Questions to ask pediatrician interview: Find a Pediatrician with Answers to these 10 Questions

Posted on 18 июля, 2023 by alexxlab

Finding a Pediatrician for Twins

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by Twiniversity

Now that you are expecting not 1 but 2 (or maybe more) little bundles of joy, finding the right pediatrician is essential. Not sure what to look for in a pediatrician? Not sure what questions to ask? Here are some helpful tips to help you find the right doctor to care for your precious little ones.

Pediatrician Interview Questions

Why did they become a pediatrician?
Do they have a sub-specialty or any special medical interest?
How long have they been practicing medicine?
Do they have any children? (Bonus points if they are a parent of multiples)
Are they authorized to work at the hospital you are delivering at?
Do they have any preemie experience?
What is their philosophy on…
- Feeding? (breastfeeding, bottle, a hybrid)
- Sleep? (Cry it out, co-sleeping)
- Immunizations?
How much time do they allow for appointments?
Ask for patient referrals (To find out if the doc rushes you out of the office, etc…)
On average, how long is the wait in the waiting room?
Do they have a separate waiting area for sick children? Do they put them right in the exam room?
For sick visits, will you be seeing a nurse practitioner or a doctor? How is that determined?
How can you stay in contact with them for small questions? Email? Website? Telephone?
What after-hours contact is available?
If you have to take the twins alone to the doctor, how can they assist you?

Things to think about AFTER you interview the doctor.

How close is the office to your home?
What days and hours are they open? Do they offer open sick hours every day? Are they open on weekends and evenings?
How long did you have to wait?
Did you have a good feeling about the desk staff and nurses?
How was your doctor’s attitude towards the interview?
Would you feel confident if this doctor had to handle your child’s emergency?
Knowing you have the right pediatrician for your family is very important. Having your healthcare questions and concerns addressed the way you want and need them addressed can make a huge difference in both you and your child’s life.

If you don’t feel comfortable with the pediatrician you currently see, do not hesitate to shop around and find other providers. Patients switch providers all the time and you should not worry about hurting their feelings because what’s most important is that your children are getting the care they need and you feel supported as a parent. Ask around to your peers for referrals; your friends with kids, co-workers with kids, or call your local children’s hospital and ask to speak to someone in the pediatric unit for their recommendations.

Related Articles

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Making Doctor Visits A Positive Experience For Your Kids

Things I Learned In The NICU That No Doctor Could Ever Tell You

The rate of twin births has risen 79 percent over the last three decades, and continues to increase. A mom of fraternal twins and a national guru on having two, Natalie Diaz launched Twiniversity, a supportive website with advice from the twin-trenches.

What to Do When You’re Having Two is the definitive how-to guide to parenting twins, covering how to make a Birth Plan checklist, sticking to one sleep schedule, managing double-duty breastfeeding, stocking up on all the necessary gear, building one-on-one relationships with each child, and more.

Accessible and informative, What to Do When You’re Having Two is the must-have manual for all parents of twins.

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The Best Questions to Ask a Pediatrician at the Interview

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There’s no doubt, the meet and greet with your potential pediatrician is an important appointment. During this time, you’ll be assessing everything that makes your doctor a viable candidate: his philosophies, qualifications, staff, location, and even his personality.

There’s a lot of factors to consider when you’re looking for a pediatrician, so coming prepared is the best move you can make.

In last week’s post, we talked about how to find a pediatrician, including the most important factors to consider during your search and how to find one in your network. I also launched a free medical binder printables to help streamline the process (you can download that below).

In this post, we’re going to take a deeper look into the interview process, namely what questions to ask a pediatrician, what questions to ask before the meet and greet, and how you can inevitably choose the best candidate.

Speaking as a first time parent who’s been exactly in your shoes, let me reassure you: by interviewing your pediatrician you are saving yourself a lot of grief. While there may not be a perfect pediatrician, there is an excellent one waiting for your family.

And guess what? You’re already on the right path to finding her.

RELATED POSTS:

How to Choose A Pediatrician Perfect for Your Baby
The Ultimate Breastfeeding Class by Milkology Review (The Only Online Breastfeeding Class I Recommend!)
How Skin-to-Skin Can Boost Your Newborn’s Development

The Best Questions to Ask a Pediatrician at an Interview

This post may contain affiliate links. If you make a purchase from one of the links I will make a small commission at no charge to you. I only recommend what I trust. Blunders in Babyland does not diagnose, treat, or give out any professional advice for any medical conditions.

