Mothers & Daughters In the Exam Room

Many years ago I wrote a column on the interactions between daughters and their mothers in the exam room.

A whole new group of moms (and daughters) are out there now, so I thought I would revisit the subject.

About half of the patients I see are female. Most come accompanied by their mothers.

Like most things in pediatrics, the age of the child determines much of what happens in the relationship.

Infant girls are usually carried in by their mothers, undressed and dressed back up by them, and often cling to them for dear life when I try to touch them.

Moms do virtually all the talking for these very dependent patients.

By toddlerhood, the girls still cling desperately to their moms but may roam about the room independently.

Mothers still do most of the talking at this age.

By preschool age, girls will usually carry on a full conversation with me.

It may or may not have anything to do with their health concerns.

Their mothers will often need to prompt them to tell me the symptoms of their illness.

Around a girl’s sixth or seventh birthday, Mom’s IQ starts to mysteriously “drop.”

While giving their daughter’s medical history, they may be interrupted and corrected by the young patient.

On a few occasions, I have even noted the startled look in a mother’s eyes when it happens.

The daughter’s war for independence has begun.

Girls today are starting puberty about 1-2 years earlier than their mothers did.

The same hormones that make girls into women also speed up their desire for independence from moms.

When I ask questions it is amusing to watch a mother speak while the daughter rolls her eyes, and vice versa.

Sometimes, just by restating what they are saying to me, I can help them come to a consensus as to what is going on with the patient.

Sometimes, an adolescent girl will want to discuss something or be examined by me (with one of my female colleagues present) without her mother in the room.

A mother may feel left out by this, but it is part of the process of a girl becoming able to address her health concerns independently.

At 18, a girl is a legal adult and often comes in without her mother.

If she has a daughter of her own, her own mother will suddenly seem like the smartest person she knows.