Care and Feeding

He Wants Antibiotics. I Want Saline Spray.

How do two parents with different health care philosophies agree on their child’s care?

A sick kid wearing a bathrobe clutches her forehead, a thermometer sticking out of her frowning mouth.
Photo illustration by Slate. Photo by Thinkstock.

Care and Feeding is Slate’s parenting advice column. Have a question for Care and Feeding? Email careandfeeding@slate.com or post it in the Slate Parenting Facebook group.

Dear Care and Feeding,

My husband and I frequently disagree about treating our daughter’s various childhood ailments. He immediately rushes to our pediatrician for antibiotics and sees nothing wrong with daily over-the-counter allergy medicine as a preventative, even when she’s not symptomatic. I tend towards a wait-and-see approach with minimal medical intervention. While I am not into the essential oil craze of my peers, I prefer healthy foods, saline nose sprays, teas, and other methods of easing common ear/nose/throat symptoms, with a doctor called in only for severe or prolonged symptoms. The kicker is that my husband is the stay-at-home parent and usually makes the medical decisions. I would prefer our daughter not become antibiotic-resistant because of overuse. How can we resolve our different approaches to our child’s health?

—Worried Sick

Dear WS,

I’m tempted to weigh in with which treatment method I think is best, but it would just be my opinion. That’s the point. In general, we know a lot less about best medical practices than we’d like to think we do. When a child is exhibiting cold symptoms, for example, at what point do you use tea and chicken soup, and at what point do you use acetaminophen? Even among experts, opinions vary.

That’s why it’s good news that I don’t think this is really a question about medicine. It’s a question about how to compromise with a spouse around an important issue. It is not unusual for parents to disagree on handling illness, sleep problems, discipline issues, food struggles, etc. It’s one of the hardest parts of co-parenting. But it’s more about the co-parenting than about the issue itself.

Do you and your husband have a methodology for dealing with shared decisions where there is disagreement? As silly as the comparison may sound, this is not unlike when my kids disagree about what to eat for dinner. In that case, we have a system where they take turns. I’m not suggesting that you handle your daughter’s physical health the same way we handle the age-old question of Chinese versus Mexican, but I am suggesting that rather than trying every single time to come to agreement about who’s right, the two of you need to come to agreement on how you handle disagreement. This is possible if there is love and trust there. If there is not, then you have an entirely bigger problem.

Antibiotic overuse is a real issue, though the problem isn’t so much that a person can become resistant as it is that a particular bacteria can become generally resistant due to collective overuse. It is worth, if you haven’t already, doing some research so that you can make a clear argument to your husband about how you’ve come to your conclusions. This may help him see things differently than he currently does. But you must also be prepared for the fact that he may be able to make you see things differently than you currently do!

One solution would be to simply select a parent who has the final call on all things medical. This does not mean installing a dictator, but simply means choosing a person who, when there is disagreement, hears all the points of contention and is ultimately responsible for making the decision. I recognize that this requires tremendous communication and trust, but that’s what co-parenting and marriage is about. Failing that, I’d suggest making use of your pediatrician’s advice line and letting that expert function as the final arbiter. Sometimes it helps to have a third party on hand to sort these things out when we cannot do it ourselves.

It is, of course, entirely likely that sometimes you are wrong, and sometimes he is. However, here’s the good news: It doesn’t sound like either one of you is so extreme in your views as to put your daughter in extreme harm’s way. Both of you are loving parents with your daughter’s best interests at heart. That is the most important thing here. Rely on it.

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Dear Care and Feeding,

My 4-year-old son is about to start pre-K at an elementary school outside our Brooklyn neighborhood. His new school’s location makes public transit to and from there too difficult. Pre-K is too young for the school bus, so there’s an independent van service that some parents pay to pick up and drop off their kids from our neighborhood; the school is not involved in this service, but they do provide the contact info.

Our friends’ daughter attended this school last year and they said that the van service started out great—the owner was a little disorganized, but it did the job and was basically punctual. So we applied to the school, but once we committed, we began to hear a different story from our friends—that the van service had gone downhill and ended up being borderline dangerous. They told us that the driver’s punctuality had declined, that sometimes the A/C wasn’t working and the kids arrived home very sweaty and hot, and that another time some kids weren’t properly strapped into their car seats.

