It is known, or is it?: Why our parents were so certain.

It is known, or is it?: Why Our Parents Were so Certain.

I have been hearing a lot from parents about how difficult it can be for the wonderful grandmothers who love our kids to get used to changes in medical thinking. Things that used to be taught as good ways to take care of kids are now understood differently.

Then: Give the newborn water to help them burp. Now: Don't ever give the newborn water because they could get seizures from low sodium. Then: Put the baby on their tummy to sleep more deeply. Now: Always put the baby on the back to sleep so they don't die of SIDS. Then: Make sure to bring that fever down as quickly as possible because it could hurt your child's brain. Now: Fever does not actually hurt a child's brain and may help us fight infection. Science shows we might get better faster if we sometimes allow our kids to have that fever. And my personal favorite…then: Rub whiskey on the babies gums when they're teething. Now: Are you serious with the whiskey? Why is it so hard to make these shifts? It’s about mindset. Prior generations were taught to care for children with certainty; so it's not just about the specific advice but about a whole way of thinking. I started having some discussions with the families in my office about the difference between the way doctors explained things when we were young and the way that we do now. We talked about the Dothraki culture on Game of Thrones. Again and again, no matter what very unusual cultural practice they were describing, the Dothraki would say “It is known.” That's exactly the kind of medical teaching that our mothers grew up under. While Science was certainly very active in medicine, most of the day to day practice was just that: a practice. It was just how things were done. Doctors learned through an apprenticeship system the way to do things. The way to do things varied from educational institution to educational institution. When they told parents what to do they didn't give them options. They said “This is how it's done.” There was a very real advantage to that: our parents had much more security about the advice they were given. As long as they felt they had a good doctor, anything the doctor said gave them a sense of certainty and stability. Eventually, as culture and science has evolved over the last generation, we lost faith in that kind of stability. We found out about stories of when it didn't work and when it was dead wrong. As a doctor practicing now, parents hear from me “this is what we know right now,” or" this is an idea that might work for you.” I talk about the process of science and how we are constantly growing in and questioning our knowledge so that we can continue to grow. The upside of this constant questioning is it creates more space for people. You're allowed to be different from someone else; we're allowed to try different things. It may make more room for growth. But the downside is that it doesn't bring that sense of certainty and stability. You've got a doctor giving you options instead of a doctor telling you how it is. So as we talk to our parents in their role as grandparents, it can help to understand that there is a huge difference between the certainty of “it is known” and a style which emphasizes the process with “this is what we know now.” While I sometimes long for simple answers, when I am honest with myself I love being part of this generation of doctors and parents. Creativity! Exploration! Try something and try again! Incidentally, the Dothraki usually say “it is known” whenever their Khalesi is about to change things up and be innovative. And of course it’s her innovations that make the show so interesting.

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Disclaimer: This article represents general education and does not constitute medical advice. My ideas are mine alone.