Is my pediatrician giving me the right advice?
Q) Dear Dr. Gwenn:
My baby boy’s head circumference was about 36 cm at birth and his head was a bit oddly shaped at birth. Today, at 12 months of age, his head is only about 45 cm. I realize that the early measurements were probably slightly skewed due to the birth but his head was fine after about 2 weeks and he was then in the 50% percentile. Now it seems his head size is gradually decreasing – at least on the charts.
Developmentally, he seems fine. He sat by himself very early, was crawling by 7 months, cruising a week later and walking on his own by 10 months. He laughs all the time and interacts well with people. He points and knows the names of different objects and can stack blocks and puts round and square pegs in their appropriate holes.
I do get concerned at times because he will hold his head in his hands as though he has a headache and at other times he seems to get a chill and shivers. The doctor has shrugged me off with these concerns (not really happy with this doctor).
I just need to know whether I should change my doctor or if there really is no need to worry. Any advice would be greatly appreciated.
Sincerely
Ruth
A) Dear Ruth:
Your letter raises a number of issues many parents face: worrying about their baby’s head growth, and wondering if they are with the pediatrician that is “right” for their family.
Given what you described, I’m not worried about your son’s head size or growth. The best proof we have that he is growing normally is his development which is perfect for his age! It is not at all unusual for a head circumference to change a percentile line either up or down after birth. And, measurements early on are often not as accurate as we’d like due to the odd shapes many babies heads have from birth. If his development continues to track as it is and his head is growing along the curve it is on, all is well.
The behaviors you described are more difficult for me to piece together without actually seeing them. It may very well be your son practicing a new movement or exploring a discovery he made on his own body. This is where having a pediatrician you trust is so important and brings us to the core of your question.
Behind the nuts and bolts of examining your son, as parents we all need that little extra TLC from our child’s doctor (even me!). I’d suggest you talk to your son’s pediatrician and express your concerns. If that does not improve your comfort level, you may want to look around and see if there is a pediatrician in your community you feel more comfortable with. You have every right as a mom to need that from your doctor and there are many, many outstanding pediatricians in every community who would be happy to provide that for you. But, like any relationship, it’s all about chemistry.
Dr. Gwenn
