All Things Sensory by Harkla

#145 - Your Guide to Navigating the Pediatrician's Office

March 24, 2021 Rachel Harrington, COTA/L, AC & Jessica Hill, COTA/L Episode 145
All Things Sensory by Harkla
#145 - Your Guide to Navigating the Pediatrician's Office
Show Notes Transcript

Today’s show is all about speaking to your pediatrician about the different developmental stages of your child when they are between the ages of three months and one year old.

Your hosts, Jessica and Rachel, are both mothers, so they are speaking from experience, and the episode is full of their personal stories.
 
Rachel and Jessica want all new parents to know that decisions regarding your child’s health are entirely up to you! Don’t feel bad to ask as many questions as you need to, ask for referrals if you aren’t getting answers, and even change your pediatrician if they aren’t meeting your requirements.
 
All children develop at their own pace but certain milestones should be reached by a certain age, and this episode will help bring awareness to some potential red flags regarding your child’s development.
 
The show covers topics such as tummy time, choosing a vaccination plan for your child (and a book recommendation on this topic), primitive reflexes (and where you can get more information on these), object permanence, and so much more! If you are a new or new-ish parent, this episode will be immensely valuable to you. 


Be sure to check out the show notes on our blog at  Harkla.Co/Podcast.

Brought To You By Harkla

This podcast is brought to you by Harkla.  Our mission at Harkla is to help those with special needs live happy and healthy lives. We accomplish this through high-quality sensory products and child development courses.

Podcast listeners get 10% off their first order at Harkla with the discount code "sensory". Head to Harkla.co/sensory to start shopping now.

Key Points From This Episode:

  • Rachel and Jessica’s personal experiences of taking their children to pediatricians.
  • This episode is about helping parents find their voice and advocate for their child’s health. 
  • One of the signs that you may be with the wrong pediatrician.
  • A simple way to keep track of the questions you want to ask your pediatrician. 
  • Don’t be afraid to ask for referrals if your pediatrician doesn’t have all the answers.
  • 3 month check-up questions: head shape, tummy time, vaccines, eye tracking, and more.
  • 6 month check-up questions: weight gain, sounds, eye contact, sleep, solid foods, and more.
  • Details about how to receive a 10% discount on your first Harkla purchase.
  • 9 month developmental milestones: interest in their environment, pincer grasps, imitating sounds, and more.
  • 1 year milestones: primitive reflexes, responses to foods, recognition of caregivers, imitation, object permanence, and more. 
  • Rachel and Jessica’s goal for the podcast for 2021! 


Links Mentioned in Today’s Episode:

Rachel:

Hey there. I'm Rachel.

Jessica:

And I'm Jessica. And this is all things sensory by Harkla. Together, we're on a mission to help children, families, therapists and educators live happy, healthy lives.

Rachel:

We dive into all things sensory, a special needs, occupational therapy, parenting, self care, and so much more. In each episode, we share raw, honest, fun ideas and strategies for everyone to implement into daily life.

Jessica:

Thank you so much for joining us.

Rachel:

Welcome back to all things sensory by Harkla. This is episode 145. Thanks for joining us. If you are one of our lifers, and thanks for joining us if you are a new listener.

Jessica:

For anyone who doesn't know, we are Rachel and Jessica, and today we're going to talk about questions that you can ask your pediatrician.

Rachel:

The reason why we wanted to talk about this topic is well, partially because I am going through this now with my child who is five months at the time that we're recording this. And I just hear so many stories of families not knowing what to ask their pediatrician, they aren't advocating for their child, that they don't know how, or they don't know that they can. And so we just wanted to kind of give you a voice and let you know that you are in control of basically your child's medical plan and their milestones and all that sort of stuff. What do you think Jessica?

Jessica:

I yeah, I agree. 100%. I remember, like, what, seven years ago, going to the pediatrician and like not knowing what to talk to the pediatrician about like, oh, yeah, he's healthy. Everything's fine. Yeah, cool. So I think it's definitely important to have an idea of what you want to talk to the pediatrician about. And here's the thing, where we are not bashing on pediatricians ever. No, what we're saying is that parents, you need to advocate for you and for your child. And you need to seek out a second opinion, if your concerns are not heard, yes.

