Strollerderby

Babble Talk: The Truth About Percentiles

Posted by Jen Chaney

Yay for Jeanne Sager, who has written a fascinating essay for Babble on a subject I have long wondered about: Those percentile charts that are constantly mentioned each time we take our kids to the pediatrician.

Sager's piece notes the anxiety many parents feel when their babies rank on the low end of the spectrum for weight. She even mentions one case in which a mother was told her baby's lack of pounds represented a "failure to thrive."

I understand the percentile insecurity complex firsthand. My son, at 15 months, has yet to hit double percentile digits for weight. He looks healthy, he eats well and he is a happy kid. Yet there he sits, in the seventh percentile. Every time I come home from the pediatrician, I wonder: Is he ranking on the tiny side simply because most American kids are too big?

Sager's story says, actually, that might be right: "According to the World Health Organization (WHO), the fatal flaw of the percentiles used by most U.S. pediatricians to chart growth is this: they compare children to other American children, and other American children are, well, big. Thanks to the U.S. obesity crisis, many of them are in fact way too big. And that leads some parents of smallish children to look at the charts and believe their kids are undernourished."

The story goes on to mention WHO's recommendation of using a fixed standard of healthiness to judge our children, rather than simply comparing them to each other. I gotta say, that makes a lot of sense to me.

But what do you think? Have you ever developed a percentile insecurity complex because of your child's weight? How did you overcome it? And was your pediatrician helpful or harmful in helping handle shrimpy kid syndrome?

Photo: Melissa Drenzel/Babble.com 


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Comments

 

giggleup said:

I have often wondered about this, and I too have a kid on the shrimpy side. In his first year of life, when I was dealing with percentile-chart-anxiety-syndrome (PCAS?), my own mother was the only voice of reason. She said I, too, had been small as a baby and stayed small for a while, but eventually caught up. Now that he's a preschooler, I can see that my son's growth plan followed the same trajectory.

Looking back, despite the anxiety it caused me, I am still glad my pediatrician was monitoring my baby's weight closely... just in case there was some underlying condition. But what I really clung to were their reassurances that he seemed happy, ate well, thriving, etc. I'd like to see them try making a percentile chart of that! "This shows that your son is happier than 15% of other kids his age, but his poops are in the 99th percentile. Congratulations!"

May 28, 2008 1:55 PM
 

skinnymom said:

My pediatrician carefully plots my child's measurements on the chart at every visit, but has never told me her "percentile score". He simply states that her growth is consistent and it doesn't matter where she falls on the chart, as long as she stays in roughly the same place. Fifth percentile or fiftieth percentile, the actual score is not that important, it's the continuity of growth that matters most!

May 28, 2008 3:00 PM
 

jen said:

My daughter has been small all along.  She was a preemie so that accounts for some of it.  She is still very low on the growth charts for height and weight (although she seems to be doing great for head circumference -- I think she is really smart) My first pedi. made me feel like a horrible mother for having a skinny child.  I switched doctors and what a difference it made.  He says he would rather have a healthy, skinny baby than a fat, not so healthy one.  He doesn't believe that chubby = healthy.  I am so great full that he has this attitude.  It makes me feel much better as a parent that my daughter is healthy and growing and that is what matters.

May 28, 2008 6:21 PM
 

Mom2Two said:

My son was very briefly labeled Failure To Thrive because he kept sliding lower and lower on the growth charts until he fell off them completely.  However, this led to a diagnosis of milk protein allergy and once we went dairy free, he gained weight.  He still remains small though, less than 5th for weight and 25th for height, and his sister, who eats like a horse, is about the same.  It did cause me a lot of anxiety and stress with my son, but when my second baby remained small, I didn't worry about it.  I think a lot of doctors stress where on the charts the child is, without looking at the parents!  Neither my husband or I are large people, so it follows that our kids would be small too.

May 28, 2008 10:01 PM
 

MamaS said:

My ped also lets me know it doesn't matter where on the chart the child is...only that she's growing consistently.  The nurse who weighs and measures tells me the percentiles though...so I know I've got a tall skinny baby...but she's been that way all along.  She's in the 99th for height and 70th for weight.  For crying out loud, she was 23.5 inches long at birth!

May 30, 2008 1:43 AM

About Jen Chaney

Jen Chaney is the movies editor and a DVD columnist for washingtonpost.com. Her byline has appeared in The Washington Post, People magazine, USA Today and the Utne Reader as well as various other newspapers around the country. She is the mother of a one-year-old boy, who has not yet learned the word Xanadu. But he will. Trust us, he will.

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