I’m Sick Of Pediatric Percentile Charts

by Amy Winter
Originally Published: 
pediatric percentile charts
AleksandarNakic / iStock

When my first son was a baby, he was pretty average size — his height and weight hovered somewhere between the 25th and 50th percentile. He was lean everywhere, but he had these delicious, monster thighs that I still wish I could go back and pinch.

But then as he became more active and taller, the thigh fat melted away, and he was just tiny everywhere. By the time he went for his one-year pediatrician appointment, he had pretty much fallen off the growth chart. The pediatrician, who was really nice about it all, said he was sort of in a smaller range somewhere below the 5th percentile. She said it was fine, and told us that a lot of kids start to slim up and lean out as toddlers. She did make me tell her everything he ate, asked me a bunch of developmental questions, and said we’d check in on his growth over the years.

I understood her concern, and I get why children’s growth is not something people should take lightly. Still, it made me a bit anxious, especially as a new parent.

When I was my son’s age, I was petite as well — all skin and bones, until I was about 8 or 9 years old when pre-puberty struck. After that, I caught up with all the other kids. In fact, I had hips and breasts well before anyone else did, and still remain at a healthy weight, and curvy all over.

My son stayed exactly in his 5th percentile spot throughout his early years. Buying him pants was always difficult. They had to be the kind with adjustable waists and were always adjusted to the tightest setting. Other pants, even the slimmest kind, almost never fit him; they’d slide right off.

But he was always a perfectly healthy kid. He had plenty of energy, was off-the-charts smart — come on, a mom gets to brag sometimes — and ate reasonably well considering he was a young kid and a fairly picky eater.

Then, as he was turning 8, he had a massive growth spurt. Suddenly, he wanted to eat everything in sight. He started outgrowing all his clothes. I even saw a tiny paunch of a tummy emerge. It was adorable, except now, I couldn’t exactly go and pinch his cute, squishy flesh.

We had switched pediatricians the year prior because our insurance had changed. When we took him for his 8-year-old check-up, I was not happy at all with the change.

As soon as he stepped on the scale, the pediatrician said, “Wow, he’s gained 10 pounds. That’s fine, but it’s not a growth pattern we want to continue.”

Really? WTF?

After all the years that I was told my son was so freaking little and we needed to keep an eye on his growth — now this? He was finally growing, shooting up, and I was getting grief about that too. I simply could not win.

And furthermore, please, for the love of God, do not say that kind of crap in front of my child. Just don’t. Ever.

I was too flustered to say anything at the time, though, as much as I wish I would have.

The pediatrician told us he was in the 50th percentile now, but warned us that’s the range in which he should stay. Then she examined him, gave him a few shots, and sent us on our way.

I hoped that my son hadn’t picked up on the pediatrician’s tone about his weight.

But he had. A few weeks later, he casually mentioned that the pediatrician said he was growing too fast, and that maybe he was getting fat. That was how he’d interpreted what he’d heard. My mouth dropped to the floor. I told him that he was perfect the way he was and that he was simply growing — just like all kids are supposed to do. I told him that sometimes kids grow a lot at once. That was what had happened to him, and it was nothing to be concerned about. It was normal.

And you know what? That’s exactly what the pediatrician should have told us.

I was so upset about what happened, and it wasn’t just because of how it made me or my son feel. Over the years, I have spoken to so many parents who have been worried sick about where their child fit on the percentile charts at the pediatrician’s office, and I seriously wonder if these charts do more harm than good.

I know that occasionally a child is not growing properly, and by all means, this needs to be taken seriously. Obesity is a huge problem in our country, and this too needs to be addressed — kindly, and with respect in all cases. But playing the numbers game seems to be pretty useless, in my opinion, and only serves to stress parents and kids out.

I have huge respect for pediatricians. I don’t take for granted the importance of the jobs they have, the endless hours they work, and the selflessness it takes to keep hundreds of children safe and healthy. I take my children to their well visits, and the few times that something has been truly wrong, I am eternally grateful for the care they have been given.

But as a parent, I am asking for a bit of reform in how pediatricians view and discuss kids’ growth with us. What if we could look at the child more globally? Is the child healthy, happy, meeting milestones? Is the child perhaps having a growth spurt? Is the child leaning out and shooting up? What was the growth pattern of the child’s parents? Is there anything actually wrong with how the child is eating, growing, changing, or moving?

Most importantly, we need to change how we talk about these numbers — and how we talk about growth, eating, and bodies — especially in front of children.

This goes beyond physical health; we are talking about mental health, body image, and body confidence. It affects kids of all ages and genders.

Instead of stressing out parents, we can find ways to empower them. We can start to look at the whole picture of health, and not get bogged down by raw numbers on percentile charts. We can remember that we are dealing with human beings with unique bodies, hungers, and ways of growing.

Parents have enough to worry about without being beaten down by more statistics about their children — more reasons to compare, to agonize that their kids aren’t stacking up. A bit of common sense and compassion would go a long way.

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