I still wrote the service expressing interest while mulling it over, and didn’t hear back. I followed up and got a one-line response that they could accommodate us. I followed up again asking about next steps, and they emailed me a basic application. There is no information about liability or safety.

I asked the school if they’d heard anything about last year’s service. They had heard nothing and clearly keep their involvement at arm’s length.

My husband and I work full time—this was our transport plan. But now, its legitimacy is questionable. I already get very nervous when people who aren’t me or my husband drive my kids around. Now I’m totally sketched out. What do I do? Note the red flags and sign up anyway, pressing them for some assurance? Sign up, relax, and trust a system that ultimately seems serviceable? Research other van options and try to recruit other parents to join me? Spend more cash on the school’s after-school program instead, complicating our schedule and budget?

I want to start this transition for him with low anxiety and high positivity, but I’m control-freaking out. What would you do?

—Driving Me Crazy

Dear DMC,

I would never, and I mean never, put my kid in a car situation with strangers where I have reason to be sketched out. Even if you hadn’t heard all you had about lateness, hot kids, or car seats, the mere fact that they took forever to get back to you is a big enough red flag to eliminate them from contention. If you want to have my kid in your possession, I’m going to need you to demonstrate that you can return a phone call. Once you add the other issues, I see no way you can resign yourself to this as your best choice. Why be uncomfortable with your child’s safety unless you truly have no option?

The only thing this company has going for them is that the school has “endorsed” them, and even that they’ve done with as little enthusiasm as possible. I don’t think “pressing them for some assurance” is a real thing. “Hey, either assure me that you’re great or else I walk”? It is actions, not words, that matter here. Your best bet is to research other options, get other parents involved, and let the school know that they should look carefully at this sketchy service so many of their children are depending on. The more parents you have on your side, the more impact you’ll have; school officials should be helping children find a safe way to their doors, not giving parents the phone number for a shady van and covering their eyes. It sucks that you applied to the school on the premise that transport was covered, but that sunk cost is not enough to ignore these warning signs. You must work something else out.

Good luck!

Dear Care and Feeding,

I attempted suicide in March of this year. I am on meds now and in therapy, as well as seeing a psychiatrist. This was a very traumatic event for everyone as I was literally out of my mind, eventually forcing my husband to call the police. I was in the psych ward for two weeks.

I don’t remember much of that day, but my son, who is 11, certainly does. He has been clingy, to the point that he cried when he hugged me when he returned from a week with his grandparents. He is in therapy himself, and I’m sure part of this is puberty as well (he said, “You guys just don’t understand!” during a discussion about grades), but I just don’t know how to help him. We’ve talked a lot, but I worry I’ve done irreparable damage to him. How can I help reassure him that everything will be all right?

—AH

Dearest AH,

I’m going to give you a hard truth. You cannot reassure him that everything will be all right. At least not yet. You, as a family, are mere months removed from an event that was infinitely more destabilizing and traumatic for him than it was for you. He almost lost his mother. What your child experienced was a complete and sudden lack of control over one of the most essential needs he will ever have, the need to have a parent there for him. Initial recovery from a trauma of that magnitude takes time, and still that trauma will be a permanent part of how he understands and interacts with the world. The goal of therapy in this case is not to make the trauma go away, but rather to teach tools for how to process and live with the trauma.

I wouldn’t necessarily use the term “irreparable damage,” but I would say that the experience has had a permanent impact and that he will spend the rest of his life dealing with that impact. And since you love him, that means that so will you. So in order to be there for him in the way that he needs, you must seriously accept that immutable fact.

I wonder if part of what appears to me to be your haste to move past your son’s outward expression of his fear has to do with your own guilt. His emotional response reminds you of how your actions have affected him, and that makes you uncomfortable. The quicker he moves on, the quicker you can. But you cannot set a timetable for another person’s recovery. You need to avoid compounding his trauma by taking away his freedom and space to recover from it. And furthermore, it is important that you deal with your own lingering feelings around it. If you are harboring feelings of guilt, self-judgment, or resentment, they can only further negatively impact your family’s ability to recover.

This event is for the long haul. Your son will recover with the proper help and support, which it sounds like he is getting, but your role is to give him space for everything he brings. All of it. My heart is with you.

—Carvell