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What is a Pediatrician

If you’ve made it to the interview process, I’m willing to bet that you’re already familiar with what a pediatrician is. Having said that, before you walk into the interview, it’s important to note that you can actually choose three different types of practitioners to serve as your child’s primary care provider.

Pediatricians

The first, and most common, is an actual pediatrician. Pediatricians are doctors that specialize in infant, adolescent, and teenager care. They will have the most experience with child-related illnesses and injuries. Ideally, they’ll have the best bedside manner as well.

Family Doctor

Family doctors focus on all age groups and possess a very diverse knowledge-base. Choosing a family doctor can be extremely convenient (less paperwork and you can schedule your checkups together), but they are less focused on children by default. When choosing a family doctor, you will want to make sure that he actually takes on young, new patients.

Nurse Practitioner

You can choose a pediatric nurse practitioner (or even an Advanced Registered Nurse Practitioner). Like pediatricians, pediatric nurse practitioners focus solely on infants, adolescents, and teenagers. They are qualified to perform most functions of family doctors or pediatricians, but may need to consult for complex conditions or illnesses.

Personally, I had a pediatric nurse practitioner and I loved her. I enjoyed the personal care she gave my daughter and she was very knowledgeable.

When to Interview Pediatrician

If You’re Pregnant

If you’re expecting a new bundle of joy, the best time frame seems to be between 28-34 weeks. That gives you enough time to schedule a meet-and-greet with your top three professionals, if necessary, and avoid any early delivery scenarios.

If You Have a Newborn

If you’re the proud new parent of a newborn, you need to find a pediatrician ASAP. It’s very important to meet with your baby’s pediatrician about a week after he is released from the hospital to check his growth.

Signs You Should Find a New Pediatrician

Now, let’s say you’ve been going to the same family doctor for years, but you’re not really getting the vibe that he is the best choice for your child. Don’t second-guess yourself. Here are a few signs that you need to look for a new pediatrician:

Doctor dismisses your concerns
High wait times, long wait lists
Unfriendly staff
Inconvenient hours or location
Doctor doesn’t seem to keep up with current practices
He makes your child uncomfortable (this is different than stranger danger!)
He disagrees with your philosophies in a disrespectful way.

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How to Find a Pediatrician

If you haven’t already asked your friends, family, and OB-GYN for recommendations, that should be your first move. Word of mouth is seriously valuable as long as you ensure that the pediatrician is still taking clients and is covered under your insurance network. Alternatively, you can use your insurance company’s “Find a Doctor” tool or the AAP’s search tool.

What to Look for in a Pediatrician

One last thing to consider before we get into what questions to ask a pediatrician: what exactly to look for in a pediatrician. We go over how to find a pediatrician and what exactly to look for in much more detail in this post, The Ultimate Guide to Finding the Perfect Pediatrician, but here’s some of the basics:

Convenience

Sometimes, it’s worth the 45 minutes drive for a great pediatrician. However, generally speaking, you’ll want to find one nearby.

You should also check the practice’s availability, including their regular hours of operation, available nurse lines, and after-hours consultations. During the first 3 years of your baby’s life, you’ll visit the doctor a minimum of nine times (and trust me, this is the minimum).

Friendliness and Professionalism

Your doctor doesn’t have to be outrageously outgoing, but you should at least feel comfortable with him. If he’s not overly friendly, at least make sure that he’s courteous and listens to your concerns.

A pediatrician’s level of professionalism often trickles down to his staff. If the staff is rude over the phone or in person, you may want to consider a different pediatrician.

Credentials and Services

Though not required, it is helpful to find an ABP or AAFP board-certified physician. This certification goes above and beyond the minimum requirements of practicing medicine, and ensures that your pediatrician is informed.

If your child has a special condition, make sure that your pediatrician is not only trained, but experienced in that field.
Also, you may want to look at the services offered at the practice, such as same-day sick appointments, walk-ins, what tests are offered, and any special requirements needed for your child.

Medical coverage and/or Payment System

You don’t want to break the bank every time you visit the doctor’s office. Make sure that your candidates are a part of your insurance network before making the interview with the pediatrician.

If you don’t have an insurance plan, ask the staff about their payment plan options or any uninsured patient discounts.

Philosophy and personality

At the heart of it all, the interview questions for a pediatrician should determine how well you jive together. If you don’t get along with your pediatrician or have zero commonality, you’ll both be miserable.

Make sure you feel comfortable expressing your concerns and opinions with your pediatrician. Even if he doesn’t agree, he should listen and respectfully say his peace. However, if you disagree on several important issues (for example, your doctor pushes formula when you’ve decided to breastfeed), it may be time to move on.

