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What Doctors Need to Stop Doing During Newborn's 1st Check-Ups

Photograph by Twenty20

You’re a brand new mom, and you’ve been home with your newborn doing everything you can to keep them happy and healthy. Which means sleeping very little, feeding constantly, counting diapers and feeding some more.

You’re desperate to know that you are doing a good job, yet you have very little to go on.

You take your baby for their first well-baby check-up, and the doctor hands you your report card. To be fair, it’s not really a report card. But it feels like one. They tell you how well you’re doing at growing that little human by comparing said human to an arbitrary median. While nobody said it was a grade, it is offered as a percentage. And while 50 percent is a totally acceptable average, it feels like an F.

Your first test at motherhood, and you're flunking.

In the early days, with little else to measure your progress as a parent, you feel like you've work hard enough for an A. So it doesn’t make sense logically when you the grades come out, but little in the 4th trimester makes sense, and you're starting to get used to that. Still, it stings.

I completely understand that doctors need to track children’s growth to make sure there aren’t any potential health problems, but the emphasis on percentiles is a stressful and unhelpful way to go about it.

Especially when all the other moms proclaim that their child is the 90th percentile. (Maybe you've even done that yourself. Feels like an A, right?)

And yet, if I'm being realistic, my son was off the charts in size mostly due to genes. He is my carbon copy and, at nearly 6 feet tall, I was always in the top percentile. The fact of the matter is every child is different, but every growth chart is the same. And not every child follows a perfect growth curve. But every pediatrician is kind of looking for them to.

Due to any number of factors, a child might start out in the high percentages early on, but gradually end up more toward the middle of the charts. Or vice versa. Constantly comparing our babies to other children, either in play group or anonymously on a growth chart, feels unnecessary and can be especially discouraging to breastfeeding mothers.

My first son, who is now 7, has always been at the top of the growth charts. He was also predominately formula fed, and my postpartum anxiety manifested in me being militant that he ate enough. My second son was exclusively breastfed and, though he started out like his brother, he slowly glided down to more average reading. This might have been because he was breastfed, and I was not a manic boob pusher in the same way I was a bottle pusher. But, more likely, it was because he is built differently than his older brother.

Honestly, my doctor was never concerned about my second son's growth, but I found the comparison, even just to his brother (let alone all the babies on that damn chart) stressful. It made me second guess my decision to do what everyone agreed was the best choice for his overall health.

I completely understand that doctors need to track children’s growth to make sure there aren’t any potential health problems, but the emphasis on percentiles is a stressful and unhelpful way to go about it. If a child is falling off their expected curve, or gaining dramatic amounts of weight, of course the parents should be informed. But there is no need to send them home with a baby book sticker that has big "28 percent" on it.

We need words of encouragement that have nothing to do with comparisons of any kind.

(And, yes, for the first two years of my children’s life, I was given decorative stickers that had their height, weight and percentiles on them. It was intended to be cute, but I always hated it.)

There are plenty of other markers of good health, any doctor worth their salt should not need to rely so heavily on growth charts to gauge how well a child is doing. And as parents—especially in the early days—we need more to go on.

We need words of encouragement that have nothing to do with comparisons of any kind. We already struggle with constant comparison, we don’t need the doctor doing it, too. Instead of emphasizing growth charts (and those stickers!) I'd rather hear “You’re doing a great job!” or get somethign for the baby book that says, “Keep up the great work!”

Because no matter where your child falls on that stupid chart, being a mother is incredibly challenging. And you, yes you, are doing a remarkable job. It's important that someone let you know that.

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