August 24th, 2011

The Whatever-Works Parenting Plan

 

Dr. Bergman LewisDr. Bergman Lewis is a senior resident in Pediatrics at Seattle Children’s Hospital. By way of introduction, I am finishing my pediatric residency at Seattle Children’s Hospital, have enjoyed being a resident editor of Journal Watch Pediatrics and Adolescent Medicine for the past 3 years, and will write as an interim blogger for the next month or so. Greg left big shoes to fill but I’ll do my best to pave the way for the next resident blogger.

When my daughter, Anya, was a few months old, I remember reading a blog post to my mom that I found when, for the first of many times, I Googled “baby bedtime routine.” One father wrote: “The solution to bedtime is that I crawl in the crib with my baby, then when she is asleep, I crawl out.” My mom and I laughed and rolled our eyes. Fast-forward 1 year and I’m blearily gazing into the crib, patting Anya to sleep, wondering if it would hold my weight. Sleep is only one area in which being a mom has humbled me and challenged the tenets of my pediatric education.

When the time to expand our family coincided with the last year of my residency, my husband and I knew it was not going to be easy. However, I did not foresee all the ways it would shape me as a physician. As a pediatrician-in-training, I knew the “right” advice to offer in each situation, but it turns out that the “right” advice carries little weight in the minute-to-minute nuances of parenting.

Sarah and AnyaWe found our stride as a family only when I started accepting that we would have our own unique challenges as well as our own solutions and started doing what worked for us. We hunkered down and my world became very narrow — hospital or home. My husband and I tried to listen to each other and tune out all the “shoulds” that made us feel inadequate. We were blessed to have local family and actually moved in with my mom for the year. The bills piled up and the voice mailbox filled. We co-slept, not for philosophical reasons, but because it felt necessary. I was tired and couldn’t spend the precious time at home with Anya listening to her cry from the other room. Anya stayed up late when I was on the wards and slept all afternoon with me post-call. When I was on nights, we took two daytime naps together. This was not the sleep-nap routine I had outlined for parents in clinic, but Anya’s adaptability gave us long hours together snug in bed, breast-feeding after 30 hours apart. By paying attention to Anya’s cues instead of outside advice, we found our own rhythm and Anya thrived — and my husband and I survived!

Once I became more comfortable in our own ever-changing “routine,” I began to recognize allies within medicine. I felt less isolated as I shared more about our solutions. After attending a Grand Rounds presented by the medical examiner on the dangers of co-sleeping, I sheepishly admitted to my intensive care attending that we spend the majority of time co-sleeping. “So do I,” she responded, “you have to when you’re away so much, right?” The fellow and the pharmacist both chimed in with their own stories of co-sleeping. It felt like we were talking about brewing gin during Prohibition.

My own experience adapting to motherhood while being a resident convinced me that our job as primary care doctors is to lay out the safe — but wide — framework within which patients can find their own path. It is tempting to preach guidelines and be quick with advice but more valuable to tailor our expertise to empower individuals to find their own way. Particularly in light of my experience as a parent, I will strive to have conversations with patient families that are nonjudgmental, honest, and practical.

I salute my fellow resident parents out there. Keep up the good work crafting a home life that is uniquely right for your family. I would love to hear your stories from the trenches.

4 Responses to “The Whatever-Works Parenting Plan”

  1. Kristie Lund says:

    Great blog Sarah! I’ve co-slept with all my kids and the grands I am raising. Once you get past the guilt you do what works 🙂

  2. Linda Porter says:

    Wow, Sarah. I am just getting to know you as a compassionate caregiver of the caregivers. Reading this affirms my faith in you and your work. Dare I confess that I, too, co-slept with my granddaughter, who came to live with me at the age of two months. She needed that, having come from living in the garage of a drug house, sleeping in her carseat surrounded by addicts in various stages of stupor or domestic violence. She had the signs of traumatic stress. Being near me was critical to her development and one day, believe it or not, on her own, she left the comfort of me to find independence in her own bed. In the end it was lovely for both of us. Sometime those of us who think we are experts are really being taught. Thanks for sharing.

  3. Gloria Dillon says:

    Great blog Sarah,

    My husband and I co-slept with our first grandson from the time he was 3 months until he was 3. It was difficult at first for us to do because we didn’t co-sleep with our children. He would not sleep in his crib, so we had to do it. We started loving the bonding we had with him.

  4. Debbie murphy says:

    I am a family doc and coslept with my sons. For each of them, it was a little different. I am embarrassed at the some of the advice I gave as a doctor to parents before I had my own children- experience and humility play a role in parenting advice, much different from a chemo regimen or surgical recommendation For me, some of the best teachers were the hispanic moms in a California county maternity ward, who with ease nursed their children on their side,and then slept. No lactation nurse in sight. There was wisdom in those women and their mothers, doulas, female attendants. Im all for evidence based medicine, but we shouldn’t be too dogmatic, nor over zealous about what we can and cannot dissect.

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