I was excited to be able to interview Dr. Charlotte Cowan, pediatrician and author of The Dr. Hippo Series.

A little about Dr. Cowan:
“Dr. Cowan is a board certified pediatrician who trained and practiced for many years at Boston’s MassGeneral Hospitalfor Children where she remains on staff. During her clinical years at the MGH, she served on the Faculty of the Harvard Medical School. Additionally, Dr. Cowan has completed a Fellowship in Medical Ethics at the University of Chicago and is a current Fellow of the American Academy of Pediatrics.”

Q&A

What should you look for when choosing a pediatrician?
There are many facets to choosing a pediatrician. Several are listed below, in no particular order.

1)  If at all possible, it is helpful for prospective parents to interview several pediatricians well in advance of the birth of their first child. Not all pediatric offices offer the service of free “prenatal visits,” but a great many do. This is a great opportunity for the parents to not only meet the pediatrician but also to check out the office in a practical way. How hard was it to park? How long did children seem to be waiting before being seen? How clean was the office? Were there toys and books for the children to use, educational materials available for the parents? Was the room child friendly, inviting?

2) You may start by asking your obstetrician for a list of doctors he or she recommends. This has the obvious advantage that obstetricians and pediatricians work together closely: obstetricians get feedback about the baby’s doctor from mothers at their 6 week post partum visit; and obstetricians also watch how the babies they deliver are cared for by pediatricians in the hospital nursery. The obstetricians are thus careful, well informed observers of the pediatrician’s style and competence.

3) If there are certain issues of special importance to the parent—ie overuse of antibiotics or the safety of immunizations—it is smart to ask about these during the prenatal interview. You will learn quickly that pediatricians not only vary in their responses but also and importantly vary in their styles. Choose a person who relates well with you, who feels approachable, and who resonates with your learning style. Make sure you feel comfortable asking questions and that the pediatrician you choose seems dedicated to answering them.

4) More practical points to be addressed during the prenatal interview include the following: What are the after hour policies? How fast will the office call back during the day if a child is sick? Where are sick children admitted to the hospital? Who is in the pediatrician’s coverage group and do they take your medical insurance?

Why choose a pediatrician over a family doctor?
The answer to this depends partly on where you live. There are many regions in this country where family physicians are far more common than pediatricians and are very well respected in their communities. Family physicians have three years of training after medical school that enables them to take care of both adults and children; pediatricians have three years of training after medical school that enables them to take care of children only. Which you prefer is a personal decision.

What are some FAQ’s that first time parents ask about their children?
New parents are consumed with worry about whether their baby is eating well, peeing and pooping normally, sleeping well and developing major milestones on time—like smiling and cooing. All of their concern is a function of their deep love of the baby and is usually very normal.

Do you encourage your parents to immunize? Why or why not?
Having taken care of babies and children who have died from preventable illnesses (!!) , I cannot urge immunization any more strongly. I used to refuse to take care of families who would not immunize their children because I believe that doing so puts their children at preventable and severe health risk. The (re)emergence of pertussis, measles, and recently H. Flu meningitis (fatal) speaks to this. Study after well designed and documented study has refuted any relationship of autism to immunizations.

How often should babies/children visit their pediatrician?
The frequency of office visits to the pediatrician varies with age and of course with what is going on in the family and with the child. Most generally, a newborn will be seen frequently and then, gradually, visits will taper off to once a year as the child grows up. Many of the visits are punctuated by shots but—even if no shots are given—well visits are important as times to learn about developmental and safety issues that are around the corner!

What to pediatricians look for in a routine visit?
In a routine visit, pediatricians will always look for excellent growth as an index of health. They will ask about all aspects of a child’s life (eating, sleeping, activities, school, etc) and often will ask about the other members of the family too. Of course they will examine the child to make sure that there are no medical problems brewing. Pediatricians also use routine visits as a chance to answer questions and to tell parents what to expect developmentally in the next few months. Safety advice is often part of this, too. These visits are very important!!!

(A big thank you to Dr. Cowan for doing this great and informative interview!)

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