When a Pediatrician Breaks Her Own Rules


I smirked to myself as I typed instructions for a nurse to pass along to my patient: “I do not recommend adding rice cereal to the bottle. When developmentally appropriate, it should be given by spoon only.” Yes, you should never put rice cereal in the bottle. I have never put rice cereal in the bottle to see if my child would sleep longer. I have never tried to sneak in a few extra calories and iron by adding rice cereal to the bottle. Ok maybe once. Or twice. Or at times when I am desperate.

As a pediatrician, I dish out parenting advice all of the time and most of it is extremely research-based. It is rare that I use more anecdotal recommendations, although I hear all sorts of home remedies from families each day. My inclination to follow the science over experiences is likely due to being early in my career. Sticking to the scientific evidence on a topic allows me to have the support of the medical community behind my recommendation, but with only a few years of practice under my belt, using anecdotal evidence from patients feels less safe. However, there are times that I use my own parenting experiences when talking with patients. It is sometimes hard to restrain from sharing these stories, as a pediatrician in the trenches of parenthood.

I was relieved when I recently overheard a colleague also giving out advice that she doesn’t follow herself. This attending physician was explaining why children shouldn’t use combination sunscreen and bug spray products, then immediately told us how much she loved using it herself. I laughed immediately, thinking of all the topics that this reminded me of in my own practice. Whether it is related to feeding, sleeping, hygiene, screen time, or discipline, pediatricians often find the evidence-based recommendations that we give to patients and parents much harder to practice than preach.

The reality of how difficult parenting by the book is has made me a better pediatrician. Instead of judging that mom who puts rice cereal in the bottle or uses the combination sunscreen-bug spray product, I see in her a woman like myself and my friends who is doing the best she can. A woman who respects the ideal practice guidelines yet modifies them to fit her family. Although I support the occasional rule-breaking for the sake of sanity, I fear telling our pediatrician as much as I imagine some of my patients fear telling me. I hope that they see in my flawed practices though permission to be honest about the life hacks that we all use to survive the turbulence in parenting.


[This is not medical advice. You should talk to your health care provider to determine what is best for your child. The opinions above are my own and do not necessarily reflect those of The Children’s Hospital of Philadelphia.]

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  1. I love your honesty here! I agree with you that it’s important as a medical professional to dispense evidence based advice knowing that patients and families are likely to take their own twist on a lot of it (which is ok for the most part!). As a pediatric dietitian, I break some of my food rules with my own kids, but only because I know I’m doing the other things to the fullest (ex if my 3 1/2 year old stays in bed all night without calling me, he can have a hershey kiss in the morning. He eats well otherwise and a well rested mama is a happy mama!)
    Danielle @ Little Mama Big Life recently posted…The Break You MakeMy Profile

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