Following the Doctors Orders
When your baby or child has Gastroesophageal Reflux Disease or GERD, following the doctor's orders isn't always as easy at it looks. Many families face financial barriers such as no insurance coverage or a high deductible forcing some to choose between groceries for the family or expensive medication/formula for the baby. I hope you will access local and state resources to cover medical expenses for your family if cost is a barrier to following the doctor's orders.
The Treatment Plan
There are other hurdles as well. During the medical appointment, you may be trying to sooth your crying baby while talking to the doctor. At home, fatigue and worry can make it hard to remember the treatment plan. The first step to following the doctor's orders is having a clear written treatment plan. Try bringing a notepad to all appointments so you can write down notes as you are talking to the doctor. At the end of the appointment, you should have a written treatment plan that includes one or more of the following types of treatment for GERD: medication, diet and positioning.
Your next challenge is facing your children and selling the treatment plan to a less than willing participant. Young children often resist taking reflux medication and dislike going to the doctor and having tests. Older children want to be independent from their parents and fit in with their peers. Pre teens and teens may feel that it is unfair to miss social events and school for a doctor's appointment or test. Older children certainly don't want to hear mom nagging about taking reflux medication or restricting foods that cause reflux symptoms. Some teens don't understand the need to take daily reflux medication to prevent symptoms, when they are feeling well. Also, if an older child takes medication faithfully but still has symptoms, it can be really frustrating and confusing.
Parents can help their children with reflux follow the doctor's order and learn to manage GERD at home but it can be a real balancing act. Parents and children need to learn new skills and children need to learn self care and independence. It can be a challenge to manage a medical condition at home without making it the focus of your family.
During the worse of the reflux years, our family still traveled by car and plane for vacations and holidays. It was something that we enjoyed and the extra preparation, although daunting and exhausting was worth it. It did take a can do attitude and the organization of a Boy Scout to execute. One year, Rebecca was hospitalized just days before Thanksgiving. We were both exhausted and I secretly wondered how we would mobilize to drive 6 hours away to visit relatives. The next thing I knew, Rebecca was asking me to get her Pooh suitcase off a high shelf so she could begin to pack.
Teach Self Care
As a parent, it is your job to teach your child to care for her personal needs. You probably see it as your job to encourage your child to brush her teeth to prevent cavities. When your child needs to take daily reflux medication or adhere to a special diet, you also need to teach her to care for her special medical needs. A parent will need to mix and measure medication but a preschooler can certainly put a sticker on a chart to indicate that she had her dose. An older child may need guidance and oversight to become increasingly independent with self care. My daughter pairs taking medication with brushing her teeth so she seldom needs a reminder (i.e. nagging) from mom. My children have learned through trial and error that carrying their own snacks and water bottle ensures that they always have something to eat that doesn't trigger symptoms when they are out. This didn't just happen overnight. At first, I carried the snacks in my purse and kept a stash in the van. Gradually, they started carrying their own supply of food. Now they are in control of the entire process.
Your family will need to communicate have an ongoing discussion about needs and concerns about home care and medical treatment. As your child gets older or the medical needs change, family members may need to take on new roles. A young child may have a fairly stable routine at home. As she gets older, you and your child may need to plan for special occasions such as camp or an overnight visit away from home. It may be helpful to include the doctor in the process. For instance, if your teen declares that he isn't going to follow the reflux diet anymore, it may be helpful to have the doctor weigh in on the discussion.
A Better Outcome for all
Clearly, following the treatment plan will ensure a better medical outcome. Over time, you and your family will find ways to integrate parenting and reflux management. You will both learn new skills and overcome obstacles. Your child will learn to care for his/her needs and increase independence. It will still seem unfair to you and your child that you have to deal with a chronic medical condition. But reflux and care giving will be woven into your parenting, teaching you and your child how to cope and stay healthy.
Published On: March 10, 2008