Rachel:

If you feel rushed, while you're talking to your pediatrician, while you're at your baby's appointment, then that might be a sign too that it's time to look elsewhere. I'll give you guys a little example because I recently went through this and I was set on this naturopath. This hippie, hippie doctor, not really actually but kind of the more natural route, and I was set on this doctor, I was like, He's gonna be great. I've heard so many good things about him yada, yada. And he basically spent 10 minutes with us, and it was just not a good experience. And the pediatrician that we ended up going with was the doctor that we saw in the hospital when Tripp was born. And he sat and talked with us, he answered all of our crazy parents questions, and he actually listened to us. So it's hard to do that, it's awkward, but if it's best for you and your family, then do it.

Jessica:

You're not going to hurt anybody's feelings. They're Hey, other patient, they have plenty of other patients. So you can just tell them like, hey, look, honestly, you don't even have to tell them anything. Just don't make an appointment with them again, find somewhere else to go. So a big thing I think, too, is that as you're going through your days, if something pops into your head, like maybe you're listening to a podcast, or you're watching your child do something and you're like, oh my gosh, what about this or this or this? Write it down. So that when you go to the pediatrician, you don't forget about it. Have a note in your like a note section in your phone where you can put it or a notebook somewhere and just remember, like, this is your doctor doctors questions. So that you have them all and you get them out and you're like, hey, we're gonna go through my questions now.

Rachel:

And if they don't know an answer to one of your questions, how to refer you to someone who can answer your question. Like if it's a more specific question about maybe sleep or diet or gross motor, fine motor, things like that, then say, Hey, can you refer me to an OT? Can you refer me to a sleep consultant, a lactation consultant, whatever it is, just ask for a referral.

Jessica:

Yeah, that's a great idea.

Rachel:

Thanks.

Jessica:

Yeah. All right. So let's get into this. We're going to talk about some questions that you can ask at various pediatrician appointments. We're going to do it based on the age of the child so like the three month checkup, and we're basing these on our knowledge, our experience with developmental milestones, our experience and research that we've done, and also talking with other parents.

Rachel:

Yep. So let's start with three months do I know sometimes it's a two month appointment, a four month appointment, but we're just going to stick those two appointments together. call it three months. You're welcome.

Jessica:

So the first one, this is really good because Rachel has been through this and if you've been with us for a while you know all about it - head shape and torticollis.

Rachel:

Yes. Now, before we go any further, if you are concerned about this, go back to our previous episode where we interviewed Jennifer from Baby Begin about these things, and she can answer all of your questions. But yes, so head shape and torticollis. Basically, without going into too much detail, just know that if something doesn't feel right, if there are some asymmetries if there is a flat spot, or if you're concerned about a flat spot developing, then ask your doctor about this.

Jessica:

At the three month checkup, definitely make sure you're talking about tummy time and how you can help your child put weight through their arms while they're in this position. Maybe what it should look like? How can you help your child get more tummy time? Are there other ways to give them tummy time than just on the floor? Ask your pediatrician and see what they say.

Rachel:

Yeah, and going along with that you can ask them about their Landau Reflex and you can say, hey, my child is supermanning all the time or maybe they aren't supermanning all the time, what can I do to either facilitate this or to kind of help move through that reflex?

Jessica:

Yeah,

Rachel:

Sorry! Do one more and then I'll go to that one.

Jessica:

Kind of going along with this is going to be hands to midline. Okay, if your child is already bringing their hands to the midline of their body, great. If they're not just asked about it, just ask see what the pediatricians says.

Rachel:

Yes. Another one is, maybe you have a family history of autoimmune disorders, and you want to possibly delay your vaccines or spread them out. This is a tough one to advocate on, but stick to your guns. If you don't feel right vaccinating your child in the same order that the CDC recommends, then talk to them about that and stand your ground if you have those autoimmune diseases in your family history.

Jessica:

Yeah, for sure you are in control of what is put in your child's body and if they try to tell you otherwise, get

Rachel:

You can walk out. out.

Jessica:

Okay.

