Interview with Paediatrician Mª Dolores Terradas
What medical checks do babies undergo when they are first born and what is the medical procedure for the first month?
I like to see the babies as soon as possible when they are discharged from the hospital, mainly to encourage breastfeeding and try to solve any early problems related to it. During the first month I do a weekly checkup to ensure the well being of the baby, as well as to clear any concerns of the parents and to keep encouraging breastfeeding.
How often are the pursuant checkups and what happens at these checkups?
During the first year of life I like to see the babies every month: body measures, full physical checkup, orientations with feeding and vaccines as needed.
Until what age are children expected to have check-ups?
During the second year of life I see the babies every 3 to 6 months and once a year thereafter until the age of 15, when they go on to adult medicine.
At what age do babies receive what vaccines? Does this differ from other countries?
The calendar for vaccines is very similar in most countries, differences being mostly on the optative vaccines, due mainly to political and economical reasons.
Which vaccines are routine and which are optional?
The optative vaccines in Catalonia (this is different in other parts of Spain) are those against: pneumococcus, chickenpox, rotavirus (diarrhea) and papyloma virus (girls, cervical cancer). Routine vaccines are: diphtheria, tetanus, pertussis, polio, haemophilus, hepatitis B, rubella, mumps, measles, and meningococcus C. Some of them combined are given in one shot.
Some parents prefer not to give their children any vaccines, what are your thoughts on this?
I strongly recommend vaccination but I like to discuss each case with the family. Some of my patients have decided not to immunize and I respect their decision, some others just decide to postpone vaccines and I respect that option too.
How long do you advise mothers to breastfeed for? and when do you advise introducing solids?
Best food for babies is breast milk and it can be their only food for up to 6 months. At this age I start to gradually introduce solids and keep breast feeding as long as the mother wants to. In most cases in Spain we have to start solids at the age of 4 months due to mum’s return to work.
How do medical records work in Catalunya?
Medical records are kept in each doctor’s office or hospital archives. I am not familiar with the official policies for requesting medical records from other area hospitals, I normally don’t have any problem giving whatever part of information the patient needs when transferring to another doctor.
You have had a lot of experience in other countries, how do you think Catalan healthcare compares to other countries?
My experience abroad has always been in hospitals, specifically in Pediatric Intensive Care. For personal and family reasons I am now working in pediatric primary care and enjoy it very much. I am not too familiar with how the general health system works in every country, I prefer to focus on the well being of each kid..
What are the typical concerns your expat patients may express?
Most concerns of expat patients are actually very similar to the ones from local families. I do tend to see a lot of minor problems during the firsts few months, probably related to psychological adjustment to the new environment, as well as to exposure to new germs.
Many people through the site have expressed concerns regarding lack of organic food in Catalunya and overuse of antibiotics on babies. What are your thoughts on this? Do you think this is justified?
Regarding organic food, I have some patients who choose to give it to their babies. They find it in a dietetic shop in Sant Seliu del LLobregat, but this is because of the location of my office. I am sure there are nutritional shops in Barcelona, Sant Cugat or any big village where organic food can easily be found, but it may be difficult in supermarkets.
Regarding the overuse of antibiotics, I agree completely with this statement and in my practice I try to use them rationally and the least possible.
Do you feel there is enough ante-natal care and post-natal care available in Catalunya for new mothers?
I think that both ante-natal and post-natal care in Catalunya is excellent and we have very good professionals too. The main problem is a lack of incentivation of the professionals and an insufficient health education of the population that leads to an overuse of the system and burn-out of professionals.