Hi all,

I'm going to make this as short as possible. Basically, we're seven months two weeks old or a 4.75 months adjusted. We went to our pediatrician last week and he wanted us in early intervention because they weren't sitting up and they were delayed. He gave me the number and said I needed to get started right away. He felt I should be feeding solids quite a bit more than I am. He also said we needed to put them in the exersaucer to strengthen weight bearing muscles. I asked him about this being normal with preemies and he said yes but they really needed services. I called EI and they asked me their adjusted age, said that we probably wouldn't qualify but they would set up an evaluation. Yesterday we had our first NICU follow-up visit and we were seen by a doctor, nurse practioner and a physical therapist. All three evaluated the babies and were thrilled by their progress. They asked if I had concerns and I said that my doctor wants us to start with Early Intervention and I was very concerned after seeing him because of all the delays he mentioned. They were appalled saying a pediatrician should not even consider their actual age and told me how wrong our doctor was. They were not slamming him at all, just had a lot of questions about why he said what he did and explained why he was wrong. Then I mentioned we were working on the weight bearing(in the exersaucer) on his advice and they were almost upset (esp. the physical therapist). I felt like a jerk. She explained why there weren't recommended at all, all the things that are wrong with them and why the doctor was wrong specifically for preemies. He also had us start solids and was pushing us to get into more foods and again they felt at adjusted age we were a little bit early (not outside of the norm but no reason to rush it at all) I just feel like I'm a first-time mother who wants to know that my pediatrician can help me should I have questions and I have three incidences where he's been wrong as it concerns our preemies. I don't think I'm starter than any doctor and I hate to just leave a practice, but I think it's safe to assume he's treating our 28 weekers the same as he would full termers and that isn't okay. We live in a small town and there aren't too many options without travelling too far.(I will absolutely travel to get the best care for my children without hesitation) I guess I'm asking what would you do?

Thanks in advance. I know this is lengthy but I'd love to hear other opinions before we make any decisions on how to proceed.

Nicole, Mom of Julia, Griffin and Braddock born at 28 weeks, 4 days
www.thedimasitrifecta.blogspot.com

I don't really have advice as far as preemies are concerned since mine were 36weekers and I got to bring them home. I didn't have to go through all that you have. My pedi has always compared everything w/actual age and mine are always small for their age but so is my 4yo singleton that was full term. That said, I think your pedi should definitely be basing your babies on an adjusted scale...just too big of a gap. If I remember correctly, only one of mine was sitting up at 7 months. The other 2 were more like 8-9 months. My pedi was not concerned at all. My singleton actually didn't sit up until 10 months, but she was already walking. As for food, mine didn't start solids until they were 9.5mos. They are 13 mos now and we are completely off of bottles. To me, all the stuff is no biggie. Nothing to worry about. I really don't like pedi's that are so strict w/time frames. All babies are different and do things in their own time. If you feel like they are doing okay, then I'd probably switch pedis. If you feel like they need to be evaluated, then do so. From the sound of it, I would not get along w/your pedi. Mine is very supportive of my relaxed attitude toward raising my kids. He tells me what is recommended but has no problems w/me doing it my own way...probably b/c he knows he'd lose my business

Sarah

Mom to:
Rylee 7-28-04

36 weekers

Kenzi Adilyn 2-19-08 (6lbs 6oz)
Devyn Elizabeth 2-19-08 (4lbs 12oz)
Caden Jackson 2-19-08 (5lbs 9oz)

If it were me, I would change or at least schedule a visit with the Dr. to discuss your concerns. Mine are even older than yours and none of mine can sit up yet; your babies were born almost 3 months early and that will play a role in their development. I did cringe at the exersaucer comment b/c they are really not recommended especially for preemies.

My beautiful boys born on 6/8/2008:
Rowan 2 lbs 10 oz
Elliott 2 lbs 7 oz
Finn 2 lbs 5 oz

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Yes!!! Change Doctor! Huge red flag. Babies are expected to sit up at 6 months with help, sit up on their own at 9 months. That would be 8 and 11 months for you. Any educated MD would know to use adjusted age for preemie babies. Fire him. and If you feel bad for it give me his number and I will call him and tell him his services are no longer required.

