Time to change my pedi? (Day care and doctor's note)

[lucy4]

My baby will be starting day care next week. He is 3 mo. old. The day care is licensed, and they ask for doctor's note for everything - like, if you want him to be swaddled or for him to sleep in swings he needs a note from his pedi.

My baby just started to roll, and he only goes one way, and then he pushes himself around like a snail - all around the bed. He can't turn himself back into his back. Since he discovered that he can roll, that's all he does as soon as you lay him down. We have to watch him 100% since I've seen him stuck in between his crib side and mattress face down. He doesn't make a peep. Not safe!

My mom is baby sitting my son, and he sleeps in his swings or hands.

I asked our pedi for a note allowing him to sleep in his swing in Day Care. She said - "No, it's not safe. Put him on his back." Me: "He doesn't lay on his back. He rolls on his stomach, and then he is stuck. Basically you are saying that sleeping on stomach and potentially getting stuck is safer than swings"? She's like - Um.... Yes.

This is ridiculous. Time to find another doctor. Don't you think?

He also has reflux a little, so he doesn't sleep well laying flat.

[cristeen]

I think it's time to find a new daycare, personally.

[lucy4]

Originally Posted by cristeen

I think it's time to find a new daycare, personally.

because they ask for a note?

[Llyra]

The part I'm wondering about is how there's room for him between the side of the crib and the mattress. A safe, modern crib should have no more than a finger's width of space between the mattress and the rail, and preferably less, so that even if baby rolls, baby is still safe. A licensed daycare will certainly have cribs that meet this standard, so I just don't see what the issue is.

[weliveintheforest]

Originally Posted by lucy4

because they ask for a note?

It seems a little excessive! Why should some doctor have more say about your child than you?

[lucy4]

Originally Posted by Llyra

The part I'm wondering about is how there's room for him between the side of the crib and the mattress. A safe, modern crib should have no more than a finger's width of space between the mattress and the rail, and preferably less, so that even if baby rolls, baby is still safe. A licensed daycare will certainly have cribs that meet this standard, so I just don't see what the issue is.

Not a lot of room, just a crease - just a regular crib... Am I being neurotic?

Why are swings not safe? I've ask that, and have never gotten a straight answer.

[betsyj]

The part I'm wondering about is how there's room for him between the side of the crib and the mattress. A safe, modern crib should have no more than a finger's width of space between the mattress and the rail, and preferably less, so that even if baby rolls, baby is still safe. A licensed daycare will certainly have cribs that meet this standard, so I just don't see what the issue is.

Yes to this.

My daycare also requires a doctor's note for a sleeping position other then baby on his or her back. They have to cover their butts. It isn't because the daycare wants to be unreasonable-they worry about SIDS like anyone else with very young babies and in this era of "Back to sleep" media campaigns and the proven effectiveness in reducing SIDS it makes sense.

For a while my son slept better propped up and my ped simply faxed over a note ok'ing it. Just another layer of safety in this litigious society.

[Maedze]

Originally Posted by weliveintheforest

It seems a little excessive! Why should some doctor have more say about your child than you?

Because if the baby dies of SIDS in an unapproved sleeping location, the day care gets shut down and the daycare owner goes to jail.

I think the fact that they ask for a note is indicative of a responsible and caring daycare, personally.

I agree that the OP probably needs a new ped.

[lucy4]

Originally Posted by betsyj

Yes to this.

My daycare also requires a doctor's note for a sleeping position other then baby on his or her back. They have to cover their butts. It isn't because the daycare wants to be unreasonable-they worry about SIDS like anyone else with very young babies and in this era of "Back to sleep" media campaigns and the proven effectiveness in reducing SIDS it makes sense.

For a while my son slept better propped up and my ped simply faxed over a note ok'ing it. Just another layer of safety in this litigious society.

I do understand their reasons for asking for a note, they told me it was because of SIDS. (They also need a note to slightly raise your baby's bed (for babies who can't sleep at all because of reflux, etc.). A *slightly raised* bed is not a hazard to SIDS. I've researched a lot about SIDS, and I think this has gone to extreme...

I would have him swaddled so that he can't push himself and roll, but his hands are so strong that he *always* gets himself unswaddled, and then pushes the thing off, so no more swaddling for us.

While I was writing I got a call from doctor's nurse. She said, we can only write a note saying something like - watch this baby carefully and always turn him from stomach to back because he can't yet do it himself.
-- I actually asked the daycare about that, and they said - We don't turn babies to their backs once they start to roll themselves. I was surprised, since some can only go halfway! And 2-4 months is the worse time!

