The right doctor

Hi everyone, I was just wondering how you "found" your preemies doctor? Do you have a doctor that specializes in preemie babies? Is there a special type of doctor for preemie babies? My baby's doctor seems so unconcerned about the fact that he was a preemie. I have no idea how to find a new doctor. Here are some of my issues with him. Am I just too worried?

1. When I stopped breastfeeding my son, I asked the doctor what type of formula to give him and if there is a special formula for preemies. He said no there isn't and for me to just give him Similac or Infamil (just the general one)

2. At his two month appointment, when they wighed my son, they didn't even take his diaper off (and it was wet). The doctor said his weight gain was fine and when I told him the nurse didn't take the diaper off, he said it's ok.

3. At his 2 month appointment, the doctor told me to come back when he's four months. I thought we were supposed to go in more often if for nothing else, just to monitor his weight.

4. Everytime I call the office, the receptionist, and the doctor himself seems really annoyed.

I really want to go to a new doctor, one who understands preemies, I just don't know how to find one or even where to start.

By MomofTeddyandEmma
Posted July 13, 2008 at 10:17 am
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I live in a rural area and there are no peditricans here. They are all about an hour away. I found a GREAT family practice doctor. It is a small practice so when we go in they greet us by name. Our Dr. was able to offer some great ideas for dealing with Emma and is will to do research when he doesn't know the answer. The best part is that the whole family can see him so even when my husband goes in the office our Dr. understands what is going on at home.

(I did try a peditrican for a while but it was such a disaster. They didn't listen. We had to wait in the wating area, with sick children, for an hour before each visit).

There are some great doctors. Just keep looking and if peditricans aren't working for you consider family practice.

By katek
Posted July 13, 2008 at 10:31 am
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We weren't able to find a pediatrician who specializes in preemie care. We did get a list of doctors whom other parents of NICU graduates seemed to go to. Also, talk with some of the doctors from the NICU and ask them who they would go to if they had a preemie.

I'm OK with our pediatrician now that our son is doing well. But there have been times when it was really a struggle to get him to act. I think that he has finally realized that although we aren't medical doctors, we are very well read on the literature when it comes preemie care, so he at least listens to our concerns. Again, it has taken a lot to get us to this point. We almost switched, but he was the second pediatrician that our son has seen. The first one didn't return phone calls in a timely fashion and told us to call on days that turned out to be her days off.

In response to your questions, my impression was that some kids do go on regular formulas, but some preemies to go on particular types of diets, depending on their weight status and age. A lot of preemies appear to have sensitive digestive systems, which is something to keep in mind. Given that a lot of kids have milk allergies (my son experienced that), finding the right formula for your child is especially important. You might have better success talking with a pediatric nutritionist than a pediatrician who doesn't understand how preemies may differ from FT babies.

At two months (whether adjusted or corrected), a preemie is really small and a wet diaper can make a huge difference on weight. Not to mention that the diaper itself will probably weight 1/2 to 1 ounce. Sounds like sloppy work on your doctor's part, especially since you called it to his attention.

We requested more frequent check ups than the standard. Our son's pediatrician found that reasonable. When our son first came home, we went every month for a few months. Then, we had appointments every two months...just to be on the safe side. Our next scheduled visit is for three months from his last visit. Our son is currently 11 months adjusted (born 25 weeks).

Our son's nanny has a daughter who is 1 year old (FT baby) and is light (17 lbs), so her mother brings her in for weight checks every 2-3 weeks to her pediatrician, which doesn't seem to perturb the ped.

If the ped sounds annoyed, then it doesn't sounds like a good fit for you.

If you can't find a pediatrician through a NICU list, then I would ask everyone you know who they take (or took) their kids to and if they liked them. If yes, why did they like them? If it were me, I'd probably cue off of someone whose child had some sort of problem that was handled well. Doesn't mean your child will have problems. But to play it safe, you want a doctor who will handle problems efficiently if they pop up.

Best wishes.

By anniem222
Posted July 13, 2008 at 11:33 am
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I have a 30-weeker and we had the same sort of experience with our first pedi. He wouldn't return phone calls (nurse did... even though I requested him) when we were having severe issues w/ reflux. When we were having eating issues (trying to BF, but he had a hard time w/ it the first 3 months after coming home), he told me "just breastfeed!" I was like, duh! I'm trying!!! It wasn't till the next appt. that he suggested we meet with an LC. He would also forget things we had talked about week-to-week (like doing a blood test). Oh- and a biggie- he never once mentioned us meeting with Early childhood intervention. So... in my frustration I called another pedi and went in to interview him, asking all the right questions. He has turned out to be wonderful and listens, calls me back personally, and takes notes about what goes on during our appts. Also, one of the first things he asked me was if we had contacted ECI! So... I would not hesitate to switch doctors if I were you... if you have a bad feeling about it trust that feeling and don't look back! Good luck.

By manda-chavez73
Posted July 13, 2008 at 12:11 pm
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If you are not happy I would definitely switch. I think it is so important to have a good relationship with your ped. We got really lucky our sons ped actually worked in the NICU where he was born and when we transferred hospitals he told us he worked in the Pediatric clinic at the Childrens Hospital Campus (He was being transferred to the Childrens hospital NICU) He is only a resident so he has his supervising doctor at our appointments too but I actually kind of like that about him. Being so new he is very well informaed on the moist current information. He always remembers us when we come in...and he was there from day 1 so there isn't anyone else who could be more familiar with what Ethan has gone through. I would definitely say call the NICU or if there is a childrens hospital nearby. They should be able to give you names of someone who understands preemie care.