Questions to Ask Before Interviewing Pediatrician

You will want to do your homework before you even set up the interview. A parent-pediatrician relationship should be one of mutual respect. Pediatricians are very busy, so figuring out the minute details beforehand will show her that you’re respectful of her time.

Before the interview, you should know:

Office hours ( you may need to ask the pediatrician about after-hours care or consultations)
How they handle billing and insurance
Doctor’s credentials, including any disciplinary actions (Google {State} medical disciplinary actions). Most of the time, your doctor’s credentials can be found on Vitals.com, Healthgrades.com, or her healthcare network’s website.

Hey, Mama. Are you pregnant and on a budget? Don’t let that keep you from taking a childbirth course! I highly recommend checking out the Birth It Up Online Class from Mommy Labor Nurse. Whether you’re planning on giving birth naturally or with an epidural, you can learn everything you need to know for under $40! Check it out!

How to Set up the Meet and Greet

I highly recommend calling the office to set up the meet and greet, rather than using any online appointment system. When you think about it, this is the first time you’ll get a gauge on the office staff. It’s an important call!

Stumped on what to say?

Simply explain that your are a parent/future parent and you’re interested in setting up a consultation to get to the know the pediatrician. Most of the time, the staff is completely understand. However, if they balk at the idea of a meet-and-greet or claim that you need to set up a first patient visit, you may want to keep looking.

Keep in mind that most offices do charge for this consultation, which may or may not be covered under your insurance policy.

Personally, I would set up three interviews. You may not attend all three, but if the first interview is a flop, you won’t be scrambling to schedule another one. Most of the time, the office will let you cancel with 24 hours notice.

The Best Questions to Ask a Pediatrician at a Meet and Greet

Okay, you’ve made it this far!

Now it’s time to get into the good stuff: questions to ask a pediatrician at a meet and greet. Some of these questions are pretty straight-forward, but there are a few that have a little more nuance.

1. Tell me about your practice.

This is an open-ended question designed to gauge what’s most important to your pediatrician and get a feel for his personality. Don’t try to fill the silence, let him talk about his practice and what matters most to him.

2. If you’re unavailable, who can I see or talk to about my child’s illness?

Urgent care clinics are expensive and you have no idea what you’re walking into. You want to make sure that if your pediatrician is on vacation for two weeks, you can take your child to someone that your pediatrician trusts.

3. Does your practice provide after-hours consulting?

It’s 2AM and your baby has a raging fever. Should you take him to the ER or wait it out until morning?

An after-hours nurse line or consultation line can answer that question fairly quickly. If your pediatrician doesn’t have this service, you should ask how long it will be before you can expect a call-back.

4. Do you offer walk-ins or same-day sick appointments?

Most practices offer same-day appointments for infants or children with acute illnesses. Double-check this fact before making your decision. If the clinic doesn’t offer that service, they should refer you to a good nearby walk-in clinic.

5. What’s your philosophy on {vaccines, infant antibiotics, circumcision, baby weaning, breastfeeding, sleep training, etc}.

Hands down, one of the most important questions to ask a pediatrician: what’s your opinion on…

Don’t go crazy here, but do focus on the controversial issues that are most important to you.

If you’re looking for extreme and disrespectful opinions. For example, if your doctor is adamantly against sleep training and criticizes you for practicing it, this is an indication you should move on. However, if he states his opinion professionally and respectfully, you may not have any issues.

You really need to use your discretion here. Your pediatrician will be your greatest ally and source of information for a long time.

6. Why did you choose pediatrics?

When I first became a mom, I saw another blogger recommend this question. I chickened out of asking it because it felt a little too personal. Now, I wish I had.

The answer to this question is an excellent indication of how committed this pediatrician is to her practice and how passionate she will be with your child.

7. Are your imaging or testing centers in our network as well?

Ideally, the practice will be able to do x-rays, urine samples, and blood tests in-house. However, if this isn’t the case, it’s a good idea to check out the locations the pediatrician requires you to use.

8. Do you have children?

Just like question 6, this is one of the more awkward questions to ask a pediatrician.

The point isn’t necessarily that your doctor has children of his own and is qualified to make diagnoses of children. You’re just trying to get a gauge on his personality and passion. Try to ask it as organically as possible.

9. Do you have any experience with {insert your baby’s special circumstances}.

If your child has special needs, you want to make sure that you find the professional most qualified to care for them. This is a non-negotiable.

