A modern lifestyle brand redefining motherhood
Print Friendly and PDF

Around their second birthdays, four to eight percent of American children previously identified as healthy are classified as underweight. What affliction is overtaking these children? Growth charts.


Obviously, the growth charts themselves aren’t responsible for children’s ill health (and, in fact, most of those children aren’t in ill health). But our systems for measuring children, often understood differently by physicians and parents, affect how we define health.

Standard versus reference

The first nationwide growth charts, developed by the National Center for Health Statistics (NCHS) in 1977, were based on one of the world’s longest running longitudinal studies at the time, the Fels Longitudinal Study. The study, which began in 1930, measured children, and eventually, those children’s children, grandchildren, and great-grandchildren.

The NCHS 1977 growth charts, based on nearly 50 years of data from the Fels study, provided a good, if imperfect, picture of childhood growth. For example, children studied during those decades were more likely to be formula fed, which made their first-year weight gains somewhat higher than comparable breastfed infants. Because of its location in Yellow Springs, Ohio, the Fels study enrolled mostly white, middle-class children, who were not representative of the U.S. population as a whole. In 2000, the CDC released revised charts based on nationwide data.

FEATURED VIDEO

The CDC charts were not intended to be a standard all babies needed to meet, but rather a reference for physicians to monitor growth, because slow growth was understood to be a risk factor for health problems like cystic fibrosis or celiac disease. Once these charts were shared with parents who wanted more information about how their children were growing, the charts gradually became viewed as standards.

The World Health Organization, recognizing this shift toward standardization, decided that if people were going to treat the growth charts as standards, growth charts should be based on the healthiest possible kids. To create a chart that described infant growth under “optimal conditions,” the WHO gathered data about infants born in six cities around the world chosen for their high socio-economic status, breastfeeding, and other factors. Because the WHO charts more accurately reflect the U.S.’s current population of breastfed infants, the CDC and other organizations recommend the WHO charts for children aged zero to 24 months.

Shrinking children

Those newly underweight children at the top of this article are not suddenly falling ill at age two. Instead, many American two-year-olds are switching growth charts. Because they are based off of different populations, the WHO and CDC growth charts have slightly different growth curves.

When children are switched from the WHO growth chart to the CDC growth chart, they have a tendency to shrink. For example, at two years of age, a boy weighing 12kg falls at right about the 50th percentile of the WHO’s growth chart. That same boy, measured on the CDC’s growth chart, would fall closer to the 25th percentile.

The WHO and CDC charts are substantially different for children at the bottom of the curve. While the WHO chart categories under three percent of children aged six to 23 months as low weight for age, the CDC chart identifies seven to 11 percent of children as low weight for age.

Children also lose an average of about a centimeter when switching from the WHO charts to the CDC charts, not because of international differences in height, but because one chart is based on length (measured while laying down) and the other is based on height (measured while standing up).

American pediatricians, likely recognizing the potential for panic over all those shrinking two-year-olds, have developed a few workarounds when shifting from one set of growth charts to another. Many pediatricians provide parents with charts that plot their children’s height and weight over the period of multiple visits, showing a clearer progression from visit to visit.

Others shift from the WHO chart to the CDC’s birth-to-age-three chart. Still others provide additional charts (weight-for-length and BMI, for example), so that parents have a more complete picture of their children’s growth.

Is bigger better

Children on the other side of the growth curve present a different sort of interpretive problem. Percentiles merely describe how a child compares in relation to other children his or her age, but those percentiles are often interpreted as value judgments. A 2007 study in Pediatrics asked parents to interpret growth charts and found that parent-respondents were more likely to interpret a child measuring in the 90th percentile as “normal” weight than a child measuring in the 10th percentile.

It’s hardly surprising, then, that parents seem to be aiming for the higher percentiles. In a study published in JAMA Pediatrics, researchers found that parents of toddlers are remarkably poor at identifying their children’s body size: 70 percent of mothers interviewed for the study inaccurately gauged their child’s size. Parents of overweight toddlers were the worst estimators of their children’s weight, often identifying their children as being of “normal” weight.

The authors attribute this difference to the cultural perception that heavier kids are a sign of good parenting. Growth charts, which depict weight in terms of increasing percentiles, might be helping support the parental notion that bigger is better.

Charts in context

One answer to the interpretive problems presented by growth charts has been to make more growth charts for different subgroups. Some charts are better for weighing very low birth weight children. A Children’s HealthWatch study concludes that, because breastfeeding and other socio-economic factors make such an impact on the shape of growth curves, pediatricians should be cautious of using the WHO standards when evaluating low-income populations.

