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Archive for the ‘Pediatrician’ Category

Remember how we were worried about Miles’ weight because his growth stalled and his percentile plummeted?  (Okay, by we I mean I.)  And how I’ve been stuffing him with waffles and Quiche and all things eggy, breaded, cheesy, fried, and meaty?  And how his growth curve has recently resembled a prairie more than a foothill?

He had a scheduled weight check today. He aced it. 

In three months, he had gained almost two pounds (one pound in the last 7 weeks alone) and grown an inch.  The pediatrician is not at all worried about him any longer. 

Huge exhale.

Robin came to this appointment because I was sure he was still “off the chart.”  I knew the doctor was going to have Alarming Recommendations for us and that we would need to make decisions. 

I wasn’t happy walking in the door, and Miles wasn’t pleased to be there either.  He’s old enough to know what the doctor’s office is all about. As soon as we got past the toys and walked to the exam room, he started shaking his head.  “No.  No,” he insisted politely.   He glared at us as he was weighed and measured.  I steeled myself.

Then the doctor breezed into the room and pronounced Miles perfectly fine. 

“Really?” I asked several times.  “Really?”

“Yeah, he never looked sick to me,” she said.  Which is true.  She said that he didn’t look sick but that we should do blood tests and stool samples just in case.  Any parent knows how horrifying those three words are, how treacherous they can be.  Like, your child might be healthy.  Or he could have a bowel disease.  You know.

“It’s usually just behavior,” the doctor said cheerfully.  “They get picky and stop eating their meals, and then you start giving them snacks all day to compensate, and then they never really get hungry enough to eat.” 

It’s kind of a head-scratcher, but whatever.  I know toddlers who graze all day and are like mini linebackers.  And while it’s true that I was offering Miles snacks all day long, he never refused to eat at mealtime.  (I’m sure this will come later. I’m not claiming to be exempt from toddler pickiness;  I just don’t think it was the issue.)  So was the doctor right, and was Miles wasting away from too many snacks?  (So weird.)  Or is this just the pattern his growth was going to take because of some instructions written deep in his genetic code?  I have no idea.

Meanwhile, as we chatted with the pediatrician, Miles nabbed a ride-on toy tiger and headed for the door.  He wasn’t about to stick around long enough for someone to poke him with needles or stick things down his throat, no sir.   

Here’s a cell phone photo of him making a beeline for the lobby.  The feet on the left are Robin’s.  The feet on the right are the doctor’s. 

I’m not sure who was most happy and relieved when we walked out and let the door swing shut behind us. 

The escape artist.
 
 

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Miles, though obviously a budding poet/athlete/astronomer/zoologist/engineer, spent most his first year being stunningly average. At every medical appointment, his height and weight came in at the 50th percentile. I for one felt absurdly proud of this: we had created a child whose measurements were in no way objectionable! No one could find fault with the length of his limbs or the rotundity of his trunk. Passers-by might make their usual way-off-base comments — “What a big boy!” or “Is he (four months younger than his actual age)? No? Well, he must be small!” — and I would smile proudly and, with great satisfaction, announce, “His doctor says he’s average!”

Five months old.

Then, at his first birthday, his weight percentile plummeted to 22nd. He had recently had some minor surgery, and the doctor said he would probably bounce back by the next appointment. But he didn’t bounce back. At the fifteen month appointment, he had dropped off the chart. He’d had the stomach flu recently, we reasoned. Maybe that explained it. At 18 months, the doctor became concerned. (It was not his low percentile that was worrisome but the dramatic drop in percentile — from average to off the chart in six months. If he’d stayed steady, no problem.)

“Often times when toddlers slim down, it’s just behavior,” our pediatrician said, meaning that they become picky and eat less. However, she warned me that we needed to rule out certain other causes for his unexplained decline in growth. We talked a little about Celiac disease (which is gluten intolerance) or “intestinal issues,” but our doctor kept the details fuzzy and the tone upbeat. We took a stool sample, changed his diet to include more protein and fat, limited snacking and milk-drinking between meals, and scheduled a weight check for six weeks later.

