How Soon Does it Start?

February 26, 2008 at 12:06 am 14 comments

Flashback 6 months. I’m with my daughter (err… let’s call her Ruth) at her regular 18month well-baby visit.

Our family practice is a teaching practice. Yay for new docs learning about family practice. Yay for them learning about rural medicine. I’m all for it. Young resident doc who’s never seen Ruth before is concerned. “She’s below average for height and weight, we should keep an eye on that, and make sure she’s growing”. Some bizarre spirit of timidity comes over me. I fail to look at him dumbfounded and ask, “you know that about half the kids are below average, right? That that’s, in fact, what average means?”

Instead, I dutifully book a 2-year well-baby check-up. Although there are no scheduled vaccinations. Although a local doc shortage means that our family doc is almost an hour away from home. Although this busy practice is often overbooked, and there are actual sick people who could benefit from getting that appointment. Although she is healthy, and happy, and I have no cause for concern.

Flash Forward.

2-year-and-a-few-weeks-old Ruth is seen by our regular family doc. “I’m not concerned” he says. “She’s always been right there, in the ‘normal’ range, a bit below average. She’s following her curve.” He could have stopped there, that would have been cool.

But he goes on to say, “I’d rather see them in the lower part of that range anyway”.

GAAAAH!

Too small is bad. But smaller is better than bigger. There is always a better size than the one she happens to be.

And this message has begun at her two year check up.

Screw that. Sideways.

My daughter is perfectly Ruth-sized. She has been since I first laid eyes on her (yeah, ok, she seemed really really big just moments before that). She will be perfectly Ruth-sized when she’s 5, and when she’s 8, and when she hits those awkward early adolescent years when ‘perfectly Ruth-sized’ means ‘with arms an inch longer than they were yesterday”. She will be Ruth-sized the day she chooses her wedding dress, and at all the fittings, and at her wedding. She will be perfectly Ruth-sized every day of her life.

And from now on, anyone who tries to tell her otherwise will find themselves dealing with perfectly mommy-sized me.

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Entry filed under: Uncategorized.

Some things should be able to go without saying. A Saddish Kind of Day

14 Comments Add your own

  • 1. Amanda  |  February 26, 2008 at 1:45 am

    This post is beautiful. Ruth is a very lucky little girl.

  • 2. Sandy  |  February 26, 2008 at 2:05 am

    That reminded me of my son’s 2yr check up (last year). He is VERY tall and very thin. He runs around like a crazy person all day, every day, super man jumps off the couch, etc etc.

    When we went to his obligatory appointment they weighed him and he hadn’t gained a ton of weight since the last appointment…but he had gained quite a few inches. The nurse looked at me and said (I can’t really remember exactly) that he wasn’t gaining a lot of weight. I just kinda looked at her like she was stupid…then she asked as if a light bulb went off in her head “he is active?”. Well…yea. He is 2 years old.

    I wanted to scream at her that he is obviously growing since he gained like 3 inches in 6 months…anyway, I never liked that nurse.

    I am lucky…so far *knock on wood* I have had any issues with doctors talking about his or my weight. That is strange that a doctor would talk that way about a 2yr old though…I mean kids go through spurts anyway where they will be chunky…then all of a sudden grow UP and be thin…they do that for a long time.

    That whole comment is just weird to me.

  • 3. apricotmuffins  |  February 26, 2008 at 2:24 am

    this makes me fear for my future children. If a doctor EVER says anything along the lines of ‘at least they’re not fat’ i think i’d explode.

    the same goes for ‘they’re slightly above average, put them on a diet!’ which will get more of an explosion, and a lecture, probably an argument.

    It starts VERY young. we need to do everything we can to prevent it for as long as possible….

  • 4. BigLiberty  |  February 26, 2008 at 2:56 am

    Thanks for this post.

    My father and stepmother adopted a preemie baby four years ago. Every time she’d go for her check-up, my dad would proudly exclaim that she was above-average in height and way below-average in weight. “She’s going to be really skinny when she grows up,” he’d say, puffing up his chest.

    I was his chunky daughter. :-/

    That is all.

  • 5. Alice  |  February 26, 2008 at 3:43 am

    I fail to look at him dumbfounded and ask, “you know that about half the kids are below average, right? That that’s, in fact, what average means?”