Any growth chart brings with it the same kinds of interpretive problems that lead us to think small is bad and big is good. It’s not unusual that, once given growth charts, both parents and physicians would come to use them as standards instead of references.

The history of anthropometry – the study of measurements of the human body – is full of examples of body measurements being used as standards, as it was throughout our darker periods of slavery and eugenics. Growth charts have, since their origin, become a tool for measuring people against one another, a source of comparison and competition.

T.J. Cole argues that a growth chart, as a graphic design, is a “road to health” trajectory that we imagine our children have to follow. Many parents receive printed copies of their child’s growth charts during visits to the pediatrician. It’s hard not to view the string of dots as a form of progress – or, depending on the results of the weigh-in, failure.

Perhaps we could develop a new design. Instead of receiving a growth chart at each visit, imagine instead receiving a punch-out paper doll, scaled according to your child’s most recent height and weight measurements. Imagine taking that doll home and adding it to the growing collection on your wall. Is the doll bigger, but proportional to the doll from the last visit? Did the doll shrink from last time? Is it widening? Is it elongating?

Your growing gallery might help you understand trends in your child’s growth without resorting to comparisons.

Who said motherhood doesn't come with a manual?

Subscribe to get inspiration and super helpful ideas to rock your #momlife. Motherhood looks amazing on you.

Already a subscriber? Log in here.

I honestly can't remember how I used to organize and share baby photos before I started using FamilyAlbum. (What am I saying? I could never keep all those pictures organized!) Like most mamas, I often found myself with a smartphone full of photos and videos I didn't know what to do with. My husband and I live states away from our respective families, and we worried about the safety of posting our children's photos on other platforms.

Then we found FamilyAlbum.

FamilyAlbum is the only family-first photo sharing app that safely files photos and videos by date taken in easy-to-navigate digital albums. From documenting a pregnancy to capturing the magical moments of childhood, the app makes sharing memories with your family simple and safe. And it provides free, unlimited storage—meaning you can snap and snap and snap to your heart's delight without ever being forced to choose which close-up of your newborn's tiny little nose you want to keep.

Try FamilyAlbum for Free

And, truly, the app is a much-needed solution for mamas with out-of-state family. Parents can share all their favorite memories with friends and relatives safely within the app without worrying about spamming acquaintances with every adorable baby yawn the way you might on a social network or a long text thread. (Did I mention I have a thing for baby yawn videos? I regret nothing 😍) It's safe because your album is only visible to the people you share it with. The app will even notify album members when new photos have been posted so they can comment on their favorite moments and we can preserve their reactions forever. It's also easy for my husband and I to share our photos and videos. All of our memories are organized in one place, and we never have to miss out on seeing each other's best shots.

And because #mombrain is real, I especially appreciate how much work FamilyAlbum takes off my plate. From automatically organizing photos and videos by month and labeling them by age (so I can skip doing the math in my head to figure out if my daughter was five or six months when she started sitting up) to remembering what I upload and preventing me from uploading the same photo four times, the app makes it easy to keep all my memories tidy—even when life feels anything but.

FamilyAlbum will quickly become your family's solution for sharing moments, like when you're sending a video to the grandma across the country. Grandparents need only tap open the app to get a peek into what is going on with our girls every day. When my sister sends her nieces a present, the app has become where I can share photos and video of the girls opening their gifts so she never feels like she's missing a thing. The app will even automatically create paper photo books of your favorite shots that you can purchase every month so you can hold on to the memories forever (or to share with the great-grandma who has trouble with her smartphone 😉). Plus, you can update the books with favorite photos or create your own from scratch. No matter what, the app keeps your photos and videos safe, even if your phone is lost or damaged.

But what I love most about FamilyAlbum is that it's family-first. Unlike other photo sharing platforms, it was designed with mamas (and their relatives!) in mind, creating a safe, simple space to share our favorite moments with our favorite people. And that not only helps us keep in touch—it helps us all feel a little bit closer.

Download FamilyAlbum Now


This year marks FamilyAlbum's 4th anniversary! Click here to celebrate and learn more about their "Share your #FamilyAlbumTime" special promotion running until March 31, 2019.

No pregnancy and birth are exactly the same. Each of us has a unique story, and so do our babies. As Hilary Duff proves, a mother's second birth story isn't a just a rerun of her first.

