The other day, I asked a tearful mom to kiss her boy goodbye before we wheeled him off to the operating room. And we didn’t have time for a long goodbye. He was three-years-old, her ‘one and only’. Just days before, he had choked while eating popcorn, seemed okay right afterwards, but his nagging cough kept getting worse and worse. His astute pediatrician listened to his chest with a stethoscope, and there was a telltale sign: wheezing on one side. “That’s not asthma”, she wisely said. Some remnant of choked-on popcorn was stuck at the left main bronchus, blocking off his lung. There was only one way to get that out: surgery.
“Foreign bodies”, as we ear, nose, and throat doctors call them, can be routine, satisfying procedures, or they can be literal nightmares. Most often, we’re able to remove the food object successfully, using telescopic instruments down a child’s windpipe while they’re under anesthesia. But sometimes the food gets stuck in the airway, and blocks it off completely before the child can even make it to the hospital.
Food choking episodes are surprisingly common, and occur most often in the toddler set. Parents, of course, feel awful when their child has an event like this, but usually it’s because they had no idea that certain foods pose choking risks for toddlers. Despite countless hours of research and patient education, foods, unlike toys, are not labeled for safety. So how were these parents to know that popcorn was a potentially deadly hazard to a young child?
As I reviewed this boy’s medical history, I noticed that he had not been immunized. At all. The minutes before a surgery were not the time to discuss that, but we’d get to that later, once all was well.
As I sat with relieved, tearful, (this time with tears of joy) parents in the recovery room, I said with a smirk, ‘Oh, and after we removed the popcorn piece, I updated all of his immunizations and gave him a whole bunch of shots’. Their response? ‘Thank you!’. But then I had to tell them I would never do such a thing without their permission, besides the fact that during an emergency surgery was not the time to run through the three years of missed vaccines. I did, however, strongly encourage them to get their boy immunized. And to hold off on popcorn for at least another year or two. “You must think we’re the worst parents in the world, because right now we sure feel that way,” said his dad. With that, I spent some time reassuring them that they were terrific parents in caring so much for their son, recognizing and addressing a problem, and doing all they could, to the best of their knowledge, to protect him.
They had had no idea about popcorn risks, but now they did. And, it turns out, they had some pretty mixed messages about vaccines, as well. In speaking with their pediatrician later that day, I asked her about his not being immunized. She explained that, until recently, there was some concern that he may have autism, but now that that was no longer the case, she would start getting his shots up to date. Wait a second. Let me get this straight. There are pediatricians out there who think vaccines cause autism? Or that they somehow make autism worse? And that somehow if a child is autistic, not immunizing him will make him less so? Or is the concern about liability, whereby if he was, indeed, autistic, the family would blame the pediatrician that the vaccines did it, and that it was her fault? Wasn’t all of that nonsense debunked years ago? My head was spinning.
Not only are they not the worst parents in the world, they are in a larger and larger group of parents who are getting mixed messages, the wrong message, or no message at all from physicians. There is so much finger pointing at parents who don’t immunize their children. But maybe our fingers are pointing up the wrong tree.
Dr. Shapiro will be a guest on Baby and Toddler Instructions radio, July 30th, 11amEST to talk about toddlers and food.
My Best Parenting Advice: The Worst Parents in the World, or Mixed Messages? by Dr. Nina Shapiro