Pediatrician Recommendations today

fyrfightermomma

New member
So today I took my daughter for her 12 month check up (she turned 1 on the 19th). She weight 22.5 pounds.

I was curious to what his answer would be to the question I was planning to ask which was "I've heard they started recommending kids stay rear facing longer....which way should be daughter face now??" I obviously know the answer, but wanted to see what'd he'd say.

For DD1 he recommended FF at 11 months at 18 pounds because she was "close enough"

Well his answer was "they recommend they must be 1 AND 20 pounds. After that point they have found their necks are strong enough to take a crash force and they can be forward facing, so your daughter can face forward now" :eek:

My thoughts are if the American Acadmey of Pediatrics is recommending ERF and Peds are suppposed to follow those recommendations....why aren't they???


I can just imagine all the parents he's told that too....its really sad
 
ADS

tl01

New member
I can't understand why they don't follow the new recommendations unless they just aren't paying attention to them. None of my docs have ever mentioned anything about car seats except one mentioned that DS would have to go into a convertible soon when he was 6 months but I tried to explain I had a SS1 and that wasn't the case. If our new ped mentions anything at our 2 year visit then he will surely get an earful from me.
 
A good reply to the Doc's statement would have been "Who are they?"

If he/she gives you an answer such as the AAP or anyone else, ask to see the study or conclusions that "they" provided.

I am not aware of a study that showed kids necks are strong enough to take crash forces at one and twenty pounds. Indeed, the studies that are actually available would seem to say just the opposite. (See Car Safety Seats For Children: Rear Facing For Best Protection; Injury Prevention 2007; 13:398-402.)

Further, morbidity and mortality reports released by The Center for Injury Research and Prevention have shown multiple incidents of FF children (usually under age two) suffering spinal injury and/or death which were likely not to have occurred if the child was RF.

Unfortunately, doctors are trained to see and treat abnormal conditions. There are some doctors that because of their training try very hard to find the abnormal in the normal. The old saying, when all you have is a hammer, everything looks like a nail, fits more than it should. Also, training in medicine, can, but usually doesn't include bio-mechanics or crash dynamics. Thus, many doctors are no more, and often less educated on child-passenger safety than those that read and post on this forum. Child passenger safety is not an abnormal condition and does not fall into the realm of medicine. Frankly, unless a doctor has special training, i.e., is a CPST, their advice on CPS is no better than the average Joe on the street. However, because they havd M.D. after their name, parents are more likely to trust them on CPS matters, sometimes to their child's detriment.
 

armyfam

New member
That happened to me too. In fact, the paper they pass out at the appointment says to turn the car seat around! Very frustrating:mad:
I explained to her Ped why its safer to RF but she didn't seem to take me seriously. When I got home, I spoke to the office and a more "Senoir" Ped at the office and she understood what I was saying. To my disgust, at her 15 month appt this month, the paper passed out says "to continue to put your child in a convertible car seat FF"! Not sure what I should do next?
 

Mommy2Marcus

New member
Hiya Ladies! My ped also told me that I could turn my DS around at his one year. I did, but was for car sickness. I plan to take some information to her about ERF when I take DS in for his 18 month in a few weeks. I also want to take her some information on EHing as well. I think she will actually listen to me as she is a very understanding ped, but she may not. I really hope she does. I have since turned my DS back to RF & am LOVING it. I am SO much happier with him RF knowing he is safer. I would recommend giving them the information to read instead of just telling them. I am also going to be giving her the link to the youtube video with the crash test on it! I think this will really help. I am also going to be giving her links to the information on EHing as well with links to videos that tell about kids having died from being in a booster to soon! The Kyle David Miller Foudation being one of my links!
 

crunchierthanthou

New member
Apparently he doesn't subscribe to or read the journal Pediatrics. They had an article about the importance of erf to the limits of the seat this month. The title was, Rear Facing Car Safety Seats: Getting the Message Right. It stated several times that rf was 5 times safer than ff under age 2.
 

fyrfightermomma

New member
Apparently he doesn't subscribe to or read the journal Pediatrics. They had an article about the importance of erf to the limits of the seat this month. The title was, Rear Facing Car Safety Seats: Getting the Message Right. It stated several times that rf was 5 times safer than ff under age 2.



