Off the Charts
Why pediatricians are abandoning percentiles.
by Jeanne Sager
May 26, 2008
But percentiles continue to be popular. Included in the packets sent home with most new moms is a CDC growth chart, and the Internet is brimming with "growth calculators" that require minimal information to spit out a number that's supposed to evaluate your child's health.
Plotting a child's weight and height should only be a starting point for pediatricians, says nurse practitioner Nancy Eschenberg, who's spent her career in family practice in upstate New York, including seven years in a pediatric office and two more working with kids with developmental disabilities.
"I view it as a screening tool," Eschenberg said. "You to need to compare it to what a child's growth trajectory is — in other words, if they're on the 10th percentile, you want them to continue on the 10th percentile or pretty near because that's their normal trend."
"You have to look at genetics," she says. "If you have a father who's 5'11" and a mom who's 5'3", you're not going to have a kid in the 95th percentile."
A jump or drop should be watched, Eschenberg continued, but practitioners can't immediately raise the alarm. "There are growth spurts children will go through," she noted. "There are times kids chub up and then they shoot up."
If a child's height or weight seems to be fluctuating drastically,
Plotting a child's weight and height should only be a starting point for pediatricians.
Eschenberg says she might ask the parent to make another appointment sooner rather than later. She'll talk with the parent about a child's eating habits, try to suss out whether a child is drinking more than he eats or if a little girl is running off all of her excess energy.
Bender and Eschenberg prefer to tell parents, "Your child is developing well," or "Your child is a little too thin; let's talk about this." They don't quote percentiles.
It's a practice being picked up by an increasing number of doctors frustrated by parents pushing for the secret to attaining the top percentiles — parents who still think higher is better. That's why many doctors are even dropping the word "percentile" from their lingo. Finally, more pediatricians are looking past the dots charted on a government-approved graph to the baby in front of them.
Photo: Melissa Drenzek
©2008 Jeanne Sager and Babble
About the Author
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Jeanne Sager is a freelance writer and photographer living in upstate New York with her husband and daughter, Jillian. She maintains a blog of her award-winning columns at jeannesager.blogspot.com. |
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