Rachel:

Another one that you want to talk about is breastfeeding or bottle feeding, if your child has a good latch, if they have maybe a tongue tie or a lip tie, have them look at that and check just to make sure and rule it out. Especially if maybe your child has more gas or they're fussy, or they're not latching or they're not feeding very well or gaining weight. Talk to them about that.

Jessica:

I was just thinking about colic, and babies who are colicky and maybe this is one that they refer out to a specialist for.

Rachel:

Definitely.

Jessica:

So another one kind of going back to bringing hands to midline is going to be is your child mouthing objects? Are they mouthing their hands at this point? And if they're not, if they're not interested in putting anything in their mouth, could be a red flag?

Rachel:

Yep. Going along with that tracking items with both eyes. So if you're moving an item above their head, across their body, they should be starting to track it with their eyeballs and if they're not, then let's look into it.

Jessica:

with their eyeballs.

Rachel:

I thought that was fun.

Jessica:

I liked it! Okay, are we moving on to six months?

Rachel:

All right, let's do six months.

Jessica:

Okay, so at the six month checkup, is your child gaining weight? Where are they on the growth chart? This is, it's so funny, Rachel and I were literally just talking about this today, about how Tripp is in a pretty low percentile for weight, right?

Rachel:

Weight and height. Yeah.

Jessica:

But his growth is still pretty steady, right?

Rachel:

Still on the chart at the same place. So he's growing.

Jessica:

Yes, he hasn't plateaued. I mean, the same thing happened with my son where he was in very low percentiles for weight and height as well. But every time that we talked about it, there wasn't a concern, because he was still gaining weight and still growing. He was just kind of small. Poor kid.

Rachel:

Yeah and if your doctor says we need to start a supplement, and if your doctor says we need to start supplementing with formula, you can say, do we need to? Are we creating a big child? Is it necessary? You are free to ask those questions. If you don't feel comfortable or if you want to put your child on formula, then talk to them about that. So either way, it's your job to advocate for your child.

Jessica:

It's your choice. You get to choose. All right at six months is your baby starting to babble and make noise? Like specific sound, specific noises?

Rachel:

I believe the sounds are the consonants M and be around six months. So maybe if they aren't facilitate that, and listen to our episode on facilitating speech and play.

Jessica:

What!

Rachel:

It's a good one.

Jessica:

This is a big one eye contact. Okay, six months your babies should be making some real good eye contact with you.

Rachel:

Yep. Ask your doctor about sleep. What is the typical? Typical with air quotes. What is the typical pattern for a six month old sleeping? Should they be sleeping through the night? Should they be waking up to eat? Should we start sleep training? Ask them all the things.

Jessica:

Yeah. Going along with that, let's talk about starting solids. I've heard a lot of different opinions on this. There's a lot out there.

Rachel:

And my doctor, actually, when we went into his four month appointment, he's like, you can start solids if you want. I'm like, he can't even sit up straight. He's not interested. Why would you recommend that?

Jessica:

Right? Okay.

Rachel:

Because they don't have specific training in baby led weaning, or nutrition.

Jessica:

And I feel like it's getting earlier and earlier all the time, I will say from our experience and understanding of how it works, your child should be able to sit upright independently before starting solids. That's just my personal opinion.

Rachel:

That's my opinion, too. And I just think so much about safety. Like if your child can't support themselves upright on their own, can they clear their throat if they're choking. I'm just kind of paranoid because I don't like choking. So I'm like, I'll probably wait a little bit longer just to make sure we are really there. But what's the rush? You know?

Jessica:

Exactly. Yeah, sure.

Rachel:

The allergies are kind of the new thing and making sure that you're introducing those foods, but..

Jessica:

But also, I've talked to a couple of people who, like didn't even start solids with their child until their child showed interest, and was like reaching and putting those foods into their mouth. And it's like, okay, we're just gonna wait until they're ready.

Rachel:

Like you held a pickle in front of trip today and he was like, what is this? He smiled at it but he didn't try to reach for it.

Jessica:

He's not ready.

Rachel:

No

Jessica:

Not ready.

Rachel:

Okay, so let's talk about allergies, the history of allergies. If you have celiac, or lactose intolerance in your family, definitely talk to your pediatrician about that and get their input.