    Ahh, not quite. While it is true that about half of all children will be below average, the arithmetic average, aka the mean, is defined as the sum of values over the number of values. This will only be exactly the middle value for symmetric distributions. If there is any skew in either direction, the mean will not be the middle value. If there are extreme outliers, then the mean can actually be very far away from the middle value, and it is therefore possible for much more than half the population to be above average drivers, which seems likely when you consider that the utterly terrible drivers far outnumber the truly superb drivers, which drags down the mean.

    You’re thinking of the median, which is defined as the value above exactly half of all values, and below the other half. It is impossible for more than half of all drivers to be above median.

    Take away the part about how the average is defined and your point still stands, though.

  • 6. jamboree  |  February 26, 2008 at 9:38 am

    My youngest is a lot smaller than her older siblings. In fact, I’ve been concerned about her growth recently, because in the past seven months she hasn’t even gained a whole 2 pounds.

    Contrast that to my gloriously chubby older babies (who have since slimmed down as they got taller), and I’m much more concerned about my little one.

    An actual doctor actually said that he prefers to see smaller babies? What if he was talking to a woman with an ED? What if he said that to a parent who withheld food from their child? That doctor’s attitude is bollocks. What an ass.

  • 7. mrsmillur  |  February 26, 2008 at 12:18 pm

    Heh- thanks Alice. I knew I wasn’t exactly right with the math, there. I curse the day I tuned out in math class claiming “I’m ever going to need to know this stuff”. 😉

  • 8. Tari  |  February 26, 2008 at 4:11 pm

    Great post. I especially liked this bit: “She will be perfectly Ruth-sized every day of her life.” I think that’s true for everyone, and I wish more people believed it, too.

  • 9. jeremy  |  February 26, 2008 at 5:55 pm

    I was a small baby, I was lucky to have a mother like yourself to back me up, and I became a very self confident and skinny man.

  • 10. entrekin  |  February 26, 2008 at 9:49 pm

    From a healthcare professional’s perspective, I don’t think that your doctor’s favoring his patients fall “into the lower part of that range,” has so much to do with weight and size as you’re making it out to. I get the perfect-sized sentiment, and it’s wonderful coming from her mother, but as her mother, shouldn’t you want a doctor whose utmost concern is her health? How many studies do we need to prove that being clinically overweight can cause issues in health?

    From a healthcare perspective, it truly is better to be smaller than larger. I don’t think he meant at all that “there’s always a better size to be than the one she happens to be.” I think you’re reading a size issue into a situation where one doesn’t, in fact, exist.

  • 11. mrsmillur  |  February 26, 2008 at 10:19 pm

    Well, Entrekin. Thanks for your healthcare profesisonal’s perspective.

    It will take a few more studies for me to believe that being clinically overweight is a universal predictor of ill health”.

    I am, however, pretty confident that telling kids they are overweight can have some pretty undesireable consequences.

    That you don’t see a ‘size issue’ in a doctors opinion that “normal below the mean” is substantively better than “normal above the mean” is your own business. But from a healthcare consumer’s perspective, I’d love for my doctor to look more closely at a person than at a chart.

  • 12. Will Entrekin  |  February 27, 2008 at 12:24 am

    He didn’t say she was overweight, did he? He said that, statistically, she falls on the lower side of the average range, which he preferred to its opposite. And he did look at your daughter closely, even noting her ‘curve’. The message hasn’t begun at her two-year check-up; doctors measure babies the moment they are born. It’s always relevant to health.

    By the way, that dangling modifier is going to get me into trouble. I’m not a healthcare professional; I was referring to your doctor. My own experience, I’m a former personal trainer with a background in medicine and sports training; I don’t know if that’s “healthcare” in the truest sense of the word.

  • 13. mrsmillur  |  February 27, 2008 at 6:42 pm

    Will, you’ve convincingly made your point that you would not have been bothered by any of that. So be it. I was. I think I’m right to have been slightly annoyed- its not like I’m gunning for the revocation of anyone’s license to practice, here.

    I’m done trying to convince you of anything. If you feel the need to convince me that what I feel about any given experience in my life is incorrect, your comment will not be posted.

    Anyone else reading this can consider that, for now, to be my official comment policy.

    Truce?

  • 14. Will Entrekin  |  February 28, 2008 at 2:12 am

    I hadn’t meant to appear I was trying to convince you of anything. I wasn’t.

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