As the third trimester weeks crawl by, many pregnant women look for any sign that labor is impending. One of these signs is the loss of the mucus plug. Many women don’t even know what the mucus plug is, or what they should look for. They only know that the loss of it signifies that SOMETHING is happening after months of waiting.

What Is the Mucus Plug?
The mucus plug is exactly what it sounds like. It is a concentration of mucus that is deposited in the opening of the cervix to block germs and bacteria from entering the uterus.

During pregnancy, the mucus is clear and would look much like a woman’s normal vaginal discharge. However, as the cervix begins to thin out and blood is released, there will be some blood deposited onto the mucus plug. As a woman’s cervix opens she will begin to lose the plug, either in bits of stringy, blood tinted mucus over a period of time, or all at once. This can happen up to two weeks before labor actually begins.

The loss of the mucus plug should not be confused with a woman’s bloody show which occurs during labor as a woman begins bleeding prior to delivery. The bloody show will be obviously different than the mucus plug as it is mostly blood and very little or no mucus.

When Should You Call Your Doctor?
Generally there is no need to call your doctor or midwife when you begin to lose your mucus plug, assuming it is clear or just has a little blood showing. Of course, if you feel any concern or have any questions, don’t hesitate to contact them. You can also mention it to your provider at your next visit. You should definitely contact your provider if the mucus becomes extremely bloody or you continue to experience discharge. It could be a sign that labor has started, or it could also possibly be a sign of a complication like placenta previa or of a placental abruption.

Making the RIGHT Choice!
If you are thinking of becoming pregnant, or you are already pregnant, it’s extremely important that you have access to good medical attention for you and your baby. Many studies have shown that early and sufficient medical attention is vital for you and your baby’s health and well being. If you choose to be treated by an obstetrician/gynecologist (OB/GYN) and if you have a doctor who you have the utmost confidence in and feel “at ease” talking to, then your choice is an easy one. However, if you choose to be treated by a midwife or doula route, then do your homework. Acquire a midwife or doula that has plenty of experience and we suggest to you that you hold many interviews before selecting one to help you through your pregnancy.

However, if you’ve relocated to a new city or town, changed insurance plans, or don’t feel comfortable with your current medical doctor, then you may find a new one. If this the case, you should ask around about doctors, meet with a few, and choose the one you feel the most contented with.

We here at Babies Online have put together some guidelines and recommendations:

Three Pieces of Advice:

1. How much?
   Make sure when you make the appointment with an obstetrician/gynecologist (OB/GYN) you ask the receptionist about pricing. Most doctors set aside 10 to 15 minutes for an initial consultation. If your discussion lasts longer than that (up to a half an hour), there is a chance you may be charged another fee (consultation).
2. The Hospital?
   During your decisions regarding an obstetrician/gynecologist (OB/GYN), you will also be deciding where you will deliver your baby. Ask questions about the hospital, like “Does it have a birth center?” or “Is it family- and child-friendly?” or “What kind of relationship does your obstetrician/gynecologist (OB/GYN) have at this hospital?”
3. The Paperwork Formalities?
   When the choice has been made, remember to telephone your old doctor and ask to have your medical records mailed to your new obstetrician/gynecologist (OB/GYN). Your new OB/GYN will need access to your complete medical history.

Questions for the OB/GYN:

