Doctor said my 6mo needs PT

@springwillow What kind of sitting are you all talking about at 6 months?

I'm so confused because I'm in Germany and here all info I've seen and am able to find says that sitting upright unassisted is supposed to start between 8-10 months. They seperate between passive (assisted) sitting (pillow, chair, using own arms) and active (completely unassisted) sitting. Making a child sit before the back is strong enough is highly discouraged to avoid damage to the spine. Developmentally it's supposed to go: rolling, then army crawl, then crawling then sitting.

So I'm really confused about this being an issue at 6 months. I know some milestones are slightly different but the development of a baby's spine shouldnt differ so much.

https://www.netdoktor.de/baby-kleinkind/babys-erstes-jahr/ab-wann-babys-sitzen/ for anyone interested in running this through a translator.
 
@springwillow That sounds very early… considering many babies may not even sit supported until 6 months (strapped to a high chair for solids), how could we expect most babies to be able to sit unsupported by the end of 6 months?
 
@springwillow I would go ahead and make the appointment NOW. If you're in the US (and from what I've heard, many other places are like this), it can be months for an available appointment, at which point if he needs it he will be very far behind. Make the appointment (likely a couple months out) and cancel if you end up not needing it.

I'm in a major midwest city and I'm currently waiting FIVE MONTHS for an appointment for my daughter with a specialist.
 
@springwillow Mine told us we needed PT at the 9 month check up because our daughter wasn’t trying to stand and pulling up on furniture.

She didn’t start sitting up until 8 months, and at 10 months she just started pulling herself up on stuff. Each baby starts differently!
 
@springwillow I went to the physio and when my daughter sit by 6.5 she said she was early... Either she lied to me, they don't have the same chart, or she's too much lol... Way too early to worry.

We have this thing where I live called "naitre pour grandir", it's like a bible... And they said to talk to the pediatrician if by 9 month they still can't sit inassisted. 9, not 7.
 
@springwillow I think it’s a bit extreme. I think my baby sat up around 6 or 7 months (can’t remember exactly). But every baby is different and there is a range for that very reason. I mean PT can only benefit your baby but I just feel like it wouldn’t be necessary unless your baby is outside the 6-8month range and not sitting up alone.
 
@springwillow I think it’s extreme!! My LO didn’t sit until 7 months, crawled at 8 months and walked at 11 months 🤷🏼‍♀️ literally nothing wrong with him he was just late to sitting up!! My sons cousin was the bang same, didn’t sit until 7 months, crawled at 8 months and took her first steps 2 days after her first birthday
 
@springwillow That’s dramatic for sure. My son started around 7 months but I wouldn’t have been nervous till 9 months. If there are any other reasons to switch this would definitely solidify that.
 
@springwillow PT is great and it's no big deal to get an evaluation.

With that said....there are some super great NPs out there. However I would not want a pediatric NP as my child's primary medical care. For that reason alone I would switch. doctors can be wrong too but they have a lot more education time behind them.
 
@springwillow My baby started sitting unsupported at 8 months. We were worried too. Every baby is different. PT at 6 months seems a little extreme. They do recommend an appointment with pediatrician if baby isn't sitting up unsupported by 9 months.
 
@springwillow I would see an actual pediatrician for a second opinion if you’re concerned. NPs are helpful for filling in gaps but they don’t have nearly as much education or hands on training as MDs
 
@springwillow Not extreme and your reaction to it is extreme. PT is beneficial for everyone. I would think I was holding my baby back by not allowing PT. I want her to go to PT because they know how to get the right muscles working the best and will only benefit my LO in the long run. A NP has a bit more experience than your average mom when it comes to noticing certain delays in babies. It seems it’s coming from a place of just ensuring your LO gets ahead of any potential issues, not because she necessarily sees an issue.
 
Alright so I think I worded myself incorrectly a bit. At his 6 mo checkup (which was the 24th of June) the nurse practitioner told me that if he's not sitting up by 7 months (July 24th) he would need physical therapy
 
@springwillow This sounds like a post for r/noctor. That's a subreddit about mid-level practitioners working beyond their scope and giving false or dangerous information. Ideally, you should see an MD, not an NP, they are not qualified to be doing diagnoses and referrals like that, especially for peds. You can ask the doctors over on r/noctor or even on r/askdocs if you'd like, but sadly, NP's scope creep is getting out of control and leads to unnecessary worry or even dangerous neglect or wrong treatments. I would strongly, strongly advise you to do what you can to see an MD and not an NP.

Off the top of my head in my own experiences with seeing NP's practicing independently without supervision instead of MD's, I've: (1) had the wrong cream prescribed for a yeast infection, (2) has a skin issue incorrectly diagnosed as bug bites, whereas when I saw my MD PCP, he immediately, correctly, identified it as a form of eczema blisters that just appear on hands and feet and then was prescribed a cream that actually helped, and (3) was given antibiotics for something that, when I saw my MD, told me antibiotics are useless for and to stop taking.

These are all relatively low stakes things but it's part of why I would never see an NP for anything diagnostic, only for things like a medication refill.

So yes, please do double check with an MD, and check out those other two subreddits I mentioned.

Edit: this is a huge issue nationally in the US. I have relatives in the UK and go to NHS clinics sometimes when I'm over there, and never had to see an NP, and they seem positively shocked that that's becoming routine in the US, with our supposed "great health care." Unfortunately, a number of states keep passing legislation allowing NP's to have "independent practice," DeSantis in Florida just vetoed a bipartisan bill that would formally disallow NP's, PA's, etc , from calling themselves "doctors" in a health care setting, and corporate conglomerates keep buying up small practices and hiring only NP's with maybe one supervising MD instead of staffing with doctors.

This is because these health care conglomerates save money by hiring NPs instead of MDs but then bill us, the patient, and insurance, the same, making their shareholders more money. At the very least, if you're made to see an NP instead of an MD, check your insurance billing and if they're coded or charging the same per visit as with an MD, demand that it be corrected and changed to the lower insurance payout for a non-physician visit. We are only getting stuck with suboptimal primary care because nobody knows about this and it makes the cost-cutters more money. We need to fight back.

Second edit: I'm an attorney and know for a fact that this is a growing issue in the country, and more and more data is being collected on patient harm and cost due to corporate and legislative-pushed mid-level scope creep.

Third edit: a three year study from the American Medical Association that's being caused by NP's being the primary point of contact for patients. This is in an emergency room setting, but is just one of many such studies. AMA: 3-year study on NP's in the ED: Worse Outcomes, Higher Costs
 
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