Since that appointment, I have thrown myself into packing the utmost calories (and nutrition) into every meal. I carry chicken sausages for his snacks, concoct quiches with bacon and heavy cream (and spinach!), whip up the cheesiest mac and cheese recipe I can find, then top it with buttered bread crumbs. I make carrot-cranberry waffles and spread them with pecan butter or, better yet, use waffles as the bread for his PB&J. I brown ground turkey, slice up spicy chorizo, and churn out cheese quesadillas with guacamole. Once, to Robin’s horror, I fed Miles butter. Just a spoonful of unadorned butter. Most parents scheme to get vegetables into their children; I view vegetables as a necessary evil. They’re low in calories and take up precious belly space. Vegetable tempura I grudgingly accept. At least it is battered and deep fried!

I know I sound a little crazy. What’s new? But the thing is, even as I have been cooking and baking and cookbook-scouring, somewhere deep inside of me I have felt that Miles is really okay. He’s perfect. His arms, his legs, his cheeks, his belly: they all seem just right. He’s happy. He’s healthy. He constantly astonishes me with his discoveries, his curiosity, his questions. He glows with joy, running toward us with his dandelion puff hair wafting in the breeze, and throws his arms up in the air for a group hug. How could a child who is so obviously thriving be sick? How could his immaculate cells hide some unknowable something wrong? They couldn’t.

We have many reasons to assume all is well. People reassure me with some variation of, “All toddlers slim down! He’s so active!” And, “He’s just burning off calories faster than he can eat them.” The pediatrician said he doesn’t look like a child who is suffering from Celiac or any other major illness. His stool test came back negative for all of the things they were looking for (whatever those might have been). Then there’s the fact that I myself was a teeny baby and am now only five feet tall. Couldn’t that explain his diminutive stature? It could. Of course it could. So I have been calm and confident. Except when I’m not.

Sometimes I can’t help but notice how much smaller he is than other kids his age. Or that he hasn’t been growing out of his clothes. In fact, other than getting more hair and becoming more agile, he hasn’t changed physically all that much for a long time. I watch him race about the playground and think, treacherously, too small. The voice of worry starts its whispery taunting.

After his six-week weight check, he had gained 9 ounces but was still “off the chart.” I bit my lip and agreed to schedule blood work. The blood work came back negative — all clear — giving both Robin and me a sense of relief. The next step is another weight check at 21 months, about three weeks from now. If he’s still off the chart, what next? What will the doctor say, and how will we respond?

My worry is two-fold. One is the pure and simple worry that something might be wrong, Celiac disease, some kind of bowel problem, or some other thing I can’t even imagine and don’t want to Google. The other is the more nuanced fear that Miles is fine. Wait, you’re thinking? You’re worried that he might be fine? Yes. Apparently, I am an extremely advanced worrier. My fear is that if we go further with tests or (gulp) see a specialist, we’ll be subjecting Miles and ourselves to needless and stressful interventions, sucumbing to a culture of fear and pathologizing our innocent child’s idiosyncratic growth pattern. Really, I should just recognize him as the healthy specimen he is and get on with the play dates and building blocks. I should tell the doctor to back off and leave us alone. Right? Right?

So I am alternately serene and apprehensive. He’s so absolutely lovely these days, but this weight thing plagues me. I understand that this is not a calamity. Parents deal with actual, real medical problems (as opposed to this phantom of a maybe problem) every day. Yet he’s my kid, and I want to know that he is healthy. I wish I knew a right way to navigate the next few months, if there is a right way. I want to stop the churning and doubting and second-guessing, just shut my brain up. Robin doesn’t churn and doubt and second-guess! It’s not in her nature, I suppose, which is probably part of why we’re together.

So, lucky you, you’re along for the ride. Would you like to see some cute photos of my perfect, obviously healthy kid? Of course you would! Here goes. And thanks for listening.

Joyful.

Barry Bear.

Fighting fires... and homophobia.

Who me? Yes, you. Couldn't be. Then who?