10. If pregnant, ask the newborn checkup at the hospital.

If your doctor isn’t able to provide this service, most of the time it’s not a deal-breaker. Many hospitals have pediatricians on-call that can perform this checkup. However, do make sure that you can bring your baby in within 5 days of leaving the hospital.

SHORT ON TIME? PIN IT FOR LATER!

Questions to Ask Yourself

Cleanliness

Does the facility offer sanitation stations? Are the parking lots, rooms, and lobbies well-kept? What about the play area? Your kid will spend a lot of time in those play areas, sharing germs with other children. Make sure that the facility is up to snuff.

Friendliness

Look at the supporting staff. Were the nurses and office admin friendly? Did they get you in on time? Don’t forget that this place seriously affects your child as well. If the vibe is cold and unfriendly, your child may pick up on it.

Knowledge

On paper, many doctors share the same qualifications. However, that doesn’t mean they share the same experiences. How did your doctor do answering your questions? Was he confident and informative or did he balk at the interview process?

Also consider if he seemed up-to-date on his practices.

Comfort

How comfortable did you feel asking these questions? Did you feel rushed? If you were respectful of the doctor’s time, you should not have felt pressured. Mostly, you want to feel heard. If your doctor seemed bored, unresponsive, or belittling, this is probably not a good fit.

Don’t Forget the Purpose of the Meet and Greet

Are you noticing a common theme here?

The interview isn’t so much for assessing the pediatrician’s professional qualifications but making sure she’s a great fit for you. On paper, most pediatricians can do the job, but you want to do more than find a qualified pediatrician. You want to find the best one for your family, right?

That requires some of the box questions that dive into who your doctor is as a person and a professional.

What Are Some of Your Favorite Questions to Ask a Pediatrician?

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I sincerely hope this list helps your interview with a pediatrician go smoothly. This is an important decision, but that doesn’t mean it has to be a big deal. You’ve got this!

If you haven’t already checked out my post on How to Find a Perfect Pediatrician and downloaded your FREE Baby Medical Binder Printables, please do! I think it’ll really make the process so much easier.

And, if you’re reading through this and you have a few of your own questions you’d like to add, I’d love to hear from you! Let’s support each other!

Good luck!

RELATED POSTS:

How to Choose A Pediatrician Perfect for Your Baby
The Ultimate Breastfeeding Class by Milkology Review (The Only Online Breastfeeding Class I Recommend!)
How Skin-to-Skin Can Boost Your Newborn’s Development

“The most important layer of work is teaching parents the red flags” – Rhea

Especially for Rhea, journalist Olga Tsipenyuk spoke with Moscow pediatrician Sergei Alexandrovich Butriy. From this material, you will learn what “magic” thinking is, how “brain” crying differs from ordinary crying, and you will also understand what year it is optimal to feed a child.

Sergey Alexandrovich Butriy — pediatrician, chief physician of a children’s clinic with 10 years of practical experience, author of the blog about evidence-based pediatrics «Notes of a pediatrician», co-author of the book «Medicine for the Smart. Modern Aspects of Evidence-Based Medicine for Thinking Patients”.

You have 10 years of professional practice behind you. Have the needs of parents changed since then? Are there any general trends?

Difficult to compare, these are fractions with different denominators. Ten years ago, I was a district pediatrician and saw a fundamentally different sample of parents. Now I am an appointment in a private medical center with a high cost of a visit, there are initially motivated and educated parents, the middle class. Such factors influence requests much more than time.

What was the socio-demographic profile of your parents like when you were a local pediatrician?

I like the phrase “socio-demographic profile”, it is suitable to describe the situation: you come to an apartment where there is a bucket in the middle, all family members urinate and defecate there, and once a day it all falls out into the street. And right after that, you go on a private call to a three-story mansion with an iguana as a pet. Of course, neither the bucket nor the iguana is a mass phenomenon, but nevertheless it is almost impossible to average, generalize the requests of parents.

How does the availability of the Internet, medical information, professional and fake information used by parents affect your work?

It all depends on the family and the specific case. In general, the current availability of information does not bother me. Yes, parents can be informed one-sidedly, they can be biased in advance towards some kind of treatment method — well, let it be, everything is discussed. The worst option is lack of initiative, passivity and basic denseness of parents. Especially if they are initially subject to «magical» thinking.

«Magical» thinking?

«Magical» thinking is the opposite of rational for me. I can reach out to a rational parent using rational and scientific arguments. With such a person, we have common value ideas about the world, for example, the data of a major scientific study published in a respected journal are considered as something, by definition, convincing.

