The Cap’n took Bill for his regular well-child visit last week to Tipat Chalav, the children’s clinic where they do weight checks, observe the child’s development, and offer dietary advice.
Back in the US, I used to find these regular well-child visits to the pediatrician’s office pleasant. Our children were usually healthy, thank God, and doing okay developmentally. They have always been small (around the 25th percentile) though, and around the nine-month mark they all begin to dip down on the growth charts (usually down to the 3rd percentile). We would usually leave the office with words of praise and encouragement from our children’s pediatrician, who knew our children well and knew to expect these dips as one child after another passed through her office.
Why the dips? The Crunch children are all breastfed long-term–Beans and Banana for over 2 years, Peach for 15 months, and Bill ongoing. Growth charts are based on the growth patterns of 
children who, by and large, are formula-fed. These children, in addition to lacking the Crunch family’s genetically small frames, tend to beef up faster than breastfed children. And while healthcare professionals should understand the limited value of growth charts in evaluating breastfed children, they tend nonetheless to use the charts as a measure of where ALL children should be. (Do they also register the same alarm at finding not all adults of exactly the same average height and weight? I thought not.)
Nurses and doctors over the years have told us that it’s fine for our children to be small; they just get concerned when the kids dip down in their trajectory, suggesting that their growth has slowed. And yet there is nothing to suggest that there is anything wrong with our kids. They aren’t sick. They haven’t stopped growing. They’ve just stopped blowing up at the astonishing rate they once did. And are they not still getting what the public health world claims is Nature’s Perfect Food? If it REALLY is Nature’s Perfect Food, aren’t the kids getting what they need in the way of sufficient fluids, fats, and balanced nutrition? Or did Hashem cock this one up, and it’s up to humans (and Better Life Through Chemistry) to fill in the gaps with things like formula, vitamin and iron supplements, and appetite stimulants?
Like a number of mothers I know, I have dropped out of taking my kids to Tipat Chalav. I am still supportive of immunizations, and there is nowhere else to get them. But I am truly sick of being badgered every time I have a 9-month-old about how my healthy, typically developing child isn’t measuring up to an arbitrary instrument based on statistics from Norwegian immigrants in Kansas City. (This last observation is from a friend who trained as a pediatrician.) So for the foreseeable future, it’s up to the Cap’n (who has smiling, nodding, and totally ignoring nagging females down to a fine art) to take the kids.
N.B. We were warned soon after making aliyah to take what Tipat Chalav nurses say with a very large grain of salt. Our family doctor in Beit Shemesh went to so far as to encourage us to contact her anytime Tipat Chalav said anything that alarmed or concerned us. We don’t panic when they harass us about putting Bill on his tummy more, or about giving him more solids and less breastmilk. But it’s still hard for a mother not to get teary or ticked off at a stranger making free to be so bossy and judgmental.
Shimshonit 
Menachem was always just right on those charts as a baby, despite the fact that he refused to eat solids for a very, very long time. (Don’t think he ate solids on a regular basis until after age 1…) He had these huge chunky legs as a baby!
However, Eliezer was tiny. He started off bigger than Menachem, but then dropped below the 0 percentile line (whatever that means). Our doctor was cool about it, said his father isn’t big and so having a little sized boy made sense. She ran some blood work just to be sure, and when it all was ok, she basically ignored it, as he was otherwise healthy (besides allergies and asthma) and was growing… just low on the chart!
I’m curious how these babies will grow, and I’ve heard all the stories about tipat chalev. I’m sure my desire to breastfeed twins will get to them, too… ! I’m not dumb enough to tell them that they’ll sleep with me, either!
I intend to either bring Eli with me, because like your husband, it just doesn’t get to him like it gets to me! I just don’t want to hear their whining if it’s for nothing… blech.
Rachel: VERY good idea not to tell them about co-sleeping. They informed me the first time we took Bill in that under no circumstances should the baby be in the bed with me–as though millions of women in other cultures who sleep with their babies are also bad, reckless mothers. It sometimes seems that their goal at these checkups is to make the parents feel stupid, inadequate, wrong (no matter how many kids we’ve seen successfully through babyhood). The Cap’n and I try to stick to the Miranda Law when we go, or answer only the questions asked and NEVER offer more information than they request. That gives them fewer opportunities to conjure up further criticisms.
You, on the other hand, have Dina Katz, a wonderful nurse (American) at your local Tipat Chalav. We miss her.
At one of Bill’s checkups (I think 6 mos), I made the mistake of sitting him up when I was getting him dressed. Somehow, according to the nurse, that was supposed to be bad for him (instead of which he should have gotten more tummy time, which after about 3 seconds inevitably lead to a crying baby).
Needless to say, that didn’t stop us from sitting him up at home (all parents know what a relief it is to get to that stage, as finally the baby can entertain him or herself for at least a few minutes!), and by his 9 month appointment he could sit himself up from tummy-time position (which is what they wanted to see).
Our eldest, who not only sat up like that, but had the temerity to walk before she could crawl, would have given the Tipat Chalav nurses a heart attack! Now she is a little gymnast, clearly none the worse off. (She even finally did figure out how to crawl, too!)
Anyway, that is when we learned never to volunteer information about what he can do — we wouldn’t want him “breaking the curve” on anything, now, would we?
I am sitting on my hands in order to prevent myself from typing how I feel about those fascist, overbearing, patronizing Tipat Chalav nurses… (Oops, it looks like my hand somehow got free…)