(Disclaimers: our doctor has been very calm and reassuring; Miles seems to be getting taller lately; and no one has even breathed the words “referral to specialist.” I just forget to focus on these things when I’m worrying. Then I reread this blog and hear Robin’s cheerful and optimistic voice reminding me of all these things. Thanks, Robin.)

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Sad sack.

So, Miles got his first fever Sunday night and has been cooking ever since.  The doctor says it’s Roseola — a virus that usually gives a high fever for three days (or as many as seven!), followed by a ghastly whole-body rash when the fever breaks.  Our poor little guy has been pitiful.  He grips us with his hot little hands and looks at us beseechingly.  Nursing him is like cuddling up to a pot-bellied stove.  When we try to make him laugh, he cackles weakly and then looks pained, as if happiness were too much trouble. 

Being soft-hearted rookie parents, we are lavishing him with sympathy and cuddles.  Robin even came home early from work yesterday, though that was partly to relieve me of duty.  Or so she said, as she rushed in the door and scooped Miles up in her arms.   “Can I take him to the doctor, or do you want to come with us?”  she asked as politely as possible.

Poor little munchkin.  For the next few days, you’ll find us cuddling and sweating.

Hold me, Mommy.

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Nine

As Miles’ nine-month check-up approached today, Robin and I were feeling pretty relaxed.  As we packed the diaper bag, we tried to think of questions for the doctor.   Usually I have 953 questions, ranging from “Will the sound of screeching subway brakes deafen Miles, and if so can I purchase special baby noise-canceling headphones and make him wear them every time we ride?” to “How warm do I have to bundle him?” to “Am I a bad parent if I take him to a hockey game?”  Today, I had zero questions. 

Those questions I used to ask were obviously just because I was a rookie mom, I thought to myself.

“We could tell her he falls and hits his head a lot and ask her how we know if he’s hurt enough that we need to bring him in?” I suggested casually, thinking about how level-headed I would sound asking that.  Like, yeah, I’m cool with Miles hitting his head sometimes.  You gotta fall to learn, right?

“Nah. I think Miles will let us know when he’s seriously hurt,” Robin said.

We ran through a few other potential questions, but the answers all just seemed so obvious.  I felt… competent.  So sure that Miles is on the right track and that we are doing fine.  I thought, who is this newly confident mom?  And how am I going to write funny blog posts about my insecurities if I am not psychotically worried?!

Finally we decided to ask her what’s next for him developmentally (other than walking, which seems to be right around the corner).  Like, should we be teaching him words?  Body parts?  Colors?  Should he be sorting shapes?   We agreed that to a certain extent we don’t want to be too Type-A about all of it.  But at the same time, we don’t want to be somehow missing something obvious.  Like, maybe we shouldn’t keep talking to him in full, nonstop complex sentences rife with semi-colons and dependent clauses.  Perhaps we should instead be pointing at things and saying their names.  Cat.  Bath.  Bird.  For instance.

At the office, the receptionist and nurse were extra chummy, adding to our feeling that we’re no longer newbies but sort of regulars.  Except not the bad kind of doctor’s office regulars.  May we never have a reason to be there too often, you know?

 As the nurse weighed him and measured him, she asked what I’ve come to think of as the red-flag questions.  They’re the questions that, if your answer is alarming, signal Very Bad Things.  I’m always eager to have the right answer, and so far we always do.  It’s practically stuff like, “Does your baby breathe?  Does your baby have hands? ”  Really basic stuff.  Yet I’m afraid it will be like one of those computerized I.Q. tests where the questions start off easy and get harder the more you get them right.  And as the questions get harder, you feel more and more eager to prove yourself — flooded with relief when you get something right, terrified when you don’t. 

So when she asked if he’s crawling, we were all smiles and “Yes, yes, all over the place!”

“Good.  Does he say any two-syllable words?”

