Dealing with health professionals can involve a hazardous journey through a maze of seemingly inconsistent advice or it can be a rewarding relationship between yourself (as a parent) and a health professional to discover the solution to your baby's distress.

The second option is of course the preferred one, but how can we achieve this partnership relationship with the doctor or nurse?  The answer is not just about having confidence in your doctor or Maternal & Child Health nurse; it is about having confidence in yourself as your child's parent.

There is no such thing as perfect parents!  We as parents are doing the best we can with the information and choices available to us.  Coping with a distressed baby should never be under-estimated; it is a difficult situation which may not have an easy solution, but it is possible to make things better by increasing your knowledge, being assertive when dealing with a health professional and having the confidence to sift through the various advice given and treatments recommended and selecting what you feel comfortable with, that suits your baby, family and situation

Health professionals are there to assist you and your baby by providing medical support and reassurance, however because of this role they can be both criticized and praised.  While it is important to have a certain amount of faith and trust in medical personnel and respect their expertise, it is also very important to realize they are people like us and they too can make misjudgments.

While these professionals are now increasingly aware of the importance of the parents' input when making a diagnosis and deciding on treatment, a few may lack the communication skills to reassure you that they are listening to your concerns and observations about your child's health.  In these cases it is necessary to be persistent in asking questions, but if you leave feeling inadequate or that your observations about your child have been dismissed out of hand, then that health professional's technical expertise is not sufficient for what you need as a parent.

You should never feel that you are wasting a health professional's time with a trivial concern.  If it is enough for you to feel worried and anxious about it, then that is sufficient reason for making an appointment.  If it turns out to be nothing then the appointment can be turned into a routine check-up.  If however it turns out to be something, then you as a parent have ensured early diagnosis and treatment for your baby.

Although you may have felt a confident, assertive person with good communication skills, coping with a distressed baby with its accompanying stress factors, including lack of sleep, can cause you to lose confidence in your parenting skills.  Information on the health of your baby, causes of distress and possible treatments, will all help build your confidence in communicating with health professionals, enabling you to ask questions and decide on the best course of treatment for your baby?

There is a wide range of services that can provide information and support, other than your doctor and Maternal Health Sister.  They are:

· Hospitals (local, maternity, children's.)

· Mother and baby units, (refer to attached listing)

· Support Groups (D.I.S.A., Nursing Mothers Association, Parents with Allergy Kids, Royal District Nursing Service, Community Health and Welfare Services, -contact your local council for a list of services in your area).

· Libraries (local or specialized libraries to be found at Universities - this means conducting your own research although librarians at each library can assist you in this).

· Internet.  (If you don't have a computer with Internet access, your local library can help)

· A Paediatric Gastroenterologist specializes in causes of distress to infants such as colic, reflux, etc.  Any doctor can refer you, and many treatments for distressed infants  may only be authorized by a gastroenterologist.


This information should not exclude the need for a consultation with a doctor or your local Maternal Health Sister, rather it should enable better communication between yourself and health professionals, as you become better informed.  Other ways to encourage communication, include preparing for your appointments with health professionals as follows:

1. Take note and write down notes regarding your child, including symptoms, behaviour and signs of distress, length of distress, physical actions when distressed, feeding patterns, feeding problems, sleep patterns, related medical history, treatments tried and anything else you consider relevant, as often these concerns aid doctors in their diagnosis and are not obvious or remembered at the time of consultation.  Refer to attached diagrams A & B.

2. Write out all the questions you want to ask.

3. Take someone with you to the appointment, to provide moral support and assistance in understanding the discussion.  It ensures that the responsibility of weighing the advice and making the decision is shared.  A partner, mother or trusted friend will do.

At the appointment:

1. Be assertive and ask questions regarding your concerns.

2. Remain calm, which will enable you to present your observations and concerns, clearly and reasonably.

3. Don't interrupt the health professional as they respond to your questions or explain their diagnosis, wait until they have finished speaking.

4. Feel free to question the course of treatment, ask about alternative treatments, medication side effects, possible risks, or for a clear explanation of anything that you didn't understand.

5. You have the right to request a referral to a specialist such as a Paediatric Gastroenterologist, as your child's distress may benefit from further investigation, or treatment which your doctor or pediatrician can't provide.

6. In order to clarify any confusion, feel free to ask the doctor or pediatrician, for a copy of their findings that they will be forwarding to the specialist.

7. Maintain eye contact as this will assure the health professional that you are listening to them, and indicates both confidence and sincerity in your questions.

8. If you feel that you are being hurried in the appointment, tell that health professional so, and be persistent in asking your questions.

9. If your baby is unsettled or particularly distressed at the time of the appointment, don't be put off, as this is the best opportunity for the health professional to see what you have to cope with at home!

10. If you leave the appointment feeling dissatisfied with the health professional's response or manner, or your not happy with their answers, advice or treatment, then you should consider seeking a second opinion.   There is nothing that prohibits you from taking this course of action, and it may help you to make a well-educated and confident decision in relation to your child's treatment.

You will probably get differing explanations and treatments advised by different health professionals.  What you need to do then is simply look at what they said and apply what you think is relevant to your particular situation.  Look for similarities in their meaning, and if you are still confused, then find someone whose opinion you know and trust, and explore the alternatives with them, before you make your decision. 

While communicating with health professionals can be daunting, especially as all parents of distressed infants often feel uncertain, vulnerable and somehow responsible for their child's distress, you are doing the best you can, and are taking a sensible step in a difficult situation.  By being assertive and confident, you should obtain more answers, and thereby increase your ability to cope with your baby's distress.

Sometimes a health professional will not have all the answers, and most will not have had personal experience in coping with a distressed baby, in these instances try other avenues such as D.I.S.A.  Remember it is never good advice if it doesn't feel right, and trust yourself, you know your baby better than anyone else.

       
Name   ?????     
       
Age    4 weeks     
       
Past illnesses  Boncholitis, Cold   
       
Date    symptoms began at 2 days of age         Colic diagnosed by R.C.H. Emergengy at two weeks      of age     
       
Symptoms child irritable and distressed, poor sleep  habits, fights feeds, can comfort feed, wind, pulls up legs, arches back, pulls off breast   
       
Management  Tried sleep and settling strategies     
     Tried positioning techniques when feeding       Attended Queen Elizabeth mother baby unit.
     Tried InfaCol  0.5ml 3 times a day   
     Tried feeding more often, less often           
       
* Some things help some times and don't help others, child cries for about eight hours a day (refer to sleep/cry chart), often an hour after the feed.  Seems to build up and worsen over a period of three or four days.  Distress begins 30 min after feed and lasts for an hour or two.     
       
Questions     
1 Could this be what's called Silent Reflux?     
2 Where can I find out more information?     
3 Why is he in so much pain?     
4 What is Colic?