Thursday, 7 January 2010

Proof that those growth charts don't mean much - they change according to country!

So, we finally got our globetrotter Bambino officially weighed.  It had been a while.  I never bother with the baby well-checks.  I would have to find a competent generalist or pediatrician here first, which I haven't succeeded in doing,** so the Bambino hadn't been weighed since our arrival in Tana at the beginning of July.
Then when we were checking in our luggage at the Morondava airport last week, the Frenchman had the brilliant idea of weighing the Bambino on the luggage scale.  It worked fairly well.  The Bambino weighed in at 9.8 kg (around 21.5 pounds?), with diaper and clothes on, so probably around 9.5 kg without.

Then yesterday, I took the Bambino to a local dermatoligist (who is a very good doctor.  I would choose her as our pediatrician if she wasn't already a dermatogist!).  The baby's arms and chest had been covered in a rash for a week and I wanted to be sure it wasn't anything more than heat rash.

"It's heat rash," she said, as she was going gaga over this beyond cute, big, bouncy, wasa baby. 

"He's so big!", she exclaimed.

"Which reminds me," I said.  "Could we get him weighed on a real baby scale?"

So the dermatologist had the baby scale brought into her office and we undressed the Bambino and put him on the scale.  Sure enough, 9.5 kg.

"Wow!  He is so big for an 8 month old baby!" the doctor exclaimed.  "Bravo!"

"Er, you think?  Because he is exactly average weight for his age on the CDC growth charts for American babies."

"Well, yes but the Americans are fat."  (She honestly said this.)

"And he is in the 75th percentile on the tableau in the French carnet de santé," I went on.

"So you see?  Even in France, he is big.  And by Malagasy standards, he is enormous!", she said.

And it's true.  Malagasy babies are tiny.  Now, part of this really is due to malnutrition, but even the well-fed ones are not that big.   Plus the Bambino really is a very tall baby.  The Malagasy tend to be on the short side.

All of which leads me to believe that those growth charts that doctors are so obsessed with don't really mean that much.  So much depends on the baby's ethnicity and genes. 

I should add that the Bambino was 4.2 kg at birth -that's around the 90th percentile on the CDC charts - so he has slipped way down in weight.  A typical pediatrician would have probably told me a long time ago to start supplementing with formula, notwithstanding that it is obvious from just looking at the baby that he is doing fine (see photo).

The Bambino was never destined to stay his birthweight percentile anyway.  We're all tall and thin in our family.

**The one generalist I have met here told me that I should be retracting my son's penis on a regular basis.  Isn't that advice from something like 30 years ago?

Monday, 4 January 2010

Car Seats and Baobabs

We spent the end of the year in Morondava.  Morondava is southwest of Antananarivo (that's the capital, where we live), on the coast.

This is a photo of the Frenchman and the Bambino.
We were taking a large van from our hotel in Morondava to some baobab trees approximately 25 km away (that's about one hour's drive on the roads we had). 
Note that:

- there are no seatbelts;
- there is a big bar at the top of each seat, which baby can bang his head into in the event of a crash;
- don't even ask about the possibility of a carseat.

I'm trying to think what the righteous ladies on the "Family Safety" board at MotheringdotCommunity would say to all of this but of course their advice would be surreal in this context.  If you have ever read their discussions about the merits of the Britax carseat, or why you shouldn't get a Maxi-Cosi, or how long your baby should stay rear-facing, you'll know what I mean.  Travel in Africa makes you realise that if your only decision is whether to buy a MaxiCosi or a Britax, your child is already very fortunate.  Most small children here, if their family owns a vehicle at all, will be in a parent's arms in an old and completely unsafe car (or worse - on a motor bike) with not much for seatbelts and nothing in way of carseats or airbags.  (Oh, and their lungs will be black from the pollution that their car and all the other cars on their road produce).

The Frenchman held the Bambino's head forcefully against his chest and we all made the journey in one piece.  Here are photos of us and the baobabs.  They're amazing trees.  Their fruit has more vitamin C than an orange and more calcium than cow's milk.  Who knew?  Some baobab trees are thought to be thousands of years old.  Six baobab species are unique to Madagascar.

And finally, to mollify the ladies at MotheringdotCommunity, here is proof that a globetrotter mom really can nurse anywhere in the world that she finds herself with her baby.