Blue Sky On Mars

The Construction Site, the Quadro building kits look way cool and even include miniature (1/5th size) versions of the same pieces so you can model the thing you’re going to build.

Sometimes I find that there are kids songs that I’d like to do with my daughter, but I can’t remember the words or I don’t know the tune. This page: Sing Along Songs (Midis and Lyrics), NIEHS Kids’ Pages has the answer for quite a few.

In May, I wrote Poor Weight Gain: A Cautionary Tale to stress how important it is to do your own research before accepting a negative diagnosis. As much as a good doctor knows, it’s impossible for one person to know it all. A letter received by Google from parents of a premie twin that were told he needed a blood transfusion talks about a very serious scenario in which doing a search on Google avoided a dangerous procedure.

I do wonder at what point it becomes standard operating procedure for medical staff to do searches to find the latest information before prescribing such a treatment. That would seem to be more productive than less-educated parents doing the searches. But, ultimately, we are our own best advocates for great health care, so it will always pay to be in the know ourselves.

Three months (almost to the day) after she stood independently for the first time, Crysania started walking without support yesterday! She seemed thrilled about it, and so were we!

For anyone else out there with an “early talker, late walker”, don’t give up hope! As long as your child makes forward progress small bits at a time, it’ll all work out. It’s actually a blessing to have a child that can communicate well verbally and isn’t running around getting into everything.

Weight gain is one of a number of things that pediatricians think about when they’re looking at the overall health and development of your child. This article is a cautionary tale, because well-meaning pediatricians may, when looking at weight gain, not be giving you the best advice.

Since I’m going to ramble on a bit and provide links to things that back up what I’m going to say, I’ll sum this up for those who don’t want to read the whole thing:

• Any time your pediatrician (or any doctor, for that matter) expresses concern about something, it pays to become informed about that topic. The experts that we rely upon are not infallible. The internet is your friend.

• The converse is also true: any time you have a concern about something and your doctor doesn’t, it still pays to do research.

• “Poor weight gain” and “failure to thrive” are two concerns your child’s pediatrician may have. If your child is breastfeeding, there’s a significant chance that this may be an incorrect diagnosis.

As with many fields, medicine is very complex and rapidly evolving. I’m a computer programmer, and it’s impossible for me to keep up with everything that goes on in my field. That’s where specializations come in. I have the aptitude to handle a wide variety of technical problems, but my deep familiarity is with certain bits of technology. Likewise, a doctor has a specialty, such as pediatrics, that allows them to focus on the needs of that particular group of patients.

When it comes to health, the complexity of the human body means that there’s a fair bit of uncertainty. People have to go with their opinions, experience and intuition until real scientific data shows up.

Around the time that I was born, breastfeeding was extremely unpopular. About 75% of babies born in the US were fed formula. That was a case of people going on advice that turned out to be bad. We now know that breastmilk is by far the best source of nutrition for a newborn. The US Center for Disease Control (CDC) now recommends breastfeeding for at least a year. The World Health Organization (WHO) recommends breastfeeding for at least two years.

Anecdotally, I just heard (firsthand) of a mother who was told by their pediatrician to feed their baby formula at two days. Medical advice cannot be much farther from current research than that.

Back to the point, though: back in the ’70s, forumla feeding was the norm in the US. It was in this environment that the CDC first produced its growth charts. What difference does that make? Formula is based on cow’s milk. If you take a look at a cow, you’ll notice that it’s a whole lot bigger than a human, but not very smart. A baby that’s fed formula is getting the proteins and hormones that drive cow growth, not human growth.

It’s not a big leap to think that this would result in a different growth pattern between formula-fed babies and breastfed babies. In fact, a study published in 1992, “Growth of breast-fed and formula-fed infants from birth to 18 months (the DARLING study)” (Dewey, et al) showed that very trend. Breastfed babies actually gain more initially and then formula fed babies pull ahead. Formula fed babies weighed a pound more at 12 months than their breastfed counterparts. After 18 months, the difference starts to disappear.

So, the CDC revised their charts in 2000 to include more breast-fed babies. While that revision reduces the skew somewhat, you still end up trying to measure the growth of breasfed babies against the growth of formula-fed babies. A study published in 2003 showed that the CDC growth charts don’t accurately depict the growth trend of babies that are fed following the international feeding recommendations.

If a doctor is following the CDC growth charts, it’s easy to see how they could come to a “poor weight gain” conclusion for a baby that’s really just following the trend for how they are raised. The World Health Organization recently found that pediatricians may have caused unnecessary concern about breastfed baby weight gain because of the discrepancy in the charts. The linked BBC article also mentions that overfeeding of babies could be part of the reason why the adult population is getting fatter. A report published in The New England Journal of Medicine states that the current generation of children in America may be the first to have shorter life expectancies than their parents.

