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This one is about: Different Doctors, Different Rules

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One mom asked why some doctors have very strict after care rules and others are very lenient? Why do some allow you to use a bottle right away while others require cup or syringe feeds for weeks? Why do some require elbow restraints, while others do not require them??

Following is my response to her:

Different doctors -- different rules - not because the "rules" change -- it's the level of acceptable risk differs from doctor to doctor. We have the natural laws of nature -- laws that say "trauma to a healing surgical site is one of the major threats to that site" and another law that says "tension placed on a healing surgical site is a major threat to that site" and so the doctors weigh back and forth -- the trauma that could be caused by introducing a spoon or nipple (another law of nature -- sucking and smacking can lodge tiny food particles into the rough, healing site and create conditions that are ripe for infection)... is weighed against the threat of tension due to inconsolable crying. They ask, Can the parent calm the baby and still feed with the alternative - safer - methods -- or Can the parent be careful with the the older, more familiar feeding methods and have a calmer baby?? And the doctor establishes his post op rules accordingly.

It is ALWAYS a trade-off. The parent whose doctor has more relaxed post-op rules needs to be aware that their doctor has chosen to accept a larger acceptable risk factor than those who have very strict aftercare rules.

Now, that is not to say that doctors with lax rules are taking big risks... They are simply bigger risks than those who have strict rules. They also take into consideration the type of stitches used -- the actual probability of a problem, and the history of their own work over time.

I always figured that I would rather err on the side of caution... Our doctor was very strict - and I followed his rules to the letter. We have a new doctor now ((sigh)) and he is less strict. I still follow an after care regimen that is stricter than my new doctor prescribes. It's ok to be more strict - but not ok to be less strict. I simply choose to allow for a smaller degree of acceptable risk.

It's all about a trade-off -- but the bottom line is - regardless of what the doctor's rules may be -- you will never suspend the laws of nature. It either IS or it ISN'T a risk... a risk is not a certainty - it is only a probability -- you just decide how high that probability will be.

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