The Portable Pediatrician, Second Edition

The Portable Pediatrician, Second Edition

by Laura W. Nathanson

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Dr. Laura Nathanson wrote The Portable Pediatrician to help parents find the joy in parenting and gain the confidence to quickly and easily assess their child's development, medical symptoms, and behavioral problems. Parents can't always visit their pediatrician every time they have a question, but fortunately with this book they have the next best thing.<

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Dr. Laura Nathanson wrote The Portable Pediatrician to help parents find the joy in parenting and gain the confidence to quickly and easily assess their child's development, medical symptoms, and behavioral problems. Parents can't always visit their pediatrician every time they have a question, but fortunately with this book they have the next best thing.

The Portable Pediatrician, one of the few child-care books written by a practicing pediatrician, offers authoritative and practical advice on:

  • Keeping up with, or even one step ahead of, your child's rapidly changing needs
  • Setting limits before the one year birthday
  • Planning the arrival of the next baby in the family
  • Coping with your own as well as with your child's separation anxiety
  • Dealing with the four I's: illnesses, injuries, immunizations, and insurance coverage
  • Getting prompt medical attention for serious crises -- and what to do in the meantime
  • Preventing childhood obesity and eating disorders later
  • Confronting complex behavior and medical problems, including ADD, autism, asthma, oppositional behavior (including potty resistance)

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Editorial Reviews

Publishers Weekly
The updated edition of Nathanson's 1994 The Portable Pediatrician for Parents looks a lot like the original (are those the same kids on the cover?), but the author has done more than give the old version a spit and a polish: she adds, for example, essays on current concerns such as autism, drug-resistant bacteria and managed care. Divided into three main sections-The Well Child, Illness and Injury, and Pediatric Concerns and Controversies-the book helps parents understand what to expect from their children (e.g., most babies lose weight immediately after birth; most three or four year olds will begin to have questions about sex), how to parent them when they're healthy (everything from setting limits consistently to taking temperatures rectally), and what to do if they're sick (how to perform CPR; when to use Syrup of Ipecac). She also includes To-Do Lists ("Laugh at Four's jokes, even if you don't understand why they're funny), discussions of common but not serious problems, and an impressively large amount of information parents should know but maybe don't ("those bumps you see at the back of the throat are normal taste buds). It's an excellent-one might even say indispensable-resource for the new parent, and Nathanson has a great bedside manner: she shares her expertise clearly, confidently and sometimes with even a touch of humor. (Sept.) Copyright 2003 Cahners Business Information.
Jo Peer-Haas
A lucid family health book covering in detail, and with common sense, what to expect at every stage of infancy and toddlerhood. Nathanson gives medical advice, of course, which she supports with a glossary and an index, so that her book may be consulted in a hurry. She also salts her counsel with the broader concerns of child rearing, from contemporary wisdom about breast-feeding (and weaning) to the psychology of building a child's self-esteem, dealing with sibling rivalry, and assessing the impact of divorce. A graceful writer, Nathanson speaks with a gentle authority on such humble subjects as the "potentially awkward situations" that new grandparents can present, and her chapter on caring for a sick child, filled with anecdotes from her practice, is compassionate and, in its way, quite lovely. This Omnibus volume is likely to be in demand.

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HarperCollins Publishers
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Chapter One

The Pre-Baby Visit

As if You Didn't Have Anything Else to Do

To-Do List

  • Figure out your insurance plan!
  • Make a prenatal or pre-adoption visit with your chosen pediatrician
  • If you're planning to nurse, get the best guide:
    The Ultimate Breastfeeding Book of Answers (Prima), by Jack Newman, M.D. and T. Pitman
  • Buy and figure out how to install a car seat for the baby
  • Turn the hot water heater down to 120 degrees

Back when dinosaurs roamed the earth, before Managed Medical Care, parents interviewed pediatricians to decide which one to choose before the baby arrived. These days, parents often have the choice made for them by their insurance plan. So the focus of the parental visit has changed for most people, and maybe for the better. Parents aren't fixed in a consumer mode, and pediatricians aren't locked into their best behavior. The visit is a social one, and the whole experience can be more relaxed and more fun.

