said, there are definitely cases where a mother is having trouble and it's getting in the way of her being able to bond with the baby because it's so stressful. Then it's not the best thing. So with each individual case, I try to assess in what is best for this family unit. I don't invariably recommend breastfeeding above all else if it's not working for that family unit.
People ask that to me a lot. Generally, insurance companies are going to cover both. It really depends on the person performing them. For example, I perform them, and we're more set up in the office. In our practice, most of us tend to prefer to do them in the office. I am credentialed to do them in the hospital, and if there is some reason a family has to have it done there, I try to make it work. But in terms of scheduling, it's much easier for us in the office.
There are pros and cons of both. In the hospital you're being cared for by the nurses. It's done by the time you go home, but you're adding another little insult to a baby that just is learning to nurse. Whereas if you wait a week or two, the baby is presumably eating pretty well by then and a little more sturdy. But in the end, it really depends on who's doing it, and who you want to do it.
The baby has to be seen by a pediatrician within 24 hours and every day that the baby is in the hospital. The only thing that may change is whether it's the same pediatrician that's going to care for that baby. If your group has privileges at your hospital, then that group will rotate in and someone from that group will come see your baby.
I love seeing people prenatally. Generally, before the baby is due is a good time, just because by the time you have that baby, you kind of want to have chosen where you're going to be going since it's within one to two days of discharge.
Some people are comfortable taking a recommendation from a very trusted friend, or colleague, or family member, or they may have their children, but if you're a new parent, and you like to do your due diligence, I would say a few weeks to months before you give birth is a great time.
If you've done a prenatal class, sometimes you may have met a pediatrician who teaches that class, and really like them. I've had people from my prenatal classes come do prenatal visits with me, just to come talk to me. I think that people benefit from it cause you can really ask questions and see if it's a good personal match.
Scripps has a whole prenatal program. I'm one of the pediatricians on that panel at one of our hospitals and teach classes. I do them at Scripps Mercy, but we can do them at Scripps La Jolla as well. But Mercy is right by our office. I really enjoy teaching them. I teach maybe three of them a year.
There is a whole series of classes that people can sign up for that can be really helpful.
There's a breastfeeding class, where you can learn a little bit about the basics. There's a hospital tour that they do depending on which hospital you're gonna deliver at. They do a class with a prenatal educator where they teach a little bit about swaddling and various things about sleep that can be real helpful.
There's the class that I teach at times, which is the "meet the pediatrician," where they get to rack our brain and ask us questions and learn some things that Scripps has set up on a formal curriculum. These can be signed up for on the Scripps.org website, and people seem to really like the series of classes.