Motherhood changes people, and for Duff welcoming her second child, daughter Banks, at age 31 was a very different experience than birthing her son, Luka, when she was 24.

Luka was born in a hospital, while Banks was born at home, and Duff recently shared a video of that amazing day on Instagram.

Sharing this video clip isn't the first time Duff has opened up about her home birth. In a two-part interview for the Informed Pregnancy podcast released last fall, Duff admitted that at some points in her home birth she was scared and asked herself why she wasn't in a hospital "with all the drugs," but she says she's so glad she did it this way and would totally do it again.

During her first pregnancy, Duff says she started out wanting an elective C-section (although she did not end up having surgery). She was 23 when she and ex-husband Mike Comrie found out they were expecting, and she didn't have a lot of peers who were having kids. She was really scared.

FEATURED VIDEO

More than five years later, during her pregnancy with Banks, Duff was way more confident as a woman and a mom. She watched Ricki Lake's 2008 documentary "The Business of Being Born" and started considering a different kind of birth plan the second time around.

"I'm older now. I love motherhood more than anything—I never thought I would be this way, I never thought I could be so happy and so fulfilled. It's not easy, because being a parent is not easy, but it's just a joy. And I thought to myself that I want to like fully get the full experience of what it is like to bring a baby into the world," Duff tells the host of Informed Pregnancy, prenatal chiropractor, childbirth educator and labor doula Dr. Elliot Berlin.

Having support from Matt, Haylie and her mom

When Duff brought the idea up with her partner, Matthew Koma, he "was amazing," she explains. He had some questions, but was down to support Duff in her birthing choices.

Duff says she thinks her mom Susan and sister Haylie were "nervous to think about not being in a hospital" at first, but once Duff explained things a bit and got to talk to them about her doula and midwives, Haylie got really pumped about the idea.

"She was so supportive and amazing. I think my mom was a little more worried but she got behind me," Duff recalls, adding that because her mom had C-sections herself, even seeing Duff deliver Luka vaginally in a hospital was a bit of a different experience for her, so being there for the home birth was taking things to an unfamiliar level.

"The first time she saw me having a contraction in the house she was cooking bacon for Luka," Duff explains, adding that she had to pause the conversation she was having and squat down during the contraction.

With the family around and the TV on, Duff's labor progressed a little slower than she'd imagined.

"When I pictured my birth I didn't picture watching Guardians of the Galaxy on TV. Luka was like explaining the characters to me," she explains.

The birth

Duff says when she was moved to the birthing tub, her brain really let her body take over. After the birth she estimated she was in the tub for about 30 minutes, but Koma told her it was really more like 90. "My brain disconnected," she says. "I remember telling myself that I don't need to be here for all of this."

At one point, she looked at one of her midwives and said, 'I'm really scared right now." Exhausted and unable to hold her body up as she channeled all her energy into pushing, Duff let her team hold her legs and arms while she pushed.

When Banks' head emerged, it didn't feel quite like the birth videos Duff has seen.

"Honestly, when I got her head out I was shocked by the feelings," she told Dr. Berlin. "I've seen women reach down and pull their baby out, and I couldn't do that…I was like, okay I'm there, I'm there, I've got to finish this job, but it was like really intense. It wasn't pleasant at that point. I think I wasn't fully in my headspace, my body was doing what it needed to do. It wasn't until her body came out that I could like want to grab onto her and bring her up out of the water."

Baby Banks needed some breaths from a midwife when she was first pulled from the water, but because her son Luka was also born looking a little blue, Duff says she wasn't freaked out. Once she figured out how to breathe, little Banks did "the most amazing thing," her mama recalls.

"They hand her to me, and I'm looking at her—and you know, babies are like floppy little worms, they just don't have any control—and she reaches up both of her arms right at my neck as to give me a hug. It was so clearly a hug."

Duff says the hug made her feel like baby Banks was saying something: "Like, good [teamwork] mom, we did it."

To hear the whole interview, check out the Informed Pregnancy podcast.

[This article was originally published November 14, 2018. It has been updated.]

You might also like:

Several years ago, when I was a high school teacher and not a mom, my ninth grade students took a values assessment in class. The point was to determine what motivated them in life: money, family, success, a moral compass, education, relationships, religion, care for the environment, etc. I thought, what the heck, I'll take it, too.

When I got the results, I was shocked.

My number one value was beauty. Not family or morality, not relationships or religion. Beauty. I had never felt so shallow in my entire life. The description said something to the effect of: "You need to be in a place that is aesthetically pleasing to feel at peace," and went onto say that I would value the arts more than others and prioritize making a space beautiful.

