Week 33: Hire a curious pediatrician

Instead of babyproofing, consider this magic wand with deities of birth and child protection, which is a much more beautiful decoration than outlet covers. |  The Metropolitan Museum of Art

Instead of babyproofing, consider this magic wand with deities of birth and child protection, which is a much more beautiful decoration than outlet covers. | The Metropolitan Museum of Art

By now, you may have taken the oft-repeated advice to look at your home from a baby’s point of view, crawling around to identify hidden dangers like exposed outlets, blind cords, and sharp corners.

Let this be your reminder that babies don’t benefit from babyproofing, because they can’t go anywhere yet. Feel free to enjoy your home as it is and start babyproofing (or really, kidproofing) only as you need it. And if you live in newer construction, you probably don’t need to worry about outlet covers.

But at this point in the pregnancy, you might need a different kind of babyproofing: guarding your baby against irrational parenting panic.

If you’ve been following along with this calendar week to week, you’re already familiar with Emily Oster, an economist who encourages parents to make more thoughtful risk-assessments. In Expecting Better, she describes a conversation she had with her obstetrician when deciding whether to have noninvasive screening test versus the invasive but more conclusive CVS or amniocentesis, Oster asked her doctor what her risk of genetic abnormality would be if the screening test went well, and the doctor said “very low.”

“How low” I asked. “One in a thousand? One in ten thousand? One in thirty thousand?”

“Yes,” was the response, “something like that.”

The problem, of course, is that one thousand and thirty thousand are very different numbers, representing very different risks.

Right now you are probably considering possible pediatricians. Even if you have a completely smooth, noncomplicated pregnancy and delivery, you’ll still be spending a lot of time in the doctor’s office during your child’s first year. The American Academy of Pediatrics recommends a first visit between days 2 and 5, at 1, 2, 4, 6, and 9 months, and at 1 year.

Your child’s pediatrician, therefore, will have a large role, not just in your baby’s health but in your perception of health, safety, and risk. None of the research lessons we’ve discussed throughout this calendar are likely to help you if your pediatrician is needlessly panicking you. It’s hard to disagree with an authority figure, especially one with whom you’ve entrusted the care of your child. You want a pediatrician who acts as a baby gate, not an outlet cover, someone who can separate serious risks from less serious ones, and advise you accordingly.

So how do you find a pediatrician who thinks critically about risk?

I’ve previously written that the most important question you can ask a prospective pediatrician is “What do you read?” Medical knowledge is constantly changing, and you want a intellectually-curious medical practitioner who is keeping up-to-date with the field. Asking your prospective pediatrician to describe the most interesting academic article she’s read lately will let you know whether or not she takes an active interest in her field. It will also let you know that she can describe complicated medical issues in an easy-to-understand format, which will be really important should your child ever have any health problems.

You could also a question designed to show the complicated middle-ground between best practices and real life, like “When have you struggled with your own advice?” If four months down the road, you’re completely sleep-deprived and asking the pediatrician if it will be safe for everyone to sleep in the bed together for one night, you want to know how that pediatrician’s real-life experience contrasts with her advice.