It would be nice to have that note to watch him.
With all this bureaucracy, "back to sleep" campaign is all about laying baby on its back, it's not about him staying asleep on his back. Useless ... as far as SIDS prevention goes, if you ask me.

[pammysue]

Any high quality child care center will not place a baby to sleep any way other than flat on the back with no blanket or a thin (think receiving) blanket placed no higher than the child's chest. In many states this is required by licensing.

The reason for requiring the dr's note is there are some medical conditions (reflux) where it is better for the baby to sleep slightly propped. It is the center's primary responsibility to ensure the safety of the children in their care.

If your DS can roll himself to the edge of the crib onto his stomach than he is safe sleeping that way (assuming it is a safe crib with an appropriate mattress and no soft objects like bumpers).

[Llyra]

I guess I just don't understand. When my kids slept without me, I always put them down on their backs or propped on their sides. But once they could roll on their own, I never turned them back on their backs. I don't think the tiny amount of space that exists in a crib that meets safety standards is anything to worry about, and I think that a baby who can roll, even just one way, likely has enough head control to lift and move the head, if breathing is obstructed. So I think I'd just let him sleep in the crib, and not worry so much about it. I am no expert on the issue of SIDS, though, so who am I to say.

[calebsmommy25]

I'm not sure about getting a new pedi, but wanted to comment on your baby rolling himself over. When my ds was in physical therapy (2 months-14 months), I questioned the safety of him rolling over and sleeping on his belly, because I was freaked out too. She told me that if the baby has the control to roll over, then as the pp said, will have (should have) enough head control to lift and move his head. It still worried me when I found him sleeping on his belly, even though I knew he could move his head around.

I hope you find a solution to your problem, and feel at peace with it.

[ASusan]

Originally Posted by weliveintheforest

It seems a little excessive! Why should some doctor have more say about your child than you?

That's the way state-licensed daycares run, at least here in our state. Drives me bonkers.

[Rose-Roget]

Will the doctor write a note to use a back sleep positioner, so that your ds can't flip himself to his side?

[lucy4]

I saw him getting stuck, and you have to see what I am talking about... he might be in side-almost-stomach right against the crib. He'd lift his head, and grunt, grunt, and then like he gives up, and lays nose down, not head to the side.... just worries me.

[lucy4]

Originally Posted by Rose-Roget

Will the doctor write a note to use a back sleep positioner, so that your ds can't flip himself to his side?

Good question. Probably not, I'll ask tomorrow when I go to pick up that one note.

[crunchy_mommy]

I would find a new daycare. I think it's unreasonable for them to ask for a doctor's note. I see nothing wrong with them asking for requests in writing ("I as the parent request that my child sleep strapped into a swing & release daycare provider from liability if injury etc. results from this sleeping arrangement" or whatever) but to request a doctor's note shows me that the daycare does not value your right as a parent to make decisions you feel are in your child's best interest. I don't know about you but my pedi & I don't agree on EVERYTHING, no pedi will agree with you 100% on each little thing and I don't think it's fair to ask the pedi to assume liabilty for your chosen sleeping arrangement. It's YOUR choice and I really really really would find a new daycare if it were me.

ETA: I hyper-focused on the note & got sidetracked from the actual issue....

I don't know *all* the reasons that swings are considered dangerous but I do know that there is some evidence that the angle causes the windpipe to compress a bit & could cause the baby to stop breathing.

I don't use a crib but I had one set up at one point & there was no crease or gap or anything... I think if the crib is up to current standards it should be safe. If you are staying with the current provider, I would consider requesting a note for them to flip the baby if he ends up on his stomach, or for them to use sleep positioners or something... I still don't think you'd need to switch pedi's over this unless you have other issues with the dr.

[ians_mommy]

Originally Posted by weliveintheforest

It seems a little excessive! Why should some doctor have more say about your child than you?

This.
I would be really annoyed that a Day Care wanted a doctor to approve my decisions regarding my child. The only thing my DC requests a doctor's note for is to return after an infectious illness.

[ians_mommy]

Originally Posted by Maedze

Because if the baby dies of SIDS in an unapproved sleeping location, the day care gets shut down and the daycare owner goes to jail.
I think the fact that they ask for a note is indicative of a responsible and caring daycare, personally.

I agree that the OP probably needs a new ped.

That is an untrue statement.
Parents are not thrown in jail when their own children die in "unapproved sleep positions". The DC owner might get sued, but would not be arrested.

[hermionesmum]

I have to agree on getting a new daycare. I don't usually read this forum, but it caught my eye after writing a tart little note to be almost-eight year-old's school stating that I prefer her to wear goggles for swimming as she gets sore, red eyes, but have not considered this worthy of a consultation with a medical practitioner to be able to produce the doctor's note they are asking for!