Billy (to Fritz): You were right. The wine didn’t taste so good. But the bread…that was good.

It’s the Bread of Life, man.

Back in June, I took Billy to a pediatric endocrinologist and then to a pediatric gastroenterologist following his regular annual physical. He, and all my kids, are falling off the growth charts. At my request, I was also referred to a pediatric nutritionist, since I was (and still am) convinced that his biggest problem is not eating enough.

After those three appointments and a bone scan and some blood work (which had some low, but not too low, numbers for iron and growth hormone), I thought we were done. But no sooner had the gastroenterologist concluded that a wait-and-see approach with some follow up blood work to check on the anemia was the best tactic, when the endocrinologist called and insisted that we go to a pediatric endocrinologist out here after our move. Had we been staying in the area, the Walter Reed team would have been pressuring us to try to stimulate the growth hormone and do some other tests, including an MRI to check his pituitary gland.

It’s not that I don’t want to know for sure that everything is fine with my child, but I don’t feel that running every test available on a person, especially a child, who has all the appearances of being perfectly normal and healthy with no aches, complaints, vomiting or any other symptoms of illness, is a good idea. For a child, even a 7 year old, this might be somewhat traumatic. It certainly would be traumatic for me.

But I was happy with this referral, because there is no military pediatric endocrinologist in the area. We would have to go civilian. I think the doctors at Walter Reed are just fine, but they are a team. There is a group-think mentality. Oh, and did I mention that one of the doctors on the team was doing a study on smaller kids who have all the appearances of being normal and healthy? I don’t mind my kid being included in a study if he needs to have certain tests run anyway. But I do mind doctors drumming up potential problems in order to scare me into running tests which are actually unnecessary.

In July, I followed up on this referral, and the resultant appointment was yesterday – finally. I took growth charts, lab results, and family history along with all five kids and drove more than a half hour to the specialist. As I drove, I prayed for a happy ending to this saga, and I rehearsed my speech about how much my kid eats and how I’m being vigilant in making sure he gets enough calories every day.

At this point, Billy interrupts my thoughts to inform me that he forgot to eat breakfast.

Well, thank goodness he told me that before I claimed publicly to be a good mother, huh?

At the doctor’s office, on the line that asked for a reason for the appointment, I wrote that I was getting a second opinion. When I met the doctor, I explained that I felt the other endocrinologists were looking for problems where none existed.

“When most people want a second opinion, it’s because they think something is wrong but they’ve been told nothing is. You’re kind of doing the opposite…” he queried.

“Yes, I want you to tell me that my kid is fine,” I admitted.

And then he did.

Hallelujah.

He does want to do another bone scan in 6 months. And keep an eye on him. But, for now, he thinks he’s just a slow-grower. Like his dad. Like we’ve been saying all along.

And as for food and eating habits? Yes, scales are off from one place to another. But he weighed 39 pounds in May at the pediatrician’s office, and he weighed 43 pounds yesterday at this office.

And that’s without having had breakfast.

God has blessed me with healthy kids. Sure, we’ve had our medical adventures, and naturally the usual bumps and bruises, but even colds and stomach upsets pass through our house with only a temporary disruption and not everyone being affected.

God has also blessed me with skinny kids. I, like most moms I know, expend vast amounts of mental energy trying to think of ways to sneak more fruits and vegetables into my kids’ daily diet. Like most moms I know, I spend a generous amount of time thinking about and preparing snacks and meals that are balanced and more nutritious than the standard fare offered via kids’ meals or school cafeterias or the snack aisles at the grocery stores. A homemade muffin, even one from a package, has to be better than a store-bought muffin. Cookies are after-dinner desserts, not mid-afternoon snacks. My pumpkin bread may be loaded with sugar, but at least it’s not loaded with high fructose corn syrup. Candy is eaten at Easter, Christmas and Halloween fairly exclusively, although long trips may warrant lollipops and M&Ms. After years, I finally cracked and do buy frozen chicken nuggets which I reserve for quickie meals or ones where the grownups get steak. I occasionally make Kraft Mac N Cheese and my spaghetti sauce comes from a jar, but this is balanced by homemade pizza dough and rolls. There is almost always more than one vegetable served for dinner. Dessert is only for those who eat a sufficient amount of the food served. Popcorn is for movie nights. Chips and soda are for parties only.

