Babyfacts: Pediatrician Andrew Adesman on What Doctors Get Wrong

Doctors don't always know best, and Andy Adesman has faced up to that. He and his wife, both pediatricians, found themselves butting heads over basic child rearing, like whether their three kids would catch a cold if they went outside without a coat: "I'd say, 'Where did they teach you that? It's not true!' "

So Adesman started looking into common beliefs about baby and child care and found that he and his fellow doctors get more than a few things wrong themselves. He did the research, and tells what's true and what's not in his new book Babyfacts (Wiley, $15.95). Here's an edited version of our chat:

There are tons of parenting books out there. Why did you write this one?
Babyfacts was never intended to compete with those parenting books. This is not the first book parents should buy. It just fills in some interesting things.

You're a parent, but you're also a pediatrician, so you shouldn't be getting this stuff wrong. Did you?
The answer is yes. I remember having the kids wait 30 minutes before they went swimming. It turns out that's a universal myth. I know when our kids were young (they're now teenagers) they got bathed daily. It's not really essential. And when my teenage daughter, who was helping me with the book, and I went to lunch together, she said, "Dad, can I get a Frappuccino for lunch?" I'm thinking, it's 12 o'clock; the caffeine won't keep her up. But it will stunt her growth. I double-checked the medical literature, and of course caffeine won't stunt your growth.

But the things that doctors and parents get wrong aren't just amusing. Some of them have real health consequences.
That's true. For instance, treating burns with butter or ice poses a risk. Butter traps the heat, and with ice you can get frostbite. People have this presumption that baby walkers, since they're designed for babies, are safe, yet they're very likely to cause an accident. Shopping carts are the same way. People think the seats must be safe, but there were 24,000 injuries in 2005 related to shopping carts.

You also warn parents against some things that pediatricians often advise, like alternating Tylenol and Motrin for pain relief. What's wrong with that?
I was just in the urgent center last night with my son, who had a minor sports injury, and they talked about alternating ibuprofen and acetaminophen. The concern is it's too easy to do wrong. You're either going to mess up the dose or give two doses of the same medicine close together and potentially have an overdose.

And speaking of Motrin, you say we parents worry too much when a kid has a fever.
People sometimes get a little nutty around fever; we go out of our way to suppress it. But fever is our friend; it's helping fight infection. And children can have a fever as high as 105 degrees without serious risk of harm. Parents also keep kids inside with fever, but those with a low-grade fever can go outside and play if they feel like it.

You specialize in treating children with ADHD, yet you say that sugar doesn't make kids hyper. How can that be?
Study after study says that when you control for sugar intake and give kids high doses of sugar vs. a sugar substitute, there are no effects. In one study, they brought parents into an observation area to watch their kids, then told the parents they were looking at the effects of sugar vs. an artificial sweetener. The parents rated the supposedly sugar-exposed kids higher for hyperactivity. But the kids all got the same thing. Despite all the research, people have trouble accepting it. As an ADHD doctor, I can't tell you how many times parents ask about limiting sugar as a way to control behavior. There are lots of good reasons to limit sugar intake, in terms of dental care and empty calories. But it doesn't have to do with hyperactivity.