For people with «magical» thinking, the opinion of experts or references to research is not an argument. Much more serious factors are some isolated cases, personal experience, prejudices, examples from the life of people whom they a priori trust.

In the eyes of such parents, research is devalued by slogans like “you can’t get the truth”, “big pharma pays for everything”, “they will draw whatever numbers they want in their research”. At the same time, methods that do not have scientific confirmation and are as close as possible to magic — homeopathy, for example — are by default considered as deserving of respect and indisputable.

Let’s move on to more specific questions about parents, for a start — about future parents. What you need to know about taking medications during pregnancy planning?

There is a whole group of substances that are undesirable during the preparation for conception, ranging from alcohol to specific medications. When prescribing, a doctor warns a woman and a man — more often, of course, a woman — about the need to comply with barrier methods of contraception for the entire period of taking the drug and, say, three months after its completion.

If a person of childbearing age does not want to take medicines that can potentially cause harm, or, for example, he is against contraception, then he will be offered safer, but often less effective means. We call them second line drugs.

For example, a child “brought” pinworms and worms from kindergarten. I can cure a helminthic invasion with albendazole perfectly. Until recently, after taking it, a woman was forbidden to become pregnant for three months, now this period has been reduced to one month. I will say that the child needs to take the pills for three days in a row and repeat the course in nine days, and the mother should take one. At the same time, of course, I will mention that after taking the medicine, she cannot become pregnant for a month. If she refuses, I will prescribe Pirantel. Its effectiveness is lower, which means a higher risk of relapse, but this drug is safer.

A separate question is what to do if pregnancy still occurs while taking medications that are potentially dangerous for the fetus. There are situations when we can insist, more precisely, insistently suggest an abortion, and sometimes we recognize the risk is not so high. For example, vaccination against measles and rubella, which is traditionally considered a mutagenic factor and is prohibited during pregnancy, is not a reason for an emergency abortion if the pregnant woman was nevertheless vaccinated by mistake in the early stages. In all these cases, there are clear recommendations.

Let’s talk about genetic diseases that manifest themselves in the first years of a child’s life.

More precisely, about the possibility of identifying their early stages.

There is a basic prenatal screening, especially ultrasound as the safest and easiest method. The study reveals, for example, gross heart defects. This method can also detect an increase in the thickness of the collar space in the fetus, which may indicate some chromosomal diseases, such as Down syndrome. In any case, the “minimum” that a woman can do is to register in a timely manner and follow the recommendations of her gynecologist.

«Maximum» is dangerous for the fetus in itself, for example, amniocentesis — the study of amniotic fluid — carries a certain risk. carries some risk. We are talking about the “maximum” when the family already has a genetic pathology, the repetition of which we are afraid of, in other words, when the risk of the disease is higher than the risk from medical manipulation, and the latter is justified.

For example, ultrasound has already shown adverse findings, and it is necessary to clarify what exactly caused them. Yes, we will do an amniocentesis and, for example, perform a karyotyping of fetal cells — a study that allows us to detect the presence of chromosomal abnormalities. But nothing can be done: if a pathology is detected, the only way out is often an abortion, which is unacceptable for many. People often think that a lot of things can be cured if recognized early, but unfortunately, no rather than yes.

Is refusing an amniocentesis a way to hide your head in the sand?

No, such a choice can be quite conscious. If a woman understands that abortion for religious or moral reasons is impossible for her and she will give birth in any case, then why should she increase her stress level in advance and expose the fetus to additional risk?

How popular is amniocentesis without medical indications — to learn more about the condition of the fetus?

I don’t have statistics, but I think that the popularity of such occasions is very low, simply because of the complexity of the procedure. It’s not like donating blood from a finger, it’s an invasive manipulation. Hospitalization, special training are needed, doctors must clearly understand why the study is being done.

You may get the wrong impression that if you are opposed to abortion on principle, then you should not be screened at all. No. It is important to emphasize that not all problems identified by prenatal screening are solved exclusively by abortion. There are a number of things we can fix or at least prepare for.

We have learned to correct Spina bifida, a herniated spinal cord, in utero. I am personally delighted with the very possibility of operating on a child in utero and clearly improving his prognosis. So far, this is an extremely rare and high-tech operation, but I believe that it will be done more and more often.

We can prepare for the birth of a child with a gross heart defect that was seen on an ultrasound. Of course, such a baby should be born not in a district maternity hospital with modest diagnostic and technological resources, but in a high-profile research institute, with a cardio team at the ready by the time of birth: these children need to be operated on in the first days of life.

