I was riding the elevator in the hospital the other day.
Two women were chatting with each other about a recent visit of the child who was with them to the pediatrician.
Woman #1: "How was his height and weight?"
Woman #2: "His height was good--its ninety five percent, but his weight is only fifty five percent"
Woman #1: "What are you going to do about it?"
Woman #2: "Feed him as much as possible."
At which point woman #2 took the little boy's hand and the three of them exited the elevator.
What is your image of this little boy? He looked like he was about 4 years old. The child was tall and of about average weight. He seemed perfectly healthy.
Did he only weigh HALF of what he should have?
What were they talking about? Take a look at the graph below which comes from the Centers for Disease Control and Prevention (CDC)
When you look at the graph, you are looking at lines that are called percentiles, not per cents. The lines are labeled as 5, 10, 25, 50, 75, 90 and 95. These are the percentile lines. If you are at the 90th percentile for height, you are TALLER THAN 90% OF THE POPULATION. Likewise, if you are at the 50th percentile for weight, you weigh MORE THAN 50% OF THE CHILDREN AT THAT AGE AND 50% LESS THAN THE CHILDREN AT THAT AGE. In other words, you are at the median or average weight for a child of that age.
The graphs are complicated, but can be used to follow the expected growth in height and weight in infants and children: there is a separate graph to look at expected head growth in children up to the age of two as well. Every doctor's office that provides health care for children should be "plotting" the child on such a growth chart with every visit. That is how we know if a child is typical or not. More recently, we have been tracking BMI in children as the obesity epidemic has gotten worse.
At first I thought the conversation I overheard was humorous, but then I started to worry.
Are we ever giving the impression to a family or caretaker that a child should be at 100% to be normal?
As always, communication is important in healthcare. We must be certain our patients and their families understand not only the words we say, but also what they mean.
Have you had any experiences with misinterpretation of the data or information your doctor has provided for you? I would love to hear about them!
For more information about growth charts, and to print out your own for your child(ren) follow this link to the CDC website