What?! Two-syllable words?  Like “apple”? Or “mongoose?”  No, he doesn’t say ANY WORDS.  And, is it just me or is every baby now red-flagged for autism and put through a battery of tests that terrify the parents?  Like, “What!   Your baby doesn’t recite the Gettysburg Address yet?  You need to see a neurologist!  And a French tutor!”  It’s cruel and exhausting.

She must have seen my face, because she hastened to add, “They don’t have to make sense, just like Dada, Ah-ah, Ma-Ma.”

Well, yeah, he does that.  So we moved on.

The rest of the visit was delightfully uneventful.  Miles’ stats all came out pretty close to average, and he’s doing great.  He weighs a healthy 18.6 pounds, and his height of 28.3 inches is 51st percentile, practically textbook. 

We asked our question about what we should be doing for Miles’ development.

“Sit back and watch,” the doctor said.  “Watch him like he’s a movie, because this is the time when he’s going to be developing and changing so fast, and it will be all him.  Read him books or whatever, but essentially just let him be.”

She assured us that everything looks wonderful with him and urged us to have fun. 

Fun, with this one?  We can definitely handle that.

Up, up, up, up!

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And the Eat Goes On…

“‘I’m sure any child of yours has to love food,” our friend Julia predicted, nodding sagely. 

She made this prediction while I was pregnant, and she was right.   The child loves to eat.

Pasta dinner.

A couple of months ago, people kept asking us, “Have you started solid foods?”  They asked it with such intensity, sometimes I wondered what the big deal was.  Why the hurry?  I wondered if they were subtly trying to pressure me to stop breastfeeding or if perhaps they were leaning on the conventional wisdom that solid foods make a baby sleep through the night.  But I totally get it now.  Solid foods are fun!  Especially with a baby whose reaction to pasta with tomato-garlic sauce is “Gimme more!”

Yes, pasta with tomato-garlic sauce.  Our pediatrician was so low-fuss about what we should feed him that we’ve been low-fuss too.  Sometimes we just mash up a banana with a fork.  Sometimes, especially when we’re trying a new flavor, we use jars of baby food from the store.  Other times, with something like pears that I know he likes, I’ll just make it myself.  (I’m no ad for Martha Stewart Baby over here — no food mills or fancy containers labeled in calligraphy.  Just simmer, blenderize, and done.)  And sometimes, if it looks like it will work, we just take what we’re eating and stick it in the blender.  Thus, pasta with tomato-garlic sauce.   Which he LOVED. 

He doesn’t love everything.  It took him several days to warm up to green beans.  But we snuck it in between bites of hummus and babaganoush (no, I’m not joking), and he accepted it at last.  Winter squash from a jar?  Not so much.  But Cuban style  black beans made in the crock pot?  Heck, yeah!

Here are some photos from our eating adventures.  We hope you enjoy Miles’ meals at least half as much as he did.

Yogurt.

Drinking water from a glass!

Cuban black beans.

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So, I totally forgot to post Miles’ stats from his six-month checkup.   Whoopsie.  Here they are.

Weight: 16 pounds, 6 ounces (31st percentile, down from 47th percentile)

Height: 26.5 inches (54th percentile, up from 38th percentile)

So he’s been burning off some of those double chins and putting most of his growth into getting taller.  She said it’s normal for his weight gain to taper off right now because he’s starting to need the nutrients from solid food.  Don’t worry, folks, if we feed this kid on demand, he’ll have his chins back in no time.  He put away some serious carrots last night before bed.  (Which led to some really purty orange pukes.)

Oh, she was also amused that he’s rolling from back to tummy (which is harder) but not from tummy to back (which is so easy it basically involves tipping his head to the side and letting go).  And she said he’s sitting up really well for his age. 

Numbers and stats — whatever.  Isn’t he just perfect the way he is?

Bathtime yumminess.

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Chow Fun

Carrots.

We are go for food!  I repeat, we are go for food!

At the six-month checkup on Monday, our pediatrician gave us the green light to go beyond dabbling in food and start feeding this kid for real.  No one could be happier than Miles himself.  Ever since we first dipped our finger in something and let him sample, he’s been impatient for the real dining to begin. 