However, I would like to point out that I am a pediatrician, not an OB/GYN, and feel insecure when answering questions outside my specialty.

What serious malformations, not detected at the prenatal stage, appear in the first years of life?

Almost everything. The main genetic pathologies, orphan diseases, as a rule, manifest themselves and, accordingly, should be detected by doctors before the age of three. Later, very rarely. That is why regular visits to the pediatrician are so important during this period. Much can be seen in the dynamics, from month to month: here it is late, here there was a rollback, this symptom is growing, but this skill still does not appear.

Pediatrician fixes indirect signs. For example, insufficient growth and weight gain or specific external signs, what we call “dysembryogenesis stigmas”: when a child has too low set ears or a strange eye shape, gross asymmetry in the proportions of the face or in the length of the limbs. The doctor begins to think whether this picture is developing into some kind of syndrome. In such cases, we directly write: «Undiagnosed genetic syndrome?».

And what happens next?

I have a rather severe little patient who could not get off tube feeding for six months: he could not digest food and refused to suck. This is a separate big problem — eating disorders in infants, infantile anorexia. The term clumsy, it is often argued whether it can be used, because in general anorexia is a teenage thing, it is associated with a violation of the body scheme. A body schema is a model, an idea of the body, which is constructed by the brain; it is based on a set of some information. Babies, by definition, don’t know their body map, so this is a controversial area in pediatrics.

Parents came to me when it became clear that the child after the maternity hospital cannot refuse the tube, is often examined in the hospital, but there is no diagnosis and the prospects are unclear. This situation is called FTT, failure to thrive, literally — “failure to thrive”, gain weight and develop. FTT is quite rare, only in one percent of cases, it is associated with a real genetic or some other pathology, more often it is just an eating disorder and metabolic features. With age, it passes, a difficult period you just have to go through.

“I get a little annoyed when they say about the pediatrician’s check-ups in the first year of a child’s life: “We came to weigh ourselves.”

But this particular child, the more he grew, the more he became like a carrier of a genetic problem. I sent him to a specialist. He also could not make a diagnosis by appearance, but ordered a series of tests. Research has confirmed a rare genetic disorder: Noonan syndrome. Having a diagnosis, we can already read the literature about it, understand how such children develop, what kind of typical problems await them, “lay straws” and speak more confidently about forecasts.

This is the work of a pediatrician, especially in the first three years of life: identifying oddities, hooks that you cling to and begin to unwind the problem. I get a little annoyed when they say about the pediatrician’s examinations in the first year of a child’s life: «We came to weigh ourselves.» You can also weigh yourself in the supermarket, there are control scales at the exit. And they still come to the pediatrician to check their health, look for pathologies, rare and not very, engage in prevention, discuss worries, receive information and support.

After the interview with pediatrician Fyodor Katasonov, the Internet audience was literally seething. He argued that the benefits of breast milk for children older than a year are exaggerated. At the same time, WHO recommends feeding up to two years. Katasonov, on the other hand, argued that breastfeeding after a year is more often used by mothers as a way not to feed, but to calm down: “The breast is sweet, it contains drugs.” What is your position?

Breastfeeding is the preferred way to feed babies up to 6-12 months of age. I recommend continuing it for up to a year and possibly longer, until it starts to interfere with the family in one way or another. In breastfeeding after a year, I see a number of disadvantages and now I have to choose my words very carefully so as not to cause the same violent reaction as Fedor’s statements.

In fact, the only thing I disagree with him about is the bad analogy with drugs. Otherwise, I am quite ready to subscribe to the fact that breastfeeding up to a year has a lot of undeniable advantages, and after a year its benefits are greatly exaggerated.

I like to refer to the American Academy of Pediatrics, which says that breastfeeding is the best way to feed up to a year, and then it’s up to the mother and baby. They withdraw themselves from a direct answer to the question of exactly how old they should be fed.

«Breastfeeding is the preferred way to feed babies up to 6-12 months»

In fact, the only thing I disagree with him is the bad drug analogy. Otherwise, I am quite ready to subscribe to the fact that breastfeeding up to a year has a lot of undeniable advantages, and after a year its benefits are greatly exaggerated.