Reta

Kipras, Kajus, Rokas born 7/4/ 2008

my babies are getting EI based on actual ages...and they were two months early...per EI..(this happen to come up a few days ago in conversation)....EI says most medical drs use actual verses adjusted age....that by doing that it pushes the babies to catch up quicker ...and helps prevent them from falling behind...the way i took it was...if peds go by actual and babies arent meetin milestones, they get help sooner rather than later once a baby does develop the problem...my kiddos are in EI based on actual milestones...they arent functioning like regular 6month olds..but they do ok as 4month old milestones...and they are 6months actual/4 adjusted....did that makesense??

We were told that normally only NICU drs and staff and developmental specialist MDs normally go bby adjusted ages.

HTH.

~Ashley~
Mommy to the six K's!
Keegan, Kyler, Kenzington and our trio Kaden,Kali and Kobe

FYI: I am an occupational therapist specializing in peds and ALL preemies should have their age adjusted for testing until 2 years. this is the norm and what is expected on ANY standardized motor test (Bayley, Peabody etc) EVERYONE should be adjusting until 2 years, if they are doing a test and NOT adjusting this is WRONG.

Alison Hanlin
Addison, Eli, and Morgan 7/8/07
33W, 4D
www.hanlinfamily.blogspot.com

I would say yes at least meet with a different peditrician. You've gotten wrong info too many times and you sound uncomfortable so it's time. I think if you stay with your current ped, you'll always wonder if you are being told the right thing. He/she is probably a good doctor but just doesn't know preemies at all. Although I'm surprised by that exersaucer comment, because the negatives are everywhere (although exersaucers are a mom life saver in small doses). My 29 weekers just turned 2 and that first year our ped was so great with everything. She knew so much about preemies and was able to help me with when to worry and when not. You deserve to have that kind of faith and support in ped.

Jennifer
GBG 2/20/2007
@29 weeks

Thank you, everyone. I went and saw him yesterday and told him how the evaluation went. I explained that we did not want any comparisons for milestones on anything but adjusted age. I also told him the evaluators said we wouldn't even qualify for EI because they'd have to be delayed beyond adjusted age 33% and there was no delay at adjusted. He was happy to hear it. I wanted to ask why he didn't know to use adjusted age but there were people in the waiting room and I wasn't going to embarrass him. We will continue being followed by the team from the NICU through this clinic, so at least I know if there's a problem it will be spotted early and by people who deal with preemies every day. I do want to have the confidence in my pedi that others here have, so I will start to explore who is in our area. I enjoyed all your responses. I am kind of timid, Reta, so I appreciate that you'll call for me. I need more of that spirit in myself.

What a great board. Thanks so much

Nicole, Mom of Julia, Griffin and Braddock born at 28 weeks, 4 days
www.thedimasitrifecta.blogspot.com

I agree that the exersaucer comment was strange and wrong, but as far as the EI comment, I would much sooner have a doctor that suggests EI than a doctor that doesn't. Your kids were preemies and will probably benefit from services from EI at some point. EI is a wonderful program and does evaluations that are much more comprehensive than a regular doctor. Our doctor had us call EI when our almost 34 weekers were only a few months old because she thought that a couple of the babies were a bit stiffer than she would have liked. Obviously, there were no delays at that point. My kids continued to be in and out of EI until they turned 3 and greatly benefitted from their services. When there was a delay or concern, EI helped us work it out. It is a great program and I love doctors that are proactive in getting babies, especially preemies, involved with it. If you have other concerns about your doctor, I would find someone that you are comfortable with, but he was erring on the side of caution and I like that in a doctor. Even the exersaucer comment, even though it was wrong, he did tell you to talk to a p/t and the p/t would have straightened it out. So, if it were me, I would not change doctors based on this experience alone.

Kelly
Ben, Jack & Drew 05/28/02
Charlie 07/06/06
Aunt to: Liam, Aidan & Connor 03/05/08
www.outnumberedmommy.blogspot.com

That is weird, because I have the same feelings about the developmental therapist at the NICU. My girls are 36 weeks today, and as of 1 1/2 weeks ago they were recommending early intervention because they lacked some motor skills - like they couldn't control their head when pulled to sitting, and were a little jerky in their movements. Well, umm, they're -6 weeks old, why should they be able to control their movements?

I guess if you like him in all other respects, I'd stick with him, and just ignore those silly recommendations because they don't compare to full-terms.

Amy
Julia Evelyn, 2 lbs, 15 oz
^Caitlin Elizabeth^, 3 lbs, 3 oz (died one day prior to delivery due to complications of an encephalocele)
Gabrielle Rose, 3 lbs, 6 oz