• Their Background:
  Find out from the doctor how long he/she’s been in practice and what he/she likes best about a job as a doctor. How long will it take you to contact them in a non-emergency situation? How would you reach your doctor in an emergency?
• Group or Solo Practice:
  If the doctor is in a group, ask how often you’ll see the other doctors. What percent of the doctor’s own patients does he/she deliver? If the doctor works privately, ask him/her about who you will see when they are away.
• Typical Pregnancy Care:
  Ask the doctor which tests he/she routinely performs. Do you, the patient, have any concerns about one of them? If so, ask the doctor how he/she would handle those concerns. If you’re thinking of working with a midwife, talk it over with the doctor in the beginning. Is the doctor open to working with a midwife? Is she associated with a midwifery practice? Find out how experienced the doctor is with high-risk pregnancies (for example, twins or multiples, gestational diabetes or hypertension can all result in a “high-risk” classification) and what you could expect if your pregnancy becomes high-risk. Does the doctor perform vaginal births after cesareans? Finally, ask if he/she recommends that you take a childbirth class, and if so, which one.
• Labor, Delivery, Postpartum
  Ask if and when the doctor (or the doctor from the practice who’s on call) typically meets a patient in labor at the hospital. If you’d like to use a doula (labor coach), see if the doctor has any suggestions. Does the doctor like working with coaches? Is there someone the doctor can recommend? Does the doctor or the practice have recommendations for labor pain? What procedures does this doctor routinely perform during labor (for example, fetal monitoring, IV’s or episiotomies). Is there any procedure you don’t want to have, and if so, what happens then? Ask what happens after your baby is born: Will you be separated? If so, for how long? Can the baby stay in your room with you? Can your partner? Are there any special services for new moms? Are there lactation consultants or other professionals available to answer special questions?

Conclusion
Above all do not worry about asking too many or too few questions. Don’t feel dumb or stupid about questions. Remember: the only dumb or stupid question is the one that is NOT asked. It is important to get answers, and it’s also important to give yourself the chance to figure out if this obstetrician/gynecologist’s (OB/GYN) demeanor and approach is a good match for you.

by Patty Hone

Before you had kids you probably witnessed an out of control child having a temper tantrum at the store. More than likely you thought or said, “If that was my child, I would ______”. Well now here you are with children of your own dealing with these exact situations. Temper tantrums are a normal part of life with toddlers and preschoolers. Almost all young children have tantrums occasionally. If handled appropriately, most children outgrow this stage by four or five.

Some children have severe tantrums and may get so upset that they vomit or hold their breath until they pass out. Although this can be extremely upsetting to the parent, the child will generally recover quickly and completely. If your child is fainting or vomiting from tantrums, you may want to consult your pediatrician to check for any other health concerns.

How you handle tantrums will have a direct impact on the frequency and intensity of the tantrums. Here are some tips on preventing tantrums and how to respond to them.

Make sure your child is not over-tired
If she is cranky or tired put her down for a nap or try doing some quiet time. You can lay down in the bed and read a book or play soothing music to help her relax.

Be consistent with your rules
If she has a tantrum and you give in to her demands, she will try this again. The more consistent you are, the more she will learn that tantrums don’t work.

When you ask your child to do something, try asking nicely first
“Mommy needs some help picking up the toys” usually goes over better than “get in here and pick up this mess!”

Don’t use bribery
Does she really deserve a cookie for going to bed on time or not misbehaving at the grocery store? By doing this you will only encourage her to break the rules to get a treat.

Don’t react to her by yelling at her to be quiet
This will probably only upset her more. Sometimes in the midst of an outburst it is hard for a child to regain composure. Help her to calm down by giving her some quiet time in her room. Offer her a cup of water to help her relax if she is hyperventilating.

Sometimes children have tantrums because they want your attention. Look at the situation. Have you been watching tv, reading a book, or talking on the phone? If your child hasn’t had much “mommy time”, she may be trying to tell you something. Once she has calmed down from her tantrum, try setting some time aside just for her.

If you are in a public place, remove the child from the situation if you can. Go to the car or the restroom until she calms down.

When to call the doctor
If you are concerned that your child’s tantrums are extreme or more frequent than they should be, call your pediatrician for help. If your child injures herself or others, destroys property, has frequent nightmares, regresses in potty training, faints, has stomach aches or anxiety attacks consult your doctor.

