Tuesday, September 29, 2009
CNN clueless when it comes to... a lot of things
CNN.com headline: "Parents clueless when it comes to kids' growth charts". The article basically says that when doctors (et al) distribute pediatric growth charts to parents, the parents often don't understand the charts and that this "has implications in the war against childhood obesity". God forbid that parents' stupidity should get in the way of the war effort!
The thing is, though, that many parents (at least the ones I know) are perfectly aware of their kids' percentiles on the growth charts. In fact, if anything (from the perspective on a non-parent who has politely sat through more conversations on the subject than I would prefer) I would say that parents probably dwell on the percentiles a little too much. In several cases, it seemed that doctors deliberately caused the parents to worry about their very young children by going on and on about the percentiles (not just on the height/weight spectrum, but also in terms of the timing of certain childhood milestones). It is true that most of the parents I know do not have low income or low education levels, and therefore according to the article they are more likely than others to be able to understand the charts. But I'm not convinced that being able to understand the charts is really such a wonderful thing if it causes people unnecessary worry about their children. Maybe in this instance, ignorance is bliss.
Just have a look at this example of a pediatric growth chart. Notice that height and weight are on separate charts -- even as crude a measure of the height-weight relationship as BMI is not represented. Now suppose little Johnny is 2 years old and he's in the 70th percentile for weight on the chart. What is a parent to "understand" about that? *Some* child has to be at the 70th percentile -- 'cause weight, like height, exhibits a normal distribution -- so what if it's *your* child? Well, if he's also at the 70th percentile for height then maybe the doctor would let it go. But what if he's at the 50th percentile for height? Is he then "overweight"? And should you therefore put your 2 year old on a diet to slim him down?
The weirdest part of this article to me is the part where this pediatrician suggests that pediatricians talk to parents about height and weight in terms of clothing size because "It is real to them if they are having to buy clothes frequently or if hems always need shortening to accommodate girth." OK, remember we are talking about *kids* here. Now every parent who has to buy clothes frequently is supposed to panic and flip out and think that their child is abnormal and "at risk for serious medical problems"? I can just imagine what those conversations will be like... "Well, Mrs. Jones, the reason that you have had to buy new pants for your daughter three times this year is that she has a height problem. As you can see on this chart here, Susie is in the 85th percentile for height at her age, which means that she is overheight." What, you think that's ridiculous? Because height is mostly genetic and is just a natural parameter of human variation that is virtually impossible to control? And while it's possible that extreme tallness or shortness could signal an underlying health problem, which the doctor may want to check for, it is also entirely possible that there's no problem at all and therefore there's no reason to cause the parents to panic? Well, I couldn't agree with you more. Now, why is weight not treated the same way? Hey, don't ask questions like that -- don't you know we're at war?