Failing to Thrive

His eyes were sunken. His stomach shrinking. His ankles thinner than his wrists.  A month ago my second son, Ezra Haines Shappell, was diagnosed with a “failure to thrive.”

I’m nearly certain that 31-year-old me could be diagnosed with the same, but by God’s grace I don’t have a doctor. What “failing to thrive” means for an eight month old is that his weight dipped below the first percentile on the pediatric growth chart, then he didn’t grow for 3 months, and now specialized interventions were required. This diagnosis was the domino for a number of doctors’ appointments and the utterance of words like “endoscopy” and “anesthesia.” Queue parental panic.

I’m not sure if you are on the Facebooks, but it is a sandbox for parents showing off the healthy development of their child. When someone posts Jaxon’s ½ birthday picture and he just so happens to be eating fried chicken off the bone, that is a parental brag. When you read something like “Soeren had a great first day in his culinary class. Best crème brulee I’ve ever had from a one year old!” the parents are trying to tell you that their kid could kick your kid’s ass.

And for the last few months I have felt like most kids could kick my second son’s ass. Literally. Ezra is so small.

But small compared to what? I began to do a little research. The weight curve used by our pediatrician is from the CDC and is based on weight and height information from US born infants and their biological parents from the 60s and 70s. They didn’t have stuffed crust pizza in the 70s. The body has changed, people. Additionally, I discovered another growth chart from the World Health Organization that uses data from other nations and that chart is said to be more in line with a breast fed baby and is easier to translate to children who have lower birth weights (like my twin son, Ezra).

The point? As is most often the case, this official measurement is comparison cloaked in science. I was freaking out because of how my son compared to others.

But this isn’t just about my son. I compare myself to the societal mean all of the time. Am I alone? Size of house, dollars in checking account, number of followers, number of gigs booked, breadth of influence, weight, and proper puffy lip shape are just a couple that we as a society are regularly comparing. And as David Brooks so eloquently stated in his newest book The Road to Character,

“There are always other people who might do better. The most ruthlessly competitive person in the contest sets the standard that all else must meet or get left behind. Thus, everybody else has to be just as monomaniacally driven to success. One can never be secure.”

As long as the measurement of development is external and based on society’s markers, we will always be losing and never secure.  So how then can we measure development differently?

In order to measure development (broadly, not just for bambinos) differently we must see our development as a linked and dynamic process. Development of an infant, of a leader, or even an organization is a process full of ebbs and flows, regressions and retreats. Therefore, the process cannot be picked apart, singled out, and studied as if it is a machine. We are more than the sum of our parts.

When I compare an image of 6 month old Jaxon chowing down on his KFC to my sweet little Ezra gurgling up his breast milk, all I am thinking about is his weight. I am not noticing that Ezra is rolling like a tumbleweed or that he’s increasingly social and vocal. We all fall into this trap. If you say you’re a writer and you haven’t written anything in six months (raises hand, hangs head) then that is data to pay attention to.  But it is not the truth about you. You were likely developing life experiences that could become things to write about. If you are slow to marry compared to your peers, you are not unlovable. Your romantic muscles are developing at a different pace because perhaps you were developing your career. If your organization has not increased revenue this quarter, but the team is more together and you are enjoying the office more, perhaps this is a season for developing the unity required to grow revenue the rest of the year.

As Ezra’s other developmental markers were hit or exceeded what became clear is that while a child may excel in one area, they may need extra time, attention, and intention in another area. We are always becoming, developing into something. Our work is to name and celebrate what is growing, not to compare and lament what is not.

In addition to my myopic focus on Ezra’s skinny baby body, I also lost site of other factors that may have impacted Ezra’s weight gain. Sometime in December Ezra got a cold that stuck with him through March. When we went our first appointment with the Gastroenterologist she suggested that this cold was the cause of his weight dip. Ha! Those Stanford educated scientist expert people don’t know anything! Why would congestion, nasal drainage, or facial discomfort impact his ability to e….OMG. That’s what did it. He was less interested in eating because it was uncomfortable for him to do it.

And as we think about human development or maturity, we must understand that numerous factors can impact learning and growth. Your unreliable roommate may be affecting your performance at school or work. Your anxiety about work may be inhibiting your ability to develop intimacy with your partner. The weather may slow down the building of trust in a loved one. I didn’t automatically think that a runny nose would cause an infant to go from 50th percentile to dropping off the chart, but it did. The factors, both positive and negative, that influence our development are vast and are often less obvious then first thought.

His weigh in was this week. For my wife and I, the results held more drama than anything Paquio and Maywhether could muster. We undressed him. He felt the same. We sat him on the scale. He had gained weight! A lot of it. Triple what she had wanted him to gain. The GI told us we didn’t need to come in again. Apparently the second percentile is thriving-ish. And just like that, Ezra’s regression had turned to progression. The set back took a back seat.

A month ago doctors told Taryn and I to give Ezra more formula, put butter in his solids, and sneak him an extra bottle at night. I guess it worked. But I can’t help but wonder if in order to grow, Ezra’s parents needed a deeper understanding of the non-linear, mysterious, unpredictable dance of development so that we could be more secure parents.

And maybe that comparison-free security is the key to us all thriving a bit more.


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