Friday, February 01, 2013

Percentile Panic

It's time for a set of vaccinations or a particular month's check-up for your little one. You pack-up and bundle up and head to the public health clinic or your family doctor's office, and if you're anything like me - you brace yourself. These visits, I'm sorry to say in my experience have never failed to leave me feeling lost, scared and usually worried. And my baby is very healthy. Is that really necessary?

Let me clarify. I do believe in the importance of vaccinating against highly contagious and often dangerous diseases and viral infections.  I also believe in the importance of checking out the major developments in a new baby, having an opportunity to ask questions, and record things like a baby's growth and milestone development. All of this, baring any major abnormalities or areas of concern should make for a fairly pleasant experience for one of these routine trips - should it not? Well in my experiences, I would say, no - it does not.

I am used to the drill - my son is weighed and measured, has his head circumference, hip alignment and sensory responses checked. I report any concerns I'm having. Then the health care professional takes these measurements and either enter them into a computer(public health) or plot them on a paper grid (doctor) and then they read me back a list of percentiles.  For example (and these numbers I am making up just for this post) let's say my son was in the 28th percentile for his height. It means (as far as I understand anyway) that he is as tall as or taller than 28% of all babies his age. On the flip side, it also means that he is shorter than 72% of all babies his age.  Should I be worried now because according to this, he is short for his age? What am I supposed to do with that information? What is the purpose of it?

When the percentiles are low, I find myself worrying that he is behind his peers; and when they are high, I worry that he is too big for his age. I worry that it is my fault for what I have or have not done with him at home.  Another question - these stats are based on information from what point in time - how recent? how many? and the big one - how accurate? There are ALWAYS discrepancies between my what my doctor reports vs. my public health clinic. One particular time my little boy was measured at both places less than one week apart, and in one particular percentile measure there was a discrepancy of almost 20% between the two sets of measures.  What one pointed out as an area of concern another totally passed over. Who do I listen to? Aren't doctors supposed to be the bottom line? Or do public health nurses know better because they are more focused on babies?

I am tired of everyone telling me that irregardless of his scores on these percentile charts, that every baby is different blah blah blah. If that's the case then why do we compare them all against each other?  It's contradictory and inconsistent - not to mention extremely stressful!

So far, because of these percentile measurements my son has had to have two further diagnostic tests, both of which came back negative.  Some say that it's better to be thorough and "let me relax" by having everything checked in order to rule things out.  While there is a part of me that does agree with this reasoning, I can't help but feel that it is totally unnecessary to put him through these tests in the first place. When all other signs point to "normal" (whatever that really means) and they've "never seen" these tests come back positive based on these percentile precautions, they still send in the referral, "just to be safe." So, what is the point other than the time spent getting it checked and the worry that fills my mind constantly until the test results come back? I think we are in a place of liability and constant fear from these health care professionals. They are terrified that they may miss any potential imperfection, irregardless of the potential stress it may place on the baby, not to mention the parents. These "non-invasive" tests are stressful and worrisome no matter how many times they are completed "just to be safe."

I know that as always, my opinion on this topic is not that of everyone reading this post and I do recognize and respect that. Personally speaking,  I am just frustrated by what I feel more often than not are unnecessary stresses caused by this need to quantify everything in these comparative percentiles.  It is challenging enough to be a parent and dealing with all the uncertainties and real issues we face on a day-to-day basis. I just don't see the need to add to this list in the extreme way that we are doing.

If nothing else, I feel a little better having a vent on this topic. I would love to hear the thoughts and experiences of my readers on this issue! Please leave your comments!

1 comment:

Anonymous said...

Very interesting! I hadn't thought of like that...good points. Cristie K