For a few weeks now, we’ve been trying out different fruits on him once a day, and he’s been wild with delight.  Bananas send him into convulsions of joy.  Pears, mango, and apples also receive an enthusiastic welcome.  We’ve developed a sweet little morning routine where we all eat breakfast together, one of us holding Miles on our lap.  But even as he’s hurtled himself wholeheartedly at our offerings, Miles has also seemed aware that we were holding out.

Breakfast club.

The kid is no fool.  He knows that whatever we’re eating is probably better than what he’s eating.  He also notices that we eat solid food three times a day or more!  At breakfast if we pause in between his bites to feed ourselves, he gropes madly for our plates or for the bite we’re about to eat.  At other times of day if I’m, say, eating lunch while watching him play on a blanket, he stares accusingly at me, tracking each morsel as it enters my mouth.  I’ve been feeling guilty for depriving him but thought I should wait for the full talk from the doctor.

We assumed that after all this build-up, the pediatrician was going to give us a big spiel about solids.  We thought she would lay out all the Do’s and Don’ts, ply us with her personal eating philosophy, and lecture us about the dangers of food allergies and artificial ingredients.  Nope.  The extent of her talk was, “He likes eating?  Great!  Have a ball with it!” 

After we — okay, I — asked her a bazillion questions, we got a few more details out of her.  She said to let him set the pace in terms of what and how much he wants to eat.  (“Sometimes they’ll eat so much they throw up!” she said brightly, chuckling as if this were utterly charming.)  She conceded, after some interrogation on my part, that things should be pureed for now (but when do we move up to chunkier food??) and that we should feed him a wide variety of foods — for instance, kale, because he needs all the nutrients.  (Yikes, we don’t even eat kale!  Note to self: find out what kale actually looks like and buy some.) 

I'll have what she's having.

“Is there anything we shouldn’t feed him?” Robin asked.

“No.”

I stared in confusion.  What about all the rules?  The Dr. Sears “Baby Book” has detailed Yes and No lists and suggests a food journal to track possible allergies.  And I have repeatedly — repeatedly — read that honey is A Very Bad Thing to give babies because it can give them botulism.  BOTULISM.  Symptoms of which include constipation, breathing problems and neuromuscular paralysis.  And death.

Mommy + bananas = happy baby.

“Except honey,” I said as casually as possible, trying to conceal my rising hysteria.

The doctor shrugged affably.  “I say no raw honey but, you know, it’s all pasteurized now.  If it would make you feel better — no honey.”  She laughed.

What about egg whites?  Peanut butter?  Cow’s milk?  Chocolate?  Can I give him water?  I was too dumbstruck to ask.

I make jokes about what a stress case I am, but some of that is just for the laughs.  This solid foods thing is an aspect of parenting where my multiple personalities compete. There’s a part of me that is (or wants to be?) low-key about feeding.  I’d like to just start giving him food off of our plates, maybe mashing it a little with a fork.  And then again I have fantasies of making my own baby food — I even have baby food recipes I clipped from a Martha Stewart Baby magazine in 1999. 

Which part of me will prevail here?  I’m not sure.  I think if our doctor were overly dogmatic, I’d rebel against her a little and be, perversely, more relaxed.  But the fact that she’s so laissez-faire that she doesn’t even mention honey or allergies makes me wonder WHAT ELSE SHE’S NOT TELLING US.  I don’t want to make some stupid, obvious blunder that results in neuromuscular paralysis!

What handsome looks like.

And then my totally awesome friend Laura emailed me asking if I’m going to use a food grinder or maybe an immersion blender, and honestly I don’t have the shadow of an idea.  Should I be pureeing one simple, wholesome ingredient at a time, like Martha Stewart and Dr. Sears seem to think?  Or can I just throw whatever we had for dinner — last night, pork tacos with mole sauce, black beans, and a salad — in a blender in its entirety and feed it to him with a spoon?  

Trust me, I know what I'm doing.

Meanwhile, some more unforgettable eating moments:

Dr. Sears would not approve.

You can handle this pineapple chunk, right?

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