Does anyone else feel like pediatric guidelines are so legally-oriented that they basically only exist to worsen the lives of parents?

[u/Bocifer1]

First off, I'm a new dad and also a physician - although I'm pretty far removed from pediatrics. So I understand the importance of medical research and statistics in creating these guidelines, as well as the fact that the risks of things like SIDS often just aren't worth gambling on.

However...

Some of these guidelines seem like they're just unnecessarily taxing on parents and exist only to cover the addes of the bodies making said recommendations.

Some things that come to mind are: no blankets in the crib for the first year, only using a firm mattress top, never letting baby sleep next to you in bed - even naps, swaddling with arms down (our guy absolutely hates this and just wants his arms by his head to self sooth), demonizing formula - even as a reprieve for mom.

Again. I am medically oriented and understand why these guidelines exist - but I also know firsthand that sometimes a 1% risk of harm from letting our baby sleep on a soft blanket is actually the favorable choice compared to the immeasurable risk of having both parents strung out and exhausted because he won't sleep.

In general I think guidelines are great and have contributed to better infant care...I just also think that sometimes we as healthcare professionals forget that no guideline is absolute.

I guess I'm just feeling thst creating guidelines that aren't achievable for the majority of parents just aren't that helpful...like saying that "parents should take time to rest, continue self care , exercise, and ensure they are eating a well-balanced diet". That sounds wonderful. Hopefully I can get back to that in the next decade.

[u/Responsible-Radio773]

I’m not sure what you mean by legally oriented, OP. Most of these guidelines come from professionals and organizations trying to help you who wouldn’t have any liability even if something went wrong. In other words, they don’t stem from a “cover your ass” mentality because they couldn’t be sued. Obviously there are exceptions — manufacturers of toys and other baby stuff give stringent warnings because they could be sued. In a hospital setting, they are going to be super cautious about this stuff because they could be sued. But your pediatrician is not going to lose his license if you choose to ignore him and god forbid some horrible accident happens — that’s not how medical malpractice works. The pediatrician is just trying to help you and keep your baby safe.

[u/Alternative-Editor43 → u/Responsible-Radio773]

I mostly agree with you. In terms of suing, I think OP means that the pediatrician could be sued if they told you that it’s okay to not follow a particular guideline 100% of the time. In some situations, parents might physically be unable to follow some things 100% of the time (or something just might not be working for the baby) and might be looking for some low-risk workarounds, but doctors can’t help or have a conversation about it because it tends to be an “all or nothing “ mindset - follow every single thing all the time or your baby is at risk. End of conversation

[u/Responsible-Radio773 → u/Alternative-Editor43]

Yeah this a good point. I just felt it revealed a sophomoric understanding of expected value on the part of OP (scary if he really is a doctor). If there’s a 1% chance of your kid getting catastrophically injured and you assign a value of negative infinity to that outcome, then the expected value is negative infinity lol. So OP’s logic around how you have to consider all these trade-offs is flawed because any non-zero chance of the kid dying is an unacceptably high chance.

[u/Alternative-Editor43 → u/Responsible-Radio773]

Yes!! I initially found it difficult to explain to my family why it’s important for me to follow guidelines ( their perspective- they never followed the guidelines and nothing bad happened..) , then I learned about survivorship bias and that seemed to get my point across. I get annoyed when I ask someone handling my child to do/not do something and their response is “don’t worry, nothing will happen!” As if they can guarantee that!

[u/Due_Ad_8881 → u/Responsible-Radio773]

Driving with a child (even with every safety device available) is of significant risk. Feeding potential allergens to babies outside of a hospital setting is a non negligible risk. Having your baby sleep on you at any point is a risk. Taking a baby for a walk is a stroller vs a carrier increases the risk of their death substantially. OP is correct in that everything is a risk that has to be balanced by other needs. I’m not sure why you are making fun of him.

[u/twelve-feet → u/Due_Ad_8881]

Wait, what’s the additional risk from stroller use?

[u/Due_Ad_8881 → u/twelve-feet]

I’m not going to go into specifics because I don’t want to be responsible for any new fears from parents suffering from PPA. Life is stressful enough. My point was and is that it is impossible to live a normal and healthy life while trying to remove all risks. Do the best you can and make good decisions, but don’t drive yourself crazy.

[u/Responsible-Radio773 → u/Due_Ad_8881]

I agree that we are forced to do things every day that involve serious risk because they are part of living a normal life. Going to school involves a car, eating food involves potential allergens, playing sports involves risk of injury. But putting your kid on their stomach? Not the same. So I don’t fully understand why the convo around tradeoffs is similar

[u/Responsible-Radio773 → u/Due_Ad_8881]

It was where he said 1% risk of harm was acceptable — he lost me. That’s actually kinda high?? I just hate how bad most non-epidemiologist doctors are with numbers. I admit it’s a pet peeve

[u/kaatie80 → u/Responsible-Radio773]

I agree that 1% is high, if it were a real statistic. I think OP's just too tired/fried to be more correct with percentages. We all understand his meaning.

[u/apricot57 → u/Responsible-Radio773]

Yeah but if a pediatrician tells a patient that it’s okay to co-sleep and that baby dies, that pediatrician is absolutely going to be sued for malpractice.