LOL....obviously he didn't "get the message right" hehe...he musta skipped that article ;)
 

Stella's Dad

New member
Apparently he doesn't subscribe to or read the journal Pediatrics. They had an article about the importance of erf to the limits of the seat this month. The title was, Rear Facing Car Safety Seats: Getting the Message Right. It stated several times that rf was 5 times safer than ff under age 2.

Wow, where can I get a copy of that to hand out to the other parents in the carpool line?
 
The commentary is in the March 2008 issue of Pediatrics, Volume 121, Issue 3,

The citation is: Bull, Marilyn J., Durbin, Dennis R.
Rear-Facing Car Safety Seats: Getting the Message Right
Pediatrics 2008 121: 619-620.

An extract of the article can be found here: http://pediatrics.aappublications.org/cgi/content/extract/121/3/619

However, to get the full article, you will either need to have a subscription to Pediatrics, or check your local library to see if they subscribe to the periodical. All University libraries that have a medical school will have the magazine as part of their collection.
 

tanyaandallie

Senior Community Member
Wow, where can I get a copy of that to hand out to the other parents in the carpool line?

I'd love to hear where to find a copy as well. At my ds's 15 mos check up he hit 20 lbs and my ped joyfully announced he could ff! I told her he would not be ff and she looked at me as if I had grown 2 heads. I am going to take her some info at his 3 yr apt in a few weeks.
 

christineka

New member
Two years ago my dd's ped told me it was okay to ff my 17 pound 1 year old. She reached 20 pounds at 22 months of age.

My ds goes in for his 12 month check up on Monday. (He's actually 14 months though.) I have a handout with erfi on one side and eh on the other. (It is a double appointment. My older ds is having his 5 year checkup.) I'm going to give the handout to the ped. I think she honestly doesn't know much about car seats because she has no children of her own. She's pretty open about not vaxing, cloth diapering, and relaxed homeschooling. (In fact she told me not to put my dd into public school.) I think she may be very open to learning about car seat safety.

Christine
 

PixieEMT

New member
My DS just had his 18 month check up.
I took some ERF propaganda with me to his check up and was straight forward with the staff. I provided the "RF Unmatched Safety" brochure, ERF materials from KDM foundation and the article from New Zeland about a little girl that sever injuries from FF at 18months. :D

My ped told us to FF at 3 months old! He lied to us after I called him out about ERF and said "I've always told parents to RF until 1 y/o and 20lbs." I hate LIARS! :mad: Thank goodness I knew 1 y/o and 20lbs, before my CPST training and learning about ERF! He was riding in a FPSVD and Comfortsport after he blew out of his Snug Ride.

I filed a complaint with the HR department about his dangerous FF recommendations.
He asked to keep my ERF materials and wanted to make copies for parents. So, maybe it got through.:shrug-shoulders:
Sara
 

crunchierthanthou

New member

jdubsm

New member
I asked my ped this year on what she recommended for RF even though my kids are past rf limits. She said that she's lucky to get most parents to do the 1yr/20lbs so she doesn't push ERF.
 

snowbird25ca

Moderator - CPST Instructor
The AAP official policy is rf to the limits of the seat, so all of these pedi's aren't up to date on the current policy of the AAP apparently. I don't have the link, but I'm sure someone around here does. ;)

I'd print out the policy of the AAP and take that in. As well intentioned as the youtube video and other materials are, unless it's coming from the AAP itself or a journal like injury prevention or pediatrics, most dr.'s aren't going to pay attention to or trust the information. So I'd really focus on getting those references/articles, and a copy of the AAP and not worrying so much about anything else...

So that would be my line of attack - cite the pediatrics article and bring in a copy of the AAP stance. Then tell him/her that if they'd like help with info to provide to parents, you'd be happy to assist with more materials. Youtube is great for parents, but dr.'s are much more evidence based for the most part and a video published on youtube likely isn't going to meet their standards for evidence based medicine - however accurate the video may be. :thumbsup:
 

Jeanum

Admin - CPS Technician Emeritus
Staff member
AAP Policy statement link: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;109/3/550

Here's the really pertinent part:

