I know I have told you about this before, but I have experienced a lot of flat lines recently. No, not a flat line on the cardiac monitor (someone will have to teach me how to use those again when I return to the states); but a flat line on growth curves. This sort of flat line should cause most pediatricians a lot of anxiety. From day one we have been taught that children grow. From intern year we learn the ins and outs of navigating the growth curve, and quickly develop buzzers and flashing lights that go off in our heads when we see problems with the curve. Failing to thrive often demands a large evaluation to discover the cause.
Here in Swaziland I have seen multiple flat growth curves in the course of just a few days. In fact, I have seen multiple upside down growth curves where the child even lost weight. Now, my work-up consist of a few things. An HIV test, a chest x-ray, if I’m lucky, to look for TB, and extensive feeding counseling. I have educated mothers to relactate. I have asked families if they have a goat or a cow (anemia takes the back burner when we’re just looking for any sort of food) in order to make baby “formula” with milk water and sugar. And I have told HIV positive women who are trying to scrape by with formula that the benefits of breast feeding (its free and nutritious) outweigh the risks of breastfeeding (contracting HIV). While I take a deep breath as I tell these HIV positive women to expose their infant to HIV, I also have seen the devastating effects of malnutrition. All of this is to make these children grow, to give them even a chance at life.
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3 comments:
hi steph, i am just catching up on your blog posts. so amazing. this one is a great reminder as i sit down on thanksgiving for dinner how blessed i am. we miss you here and are thinking you often. thanks for continuing to share your words and pictures.
love, julia (sorry, am posting as "aunt julia" because i am usually posting on grant's page)!
I'm echoing Julia... reading your post about flat growth curves reminds me once again how very lucky I am, how lucky my children are. Tessa was always a skinny baby, and she still is long and lean, but she always grew steadily, and has always been healthy. Still, there is something about Calder's rolls and rolls of chub (he's consistently been in the 90% for weight - and only 50% for height!) that inspires such absolute JOY in me. I just love his fat little legs and his pudgy belly and round head. Yes, he's adorable, but there must be some evolutionary explanation there too, because as you said, children SHOULD grow. Thanks for helping those little ones in Swaziland have a shot at what we take for granted... They are lucky to have you.
Holy cow Stephanie! I just found you out here in bloggy land and am so glad to see what you are up to. I am so proud of you making a difference in these children's lives. My own girls have never had a "failure to thrive" issue. We are so blessed and fortunate to live where we do and have the access to the resources and healthcare that we do. Thank you for making a difference in the lives of these children and their mothers. My hat is off to you and I am so proud. You are a hero and a role model for all of us! Love, MaryLea
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