March 10, 2009: There are many factors, which may be contributing to Paige’s presentation, including her prematurity, lack of prenatal care, and the drug exposure.*
I sit in front of a corner desk in an examination room. Paige sits on my lap, smelling of diaper cream and baby shampoo. Her skin is smooth and tender, slightly wrinkled from the bath she barely tolerated this morning.
Dr. Elaine Hertford**, a Child Development Pediatric Physician, sits across from me. She is a small, middle-aged woman with graying brown hair cut shoulder length and layered, brown eyes hidden behind black, cat-eye glasses, and a smile that reveals slightly crooked teeth.
“What brings you here, today?” Dr. Hertford smiles at Paige, who is in the early stages of stranger anxiety and steadfastly avoids eye contact.
I explain that Paige doesn’t yet sit up or roll over. “She doesn’t raise her head for tummy time – I don’t know if it’s because she can’t or she because doesn’t like it.” I mention her mood swings and averseness to things, such as baths.
Dr. Hertford encourages me to continue with a slight nod as she jots down notes.
“She has reflux but we were told to stop putting rice cereal in her formula because she isn’t gaining weight.” I pause a moment and add, “She gets severe constipation and diarrhea.”
Dr. Hertford sits down on the floor and gestures for me and Paige to join her. Sitting across from Dr. Hertford, Paige examines her suspiciously.
“Hi, Paige! Do you want to play with the blocks?” Dr. Hertford places a few wooden blocks on the floor and waits.
Paige examines them and then picks one up and puts it in her mouth. Dr. Hertford’s pen scratches across her notebook while her head nods up and down. She offers more toys, alternating between observing and writing. She talks to Paige as though they’re best pals, and asks me questions from time to time.
When Dr. Hertford finishes, she steps out of the room to calculate Paige’s scores. “It’ll take me about ten minutes,” she says, closing the door softly as she leaves.
* Dr. Hertford’s notes from the appointment
** Name changed to protect privacy