Seat Selection

1. Children should face the rear of the vehicle until they are at least 1 year of age and weigh at least 20 lb to decrease the risk of cervical spine injury in the event of a crash. Infants who weigh 20 lb before 1 year of age should ride rear facing in a convertible seat or infant seat approved for higher weights until at least 1 year of age.3,4 If a car safety seat accommodates children rear facing to higher weights, for optimal protection, the child should remain rear facing until reaching the maximum weight for the car safety seat, as long as the top of the head is below the top of the seat back.3

Note the date of this policy statement is 2002, and the AAP's ERFing recommendation goes back at least that far in time. It's not exactly a super new-fangled recommendation from the AAP now that it's 2008, yet word still needs to reach peds. out there.
 

firemomof3

New member
I have a very open minded pedi. so at my daughter's 2y/o appointment next week I have some handouts for him to show him the extreme benifits of extended RF & FF!! Because I know I have never heard him say anything to me about car seats, so maybe he'll see how many other parents just need the education! I will let you know how it goes! :thumbsup:
 

NHCPSTECH

Senior Community Member
What I don't understand is why a CPS Tech would ask a Pediatrician a question about car seat usage when they already know the correct answer to the question. By pretending you don't know the answer, and then receiving the wrong answer, how do you maintain your professionalism and credibility as a CPS Tech when at this point you have to (or should) do a complete 360 and suddenly start talking like you DO know the answer. I think the doc might be kind of embarrassed if you trick him into telling you something you know is wrong. And as a CPST, we should be obligated to provide the correct info. Our goal should not be to catch ignorant Peditricans giving out wrong info but instead empowering them to give out correct info. There's a big difference and the latter is much much more effective. The Pediatrician should be the CPST's ally not enemy.

This is just what always comes to my mind when I read threads like this..

R.
 

Kat_Momof3

New member
this is why I was so thrilled when our ped (who I picked by virtue of it being the one the insurance picked on two of the three cards... so I called both, picked the friendlier receptionist on the one that was on two cards, and figured I'd give them a shot.... it's a practice with 4 peds and I love them all) office gave out handouts... have not said anything carseat related unless there is a question about the handouts... and the handout for the baby checkups always said... if baby outgrows the infant seat, they need to be moved to a bigger rearfacing convertible carseat.

the one for all the ones up to the 1yr checkup says they MUST

then the 1yr checkup says (can't remember exact wording) something to the effect that if they way 20lbs they can be forward facing, but to check the carseat manual, that many carseats rearface for much longer, that rearfacing is safest, and that the AAP recommends rearfacing to the limit of the convertible carseat.

I knew they were better than most, but I really never knew that most peds weren't at least good about knowing the minimums and deferring to "the longer you ____ the better" when it came to breastfeeding, rearfacing, harnessing, etc.

the peds I've had before, I know I got lucky with.

This time, I would have said BLESSED.

I just can't believe some of these docs that feel they are qualified to give advice and yet don't keep up to date on the plethora of info.
 

southpawboston

New member
I can't understand why they don't follow the new recommendations unless they just aren't paying attention to them. None of my docs have ever mentioned anything about car seats except one mentioned that DS would have to go into a convertible soon when he was 6 months but I tried to explain I had a SS1 and that wasn't the case. If our new ped mentions anything at our 2 year visit then he will surely get an earful from me.

doctors have to read an OVERWHELMING amount of medical literature to stay current, and even the best doctors can't possibly stay current on everything while keeping full-time hours. something has to get left out. frankly, i'd rather my ped be up to speed with current *medicine* than carseat recommendations. :twocents: if i need carseat advice, i'll go to a seatcheck. if i want medical advice, i'll go to my ped.

What I don't understand is why a CPS Tech would ask a Pediatrician a question about car seat usage when they already know the correct answer to the question. By pretending you don't know the answer, and then receiving the wrong answer, how do you maintain your professionalism and credibility as a CPS Tech when at this point you have to (or should) do a complete 360 and suddenly start talking like you DO know the answer. I think the doc might be kind of embarrassed if you trick him into telling you something you know is wrong. And as a CPST, we should be obligated to provide the correct info. Our goal should not be to catch ignorant Peditricans giving out wrong info but instead empowering them to give out correct info. There's a big difference and the latter is much much more effective. The Pediatrician should be the CPST's ally not enemy.

This is just what always comes to my mind when I read threads like this..

that is a very good point. :thumbsup:
 

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