Ask A Doctor 3-7-11

Pediatrics
Tony Conte, MD

Q: As an expectant, first-time mother, when should I schedule my first visit with a pediatrician?
A: In general, seven to eight months in your pregnancy. Interview your potential pediatricians; it’s important to be sure your personalities match and that you are comfortable with your doctor. Keep in mind that every doctor handles things differently. Some may take a structured approach while others are more laid back. Make sure you both will be on the same page when it comes to managing your child’s health and wellness so there will be a good level of trust in your relationship with your pediatrician.

Q: Vaccinations can be controversial for some families. Are they safe?
A: It’s really important to sit with your doctor to discuss your concerns. We are in favor of vaccinations; the benefits far outweigh the risks. For instance, if you have ever seen a child with pertussis (whooping cough) you would know how awful it is. If you don’t vaccinate your child, you are creating a risk and a dependency that everyone else has been vaccinated.

Q: When is the best time to start solid foods and are there any foods to avoid?
A: Every few years there are new recommendations. Some cultures start solid food almost right away. When I was practicing in San Luis Obispo, I saw many families of the Oaxaca culture from Mexico. They would chew food to feed to their infants. I also know some Indian families who give their very young children curry. They all do just fine. Kids are really good at taking the right food they need to grow if you give them a good, healthy variety. We are blessed in America to have enough calories around for our children to grow.

Q: What do you think about researching diseases, treatments, and other medical information on the internet?
A: The internet is a fantastic resource that is changing the way we live and the way doctors practice medicine. It’s common that a parent will bring me an article they have found about a disease I’ve never encountered before. Because there is so much information available, it’s important to know where the information is coming from and the motivation for the site – Education? Profit? The bottom line is that anyone can say anything on the internet and not be held accountable.

Q: Are there certain warning signs that may signal that my child has a developmental disorder?
A: There are milestones that people expect to see by a certain age but every child is different. With regular visits to the doctor, your pediatrician will help you track your child’s unique development. Be sure to have good communication with your doctor – let them know what is happening with your child and express any concerns you have.

Q: When do I know my child needs to go to the emergency room?
A: Obviously if your child isn’t breathing, is non-responsive, or has a serious injury like a broken bone, they need to be seen in the ER. A fever in the first two months is abnormal, could be cause for concern and should be treated as an emergency. In older children, fevers cause a lot of worry for parents. But even if your child has a high fever, if they are acting normal they are probably okay. However, a child with any degree of fever accompanied by abnormal behavior such as lethargy or a fever that lasts more than five days needs to be seen by their doctor.

Q: What is Sudden Infant Death Syndrome and are there any precautions I can take to protect my baby?
A: Sudden Infant Death Syndrome, or SIDS, is unexpected, sudden death of an infant below the age of one year that can occur during sleep. It is devastating, but thankfully rare, and there are steps to protect children including placing a child to sleep on his or her back, breast feeding, using a pacifier, and not letting the child sleep with fluffy toys or blankets. Also avoid smoking – SIDS has been linked to smoking during pregnancy and exposure to second-hand smoke.

Q: I can’t get my child to eat anything healthy and he’s overweight. Should I be concerned about the risk of disease?
A: American adults and children have never been bigger or heavier, and being overweight and sedentary are significant problems. As I parent, I worry when my child won’t eat, so I will offer him foods I know he will eat, but aren’t necessarily the best choices. I feel better for the short term, but am creating a problem for the future. Kids will eat when they are hungry, and can and will eat foods that are given to them. It’s up to us as parents to provide our children with the right foods. We also must monitor and limit television and computer games and get kids outside and playing.

Bio:
Tony Conte, MD, is a pediatrician with the Forest Road Health and Wellness Center, a Sonora Regional Medical Center clinic. Dr. Conte grew up in the Bay Area and studied at UC Davis before attending Medical School at Wayne State University in Michigan. He completed his residency and internship in pediatrics at Northwestern University in Chicago, Illinois. He has been with the Medical Center for eight years and has also worked at a clinic in San Luis Obispo and for Kaiser in Modesto.