After all the late-night/early-morning work I did covering the Winter Olympics (in addition to my standing freelance assignments and that whole parenting three kids thing), I promised my husband that I would take some time off afterwards and not do any work at all. (Well, except for my standing freelance assignments and that whole parenting three kids thing).
My husband didn’t believe me. God, apparently, didn’t believe me, either, because, literally less than 24 hours after the Ladies’ Long Program ended in Sochi, God decided to make certain I kept my promise to take it easy by striking me down with a case of shingles.
For those unfamiliar with shingles, it’s caused by the chicken pox virus that has been lying dormant inside you probably since elementary school flaring up and making one half of your body feel like it’s on fire. There are also some blood-red blisters (in my case along the back and above the rib-cage; but that can vary from patient to patient) that eventually erupt and scab over for visual effect. Read the rest of this entry →
I am a card carrying member of Generation Y. Having grown up on the internet, rocked to tunes on my iPod, and texted all through high school, I am more than amply tech-savvy and embrace all things digital. I never shuddered at the thought of snuggling up in bed with an e-reader, and am perfectly comfortable depositing my checks via my smart phone. Now that I think of it, most of the transactions I make are via the World Wide Web; heck I just did my Menorah shopping online (who knew, right?).
As such, I am an app person. I’ve got an app for everything from breastfeeding to business and beyond. So, when my little guy began grabbing and biting my phone, I downloaded some baby apps for him, too.
I do not delude myself into thinking these apps are educational. They are, however, entertaining. Very entertaining. And God knows, every mom needs an entertaining trick up her sleeve if she is to survive seeing her children into adulthood.
That brings me to this Sunday. Aforementioned little guy was under the weather long enough to warrant a visit to the pediatrician. While I love my doctor, the waiting time in his office is notoriously long and offers very little in the way of distraction. So it was armed with a diaper bag full of goodies that I lugged my cranky babes down to the office. Read the rest of this entry →
My first thought on reading that sentence was, “That doesn’t even make sense.” I’m familiar with abusive relationships, as well as with labor and birthing. This sentence, from an abstract of an article in the Journal of Perinatal Education entitled “Abuse in Hospital-Based Birth Settings?” piqued my curiosity with its deliberate use of a red-flag word.
I’m not sure if the word “abusive” is warranted for the doctor-patient dynamic in the L&D setting (certainly it hasn’t been within my experiences)–but I do feel, inappropriately enough, that the word “paternalistic” often is. Read the rest of this entry →
Recently, Kveller posted this image on their Facebook page of a baby bib with the words “Future Doctor” and a pocket adorned with coins. That alone is offensive enough but the product is labeled “Jewish Baby Bib.” [Update: as of this morning, this product has been removed from Amazon.]
These societal misconceptions are the main reason that I don’t write about the fact that my husband is a surgical resident.
The stereotype of money hungry Jews flocking to medicine is based on a very complex history that at this point is almost completely antiquated. Anyone, Jewish or not, looking to make it rich isn’t turning to medicine’s long hours and dwindling reimbursement, and the very slim odds of getting into medical school are in no way increased by religious affiliation.
My husband and I met in graduate school. Shortly after, we moved to a little rental house in southwest Ohio where he worked as a high school biology teacher for two of the most wonderful years of our life. He cooked meals, we rode bikes, and took impromptu trips to Europe. He had vacation days for when he wanted to go on vacation and sick days for when he got sick. We had what I look back on as a “normal life” before he was accepted to medical school. Read the rest of this entry →
My son has been sick a lot during his life. Fortunately, it hasn’t been anything too severe, but especially during the first two years of his life, it seemed pretty constant. And while some of it was totally normal, typical childhood stuff, we also saw our fair share of specialists.
You know that it’s bad when the doctor says that your son has conjunctivitis and you’re relieved. Yeah, he has to be out of school for a day, but it doesn’t have a huge impact on quality of life and there’s a relatively easy treatment for it. Read the rest of this entry →
He was the senior partner in a four man group when I first walked into the office with my 8-month-old daughter, my first child, after we had moved from Manhattan to Queens. Although Dr. B. was very reserved, he was an excellent doctor who gave me good support and advice as I raised four kids, and he saw us through many an illness. I made my check-up appointments with him and would wait for him to see my kid when I came to the office for a “sick visit” instead of being randomly assigned to another doctor. I also liked Dr. N., who became our primary pediatrician after Dr. B. left the practice to retire out West.
A study published earlier this week claims that singleton babies born at 37 and 38 weeks may not do as well in school. As you can imagine, the study got quite a lot of attention.
Dr. Kimberly Noble, the lead author of the study and a pediatrician and developmental cognitive neuroscientist in Columbia University’s Department of Pediatrics and G.H. Sergievsky Center, took the time to talk with Kveller.
You recently published an article in the Journal Pediatrics that’s getting a lot of attention. Can you summarize the findings for us?
In this study we were able to link two databases, one from the New York City Department of Health (which keeps birth records with detailed info) and another from the Department of Education (a database with third grade reading and math test scores). What we found is that within full term range, which is defined as 37-41 weeks, babies born at later gestational stages performed better on reading and math tests.
What prompted this study?
We know from hundreds of studies that children born preterm, prior to 37 weeks, are at increased risk of developmental and academic difficulties. However, very little is known about any differences among children born within the full term range of 37 to 41 weeks. Brain development is ongoing during the last month of gestation, and so it is somewhat surprising that this hasn’t been looked at.
In the abstract of the article, you and your fellow researchers state that “achievement scores for children born at 37 and 38 weeks [were] significantly lower than those for children born at 39, 40, or 41 weeks.” What were the degrees of difference here? Were they very significant?