Many pediatricians and books talk about starting solids between 4 and 6 months of age, though some books talk less in terms of age, and more in terms of developmental milestones. The WHO recommends exclusive breastfeeding until 6 months of age. Starting solids too early can increase the chance of food allergies. We started Crysania at 5-1/2 months, and that was probably too early for her.

At Crysania’s 1 year pediatric appointment, her doctor raised the concern that her weight had “leveled off”. At her previous appointments, she had been gaining in percentiles, and at that one she had dropped. It turns out that this was the normal pattern for breastfed babies, as the WHO charts coming out later this year show.

Had we done research then, we would likely have learned this and would have reacted cautiously. Instead, we reacted by introducing a whole bunch of foods that we would not have likely introduced otherwise. Between August 2004 and April 2005, Crysania’s weight gain was slow and erratic. This despite the fact that we were trying all kinds of foods and re-trying foods that she seemed sensitive to.

She seemed to be tolerating egg yolks well, so we were giving that to her every day. In December, at her pediatrician’s recommendation, we took her for an allergy test. That was a good move, because she tested positive for allergy to eggs. Many children have sensitivities that they grow out of, so this was a good thing to know.

She tested negative for dairy allergy, so we tried all kinds of dairy with her again despite various reactions that it seemed to cause. It’s worth noting, however, that the allergy blood test has a 15% false negative rate. It would appear that Crysania fell into that 15%. We closely tracked different foods that we introduced, and found that between mid-March and mid-April, Crysania had been having dairy every day. During that period, she lost 8 ounces. Her pediatrician was recommending blood tests to see if there was some serious problem. Instead, we stopped dairy altogether.

In the first dairy free week, she gained 10 ounces. Since then, she has been gaining steadily 1.5 to 2 ounces per week. For her, dairy caused a serious loss of appetite and constipation. We had tried lactose free products, but they didn’t help, so it would appear that she has a dairy allergy.

We had seen reactions to dairy earlier. Had we not been as concerned about her weight gain, we would have just held off on dairy for a longer period of time. Her weight gain would likely have been better.

True poor weight gain can be a sign of a serious problem, so it’s worth considering the issue seriously. But, it’s good to know if there truly is a weight gain problem, or if you’re really just seeing the effects of skewed data. I’m hoping that the links I’ve provided in this article will help others make good choices concerning their babies’ weight gain.

For many parents in the US, the name Graco is usually associated with top quality, well-engineered baby products. Apparently, though, Graco has not been diligently reporting injuries that have occurred through use of their toddler beds and was fined $4M as a result.

”At Graco, the safety and welfare of our consumers is always our top priority,” the company said. “As this settlement makes clear, it is our understanding that Graco did not knowingly violate the CPSC’s reporting requirements.”

The article doesn’t go into detail about how they misunderstood CPSC’s reporting requirements… but, Graco’s been at this a while. They’re a big company that is part of an even bigger public compnay. It’s easy to be skeptical and think that perhaps Graco just didn’t want to get involved in recalling 1.2 million toddler beds if they could avoid it.

Yesterday, I worked from home because Crysania was suffering from fluid in her middle ear. Having two parents around at such times definitely seems a big help. Crysania just turned one last Saturday, and this is her second “ear thing”. The first was after we got back from Hawaii in December and was likely caused by the plane travel. These things are very uncomfortable, and I’m thankful that she’s only had two. Some kids in day care have these kinds of problems regularly. Crysania’s doctor even asked if she was in a group care setting.

Today, I’m home sick. Crysania doesn’t have any cold symptoms, so I don’t know where my bug came from. No coding today, I’ll give my brain a rest to try and recover. We were supposed to be in Kentucky now, but we cancelled because of Crysania’s ear pain… the previous few days had not been very restful because of getting ready for the trip.

It’s so nice when things warm up after a long Michigan winter. Crysania is taking her time in crawling, which makes her a bit more amenable to things like going out to eat. So, we did!

As you can see from the photo below, we weren’t the only parents there at the restaurant. The geese below were dining courtesy of a couple of kids at a nearby table.

Crysania added two new behaviors to her repertoire today: she wrapped her arms around Surekha’s neck earlier in the day (which I missed), and just now she waved goodnight to me as I waved to her on the way out of the bedroom. Sweet sweet sweet little baby.

Sunday was a fairly talkative day for Crysania, and I guess over the course of the day she figured some stuff out because on Monday she suddenly kicked in to what I’d call “articulate babble”. She’s now making more sounds than before and using different inflections as she’s talking. We can carry on whole conversations now! I just hope I haven’t already promised her a car for her 16th birthday without realizing it!