Jessica:

And go ahead and keep the conversation about vaccines going. Where are you guys at with your vaccines? Are you ready? Are you wanting to keep the schedule? Kind of plays into every checkup, I think,

Rachel:

Yeah and I will say I'm reading a book called The Vaccine Friendly Plan, and there's a little bit, there's actually not as much on vaccines in there as I thought there would be. But it's just a good alternative opinion if you guys want some additional information about like what's in the vaccines, and I'd get that book. It's been helpful for me

Jessica:

Totally. So at this six month checkup is a great time to talk about some developmental milestones, and they probably will, Most pediatricians will have like a little checklist, which I know is super fun for a lot of parents. But we're going to look at sitting, rolling, imitating, being in quad which is on your hands and your knees and doing a rocking almost like a pre crawling.

Rachel:

And if your child isn't doing these things yet, that's okay. Keep in mind, all these babies are on their own trajectory. But it's important to let your doctor know that you're aware of these things, and you want to make sure that you are intervening if you need to.

Jessica:

And going along with that if you're a pediatrician says oh, your baby's fine, give it a couple more months, and you're not okay with that answer. Speak up and so you want a referral to someone who can help, which could very likely be OT.

Rachel:

Yep and if they say no, then walk out. That's okay. We'll go somewhere else who will give us a referral..

Jessica:

Be assertive I was. I was assertive recently.

Rachel:

Oh. I like it!

Jessica:

So you can do this?

Rachel:

All right, you guys, let's move on to nine months. We just want to take a minute and talk to you about our company Harkla. Our mission at Harkla is to help those with special needs live happy, healthy lives. Not only do we accomplish this through the podcast, but we also have therapy products, easy to follow digital courses, and the Harkla sensory club to try to bring holistic care to you and your family.

Jessica:

Listeners of the All Things sensory podcast get 10% off their first purchase at Harkla. With the discount code sensory. We'd recommend checking out some of our best sellers like the compression sensory swing, weighted blankets, or our course on sensory diets.

Rachel:

And here's the best part 1% of each sale gets donated to the University of Washington Autism Center to support autism research and fun scholarships to families in need to receive in-clinic therapy for their child.

Jessica:

Learn more about Harkla and all we have to offer at harkla.co That's h a r k L A dot C O and don't forget to use the discount code sensory to get 10 percent off your first purchase. That's s e n s o r y for 10% off.

Rachel:

And the best part is all Harkla orders come with a lifetime guarantee and free shipping.

Jessica:

You really can't beat that.

Rachel:

No,

Jessica:

You can't. Okay, let's get back to the show. All right, so talking about some more developmental milestones, we want to be crawling. Now. This is an interesting one. Your child should be crawling on all fours. What is a monkey scoot? There's like a monkey scoot crawl.

Rachel:

There's so many different, the janky crawl.

Jessica:

I love that word janky.

Rachel:

So if they are crawling on their hands and one knee and one leg is kind of out to the side, it's not functional. Maybe they're scooting and they're sitting on their bottom, and it's super cute, but it's not good.

Jessica:

Yep, we could talk about this all day. It really plays into primitive reflexes, which is the foundation. So definitely be aware of this one.

Rachel:

Is your nine month old pulling up to stand? Are they cruising? Are they're working on getting ready for independent walking? They should be interested in getting up and moving and exploring and seeing the world in a vertical plane instead of the horizontal plane like they've been for so long.

Jessica:

And going along with that? Are they pointing at different things in their environment? And are they engaging with you? This is really, this is a big thing I believe. Maybe we've talked about this before, but talk to your child about their environment. Tell them what is in their environment. Don't just carry them and go quietly throughout your day, but actually point and talk about the things that are in the environment.

Rachel:

Anyways. So another thing that you want to look at is their pincer grasp. So are they using their thumb and their index finger to pick up little treasures like cereal, or beads, or blocks?

Jessica:

Yeah, if you're noticing that your nine month old is using what we would call like a raking grasp where they're using all of their fingers and driving items into their palm versus this more precision based grasp than that could be a sign of some fine motor delays that you could talk with your pediatrician about.

Rachel:

Are they making sounds like ma ma, da, da, da, bah, bah, bah?

Jessica:

imitating those sounds too.

