Nine-Month Wellness Check

Oliver had his nine-month wellness check today and like every appointment before this, he received a clean bill of health. I'm relieved to have a healthy baby, but also that I may have finally settled on a pediatrician. Oliver has seen a different doctor at every wellness check because I haven't found anyone I have liked. Despite the raving recommendation of a particular clinic a mere three minutes from our house by Chris's co-worker, I was disappointed with the three different doctors I saw and finally accepted that the hunch I had during my first visit that I was never really going to like the place wasn't going to change. A friend from a parents group recommended her son's pediatrician, and others in the group happened to go to the same practice, so I decided it was worth switching in the hopes that I could finally find someone I can envision sticking with throughout Oliver's childhood since I believe a relationship with a doctor is as important as his or her diagnosis at a particular appointment. Oliver has seen two different doctors, one at his six-month appointment and another today, and I like them both.

I feel like the wellness checks are not just assessing Oliver's health, but also affirming whether or not I'm doing a good job as a mom. We're all dealt with a deck of genetic cards that will determine most of our health, but as Oliver's primary caretaker, and especially as the one who provides Oliver is main sustenance, I feel the burden of his well-being. If he's not thriving and hitting his developmental milestones, I'd feel I am the cause since I'm the one who spends so much time with him, or if there were concerns about his weight, whether under or over, I wouldn't be able to help but feel it were my fault, like I hadn't fed him enough or fed him too much of the wrong kinds of foods. So when the doctor turns to me and says it's obvious he's a happy, healthy, well-fed baby, I feel both relief and pride.

Among those with similar-age babies in my moms group, we're starting to thinking about the next stage in car seats, the convertible. I was curious, therefore, to find out how much Oliver weighs, but at 17 pounds, 4 ounces, and 27 inches long, he's not in danger of outgrowing his infant car seat with its 22-pound, 29-inch-long size limits. In three months, he's gained about a pound and a half and less than an inch, which is on target. He's also dropped to the 10th percentile in height and the 7th percentile in weight. Since his percentiles seem to be going down every visit, I asked if that is a concern, but the doctor said his main concern is if the measurements take a steep drop or if he's, for example, in the 10th percentile for height, but 90th for weight (which might suggest I've been feeding him donuts instead of slices of sweet potato, toast and peaches). As for the lower percentiles, the doctor said between nine and 12 months, babies settle into their genetic path on the growth charts and follow it pretty consistently from there on out. Whether babies measure big or small in the first six or nine months isn't an indicator of future size, but it's where they level out at that nine-12-month mark. So when the doctor at Oliver's four-month appointment said that where he fell in the height percentiles indicated that he's gong to be six feet as an adult, my guffaw was not an inappropriate reaction. Given the genetic makeup of Oliver's parents, his current doctor is not surprised by bottom-of-the barrel measurements and expects to see similar measurements at the 12-month wellness check.

Besides taking measurements and doing a physical exam on the baby, the doctor at infant wellness checks runs through a list of milestones and today asked me if Oliver is doing things like grasping for objects, (yes) pulling himself up, (showing some interest, but no) responding to his name, (yes) clapping his hands (no, but he smacks his tray with his hands when he's run out of food) or rolling over (yes). I added that he's not crawling yet and only made his first (unsuccessful) movements towards crawling on Saturday. Chris's parents often tell the story that he nearly skipped crawling as a baby - crawled for maybe a week and then not to be outdone by the neighbor girl who was already walking, took to it. I was told that crawling is not considered a developmental milestone (except to us parents) and not something the doctors look for, because whether a baby crawls or not has no indication on whether he or she will walk. The doctor said that most babies crawl, but a small percentage never do.

I read more about crawling when I got home and learned that while we associate babies with crawling, there are actually many different ways that babies move from point A to point B, some of which are crawling, but not in the classical sense and some of which aren't crawling at all. What's important developmentally is whether babies can move horizontally across the floor to reach a desired object. Some will stay upright and scoot on their bottoms, some creep, some wiggle forward on their stomachs or pull themselves across the floor on their stomachs with their forearms, marine-crawling-under-barbed-wire-style. Some crab-crawl, moving backwards and some just roll. Remember, points aren't awarded for efficiency.

Thinking back to the last playgroup Oliver attended, where his group of baby friends had transformed from stationary babies to movers and shakers seemingly overnight, some of them crawled in the traditional sense, but the others used the exact same unique methods I just mentioned. Even Oliver is starting to at least roll. So Oliver may or may not crawl and whatever he does will be on his own time. I've just got to continue what I've been doing which is to give him plenty of floor time and let him work at it himself.