About The Author
Patty Hone is a wife and mommy to three kids. She is also co-owner of Justmommies.com. Justmommies is an online community of moms sharing the joys and struggles of motherhood. Message boards, chats, articles, parenting, pregnancy info and more. www.justmommies.com.  email@justmommies.com

by Armin Brott

Dear MrDad: I’m really excited about my wife’s pregnancy and started to go to the doctor’s appointments with her. But the doctor basically ignores me or gives me a silly looking smile. I want to stay involved but I’m getting really angry. Is there anything else I can do?

Armin answers: For some expectant dads, the joys and excitement and anticipation they experience as the pregnancy progresses can be outweighed by the bitterness they feel at the way they’re treated by their partner’s doctors.

Sadly, most men who go to their wife’s OB appointments feel just like you do: as though they’re cute or novel or just annoying. And a big percentage of expectant dads complain that medical professionals—OBs, nurses, ultrasound technicians, and support staff—tend to treat them as though they’re little more than intruders or spectators and the wife is the only one worth dealing with. If they get talked to at all, it’s only to discuss the ways they can support their wives. The fact that the dad-to-be might have some specific and important needs, concerns, questions, worries, or anything of his own else rarely seems to occur to anyone.

Fortunately, this isn’t true of every medical professional. Some OBs will go out of their way to include the dad in the process. They make a special point of looking at him while talking about what’s going on with his wife and baby, they encourage him to ask questions and they answer them thoroughly and respectfully.

But don’t just sit back and expect to be welcomed into what is generally women’s private domain. Make it clear as early as you can that you want to be involved—especially if you have even the slightest suspicion that you’re not being taken seriously. Ask a lot of questions, behave as interested as you possibly can, and make it impossible for them to ignore you. If you still don’t get the respect and attention you deserve tell the doctor point-blank that you want to be included. You may have to do it more than once but eventually he or she will get the point.

About the Author
Armin Brott, hailed by Time as “the superdad’s superdad,” has written or co-written six critically acclaimed books on fatherhood, including the newly released second edition of Fathering Your Toddler: A Dad’s Guide to the Second and Third Years. His articles have appeared in The New York Times Magazine, Newsweek, American Baby, Parenting, Child, Men’s Health, The Washington Post among others. Armin is an experienced radio and TV guest, and has appeared on Today, CBS Overnight, Fox News, and Politically Incorrect. He’s the host of “Positive Parenting,” a weekly radio program in the San Francisco Bay Area. Visit Armin at www.mrdad.com.

by Elizabeth Pantley, Author of Kid Cooperation and Perfect Parenting

Question:
I can’t believe it! I walked into the playroom and found my child comparing private parts with a friend. They said they were playing “doctor.” I yelled at them and sent the friend home. Later, I felt like I should have handled it in a better way. How should I have handled it?

Think about it:
If you found the kids eating candy before dinner, or playing with a baseball in the house, you’d handle the situation easily. If, however, they were eating candy or playing ball with their clothes off, you’d suddenly feel confused and concerned. That’s because you’re viewing the situation from an adult point of view. Most times, childhood nudity and mutual curiosity is normal and natural. You just need to teach kids what’s appropriate and what’s not.

Say calm:
If you actually walk into a room and catch children playing with their clothes off, it’s best if you can remain calm. Make a statement such as, “It is not appropriate to play with your clothes off.” Help them get dressed and find an activity to get involved in. Later, at a quiet time, have a brief conversation with your child about what is and is not appropriate. Teach that they must always keep their private areas (bathing suit areas) covered. If this happens with the same two children more than once, don’t let them play together unsupervised. (Don’t make a major announcement, just monitor their time together.)

Teaching time:
Take the situation as a cue that your child is ready for more sex education. Spend a brief amount of time answering any of your child’s questions. Let your child’s interest and questions lead the discussion and don’t overwhelm your child with too much information. Give straightforward answers in accurate, but simple terms. Address the issue of appropriate versus inappropriate touching so your child will learn how to be respectful of his own and others privacy.