Yes, WHO writes for up to two years, in some sources even up to three. But when we, pediatricians, are presented with this, we usually say that the WHO recommendations apply primarily to developing countries with low levels of hygiene and poor quality products. When everything is so bad, of course, prolonged breastfeeding significantly increases the banal survival of children and its benefits in such conditions are undeniable. If we are talking about developed countries, then the minus, in my opinion, is in tying the mother to the house, violating career and personal plans.

Of course, if that’s her choice, okay. I’m just not sure that the active promotion of breastfeeding does not create undue pressure on a woman. We avoid undue pressure on parents by recommending vaccinations for children: our job is to inform. When it comes to promoting breastfeeding, educators allow themselves to be less ethical and more authoritarian. I don’t like these double standards.

Do you think that mothers make choices based on social norms?

In many ways, yes. Many women are ashamed and scared, they are tormented by a sense of guilt if for some reason they failed to feed or breastfeeding had to be curtailed early. In such cases, they sometimes literally sob at my reception. But, like any effective medicine, such a wonderful natural phenomenon as breastfeeding has side effects, and we need to talk about them. For example, this feeling of guilt and feelings of inferiority as a mother.

Are there negative physiological effects?

Let me give you an example. There are children who, while breastfeeding, gain a lot of weight at first, one and a half to two kilograms. In most cases, this will stabilize by nine months. But it often happens that the weight continues to grow faster than necessary. In my subjective opinion, after nine months, when the child should already begin to actively move, breastfeeding is a provoking factor in excessive weight gain.

In the case of such children, I begin to lead the mother to the idea that by the age of one it is better to stop breastfeeding precisely for reasons of weight correction and stimulation of physical activity. It’s not just about overeating, although this is also important. We are talking about a decrease in activity: the child holds the nipple in his mouth for hours and moves little.

As a rule, long-term breastfeeding is at the expense of solid food — such children do not perceive complementary foods well, it is difficult to switch to a common table, — it is at the expense of mother’s time and strength. Babies can literally suckle for 20 hours a day. Mom is forced to sleep with the child, sit on the toilet with the child — there are such stories in my practice. These children are literally terrorizing the mother! She stirs porridge on the stove with one hand, and with the other she holds a 13-15-kilogram baby at her chest. An unhealthy situation, harmful to both of them.

There are still attempts to investigate whether prolonged breastfeeding damages the teeth. I tried to look for this information, but, apart from individual expert opinions, I did not come across any serious data.

How, on the one hand, not to panic from every child’s sneeze, on the other hand, not to miss a serious problem?

The most important part of a pediatrician’s work is enlightenment, in particular, teaching the so-called «red» flags, that is, symptoms that are simple and understandable to a non-medical person, which indicate that the situation no longer fits into the category of functional and safe. In other words, that expectant management is no longer indicated, it’s time to see a doctor or call an ambulance. If you give a set of such «flags» to the parent, he has control over the situation, even when he does not know the exact diagnosis.

Where does the borderline between colic and intussusception pass in a two-month-old baby? This is a standard surgical pathology that is discussed at one of the first visits to the pediatrician. I usually talk about an hour and a half of continuous crying, when you can’t calm the baby with anything. Colic has breaks, you can put the child half asleep for 5–7–15 minutes, rock him, distract him. He will take a breath, then start screaming again.

«Where is the boundary between colic and intussusception in a two-month-old baby?»

With intussusception pain, you won’t even have those five minutes. Each parent has their own life hacks, their own tricks to calm them down: “white noise”, driving around the yard in a car seat, something like that. So, when the crying lasts one and a half to two hours and the methods that used to help do not work, you need to call an ambulance, see how it looks like an acute stomach, whether the intervention of a surgeon is necessary.

Another example. The boundary between the usual headache due to intoxication during SARS and meningitis headache — where does it go? First of all, a simple headache has a beginning and an end, and it usually correlates with the level of temperature. The temperature rose — the child whines, the temperature was brought down — he was released.

By the way, here is the “green” flag: when a child is cheerful, fooling around, eating when the temperature drops, this is a calming symptom, which means that the situation is under control, the body will soon cope with the disease. The «red» flag is the so-called «brain» crying. The child is disturbed by a severe headache, he cries, but at the same time, the crying itself, like any loud sound, intensifies the headache. Because of the sound fear, the baby chooses a compromise: a quiet monotonous whining on one note. This is called «brain» crying: «N-n-n-n-n, n-n-n-n.» Together with the forced tilted back position of the head, it is a very “red” flag.

But it is impossible to provide parents with a complete set of such “flags”.