I think I have a moderate approach to food. My goal has been to instill in my kids a healthy attitude toward food wherein they recognize certain foods as treats and other foods as necessary for good nutrition and select an appropriate quantity from each category. Over the years, I’ve read tons of articles on childhood obesity and what parents can do to avoid it. I’ve modified the ways I used to cook and types of food I make: I’ve withheld butter on vegetables I serve, used chicken breasts and shunned dark meat, baked instead of fried, broiled instead of sauteed, limited potatoes and rice and pasta, tried to encourage fish even if it was just fish sticks. I’ve allowed my children to indicate when they were full. I’ve simply not purchased certain foods (chips, candy, sugary drinks) and avoided fighting with my children over their consumption by not having them as an option most of the time.

I’ve done lots of things “right.”

But I’ve been wrong.

Because my skinny kids, and in the spotlight for the past month has been my son, Billy, are too skinny. This is not a problem that I have ever personally had to deal with. Once, maybe, I’d like to be too skinny. For a day, perhaps. I would much rather have to work at keeping some meat on my bones than work at keeping it off. And I’d much rather have too skinny kids, than ones who sneak into closets with fistfuls of candy. But still, I have the worry and concern that comes when doctors look at your kid with a critical eye and ponder what could be wrong with him.

Last month I took three of the kids for physicals, and although all are skinny, Billy is off the charts in height and weight – off the lower end, not the upper end. This led to a referral to an endocrinologist who ordered blood work, a urinalysis, and an x-ray of his hand to look at bone growth.

In between the pediatrician and the endocrinologist, I had thought long and hard about my son and his height and weight and the possible causes. My motherly analysis decided he just did not eat enough food. I recorded his caloric intake for a day, and it was under 800. But he was “full.” After the endocrinologist listed for me the tests she thought ought to be run, I asked her if seeing a pediatric nutritionist might not be a good idea, since I was pretty sure that he wasn’t eating enough food, and I desired guidance in what kinds of foods I should have him eat. She lauded me for being a pro-active mother, which I thought was bizarre, and put me in for a consult.

We had the blood work done, and while waiting for the results I managed to get to the pediatric nutritionist. I told her about my food philosophy described above, and she said that it was well and good for lots of families. But not mine. My kids don’t sit still at a desk all day long (I often wish they did). My kids don’t fend for themselves in the kitchen for snacks and even frequent meals. My kids don’t sit alone in front of the TV with a snack or their dinner. My kids don’t associate people and food – they play with little regard for eating (they eat with quite a bit of regard for playing instead). They don’t live from meal to meal, but from game to game. I must add that, quite to my complete embarrassment and annoyance, all five of my kids were in the exam room for this discussion and did everything they could do demonstrate just exactly how active and non-food focused they were.

The bottom line is that my kids now no longer get to decide that they are full. They get ice cream for dessert. They get chocolate Carnation Instant Breakfast heaped into their whole milk multiple times a day. They get Flintstones Complete vitamins which vaguely resemble candy, and I am very thankful that they have child-proof caps. They have to stop playing and sit down and eat their breakfast or lunch or snack until I say they can get up. We’re now eating chicken thighs instead of breasts, buttered vegetables and rice, and more pasta.

After the lab results came back, the endocrinologist called and said they indicated that Billy was healthy in every way, except for one: he was anemic. Possibly this was a result of diet, but possibly it meant something else. She put in a referral to a pediatric gastroenterologist. We went to see this GI doctor yesterday. Fortunately for Billy, he had gained a whole pound in two weeks, which comforted the doctor and added credence to my assertions that the child is simply underfed. Had he not gained any weight, she would have been completely baffled. The kid has all the outward appearance of being healthy, but his consistent drop from the 50th percentile in height and weight at age 2 to his less than 3rd percentile at age 7 is so “remarkable” that the experts seem strongly inclined to study his “case.” I have this strange feeling that Billy is the trick question on the final medical exam – only the “trick” is that he really is healthy and really just needs to eat more food, but the experts think there must be something more…the other answer is just too easy.

But since he has gained weight, mom’s tactic seems to be working, and maybe, just maybe, a wait and see approach would be best in this case. So, we’ll continue to stuff him up like Hansel at the witch’s house, and in four months or so, have his anemia and weight checked. That’s around the time the baby is due. Maybe we’ll all be able to back off on the ice cream by then. I know I’ll need to.

Billy asked me yesterday if this was the last time we’d be going to Walter Reed. I responded, “Just don’t do anything crazy, Billy. No dramatic events in the next two weeks, ok? And then, yes, hopefully, this will be our last time at Walter Reed.” God willing.