Read about it:
Purchase a book about sexuality and development. Read it yourself, first, because there’s lots of stuff you may have forgotten, and some things you may not even know! Share it with your child at an appropriate time. Let your child know that you’re available to answer any questions. Two outstanding books for this purpose are: My Body, My Self for Girls and My Body, My Self for Boys both by Lynda Madaras. (Newmarket Press, NY, 1993)

Are they mimicking something they’ve seen? Take a serious look at what television shows or movies your child has been watching. Children model the behavior they see, even if they don’t understand it, so be careful what images they are being exposed to.

Take note:
Excessive interest in sexual topics, or repeated occurrences of sexual play, may be a warning sign of other problems. There may also be cause for concern if one of the children is several years older than the other. Discuss your observations with a pediatrician, school counselor or family therapist.

Copyright Elizabeth Pantley. (McGraw-Hill, 2003)

About the author:
Elizabeth Pantley is the author of several books, including Gentle Baby Care : No-cry, No-fuss, No-worry — Essential Tips for Raising Your Baby, The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night, Kid Cooperation (with an introduction by William Sears, MD), Perfect Parenting, as well as her latest The No-Cry Sleep Solution for Toddlers and Preschoolers and is also president of Better Beginnings, Inc. She is a popular speaker on family issues, and her newsletter, Parent Tips, is seen in schools nationwide. She appears as a regular radio show guest, and has been quoted in Parents, Parenting, Redbook, Good Housekeeping, American Baby, Working Mother, and Woman’s Day magazines. Visit Elizabeth’s web site http://www.pantley.com/elizabeth.

Some drugs can be taken by a nursing mother if she stops breast-feeding for a few days or weeks. She can pump her milk and discard it during this time to keep up her supply, while the baby drinks previously frozen milk or formula. Radioactive drugs used for some diagnostic tests like Gallium-69, Iodine-125, Iodine-131, or Technetium-99m can be taken if the woman stops nursing temporarily.

Drugs that should never be taken while breast-feeding include:

Bromocriptine (Parlodel): A drug for Parkinson’s disease, it also decreases a woman’s milk supply.

Most Chemotherapy Drugs for Cancer: Since they kill cells in the mother’s body, they may harm the baby as well.

Ergotamine (for migraine headaches): Causes vomiting, diarrhea, convulsions in infants.

Lithium (for manic-depressive illness): Excreted in human milk.

Methotrexate (for arthritis): Can suppress the baby’s immune system.

Drugs of Abuse: Some drugs, such as cocaine and PCP, can intoxicate the baby. Others, such as amphetamines, heroin and marijuana, can cause a variety of symptoms, including irritability, poor sleeping patterns, tremors, and vomiting. Babies become addicted to these drugs.

Tobacco Smoke: Nursing mothers should avoid smoking. Nicotine can cause vomiting, diarrhea and restlessness for the baby, as well as decreased milk production for the mother. Maternal smoking or passive smoke may increase the risk of sudden infant death syndrome and may increase respiratory and ear infections.

About this Article:
Provided by FDA

One of the hardest things for a new mom to go through is watching her baby get sick and not being able to do anything to make it go away. Whether it is a simple cold, or something more serious it is very hard to watch your baby feel bad, cough, sneeze or run a fever and be able to do little to make him feel better. It is not easy to look in a face that clearly doesn’t understand WHY he feels so bad and sit idly by. So how do you know when your baby has just a little bug, or it is something more serious and you need to take him to the doctor.

When in doubt it is never wrong to call up your baby’s pediatrician to ask for advice. Sometimes a simple call may help you feel more relaxed, or the nurse may have a hint to help relieve your baby’s discomfort. In the end it is important to remember that your doctor is not only there for well-checks, but also for sick baby calls.

Colds
Little coughs, a hardly heard sneeze, watery eyes and a runny nose can hit your baby as hard as it hits you. There are several different things you can try to do to help relieve your baby’s discomfort. First, ask your doctors what medicines you can give your baby. There are several items on the market made specifically for babies. Make sure you ask your pediatrician first however, and follow dosing instructions precisely. Second, invest in a humidifier. Often changing the air around your baby can help clear his head and chest. Third, make use of the “bulb” you are given in the hospital that they use to suction out your baby’s nose. They are too young at this point to understand how to blow their nose, so the only way to help them clear their sinuses is the bulb. As much as your baby may hate it and cry, it is a great tool for you.

