The mother of a two year old came to see me because of something new in her daughter’s behavior that was a source of concern. The child has started making a throat clearing sound at intervals. This happens at home and the teachers have become aware of it at school. The doctor can find no basis for this medically and reassured the mother that it was just a passing tic like others that come and go in children. The mother, however, was not reassured.
In further discussion it emerged that the child recently had a traumatic experience. She had swallowed a fruit pit which lodged in her throat and was rushed to the emergency room. An intrusive examination followed, and although the pit had apparently gone down without further intervention, the experience had been frightening for both child and parents
The mom then hesitantly ventured her idea that the throat sound is a self-soothing behavior for her daughter and serves to allay her anxiety. She then further explained that a pacifier used to serve this purpose but the parents had recently limited its use in an attempt to rid her of it. Perhaps the development of this new behavior was connected to these recent events.
I told the mother that I thought her insight was extremely important, and we then discussed ways that might be helpful to the child given mom’s understanding of the situation. It was clear to me that this mother had not been reassured by the earlier medical reassurances she had been given because on some level she had been aware of what this was all about. It was the deeper question for which she was seeking help.
This encounter brought back for me an experience of my own. As an infant, my son had episodes of vomiting followed by unconsciousness. Needless to say, this was extremely frightening and worrisome and many specialists were consulted. The best guess was that some sort of seizures was involved and various intrusive tests were recommended. Before moving forward I consulted a neurologist/psychiatrist I knew from my own training.
After relating all the information, this doctor asked me what I thought was wrong with the baby. To my surprise, I found myself telling him that I thought it had something to do with food. Acting on that idea, he outlined a course of action to follow that involved starting with nothing but formula and then a week at a time adding each of the various foods that earlier had been introduced.
In following this recommendation, I discovered that unaware I had even made a connection between the episodes and one particular baby food. I never gave that particular food again and there was never another episode. Reporting back to the doctor, I told him of my amazement at discovering what I had apparently known without knowing that I knew it, and said that no doctor had ever asked me that question before.
He told me he had learned that from a pediatrics professor in medical school who had taught them, “If you don’t know what is wrong with a child, ask the mother.” Following up with a pediatric allergist, I later learned that this was a rare food allergy that was subsequently written up in a pediatric journal.
The point of this story is not that as parents we should pay no attention to the medical specialists we consult about our children. It is rather that we are the ones who know our children best and our judgments and understanding are valuable. Sorry to say, mothers in particular are not always heard, especially in this day and age when there are time pressures on everyone. This is also an era when people google everything and have the latest findings from the Internet. All sources of information can be valuable, but not without the insight that comes from knowledge of our children.
The meaning to me of my own story, and that of the mother I described, is to have enough confidence in our perceptions to allow them to surface into our awareness, to be given weight and pursued along with those of other “experts.”
Good Enough Mothering 