I’ve had this post in my drafts folder since May. It was started as a point of talking about growth curves and has been a bulleted and fragmented list of a post. When I started this topic was charged with EMOTIONS, and while still an emotional topic for me, time and change have lessened the raw feeling.
Have you seen the AT&T commercials with the kids sitting around a table being asked questions about which is better? The conclusions that 2 is better than one, and bigger is better, and I really really hate those commercials. Because why is bigger better? And is bigger always better?
We have this underlying value in our culture that bigger is better. That for boys stronger is better. That smarter is better. But we need to stop and ask – what do we mean by better? I spent 18 months stressed about Simon’s growth and eating habits and grappling with this, but in some ways I didn’t really step back to think about this until last spring.
In one of my classes I was talking about some research I’d been working on and some talks I’d attended at a conference. The topic was increasing executive function and information processing skills in pre-schoolers in order to improve academic outcomes later in school. The argument is that enhanced executive functioning is necessary (better) for success. Then my professor asked WHY? And that got me thinking. Because why do we find it necessary to train four and five year olds for academic success. Why not instead work with the individual to enhance their innate skills to become the best them they can be. (And rather than go into a long tangent of institutional schooling and how we teach our children I will stop here. Asking the question was enough to get me thinking.) Definition of success can vary.
So if “smarter” isn’t necessarily better – can the same argument apply to bigger and stronger? Let’s talk percentiles for the purposes of this post (FYI – I HATE PERCENTILES).* Simon was born 7 lbs. 8.5 oz (56%) and 21 inches long (97%). At 3 months he was in the 25% for weight I asked the ped. if I should be concerned that he’d dropped curves and was told that since he was gaining there was nothing to worry about.** I kept breastfeeding and life went on. At 4 months he was in the 15%, still dropping, but breastfeeding was working and he was still gaining. I wasn’t worried. Then we got to his 12 month appointment and I was told he was under weight (<3% according to CDC charts) and I needed to wean immediately so that he would start eating more solids and gain weight. Nothing else except to schedule the 15 month appointment.
So many things wrong with this. 1) on the WHO charts he was 8%, which is a drop but not alarming – or maybe it is because of the constant fall but not the percentile itself. 2) weaning is NOT the answer as breast milk has more calories per ounce than any solid food. 3) Simon just wasn’t all that interested in food until about 20 months, but I didn’t worry about it until this moment. 4) scheduling a follow-up three months later seems a little long if there actually is a problem.
I then spend 12 – 15 months stressed out about his size. About his eating habits. Second guessing myself and maybe I should have been supplementing with formula all along.*** So much anxiety. And neither of us were ready to wean. I trusted information from LLL Leaders and an IBCLC much more about infant nutrition. (I never supplemented and nursed to 26 months). Meeting other kids on the small side helped. At the 15 month appointment we went in to get weighed and I insisted the WHO chart be used. at 12% was told – nothing to worry about you’re fine. So WHY ALL THE FEAR. We switched to a ped. who is much more supportive and while not overly concerned agreed to keep an eye on weight gain and took my concern and questions seriously.
But it had started. The constant comparison to kids withing a few days or weeks of Simon in age and why is he so small. The doubting myself. The wondering WHY WON’T MY KID EAT? Because the “books” say at some meals your toddler may eat as much as you. I hate a lot of the parenting books. One that did help though was “Why Won’t My Child Eat” The to-scale picture of a baby’s stomach and a banana is awesome. And seeing the individual growth curves that are all over the place helped too. And remembering an article I read a couple of years ago where babies were measure daily that showed growth is not linear. It is in fits and starts so a lot depends on the day the doctors appointment happens to be.
The thing with percentiles is that they are based on a normal curve which means someone has to be at the ends. 10% of kids HAVE to be in the 10% percentile, that’s just how statistics work. But in this bigger is better culture we look at growth like grades where 90% is good and 10% is bad. It is NOT the same.
Simon didn’t love food, but we kept offering. We tried all kinds of tricks. I felt a lot of guilt. I don’t want Simon to be the smallest boy in his class. But so what if he is? Rob is 6’1″ and I am 5’6″; my mom’s family is very tall, most men 6’3″ or taller and all are bean poles. But my dad and brother and Rob’s dad and brother are all under 6 feet. And all are skinny (my dad and brother both wrestled in the 103 and below weight classes in high school) so smaller stature shouldn’t be surprising or worrisome as I think all of these men in my life are of normal size and success. But bigger is better right?
Since his birthday, with that first “scare” Simon’s weight gain has remained in the 8-10% and his height in the 25%. As of October at 27 months we no longer have quarterly weight checks as part of our “well-child” schedule. This is a relief and one more step in my letting go of the worry and guilt that comes with my child’s size. Because Simon is an awesome kid who is at or ahead of every other developmental milestone (believe me I’ve run him on lots of them – a perk of the degree).
So the point of all this rambling is that kids grow and develop at their own pace and there isn’t an “ideal” size or weight.**** Bigger doesn’t always mean better. Really thinking about underlying cultural values and letting go of mom-guilt have been an education for me as a parent. I’ve become more confident about “eating issues” and things are much better. I plan on exclusively breastfeeding baby brother and letting him nurse as long as he wants.
Simon will be 2.5 on Thursday and he is perfect and exactly how he should be.
*Growth curves are useful if you are using the WHO growth charts. Our first ped. was using the CDC charts and when I requested they use the WHO charts was told that it didn’t make a difference and they used the CDC charts. That should have been an indication to run not walk to someone else. The CDC recommends not using their charts and that the WHO charts are more accurate. All percentiles in this post are according to WHO, except when noted. Not all kids will follow a standard trajectory, percentiles and growth curves are a useful tool, but they are just one tool and other measures are also important when determining if there is a problem.
**This was actually the right advice in this case, he was gaining an appropriate amount per week, which is the most important thing.
***Let’s note that I donated 150 oz of breast milk because I pumped much more than Simon ever drank from a bottle. And since I was committed to reverse cycling, I don’t really think that he was deprived of as much breast milk as he wanted, even if he always hated the bottle.
****I am not a medical professional, I am working toward a PhD in Developmental Psychology, but I write this as mostly a parent. There are times when you should be legitimately concerned about weight gain and Failure to Thrive. Please discuss your concerns with a doctor you trust as each child is unique and should be assessed individually.
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