Fever
When is your baby’s fever too high? There is no “right” answer to this question. A lot of it depends on your baby’s health since birth. Was he full term or premature? Has he been sick a lot or healthy for the most part? At your baby’s next well-check be sure to ask your pediatrician what degree of temperature he would suggest you call his office about. Some doctors will say 100 degrees, others may say to wait till it is a minimum of 102 degrees or slightly above. It is best to find out the answer to this question before you need it. Also, be sure to ask your pediatrician what medications he thinks is ok for you to give your baby when he spikes a fever.

Hospitalization
Occasionally your baby will get an illness that will cause him to be hospitalized for anywhere from a few hours to possibly several days. This is hardest on parents especially if there are IVs and tubes involved. It is best to remember during this time to ask a lot of questions and not to be afraid to ask for a second opinion. In most cases a hospital will allow at least one parent to spend the night at the hospital with your baby. If your baby is breastfed or you co-sleep with him, don’t be afraid to ask the hospital to get you a real hospital bed so that you can curl up next to your baby and help him get the most rest possible. Babies are very intuitive and yours will know when you are upset, scared, sad or happy. Try not to panic in front of your baby. Keeping a calm hospital room will help your baby stay calm and relaxed as well.

Remember, your baby getting sick is a part of life. He will have many more healthy days than he does sick days, but the sick days will come. Try to keep your wits about you, don’t be afraid to call the doctors, and give your baby some extra cuddles while they get better. Luckily, your baby is too young to remember being sick and will forget about it much sooner than you will.

by Elizabeth Pantley, author of Gentle Baby Care and The No-Cry Sleep Solution

You may have heard the term colic applied to any baby who cries a great deal. Not all crying babies have colic, but all colicky babies cry ? and they cry hard. They may stiffen their little bodies, or curl up as if in pain. They may cry so hard that they don’t seem like they even know you are there. When babies cry like this, they take in a lot of air, which creates gas and more pain, which makes them cry even more.

Researchers are still unsure of colic’s exact cause. Some experts believe that colic is related to the immaturity of a baby’s digestive system. Others theorize that a baby’s immature nervous system and inability to handle the constant sensory stimulation that surrounds her cause a breakdown by the end of the day, when colic most often occurs.

Dr. Harvey Karp, in his book The Happiest Baby on the Block (Bantam Books, 2002) introduced a new theory. He believes that babies are born three months too early, and that some babies find their new world too difficult to handle. They yearn for the comforting conditions that occurred in the womb.

Whatever the cause, and it may be a combination of all the theories; colic is among the most exasperating conditions that parents of new babies face. Colic occurs only to newborn babies, up to about four to five months of age. Symptoms include:

• A regular period of nonstop, inconsolable crying, typically late in the day
• Crying bouts that last one to three hours or more
• A healthy and happy disposition at all other times of the day

Can Colic Be Prevented Given that we aren’t sure what causes colic, we don’t know if it can be prevented. Even if you do everything “right” and take all the steps to discourage colic, it still may happen. If you think your baby has colic, talk with your pediatrician and take your baby in for a checkup to rule out any medical cause for your baby’s crying. If your baby is given a clean bill of health, then you’ll know colic is the culprit in the daily crying bouts.

Since colic occurs in newborns, parents often feel that they are doing something wrong to create the situation. Their vulnerability and lack of experience puts them in the position of questioning their own ability to take care of their baby. Hearing your baby cry with colic, and not knowing why it’s happening or what to do about it is painful for you; I know this because one of my four children suffered with colic. Although many years have passed since then (Angela is now 15), I remember it vividly. Hearing my baby cry night after night and not knowing how to help her was gut wrenching, heartbreaking, and frustrating. The most important piece of research I discovered was this: It’s not your fault. Any baby can have colic.