By Yolonda
Posted July 13, 2008 at 12:47 pm
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We were blessed in that my daughter's Neonatologist also is a pediatrician, so once she was discharged from the NICU, we started being seen in his office. It truly has been a blessing because he truly knows my daughter best medically.

Good luck on your search!

By babyalex
Posted July 13, 2008 at 6:59 pm
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Our Ped. is really good. We heard about him through other family members. While we were at Arkansas Children's Hospital we asked around about him. We were so lucky to find out that he was a ped. there. My husband also researched him on the internet. Once Alex was back transported to Saint Edwards we asked the Nurses. That is when I found out that he works with special needs children. Did we hit the jack-pot or what? He also visted Alex in the hospital just to say hi. The nurses said Alex waved at him one mourning. Alex's Neo. also keeps up with him. Everytime we go to visit him he always ask about his progress.

My advice would be to ask your friends who they would recommened? Then give him/her a call to see if they are even taking new clients.
If your child receives early intervention you could also ask them?

I hope this helps!

By dannysmom
Posted July 14, 2008 at 3:18 am
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Thank you so much for your advice. I will ask the NICU if they have a list of doctors. Another thing I was concerned about was where to go to enroll for EI since my son's doctor never mentioned anything about it. I will definitely ask the new doctor about it. Once again thanks.

By lcc
Posted July 14, 2008 at 8:13 am
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Our choice was made clear by almost every NICU nurse suggesting one doctor in our area. After 2.5 years with our doctor I know the NICU nurses were right.

By alskwirut
Posted July 14, 2008 at 8:28 am
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I'm so happy that there are preemie parents out there that had a good experience with the docs the NICU recommended. We got a list from the NICU when my son was discharged and when we went, I didn't know any better, being a new parent. When Jeff started with reflux and severe GI problems, I brought him to the doc and she told me that he was just fussy and didn't have colic. I had to get him his RSV shot but then I immediately switched docs when I waited 2 hours to see the doc for the lung shot. The ped we see now is FANSTASTIC. I was so upset when I came home from that visit my hub got me an appt with this new doc. He saw him the next day. And guess what? Jeff had colic. We switched formulas and BAM. 4 days later it was like night and day. This ped doesn't specialize in preemies but he is very attentive and proactive. Just look until you find one you like. Your mommy instinct will tell you whether or not the doc is right for your baby. And EI, call your local children's and families office. They will be able to help you. Also, seek it on the internet. I searched NJ Early Intervention and I got everything I needed. Email me if you have any more questions :-)

By jaredkate
Posted July 14, 2008 at 10:48 am
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If you delivered in a university hospital with a Level III NICU, they often have high-risk infant clinics, which are specifically designed for preemie care. Ask your NICU about that. Otherwise, a NICU referral is your best bet. We found our doc by referral and he's great. He saw us once a week for the first month after my son came home (so until he was 2 months old, actual) and then we've been seeing him once a month since (and my son is 4 1/2 months old). He has spaced out his vaccinations and I definitely feel that he has adjusted his standard of care to my son being a preemie. We feel very comfortable with him.

As for formulas, here's what the Premature Infant Nutritionist in the NICU told us (our NICU has one of the only preemie nutrition research programs in the country). There is some (but thin) evidence that preemies fed Similac Neosure for the first year gain weight better and have better results than preemies fed regular formula. This study is why so many NICUs have parents fortify breastmilk with Neosure to 22 or 24 cals. However, the study doesn't actually compare results against breastfed babies--it only compares results against preemies fed regular formula. Additionally, the study only showed the Neosure difference only benefitted male preemies born before 32 weeks. Apparently some new studies don't show any difference. So, our NICU is no longer automatically recommending Neosure fortification of breastmilk. What does make a big difference, however, is DHA/ARA in formulas and apparently Enfamil Lipil has the best and most beneficial form of DHA/ARA. Our ped advised that if we were to use formula, we should use Enfamil and not Similac or any other brand.

By mickeymom
Posted July 14, 2008 at 11:24 am
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My son's neonatologist is also his pediatrician and that has been a huge help. I would look for a doctor who has been trained in neonatology for a few years even though they might not be working in the NICU now (apparently it is a pretty stressful environment and hence many of them switch).
Also, my son is on regular formula since he turned 5lb (which was a couple of weeks after he turned 40 weeks) and that has worked well for us. Before that he was on the hypoallergenic formula Neocate. It took him a couple of weeks to adjust to the new formula but seems to be doing well on it and gaining weight (no extra calories added).
For the first couple of weeks after we came home we went to the doctor on a weekly basis, then every 2 weeks and now we go to him on a monthly basis (my son is now 2.5 months adjusted).

By dannysmom
Posted July 14, 2008 at 5:31 pm
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So I got a list of doctors from my insurance company online and a NICU nurse recommended about 5 doctors off the list. I called the closest one to me and was relieved to hear the he sees preemie babies at 3 months for a physical. We have an appointment next week and I really hope he's the right doctor. Thank you so much for all your replies and for sharing your own experiences. I will let you know how it goes next week.

By 1pair-n-1spare
Posted July 16, 2008 at 11:17 pm
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You can go right on the INternet and get the numbers for EI. You don't need your Pedi to refer you... you can refer your own son. Also the NICU should have refered you already... you can call them and have them send the referral too, that is part of their job for any child born prior to 34 weeks.

As for the formula... Enfacare and NeoSure are formulas that are specifically made for premature babies. They not only carry more calories (generally 22 calories/ounce) but they carry more of the vitamins and minerals that preemies need to grow than regular formula does. You should also get a prescription for the formula as it is generally covered by your insurance carrier as a medically necessary item.

Lisa R>
Boston

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