And the truth is: It was absolutely 100% accurate.

Before I became a mom, I spent a lot of time beautifying our space. I would tidy up a pile of books, vacuum streaks into the carpet several days a week. I couldn't stand the sight of piles of dishes on the counter, nor a pile of clothes on the floor. I would change decor seasonally. I would cut fresh flowers and put them around the house, light candles, dim lights, put on quiet music when company came. It wasn't completely because I was trying to impress—it was because I liked it that way.

FEATURED VIDEO

And then came kids.

Every pile of books I've tidied has been pulled onto the floor. The vacuum chokes down crumbs and bits of paper maybe once a week. For three years straight, I've had a breakdown on Christmas-decorating day. We pick fresh flowers together, but I somehow always forget to notice when their vibrant petals turn to spindly black stalks. Now, when company comes, my children greet them with big grins in dirty clothes, and I yell from my kitchen, complete with stacks of unclean dishes, "Sorry, my house is a wreck!"

I had to choose, as we all have to: Do I prioritize housekeeping or parenting?

I remember trying to lay my son down as a newborn. I expected him to sleep peacefully in his woodland-themed room, the room I had put together with great care. But moments after I would fill the sink with sudsy water, I'd hear him cry. I'd run upstairs and pick him up, soothe him to sleep, and lay him back down, only to have it happen again. I felt anxious.What about the dishes? What about the 100 other things on my to-do list?

But when I looked down at that little face, and I saw the most beautiful thing I'd yet to encounter. My values system didn't entirely shift, but my perception did.

This morning, as I sit in the warm morning glow, my baby girl is asleep on my chest. I can see the sunlight dancing across the floor, illuminating the dust and crumbs. From my vantage point, I see little lopsided piles of laundry on my dining room table that is still doubling as a fort for my toddler. And beyond the dining room is the kitchen, and in that kitchen is a sink filled with unclean dishes. The dishes will always be there.

But my baby, with rose-petal lips and a perfect fan of lashes, with skin as flawless as a cloudless sky, she won't be this small ever again.

My house is a mess, but it's a beautiful mess andI wouldn't have it any other way.

Originally posted on With Quiet Hands.

You might also like:

My dear daughters,
Tomorrow I go back to work, and it's going to be really hard. All I can do is hope that it's harder for me than it is for you. Twelve weeks have come and gone faster than I could've imagined. I thought that going back to work after my second child would be easier, but I actually think it might be harder.

Baby Girl #2, not only have I enjoyed your newborn snuggles every day but Baby Girl #1, I've had special time with you that I'd been missing so much. Because this is my second child, I realize even more how quickly this time goes by—and that I'll never get back these sweet moments.

Tomorrow I go back to work, and I keep thinking about all of the things that people say to me to try to make it better.

People say you'll look up to me and learn to value hard work.

People say it'll be nice to have time away and that it will make our time together more special.

People say that most moms need to work nowadays.

People say you won't remember this and that you'll be fine while I'm away.

Maybe those things are true, but it doesn't make it any easier. Of course, I want you to look up to me and to see the passion and love I have for my job, but I hope you never feel like I'm choosing my job over you.

FEATURED VIDEO

As a high school assistant principal, I have 600 other "kids" that I get to take care of, and I love that, but I worry about what I'll lose, what I'll miss out on while I'm away from you. Could your dad I and I make it work on one income? Maybe. But that would come at costs, too.

Tomorrow I go back to work, and I realize I'm luckier than most.

I'm lucky that because of his shift you'll get to spend a few days during the week with your dad and get to have special time with him. I'm lucky that he's such a wonderful father and partner who is supportive of my career.

I'm lucky to have a daycare provider that I trust. I'm lucky to have family members who help out whenever needed.

I'm lucky that I love my job and work at a school where you're not only allowed to come in but where my boss and co-workers love you, too and understand that family comes first.

You are both blessed to have so many people who care about you, so I know that when I can't be with you, you are well taken care of, but I still wish it could be me.

Tomorrow I go back to work, and there are a few things I want to promise you.

I want to promise you that for the time we do get to spend together, you will have my attention. I will do my best to turn work off, put my phone down and focus on you two. We will find fun things to do or we will just relax in our jammies and watch movies. But whatever we decide to do during our time together, I will do my best to be present. You both deserve that.