Things That May Help Your Baby
Remember that nothing you do will eliminate colic completely until your baby’s system is mature and able to settle on its own. That said, experienced parents and professionals can offer ways to help your baby though this time ? ask around! I did, and from what I uncovered, I compiled the following suggestions for helping your baby feel better. Look for patterns to your baby’s crying; these can provide clues as to which suggestions are most likely to help. Stick with an idea for a few days to see if it helps. Watch for any signs of improvement (not necessarily complete quiet). If the particular course of action doesn’t seem to change anything, don’t get discouraged ? just try something else:

• If breastfeeding, feed on demand (cue feeding), for nutrition as well as comfort, as often as your baby needs a calming influence.
• If breastfeeding, try avoiding foods that may cause gas in your baby. Eliminate one possible cause for a few days and see if it makes a difference. The most common baby tummy offenders are dairy products, caffeine, cabbage, broccoli and other gassy vegetables. But don’t assume the culprit, if there is one, will be obvious: I know one mother whose baby reacted loudly and consistently after any meal that included eggplant, asparagus or onions.
• If bottlefeeding, offer more frequent but smaller meals; experiment with different formulas with your doctor’s approval.
• If bottlefeeding, try different types of bottles and nipples that prevent air from entering your baby as he drinks, such as those with curved bottles or collapsible liners.
• Hold your baby in a more upright position for feeding and directly afterwards.
• Experiment with how often and when you burp your baby.
• Offer meals in a quiet setting.
• If baby likes a pacifier, offer him one.
• Invest in a baby sling or carrier and use it during colicky periods.
• If the weather’s too unpleasant for an outside stroll, bring your stroller in the house and walk your baby around.
• Give your baby a warm bath.
• Place a warm towel or wrapped water bottle on baby’s tummy (taking caution that the temperature is warm but not hot).
• Hold your baby with her legs curled up toward her belly.
• Massage your baby’s tummy, or give him a full massage.
• Swaddle your baby in a warm blanket.
• Lay your baby tummy down across your lap and massage or pat her back.
• Hold your baby in a rocking chair, or put him in a swing.
• Walk with Baby in a quiet, dark room while you hum or sing.
• Try keeping your baby away from highly stimulating situations during the day when possible to prevent sensory overload, and understand that a particularly busy day may mean a fussier evening.
• Lie on your back and lay your baby on top of your tummy down while massaging his back. (Transfer your baby to his bed if he falls asleep.)
• Take Baby for a ride in the car.
• Play soothing music or turn on white noise such as a vacuum cleaner or running water, or play a CD of nature sounds.
• As a last resort, ask your doctor about medications available for colic and gas.

Tips for Coping
As difficult as colic is for a baby, it is just as challenging for the parents. This can be especially hard for a mother who has other children to care for, who has returned to work, or who is suffering from the baby blues or postpartum depression. Even if everything else in life is perfect, colic is taxing. Here are a few things you can do to take some of the stress out of these colicky times:

• Know that your baby will cry during his colicky time, and while you can do things to make your baby more comfortable, nothing you can do will totally stop the crying. This is not a result of anything you’ve done or not done.
• Plan outings for the times of day when baby is usually happy, or if outings keep your baby happy, plan them for the colicky times.
• Take advantage of another person’s offer to take a turn with the baby, even if it’s just so that you can take a quiet bath or shower.
• Keep reminding yourself that this is only temporary; it will pass.
• Avoid keeping a long to-do list right now; only do what’s most important.
• Talk to other parents of colicky babies so you can share ideas and comfort each other.
• If the crying is getting to you and making you tense or angry, put your baby in his crib, or give him to someone else to hold for a while so that you don’t accidentally shake or harm your baby. (Shaking a baby can cause permanent brain damage, so if you feel angry, and colic can do that to you, put your baby down.)
• Know that babies do not suffer long-term harm from having colic.