Rachel:

Super important. Maybe they are beginning to recognize their name and the word no. So if you say, Hey, Jessica, come here and they don't even turn to you or you say no, don't do that and they don't hear you or they aren't turning their head or recognizing it at all, then that can be a red flag as well.

Jessica:

Yeah, for sure. Are they enjoying games like peekaboo? Are they wanting to try to engage with those types of games and initiate those games for you to play with them.

Rachel:

And another kind of fine motor developmental milestone would be transferring toys from one hand to another. So maybe they pick up a block in one hand, and then they pass it to their other hand and stack it on the tower.

Jessica:

Yep.

Rachel:

All right. Let's do one year!

Jessica:

12 months, y'all.!

Rachel:

Okay.

Jessica:

All right, let's do a primitive reflex check. Where are your child's primitive reflexes at? If your pediatrician is not familiar with primitive reflexes, see if they know somebody who is that they can refer you to.

Rachel:

Definitely better to addressing these earlier than to come in at maybe five years old and you're like, Oh, help, I think my primitive reflexes are still retained, which isn't a problem if you didn't know about them. But if you have a young child, it's definitely helpful to be aware of those from the start.

Jessica:

Now we do have a podcast series where we did an episode on each of the main primitive reflexes that we have worked with in the past, so you can go check those out. And then we also have a primitive reflex crash course that you guys can check out and see if it's something that would fit for your needs.

Rachel:

Another thing that you'll want to ask your doctor about is are they walking or are they showing signs that they are getting ready to walk?

Jessica:

Which would be when they're pulling themselves to stand and they're cruising, so means they're walking, but they're holding onto a piece of furniture or maybe your hand. Now, we've already said this once, but let's reiterate it again, every child is going to develop on their own timeframe and a great example is my son, Logan, who didn't start walking independently and taking those steps, until he was a year and one month old. Actually, probably a year and almost two months old because it was right around Christmas of his first after he turned one. So,he was what they would say was a little bit of late walker. But though I mean.

Rachel:

I'd say if your child isn't walking by like 16 months.

Jessica:

16 months, perfect.

Rachel:

That would be, that'd be like the latest.

Jessica:

That would be like a red flag maybe.

Rachel:

Yeah. But I'm sure at a year he was showing these readiness signs.

Jessica:

Oh, he for sure was and that's why we weren't concerned about it.

Rachel:

Exactly. Cool.

Jessica:

But I just know, oftentimes, I hear people say, Yeah, my kid crawled for like, a week, and then they just pulled himself up and never crawled again. So that can also be a red flag. You guys, we do want these kids to progress through these crawling stages, and have a good amount of time in crawling. And yeah, it's cool. It's great if they're up and walking early. But get some tunnels and do some crawling.

Rachel:

Yes, get down and crawl with them. Yeah, I know, it's so interesting. I feel like Tripp will be a lake walker, and my niece who's 11 months just like took her first steps. So it's so it's hard not to compare them.

Jessica:

Sure.

Rachel:

But it's also so eye opening and it's such a great example of what their lives look like. |What makes them late? What makes them early? Does it matter? No. Are you gonna remember this when they're 30? And are they gonna say, Oh, I was a, I walked when I was 11 months old.

Jessica:

I mean, they might? I would.

Rachel:

Yeah, exactly. But the point is, is as long as they're hitting those milestones, these milestones that we're talking about, it doesn't matter.

Jessica:

All right, at one year old, are they starting to eat a variety of foods and textures? Have you started some of those solid foods and are they able to try new things? Or are they super, super picky? Are they still gagging? Are they not able to tolerate? Those would be some things to ask your pediatrician about.

Rachel:

Oh, right. So at a year old, they might start showing fear or they might be upset when mom and dad leave

Jessica:

or the main caregiver.

Rachel:

Absolutely. So they're recognizing I don't want you to leave caregiver, whoever you are. I don't want you to leave. I want to hang out with you.

Jessica:

Yeah and that's a normal thing. That's not something that you need to be worried about. Right?

Rachel:

We want that.

Jessica:

Yeah. We don't need to reassure these one year old that oh, my gosh, I'm so sorry. I'm leaving. No. empathize with them, identify their feeling. - Yeah, you're sad. And that's okay that you're sad. I'll see you later. Go ahead and give them those words for those feelings. But it's okay.