But why make a parental visit at all, if you already know who the pediatrician, or group of pediatricians, is going to be? If you're already stuck with each other?

I think the most important reason is to bring home the realization that the big climax of pregnancy is not the act of delivery, but the arrival of the child: the delivery is but a means to an end. This may seem obvious intellectually. But there is something about obstetrical visits that induces a kind of fog over post-delivery events. The ob-gyn waiting room is quiet. Nearly everyone is an adult. You look at the size of the bellies, and compare them with the one housing your ownfetus. You overhear the nurses and receptionists reciting the litany of pregnancy and labor. Most adopting parents these days participate to some degree in the pregnancy of the birth mother, so they get fogged-in also.

Walk into the pediatric waiting room, and savor the contrast: the pungent odors, the wild spectrum of pitch and decibel. Be careful you don't step on somebody who comes up to your ankles. Try to figure out what that obviously beloved scrap of material, coiled around that sucked thumb, used to be. Hear the office staff rejoicing that Jessica finally has pee'd in the cup, extolling Thomas's juicy pinchable thighs, offering stickers to Enrique for being so brave after his many pokes. You put your hand on the pregnant belly and feel your fetus kick, or you think about the readied nursery at home, and suddenly you realize: This is a baby we're talking about here.

Before this appointment, it's useful to have considered some basic questions. That way, you know what you want to discuss with your Pediatrician To Be. Here's my list, with my answers. Think about what questions you want to ask.

  • How important is it to nurse when you really don't want to? How important is it to try to nurse if you are pretty sure you won't be able to do so? If we use formula, how can we discuss intelligently with the pediatrician which one to use?
  • What are the most frequent medical interventions babies need right at birth, how scary are they, and what do they mean?
  • What medical routines can be expected in the hospital nursery? Are they really necessary, especially the ones that are uncomfortable for the baby, or involve separating the baby from the parents?
  • What are the pros and cons of circumcision?
  • How far ahead of time, and on what basis, should we choose a daycare provider? What if we have to put the baby in daycare really soon after birth -- how can we keep the baby from being endangered physically or emotionally? How can we cope ourselves?
  • What should we try to learn about our pediatrician, even if we don't have a choice about which one to see?
  • What's most important to understand about the insurance plan for the baby?

Before we turn to these questions, however, a word about the most important item you'll need to purchase before the baby arrives: the car seat.


Don't even think of bringing the baby home from the hospital in someone's lap. Many hospitals won't discharge a baby if you don't have a car seat. They'll try humor and tact first; but if you persist, they will call The Law: Car seats for babies are required in all states and the District of Columbia. And for good reason. If you have an accident, the possibility of death or injury is reduced by 80% when a car seat is used. If you are riding in a cab, take the car seat along.

Infant car seats must face backwards. They should be installed in the center of the backseat. The car seat should be installed so that it is not in a seat with an air bag in front or next to it: the detonation of the air bag could prove fatal. Consult your car manual for indications for disconnecting the air bag.

Babies should sit facing backward as long as they can fit into the car seat: the minimum age to face forward is One Year, the minimum weight 20 pounds. (Both milestones should be achieved.) If your baby is under about six pounds at the time of hospital discharge, make sure that you have positioned the baby in the reclining, rather than the sitting, position: you don't want Cherub's chin down on his chest. Such a curled-up, fetal position can close off the airway.

You will need a seat with a "five-point" harness-shoulder straps, lap belt, crotch strap. Many good brands are available, but you must be sure that the one you choose is compatible with your vehicle. Check the manual.

Car seats with shields can overwhelm an infant; Consumer Reports suggests these be reserved for toddlers. A padded armrest may help a baby be comfortable, but is no protection in a crash.

Once you've chosen your seat, check it out through the Auto Safety Hotline: 800-424-9393 to make sure there hasn't been a recall. Have the manufacturer, model name and number, and date of manufacture ready.

The Portable Pediatrician, Second Edition. Copyright © by Laura W. Nathanson. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.

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Meet the Author

Dr. Laura Nathanson is the author of The Portable Pediatrician, as well as several other books. She has practiced pediatrics for more than thirty years, is board certified in pediatrics and peri-neonatology, and has been consistently listed in The Best Doctors in America.

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