When Should I Call the Doctor
Anytime you are concerned about your baby, call your doctor. That goes for anything concerning your precious little one. In the case of colic, be sure to make that call if you notice any of the following:

• Your baby’s crying is accompanied by vomiting.
• Your baby is not gaining weight.
• The colicky behavior lasts longer than four months.
• Your baby seems to be in pain.
• Your baby has a fever.
• Your baby doesn’t want to be held or handled.
• The crying spree isn’t limited to one bout in the evening.
• Your baby does not have regular bowel movements or wet diapers.
• You notice other problems that don’t appear on the previous list of symptoms.
• Your baby’s crying is making you angry or depressed.

Copyright Elizabeth Pantley. (McGraw-Hill, 2003)

About the author:
Elizabeth Pantley is the author of several books, including Gentle Baby Care : No-cry, No-fuss, No-worry — Essential Tips for Raising Your Baby, The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night, Kid Cooperation (with an introduction by William Sears, MD), Perfect Parenting, as well as her latest The No-Cry Sleep Solution for Toddlers and Preschoolers and is also president of Better Beginnings, Inc. She is a popular speaker on family issues, and her newsletter, Parent Tips, is seen in schools nationwide. She appears as a regular radio show guest, and has been quoted in Parents, Parenting, Redbook, Good Housekeeping, American Baby, Working Mother, and Woman’s Day magazines. Visit Elizabeth’s web site http://www.pantley.com/elizabeth.

By Elizabeth Pantley, author of Gentle Baby Care

Choosing your baby’s doctor several months before her expected arrival is a good idea. This way, you won’t feel rushed and can take the time to make the right decision. During the first few years of life, your baby will have frequent visits for routine checkups and illness; so selecting a healthcare professional you trust is important.

Decide which type of healthcare provider

Different types of healthcare professionals are qualified to care for your baby:

A pediatrician is a medical doctor with specialized training in caring for children from birth through adolescence.

A family physician or general medical practitioner (GMP) is a physician who is educated and trained in family practice, which is medical care that covers every member of the family for well and sick care. You already may have a family physician for your own healthcare.

A nurse practitioner (NP) is a registered nurse (RN) with advanced education and training. Nurse practitioners often work in partnership with a licensed physician.

Once you’ve determined what type of professional you would like to consider, find prospective doctors through these sources:

• Recommendations from friends who have children
• Your obstetrician
• Your local hospital’s referral service
• Medical schools and medical directories
• The American Board of Pediatrics

Determine your insurance company’s requirements

Check out the rules of your insurance policy prior to choosing your baby’s doctor. You may have to designate your baby’s doctor for your health insurance carrier, or you may be required to have your selection approved in advance. Many health plans have strict rules about which doctors you can visit, so it’s important to determine if your choice of primary care physician also decides which specialists and which hospitals you will be able to use if your baby should need specialized care, since oftentimes these are linked together by the rules of a health plan.

Consider your parenting philosophy

Choose a doctor who has a similar philosophy with regard to important parenting issues, since most parents turn to their pediatrician for advice and guidance on more than just health-related issues. While this similarity in outlook is not crucial, it certainly makes for a more complete and enjoyable relationship that allows open conversation and precludes the need to avoid topics on which you disagree. A like-thinking pediatrician understands your starting point when advising a particular course of action, and is more likely to prescribe one that suits your ideals. An easy way to find out what a doctor’s opinion is to ask open questions, such as, “What are your recommendations about breastfeeding and bottlefeeding?”

Here are just a few of the important topics you should consider:

• Feeding – Does the doctor support your goals for breastfeeding, bottle-feeding and weaning?
• Sleep – What is the doctor’s opinion on sleep-related issues, such as co-sleeping and letting the baby cry herself to sleep? Are her views similar to yours?
• Immunizations – Will the doctor provide you with ample information to make decisions about various vaccinations? Do his standard recommendations suit you?
• Discipline – Does the doctor believe in the same approach towards discipline as yours?

