Thursday, September 13, 2012

breastfed baby growth chart

Oh, "the chart."  Am I ever familiar with "the chart."

My baby is at the top of the chart!
My little one never made it onto the chart . . . 
My daughter fell off her growth curve and our doctor is concerned.
My newborn wasn't gaining on the chart right and was diagnosed with failure to thrive.

Here's the thing about the chart.  Doctors have all different ones that they use!  Some doctors are using a growth chart from the American Academy of Pediatrics.  Some doctors are using a chart drawn up by using their patients as a sample, so your child is being measured against all the other children in that practice.  The one that they should be using, according to the CDC, is the World Health Organization breastfed baby growth chart (if the child is breastfed, of course!).  I eventually started disregarding the chart the doctor pulled out at our visits, and plotted the weights I took at the breastfeeding clinic onto the WHO chart myself.  I have only recently stopped doing this!  It became somewhat of a ritual for me.

You can find the links to all the charts - boys and girls for weight, height, head circumference, and more - here.  

Another thing about "the chart" is that it functions sort of like a bell curve.  Not everyone in this class can get an A.  For every child that is in the 90th percentile, there must be a child in the 10th percentile.  For every child that is "off the chart," there must also be one that never made it on.  For each parent to think that their child should be near the top of the chart is a logical fallacy.  This is something my doctor never pointed out to me.

Vicki Jo started off right at the 50th percentile:  7 lb, 1 oz at birth.  But here's yet another thing about that weight:  we had both been pumped full of IV fluids for about 24 hours before she was born and weighed.  It certainly bloated me with extra water.  I can only imagine it did the same for her.  By discharge, 24 hours after birth, she was down to 6 lb, 12 oz.  I suspect this is nearer to her actual birth weight.  Turns out my suspicion is probably right.  If we had used her discharge weight instead of her birth weight as the starting point on the chart, no one would have been concerned about her low weight of 6 lb, 6 oz.

Because she lost a lot and was slow to gain it back, though, I was discouraged about the progress we were making with breastfeeding.  And all of this parenting stuff is a confidence game, let me tell you.  I swore to myself that after receiving this blow to my confidence early on, I would tell other new parents I knew about the WHO chart, in case it might help them.  So consider this your PSA!  In fact, I used it just last week, in a rather underhanded way.  Our friends Eric and Mackenzie had a baby in April, and they have been hosting a friendly "guess the baby's weight/height/head circumference" after her regular well-baby visits.  They provide the last check-up's figures, then solicit guesses.  I just took those last figures, plugged them into the chart, and saw where she should be on her curve at this point.  Lo and behold, I was right - down to the ounce! 


Emily said...

Oh, one other thing. Of course there are a bazillion pounds/ounces-to-kilograms conversion tools on the web. I always did it by hand, as part of my ritual. Let's say the baby was 10 lb 6 oz. I would divide 6 by 16 to get the ounces into pounds, so .375. Then add that to the number of pounds: 10.375. Then divide that by 2.2 to get kilograms: 4.7 kg. Math! It rocks!

mama foosa said...

I also knew I didn't want to be pumped with fluids at the hospital and they ended up doing it anyway without my consent - Liam also lost a lot, causing our pedi to have us come in for weight checks and me to be freaking for no reason. Silly hospitals causing all sorts of drama!

Emily said...

Yep. I really liked the approach of a friend who was at a birthing center. No weighings beyond the birth weight. They just had her count wets and dirties. When I think of all the stressful visits to the doctor and clinic in the first few days when we should have been resting . . . it's a shame.

Israel Knife said...

I have come to despise these charts. They serve little purpose, but can create real insecurities in parents who truly have nothing to fear. Our children grow in unpredictable stages, despite that gently sweeping curve on the chart. There are plateaus and amazing spurts, sometimes they seem only to grow only in diameter. Yet we are granted this vision of a smoothly arched continuum- the disruption of which furrows our brows in concern.