Tomorrow I go back to work, and I keep hoping that by the time you have children, if you choose, that our country realizes that 12 weeks just isn't enough.

I'm sorry that I can't have more time with you, but please know that in our time apart, I'm loving you still. Please know that I'm working hard to provide for you. Please know that when I come home, I will take off all of my other hats and just be Mama because no matter what, that will always be my number one job.

Love,
Mama

You might also like:

We hear a lot about the wage gap between men and women in the workplace, but the wage gap between mothers and fathers is even wider. Women make just over 80 cents for every dollar a man makes, but if we look at the paychecks of parents only, the gulf widens.

According to the National Women's Law Center (NWLC) analysis of U.S, Census data, mothers only make about 71 cents to a dad's dollar, resulting in a loss of $16,000 in earnings annually.

This, despite the fact that millennial women are getting college degrees at higher rates than men, proving that we can't educate ourselves out of the motherhood penalty.

"Families depend on women's incomes, yet mothers, regardless of their education level, their age, where they live, or their occupation, are paid less than fathers. When mothers are shortchanged, children suffer and poverty rises. Families are counting on us to close the maternal wage gap," says Emily Martin, NWLC General Counsel and Vice President for Education and Workplace Justice.

Why the motherhood penalty (and fatherhood bonus) exist

The gap in the pay between mothers and fathers is due to how parents are perceived in our culture. A 2007 study published in the American Journal of Sociology found working mothers are penalized in the form of "lower perceived competence and commitment, higher professional expectations, lower likelihood of hiring and promotion, and lower recommended salaries."

FEATURED VIDEO

And as CNBC reports, a more recent study by childcare provider Bright Horizons found that 41% of American workers perceive working moms as being less devoted to their careers.

But becoming a dad doesn't put dads at a disadvantage, or make them appear less committed. It actually often results in a so-called "fatherhood bonus." A recent study published in the journal Work, Employment and Society, found having kids often results in men earning more, even when they aren't particularly hard workers.

According to the study's lead author, Sylvia Fuller, this suggests that our preconceived cultural ideas about fatherhood are impacting employers thinking and parents' paychecks. "They think dads are working hard, they have positive stereotypes about them, or maybe they just think, you know, dads deserve more because they're thinking of their family responsibilities," Fuller told Global News.

Moms are still the default parent

While parenthood dulls a woman's CV, it gives fathers' a shine because mothers are still seen as the default parent in our culture. Not only do men make more after becoming dads, but researchers have also found that men's leisure time increased after parenthood, while mothers see their workload at home increase. And because the wider society knows that women carry heavier loads at home and spend more work more hours doing unpaid labor, employers see us as distracted by our other responsibilities.

Basically, employers see fathers as people who have big-picture responsibilities to their families and a lot of support in raising their kids. They see moms as the managers of the small stuff and know that many of us don't have a lot of support in managing that load.

Closing the gap by changing the way we view fathers

We can't close this gap by only changing the way employers think about mothers. We also have to change the way our society thinks about dads. Today's dads want to be more involved in their children's lives and have pretty egalitarian beliefs about dividing household responsibilities between partners, but many find they can't live up to those beliefs. Most fathers in America can't take paternity leave and those that have the option of doing so only take about a third of what is available for fear of being seen as uncommitted.

"Fathers repeatedly tell researchers they want to be more involved parents, yet public policy and social institutions often prevent them from being the dads they want to be – hurting moms, dads and children alike," writes Kevin Shafer, an associate professor of sociology at Brigham Young University.

An investment needs to be made

That extra $16,000 that mothers are missing isn't going to come without investment from society. The United States is the only member country of the Organization for Economic Cooperation and Development (OECD) without paid parental leave and also spends less on early childhood education than most other developed countries.

Investing in paid family leave and affordable, quality childcare would level the playing field for mothers, but that's just the first part of change that needs to happen. We need employers and lawmakers to implement parental leave policies, but we also need our peers to embrace and encourage their use for all parents.

When fathers are expected and respected as caregivers, mothers are no longer seen as the default parent at home or at work. When the parenting responsibilities equalize, so will the paychecks.

Pay inequality happens all over the world, but the country that has come the closest to closing the gap, Iceland, the majority of fathers take parental leave. That isn't a coincidence, it's a recipe for change.

You might also like:


Motherly provides information of a general nature and is designed for educational purposes only. This site does not provide medical advice, diagnosis or treatment.Your use of the site indicates your agreement to be bound by our  Terms of Use and Privacy Policy. Information on our advertising guidelines can be found here.