Rachel:

We do have a previous podcast on supporting separation anxiety. So go ahead and check that out. They also might start helping to get themselves dressed

Jessica:

and undressed Yeah.

Rachel:

Probably undressed before they start dressing..

Jessica:

If your one year old is not showing interest in helping to take their clothes on and off, then that can be a sign that something might not be working right.

Rachel:

Yeah, that's not a bad thing. It's just we want to be proactive in finding help for them. Another thing we want them to be working on at 12 months is imitating gestures, imitating words that you're saying like mama da aa, uh oh, ball, things like that.

Jessica:

Yep. And this is a tricky one. And I think this could be another one that some pediatricians might say, let's wait and see. But again, if you are not comfortable with waiting and seeing, then don't. Go somewhere else.

Rachel:

Yep. Another one is container plays. So at 12 months, our baby should be putting in and taking out toys from containers.

Jessica:

They should also be pointing with their index finger and I think we talked about that at the nine month one as well. So if your child's not pointing at things in their environment, maybe pointing and trying to say the words, that could be something to talk to your pediatrician about.

Rachel:

Yep and the last one is they should be interested in finding objects that you hide. And so if you hide the ball behind the couch, they shouldn't be like, Oh, where did it go and kind of have that object permanence idea going on. So

Jessica:

yes, that's a good one.

Rachel:

So if you're not seeing that stuff, and maybe you just haven't tried that with them, then you can take this episode and kind of use it as a guide for what your kiddos should be doing at these certain ages.

Jessica:

Yeah and just different things to look at, to look for. Therapists, if you have young children on your caseload, go ahead and talk to the parents about these things.

Rachel:

Yeah, we thought that it would be helpful to create a checklist for you guys and so we're going to put that in the shownotes. A free download, enjoy! It's just a little guide for you guys to just use and follow along with your own child's development, or take into the pediatrician and say, this is what I'm concerned with. This is what I'm not concerned with.

Jessica:

This is what Rachel and Jessica said to do. Okay, you know them right? If not, you should. You should. Go tell your pediatrician about us.

Rachel:

All right, friends, thank you so much for listening to this episode. Hopefully it was hopeful. Hopefully you learned something.

Jessica:

Hopefully you leave us a review on iTunes. Hopefully you share this episode with your friends and your family and your co-workers and every single person that you know.

Rachel:

Did we tell you guys that we hit our goal of 500,000 podcast downloads?

Jessica:

We did.

Rachel:

We did in February.

Jessica:

We have a goal to hit 1 million before the end of 2021.

Rachel:

December 31st.

Jessica:

So y'all need to help us with this and share this episode with everyone you know. Share this podcast, just the podcast with everyone you know, and help us to reach 1 million downloads.

Rachel:

Oh my gosh, that's so crazy.

Jessica:

We'll have to do a giveaway.

Rachel:

Oh, yeah.

Jessica:

Okay.

Rachel:

Okay.

Jessica:

All right. Thanks for being here.

Rachel:

Well, we'll chat with you next week next week. Thank you so much for listening to all things sensory by Harkla. If you want more information on anything we mentioned in the show, head over to harkla.co/podcast to get all of the show notes.

Jessica:

We always have the show notes and links plus full transcripts to make following along as easy as possible for everyone. If you have follow up questions, the best place to ask those is in the comments on the show notes or message us on our Instagram account, which is at Harkla underscore family. If you just search Harkla, you'll find us.

Rachel:

Like we mentioned before our podcast listeners get 10% off their first order at Harkla. Whether it's for one of our digital courses, one of our sensory swings, the discount code sensory will save you 10% That code is sensory. Head over to harkla.co/sensory to use that code right now so you don't forget.

Jessica:

We're so excited to work together to help create confident kids all over the world and work towards a happier, healthier life.

Rachel:

All right, we'll talk to you guys next week.

Jessica:

Just a friendly reminder this is general information related to occupational therapy, pediatrics and sensory integration. We do not know you or your child therefore we do not know any specific needs therefore you should always refer back to your pediatrician and occupational therapist for more information