Certainly. Even a pediatrician does not know everything, and even more so parents. But to know the most common is already a lot. And for the rare, there is parental intuition, which we are increasingly talking about in a completely scientific way. I came to this idea a long time ago from personal experience, and when confirming studies appeared, I was very happy. For example, there is a Western study of the behavior of parents who go to the hospital emergency room.

There is no such thing in Russia, which is a pity. This is a department of the hospital, something between a full-fledged hospital and a clinic. You arrived, sat in line, you were invited to a little room, the pediatrician examined the baby, for example, with false croup or vomiting. He prescribed an intravenous infusion or inhalation for the child, relieved the symptoms, took express tests, ruled out serious problems. And he let his family go home to be treated, where it’s definitely more comfortable and calmer.

There is simply no such thing in Russian reality. This is not included in the list of polyclinic services, pediatricians and nurses are not equipped to administer intravenous infusions at home. In our country, a child in such a situation ends up in a hospital, but after six hours, even if he feels better, he will not be discharged. It will lie as long as they say or until the parents decide to sign a waiver of hospitalization.

The study I’m talking about showed that in most cases, in my opinion about 70%, when parents go to the hospital emergency department with a problem that literally sounds like «something is wrong with the child», doctors really find a dangerous disease. “Not so” means that the parent cannot name a specific symptom, but there are changes that are alarming: shortness of breath, swelling, change in consciousness, excessive moodiness.

Watching a child every day, mom or dad intuitively know how he behaves when he is sad, when he is happy, when he is hungry, when he has not had enough sleep. And then something new: “It didn’t happen like that before, I don’t know what to call it and why it arose. It worries me a lot.» This state is the main «red flag». It works, of course, with reservations for personal anxiety. There are mothers who can’t rely on their intuition, knowing that every cry is assuming the worst. But there is, as a rule, a second parent or someone else close who can supervise and say: “Here you worry in vain, but here — yes, perhaps I don’t like something either.”

The second part of the interview with pediatrician Sergei Butriy is here. The doctor spoke about his attitude to hardening and unnecessary medical examinations, and also gave information about children’s covid vaccination.

Photos: cover and photo of the hero — from the personal archive; illustrative photos in the material — Unsplash (Charles Deluvio, Jaye Haych, Brooke Cagle, Joshua Coleman, Syed Ahmad).

How not to behave at an interview — Work.ua

An interview is an important process in employment with its own rules, during which applicants keep making the same mistakes.

Let’s list the most common ones.

Quite simple things often go unaccounted for, and applicants continue to make typical mistakes, especially young professionals.

Lateness

«Accuracy is the courtesy of kings and the duty of all good men.» Being late for your first meeting with an employer will not do you any good. But there are different situations in life, so if you are still late for a meeting, do not forget to warn about it. Read more in the article “Is it so terrible to be late?”.

Appearance

Don’t think that an interview is not a job and business appearance can be neglected. Jeans, an unusual hairstyle, sneakers and T-shirts with interesting prints can be afforded by people of creative professions: photographers, designers, models, etc. If you are not one of them, then do not forget about the appropriate style of clothing and neatness.

Self-presentation

The ability to present oneself well also plays an important role. An employer will have less interest in a candidate who stumbles over the word and gets nervous at every question. But you shouldn’t look like a superman either — find a middle ground. Be open and friendly person, prepare for meetings in advance. Read more about this in the article «Rules of self-presentation».

Professional questions

Forget the phrase «don’t know» and the like if you are asked questions related to your specialty. Don’t worry, think out loud, give examples, but never shrug your shoulders.

Interest

An interview is not an interrogation. To show your interest, you should also ask the interviewer questions. After all, not only you should approach the company, but the company should suit you too — this is the only way to achieve good results in business. Read more about this in the articles What to Ask the Interviewer and 10 Questions to Ask the Interviewer.

Lie

Sometimes it doesn’t hurt to embellish reality a little, but still, a lie is not the best start to a new business relationship. In addition, it can also become a reason for dismissal if the truth is revealed in the process of work. Read more about this in the article «Lies on the resume and at the interview.»

Reasons for changing jobs

In almost every interview you will be asked about the reasons for changing jobs. You should always have an answer ready. At the same time, you should refrain from negative reviews about the past employer, your motivation should be logical and transparent.

Mobile phone

Remember to turn off your mobile phone during the interview, or at least put it on silent. Nothing should distract you from the conversation.

Position and company

You must know and understand exactly the requirements of the position you are applying for and the duties you will be performing. It will be strange if you are required to have a good knowledge of a foreign language, but you do not speak it, although this is clearly stated in the vacancy announcement.