Actually the game has been on since before baby was even born. You may have come across unthinking friends or even strangers that commented on how big your belly was, and thus how big your unborn child is. Your doctor may have felt your stomach and estimated baby’s size. You may have been talked to about scheduling a cesarean because baby was going to be “too big” to birth vaginally. Or you may have been put on bed-rest and have had baby’s growth monitored because baby was measuring “too small”.
How big baby is before birth and how big baby is after birth and through the first two years have little to do with their stature as an adult.
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| A growth chart of a baby not following a growth curve |
Growth charts were not designed as a test. There is no gold sticker for a child who is at the 99.9% curve for their weight and height and the child at the 5% curve is certainly not bringing up the rear. Growth curves were designed to provide statistical information about the growth of children. This isn’t school. Having a child that is at the 50% isn’t a failing grade. Having a child at the 50% means that 50 out of 100 children would be bigger than your child and 50 of them would be smaller. It is that simple, and sadly many doctors don’t think to explain the charts this way. Rather as a new parent you often feel a sense of letting your child down because they aren’t at the 99.9%. This is not the case; you are not failing by any means by not having a “super sized” child. (And as a mother of a 2 year old that is larger than most 4 years old I can honestly say it is not easy having a child that large.)
There are a few important factors to notes about growth curves –
1) There are 2 growth curve charts still in use in the US.
a. One of the CDC one which was developed before 1977 when formula feeding was all the rage. This chart is referred to often times as the “formula chart”.
b. The other chart is the WHO one which was developed using statistics (remember these charts are just that statistic markers) of breastfeed babies. This chart is often referred to as the “breastfeed chart”.
2) Make sure your child’s doctor is using the correct chart. Remember you are the only one that can speak up for your child, so make sure you do.
3) These charts are different in reflecting that fact that breastfed children typically (but not always, remember this is statistical information) grow more rapidly in the first two to three months than their peers that are formula fed. These charts are reflect the inverse in the following three to twelve months.
Another very important fact to remember; babies size at birth does in no way indicate what their growth curve should be. A baby born at 10 lbs. is not expected to remain off the charts for weight for the rest of their life. Conversely a baby born at 4 lbs. is not expected to always be the smallest in their class. Many factors can influence a baby’s size at time of birth. These things ranges from heavy use of IV fluids in the laboring mother, cesarean or rapid births, pre and post term births, and maternal medication conditions (such as diabetes). When looking at a newborn’s weight gain it is IMPORTANT to reflect on their lowest weight (typically 24 to 36 hours after delivery) in order to determine how well they are gaining. A baby that lost 20% of their birth weight cannot be expected to double their birth weight in the same amount of time a child that lost only 3% of their birth weight did.
When looking at a growth chart it is important to see that the baby is following THEIR growth pattern, and not necessarily a particular growth curve. A chart that has a lot of hills and valleys in it should be addressed, and reasons for those spikes should be looked at. A baby that is continuing to lose weight
and is rapidly dropping off the growth curve should also be monitored, as should a child that continues to climb and climb in size off the chart. These are things your doctor should be looking for and explaining to you when reviewing your child’s individual growth patterns.
As a child nears the age of two their growth will begin to follow more a particular curve, and their height at age 2 is estimated to be about half of their adult height. That being said all children hit puberty and have growth spurts at different ages, but in the end they will have followed THEIR growth curve to a particular height. Also, as your child gets older your doctor will start monitoring their body-mass-index (BMI) and charting this as well. This is in an effort to combat the obesity epidemic in the US; but as we know people come in all shapes and sizes.
This is why it’s OK to have a baby that is long and lean, or short and round, or round and long, or short and lean. As long as they continue to follow the INDIVIDUAL growth patterns that routinely indicate this.
Lastly, please remember you are looking at an infant’s weight gain in ounces. An ounce isn’t very much at all. If you child had a massive blow out diaper right before getting weighed this could look like a blip on the screen. Alternatively if your child just had a full breastfeeding session before getting weighed then could weigh in many more ounces than you might have expected. The same goes for ensuring that your child is always being weighed naked. A wet diaper and or a cloth diaper add a lot of weight when you are comparing ounces. This also goes to the fact that weighs should always be done on the same scale, a difference in calibration can through off weights by a few ounces as well. If you combine all of the possible deviations here, you might expect a weight to be off by as much as a pound.
Additional recourses on weight gain and growth charts:http://kellymom.com/health/
