Copyright 2018 by Luke Voytas
All rights reserved. No portion of this book may be reproduced or utilized in any form, or by any electronic, mechanical, or other means, without the prior written permission of the publisher.
Published by Sasquatch Books
Editor: Susan Roxborough
Production editor: Em Gale
Design: Bryce de Flamand
Copyeditor: Shari Miranda
Cover photo: mapodile | iStock.com
Library of Congress Cataloging-in-Publication Data
Names: Voytas, Luke, author.
Title: Beyond the checkup from birth to age four : a pediatricians guide to calm, confident parenting / Luke Voytas, MD.
Description: Seattle, WA : Sasquatch Books, [2018] | Includes bibliographical references and index.
Identifiers: LCCN 2017061249 | ISBN 9781632171979 (paperback)
Subjects: LCSH: Parenting. | Child rearing. | BISAC: FAMILY & RELATIONSHIPS / Life Stages / Infants & Toddlers. | FAMILY & RELATIONSHIPS / Parenting / General.
Classification: LCC HQ755 .V69 2018 | DDC 649/.1dc23
LC record available at https://lccn.loc.gov/2017061249
ISBN:9781632171979
Ebook: ISBN9781632171986
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For Augie and Elsie, always
Table of Contents
Introduction
You are so lucky! You get to have a kid at a time when everything you need to know is right at your literal fingertips. Diaper rash? Fussiness? Question about potty training? BAM! A five-second Google search gives you instant answersactually, about ten thousand of them. Then you get to pick the one that works best for you. If you like judgy or preachy answers, or occasionally enjoy feeling a touch of shame, youre really in luck. And you have social media as a backup, where you dont even have to ask a question to get help. Just watch as formerly laid-back family members and friends turn into authoritative health experts!
All right, enough sarcasmbut you see the paradox of being new parents today. For your parents it was simple: listen to Grandma, trust advertisers, and occasionally thumb through the tattered copy of Dr. Spocks baby book. But now we know that a lot of the things your parents did to you are illegal or cause cancer! You have access to all the material ever created on parenting but probably come away anxious from that mess of information. This makes it hard to feel confident about what youre doing for your kid! What information is good? Who can you trust? If youre Googling and asking friends online to figure out why your toddler has had a tummy ache for three weeks, youre going to narrow it down to leukemia, constipation, celiac disease, gluten allergy, gluten intolerance, or gluten sensitivity. Not very comforting. And no matter what you do, youre often going to feel judged, sometimes in a snarky way and sometimes in an earnest I just want to help you be a better parent way thats just as infuriating.
I think you deserve to be a more confident parent, and I think I can help. Ive been a general pediatrician for thirteen years and have worked with thousands of new parents. I see them wide-eyed with their newborns in the hospital and get to watch month by month as they grow into calm, confident parents who handle the chaos of toddlerhood like pros. Helping them to develop that confidence is 90 percent of my job (9 percent is playing with your baby, and 1 percent is getting peed on). That doesnt happen when I give you handouts or preach to you. I could give you a flyer on feeding, for example, that says, Make sure to give your child three to five servings of fruits and vegetables a day. Terrific stuffuntil your eighteen-month-old smacks those veggies off the table and onto your drapes. Thats where the real conversation begins. I cant give a one-size-fits-all answer to help your kid sleep better either. As a parent of two young kids myself, I know that it depends on your schedule, your childs personality, the layout of your home, and whether hes prone to pooping on himself at night. Ive struggled through most of the topics in this book with my own kidsthe sleep deprivation, the meltdowns, the poopy diapersthe endless poopy diapersand am a better pediatrician because of it.
All the technology in the world cant replace a conversation. Raising a kid is rarely black or white, and thoughtful chats are how we muddle through the gray. Conversations are relaxed, authentic, and one of the best ways to ease your anxiety as a parent. But I only have fifteen minutes every few months to help you sort through the nonstop barrage of opinions that is thrown at you every day. That has always frustrated me. I wrote this book to extend that discussion and give you some support until your next visit.
Well begin with what science tells uslots of interesting studies on kids just like yours that try to answer questions about behavior, eating, and sleep. Being able to distinguish good evidence from bad is more important than ever, and we doctors dont do a good enough job of helping you with that. Research is never the final answer for your kid, but its a good place to start.
ON THE SOURCES CITED IN THIS BOOK
Ive cited seventy-one sources for this book out of hundreds that I reviewed. Most are articles from reputable peer-reviewed journals (this means that articles written by experts are reviewed by other experts before they are published). Youll notice that many are from Pediatrics, probably the most respected and influential journal in my field. Most studies are recent and use large sample sizes. Whenever possible Ive tried to use research that is randomized (participants randomly assigned to different study groups), double-blinded (neither the researchers nor the participants know which group theyre in), and placebo-controlled (one group gets a sham treatment, which should have no effect), because these factors make conclusions stronger. Ive favored studies that are prospective (following a group of subjects over time) over those that are retrospective (looking backward and depending on parents recall of events.) That all being said, you cant experiment on young kids as readily as adults, so some of the studies are not perfect. I also use a lot of data from the Centers for Disease Control and Prevention (CDC), which keeps meticulous and trusted statistics on everything from vaccines to sugar consumption.
I give brief descriptions of many of the studies in the text but have written expanded summaries for some of the more important ones in the endnotes. I hope that you feel empowered to use the references to look up additional information on any topics you find interesting.
Then, well admit that the work of raising a kid is mostly off the map, without any studies to tell us what to do. Well acknowledge that theres no precisely perfect way to do things, so well just be reasonable and flexible. Like me, you might have pretty strong opinions about some of these issues, like vaccines, sleep training, and discipline. Our opinions might be different. Thats okay. I give you the best information I can, and then I trust you to do whats best for