Claire's 9 Month Check Up

Today was Claire's regularly scheduled well-child pediatrician visit (for 9 months old). Since Kyle had to work I had my mom come to be a second set of ears because I had a lot of questions.

She weighs 19 lbs 5 oz (65th percentile) and is 28.25 inches long (75th percentile). But her head circumference was 16.25 inches, which is less than the 3rd percentile. In fact, when I looked up a chart online it came in at 1.2%. This was pretty alarming to me. Here is how her head measurements have gone over time:

Birth: 5%
2 Months: 10%
4 Months: 25%
6 Months: 5%
9 Months: 1.2%

For those of you unfamiliar with percentiles for growth, saying she is at 5% (for example) means that only 5% of children have smaller head circumferences. So at this point, only 1.2% of 9 month old children have smaller head circumferences than she does.

A measurement in and of itself is not always the most important thing. It is more important to remain at a consistent growth pattern. I am more concerned because it seems her head is not growing proportionally with the rest of her body. But 1.2% alone is scary to me anyway.

Her pediatrician asked whether we had followed up on her referral (to Dr. Mesa) and I told her the whole story to this point. She is very interested to hear what we learn next week. She was familiar with both local surgeons and told me she thought both were very good. I shared with her our opinions and preference for Dr. Phoenix and she was glad to hear my feedback since she said she sends a lot of patients to Dr. Mesa. Oh, and for good measure she also called Claire a Klingon again. Actually, she said, "She looks like that Star Trek character." It seems to my mom and me that she just doesn't get that it could be taken offensively. Several of you reading this have expressed horror that she had said that last time. Honestly, I really like her as a pediatrician and the fact that she is even aware of this condition is rare among pediatricians. I guess that is just her personality and I really don't think she means any offense by it. It is annoying though.

She also felt Claire's soft spot and seemed concerned that it was smaller than she would expect (the size of a fingertip). When I asked her if that was abnormal she simply said, "I think she will need the surgery."

Thank goodness we have our appointments next week. We really need to have our full set of opinions and get to making our decision. Waiting is killing me.

Another thing I should mention about the head size that I don't remember if I have already written here.... we asked Dr. Phoenix about her head size and it's failure to follow a normal growth curve. He said that with craniosynostosis that because the head grows abnormally that circumference size doesn't necessarily give you an accurate idea of head volume. Her head is probably growing taller than it should due to the restrictions so it's possible the circumference is deceptively small. In other words, if you were to compare head volumes for children rather than circumference she probably would not be so far behind. Obviously circumference is just a convenient way to get an idea of head size. Nonetheless, I think the change in growth pattern indicates that her head is growing more improperly than you may guess by looking at her.

Lastly, we also discussed milestones with the doctor. She asked if she could sit up unassisted and mom and I laughed. She could take her first steps any day now. She stands unassisted! Anyway, we spent more time on language since that is my major concern. She confirmed that it is really too early yet to know anything. You wouldn't expect any words yet and she asked if Claire does 'mamamama' and 'dadadada', which she does. She also demonstrated for the doctor the way she angrily uses a 'buhbuhbuh' sound when she is mad! She asked if Claire has her own opinions. Boy, does she!

I guess that is all for now. I'm sure I'll post after her appointment on Monday. As always, thanks for reading and for all of your support.