The differences were small but significant. Children at 37 weeks performed about a point below children at 41 weeks. This would not be noticeable from one child to the next, but it is important on a population or public health level, because it means that children in the early term range are more likely to have reading or math disabilities. For example, children born at 37 weeks are 33% more likely to have a severe reading disability and are 19% more likely to have a moderate math disability, relative to 41 weekers. Again, most children will perform normally, but there is an increased risk at earlier gestational age within the term range.
What do you think will be the practical implications of this study?
I think the most important implications come in the realm of early elective deliveries. Until we have further data, we urge parents and clinicians to exercise caution in scheduling elective deliveries for logistical regions (vacation, scheduling preference) in the “early term” range, prior to 39 weeks. Of course, if there is a medical indication for scheduling an early delivery, that is very different, and we recommend that women discuss this with their clinicians.
What might you say to those parents who have had children born at 37 or 38 weeks and might be concerned about these results? (Or to parents who already know that their child will be delivered prematurely)?
The differences that we found in average scores were small–only about a point on standardized tests. It is true that, at the lower end of the scale, children in the early term range have a somewhat increased risk of reading and/or math difficulties. However, increased risk is not the same as inevitability. Most children within the early term range of 37 or 38 weeks will perform normally. To the extent that early term birth confers risk, this may be used by pediatricians to identify children who may benefit from extra services.
I happen to know that you recently gave birth to a healthy baby girl—Mazal Tov! How did the results of this study–and what you know about neurocognitive development in general-affect you during your pregnancy? Did you find yourself thinking a lot about prematurity or did you just turn it off?
Thank you! I would say that what affected me more was having seen extremely preterm births during my training in the neonatal intensive care unit (at Columbia). In fact, during my own pregnancy, once I reached 37 weeks I was pretty relieved!
What’s it been like to be a pediatrician/mom, so far? Do you find that you reference your clinical and research knowledge as you watch the way your daughter makes eye contact or holds her head up? Or have you been able to just enjoy the burps and gurgles, unqualified?
I would say it’s a mixed blessing. There are definitely things I’ve worried about that I know I don’t need to, and it’s easy to wonder if every little thing is an indicator of some rare condition. I’m definitely glad to have a pediatrician (that’s not me!) who cares for my daughter, and even when I’ve known the answer to certain questions, I’ve tried hard to play mom instead of doctor to her.
Final question: if you could give a new parent just one piece of advice regarding child development, what would it be?
The most important ways parents can promote healthy child development are through early exposure to a cognitively stimulating and emotionally warm environment. Parenting is critical, and its effects far outweigh the small effects we see of gestational age within the term range.
To read more Interviews with Interesting Jews, go here.
My 3.5-year-old, who has been potty trained since last summer, has been having frequent urine accidents off and on over the past few months. My little girl is a sweet, smart, earnest, rule-follower who generally doesn’t give us a hard time about going to the bathroom. She tells me that she wants to keep her pee-pee in her body, but she doesn’t know how. It breaks my heart. Until the fourth accident of the day, when it frustrates the hell out of me.
A few friends had mentioned the possibility that constipation might be the cause of her accidents, but I wasn’t sure, as she’s pretty regular (or so I thought). Yesterday morning I stumbled across this article in the New York Times, which I immediately emailed to my pediatrician. She called a few hours later, and gave us an appointment for 5 p.m. An x-ray of my daughter’s tummy revealed that constipation does seem to be the culprit. We start the Miralax today. Read the rest of this entry →
Happy July 1st! For some of us, i.e. me, this is the month where we’re scheduled to have a baby. For others, this is the month where a new job will commence. And in some situations, these two unusual circumstances will collide.
New medical residents start their shifts on July 1st. The maximum hour shifts for first year residents, as of today, is 16 hours…apparently laid-back, compared to the normal way of life of a first year resident. Second year residents are allowed to work 24 hour shifts, although “strategic napping” is recommended. Sort of like being a new parent, isn’t it?
I’m due next week, so who knows what will happen…but here in the US, many know that July 4th is…well, July 4th. And on July 4th, everyone with any seniority in any job in the world decamps for beach, mountain, or recreational locations, leaving people who don’t know what they’re doing…I mean, people who are comparatively new on the job…to do the work. I’ve been in that position myself, and have fond memories of spending my Fourth of July weekends working on briefs that were fairly eviscerated by partners after the fact.
I don’t like the idea of my baby, due to scheduling constraints beyond my control, being delivered by someone who has less experience delivering babies than I do (this will be my third, after all).
But the fact of the matter is that baby birthin’ is fairly unpredictable business, regardless of the time of year. You never know what’s going to happen or where. With my first child, I remember going to my Lamaze class and being surprised that everyone had drawn up elaborate birth plans. I looked down at my piece of paper, which said, “Have the baby.” I mean, homework for Lamaze class is a bit much…but also, the fact is that this is one of those “Women plan, God laughs” kind of situations. The more elaborate the birthing plan, the more guaranteed it seems one is of having a c-section.
I’ve been having off-and-on contractions and pain for the past few days and am trying to go through life with as little variation as possible. I went to a film screening yesterday, and am relieved to report that I didn’t give birth either inbound or outbound in the Lincoln Tunnel. In an effort to court as many germs as possible, I’m taking my older son to the pediatrician today so he can get over his cold in time to hopefully meet his little sister in the hospital when she’s born. I have flip flops to return. Will the day end with me having a baby? Who knows?
You can’t sweat the small stuff or the big stuff. Resident possibly delivering my baby? I can’t stress about it – you never know what’s going to happen. And so that’s why when I watch the fireworks with my husband, parents and boys Monday night, I’m going to make sure I get a good seat – right next to the E.M.T. truck.