The Home School Court Report
Vol. XXV
No. 2
Cover
March/April
2009

In This Issue

SPECIALFEATURES
REGULARCOLUMNS
ANDTHEREST

Doc’s Digest Previous Page Next Page
by Dr. Rodger Sayre
- disclaimer -
Short Stuff and Long Drinks of Water

During my medical school days, I would often sit in my room on the corner of 11th and Pine Street in downtown Philadelphia and stare out the window. Having grown up in the country, I was unaccustomed to seeing so many people. People-watching was sometimes a welcome diversion from my studies. I could not help but be impressed with the diversity—the human race comes in all shapes and sizes! One of the challenges of pediatrics is in differentiating normal variations in height and weight from pathologic conditions. I must confess, sometimes I scratch my head and wonder, is this just genetics, or is there something wrong here?

www.comstock.com
...
IT IS HELPFUL
TO PLOT HEIGHT
AND WEIGHT OVER
TIME, SINCE CERTAIN
DISEASE STATES CAN
CAUSE VARIATIONS
FROM THE NORMS.
...

Wide variations in size and shape are commonplace even at birth. Some babies, such as my own children, start out at the top of the chart. (Mary delivers babies that go right into 12-month clothing.) Our kids start out looking like they are going to be 6 feet 6 inches and 250 pounds. They end up an average height and … well … average weight. (I have to be careful here or I may not get supper.) Other times, a newborn is much smaller than expected, judging from the size of the parents, and growth accelerates rapidly after birth.

A baby’s size at birth is unquestionably impacted by the environment present in the womb. A mother with a good diet and a healthy placenta, who does not smoke or consume alcohol, will be more likely to have an infant whose size is consistent with that of the genetic makeup of the parents. These babies are usually relatively content, with no calorie debts to settle during their infancy.

An infant whose size is less than would be expected, considering the size of the parents, can be very fussy for the first few months. He or she may have a voracious appetite, eating incessantly, due to a need to pack on pounds before settling into the appropriate niche on the growth chart.

A child at 24 months of age will usually track up the growth chart, with minimal shift occurring from the percentile at which he or she has settled. It is therefore very helpful to plot height and weight over time, since certain disease states can cause variations from the norm. Traditionally, supine length and weight are checked every couple of months during the first 18 months, then every 6 months until age 3. From that point on, yearly heights and weights are plotted to ensure tracking is along expected standards.

Standard growth charts may be found at www.cdc.gov/growthcharts in a PDF format. These can be downloaded and printed for personal use for you do-it-yourselfers. (Come to think of it, all homeschooling parents are do-it-yourselfers, by definition!) Of note is the fact that for the first two years, heights are assumed to be measured with the child in the supine position, whereas heights are measured standing thereafter. The growth charts are calibrated with this assumption. It is worth purchasing a good-quality scale to ensure accuracy.

Sayre Family
Courtesy of the family
Dr. Rodger Sayre and his wife, Mary, a registered nurse, have graduated 5 of their 11 children and continue to teach the rest at home in Pennsylvania.

If you should notice a mismatch in the height and weight of your child, either too tall for weight or too heavy for height, or if he or she is tracking off the growth chart (above the 97th percentile or below the 3rd), a medical evaluation by your pediatrician or family physician will help rule out disease processes.

Now, off with the doctor’s hat and on with the father’s hat … For some reason, about 10 years ago, a couple of our kids decided to stand next to our bedroom door and mark their heights in pencil on the wall. This was a newly painted wall. I was not happy! Moments after its discovery, I stood with a sponge, ready to wipe away this spontaneous, makeshift, kid’s version of a growth chart. But before I could set my hand to the task, it occurred to me that these etchings represented something entirely unique to the day. On a day not far hence, these same children would be an inch, then a foot, then several feet taller. So instead of erasing the markings, I labeled them. That day I grew a little wiser and more balanced in my view of what’s important in life. Now the wall is covered with pencil marks, initials, and dates. I can’t leave my bedroom without being reminded of the brevity of childhood and the temporary but profound privilege of serving as my children’s daddy.

Parents, your children won’t stay little for long. Make every moment count. On days of discouragement, when you’d just like to throw in the towel, remember Galatians 6:9: “Let us not lose heart in doing good, for in due time we shall reap if we do not grow weary.” (NASB)


About the author

Rodger Sayre, MD, FAAFP, has been an HSLDA board member since 1997. He and his wife, Mary, homeschool their 12 children.