Take the time to interview prospective doctors

Most medical professionals are happy to provide a brief interview meeting at no charge. This gives you an opportunity to meet the doctor and ask questions. Here are a few tips to make this a productive event:

• Make an appointment.
• Arrive early and observe the waiting room, staff and other patients. Is the staff helpful? Is the atmosphere child-friendly? Is the office clean and tidy? How long do people wait for their appointments?
• Be prepared with a brief list of questions.
• Stick to your most important topics.
• Refrain from small talk or lengthy explanations.
• Remember that your main purpose is to listen, not to talk.

Before your interview

If you do a little research and handle the technical details before your appointment, you can use your time with the doctor to obtain answers to your most important questions.

You can obtain information about a doctor, such as certifications and residency background, from:

• The American Board of Pediatrics
• American Academy of Pediatrics
• The American Medical Association
• Royal College of Physicians and Surgeons of Canada

You often can get information from a receptionist or secretary at the doctor’s office. First, ask for a brochure or other written information about the doctor and the practice. If the following information isn’t covered, then call the office and ask for the following:

1. The background and experience of the doctor. (Asking for a verbal answer from the doctor during your upcoming appointment may well take up a large portion of your meeting.)
2. What are office hours? Are there evening or weekend hours?
3. How is billing handled?
4. What insurance is accepted?
5. What are your after-hours and emergency procedures?
6. What hospitals is the doctor affiliated with?
7. How do you handle questions by telephone?
8. Will my doctor personally see us for every scheduled appointment?
9. If he is unavailable, who will see us?
10. How many doctors share this office?
11. Do you have a special waiting room or a separate entrance for sick children, or how do you separate them from others?
12. Do you have a lactation specialist in the office? If not, can you recommend one?

Interview questions

Arrive at your appointment to interview a medical professional with your list of questions. Don’t ask about issues that sound good but don’t really matter to you; the meeting likely will be short, maybe five to 15 minutes (ask in advance how much time you will have).

Stay focused on your own priorities. Relax and be friendly, but stay on track. Here is an assortment of sample questions to help you create your own list:

1. Can you explain how we will work together during our baby’s first year?
2. Will you examine our baby at the hospital (or at our home) directly after birth?
3. What is your typical advice to new parents about… Circumcision? Breastfeeding? Bottlefeeding? Sleeping through the night? Immunizations?
4. Can we come to you with questions about non-medical issues, like feeding or behavior?
5. What do we need to know about our newborn’s health and care?

After your interview

Consider the answers to these questions to help you make your final decision:

• Is the office conveniently located for you?
• How long did you have to wait in the waiting room?
• Did you feel good about the office and staff?
• Did the doctor listen thoughtfully to your questions?
• How willingly and thoroughly did the doctor answer questions?
• What was his attitude when he answered them?
• Do you feel comfortable with the doctor’s specific child-rearing philosophy?
• Did you feel that you could freely ask questions?
• Did the doctor appear knowledgeable and current with his information and advice?
• Would you feel comfortable bringing your baby to this person for care?
• Would you feel confident having this doctor handle an emergency with your child?

Copyright Elizabeth Pantley. (McGraw-Hill, 2003)

About the author

Elizabeth Pantley is the author of several books, including Gentle Baby Care : No-cry, No-fuss, No-worry — Essential Tips for Raising Your Baby, The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night, Kid Cooperation (with an introduction by William Sears, MD), Perfect Parenting, as well as her latest The No-Cry Sleep Solution for Toddlers and Preschoolers and is also president of Better Beginnings, Inc. She is a popular speaker on family issues, and her newsletter, Parent Tips, is seen in schools nationwide. She appears as a regular radio show guest, and has been quoted in Parents, Parenting, Redbook, Good Housekeeping, American Baby, Working Mother, and Woman’s Day magazines.

Visit Elizabeth’s web site http://www.pantley.com/elizabeth.