three year old check-up

Yesterday Hannah had her three year old check-up. She has always been very tearful when she has a doctor's appointment. I talked to her a lot this week about going to the doctor. We practiced saying her doctor's name and picked out some artwork on the refrigerator to bring to give to her. I talked about how Hannah was going to be measured to see how big she is, and that the doctor would look in her ears and in her eyes and listen to her back and tummy. Great plan, right? I thought so, and was looking forward to seeing how this would go over.

Well, she froze up and got clingy as soon as we got to the office. Hannah cried and refused to stand next to a growth chart and step on the scale. Watching Mommy do it and being offered the reward of a sticker didn't work. Our pediatrician did a great job in showing the "flashlight" on her otoscope and let Hannah press her finger to it. She even looked into the ears on Hannah's Woody tattoo to show that it wouldn't hurt. Sigh. Lots of screaming and tears, as usual.

At 37 months Hannah is 34.5 inches tall and weighs 22 pounds 12 ounces. Hannah was deemed on target developmentally and had no speech or motor delays. This is just what a family that has graduated from First Steps early intervention wants to hear! Yay!

We talked a lot about how Hannah is very reserved in new social situations, and often takes a half an hour to warm up to a new environment. She's not fearful of the environment, but takes some time to feel comfortable enough to talk and participate. In the opinion our pediatrician, there's nothing wrong with that. It's just Hannah's little personality. She talks about enjoying her social situations like story time at the library and toddler classes by requesting, "I go back," even if she didn't talk every much during the experience.

Bringing the pediatrician one of her works of art was a great way to get Hannah to open up and start talking during the appointment. She gave the doctor a Chinese New Year sticker scene with lanterns, dragons, golden coins, and lion dancers and told the doctor about what was on the paper.

The pediatrician plotted this year's growth on an American chart and decided to keep using her adjusted age. Hannah's still hanging out below the 10th percentile for height and we're still way off the chart for weight, but Hannah's following her own little curve down there that's just right for her.

When I went home I got out my scans of a Taiwanese growth chart to see how plots of Hannah's two and three year old measurements compare between the charts. On the Taiwanese chart she's just barely off the chart for weight. Very interesting to see how much these plots differentiate between the two charts.

Figure 1: US growth chart for girls. Black plots are age adjusted. Blue plots from two and three year old appointments are not age adjusted for prematurity.



Figure 2: Taiwanese height chart for girls. Black plots are age adjusted for prematurity and blue plots are at the actual age.



Figure 3: Taiwanese weight chart for girls. Black plots are age adjusted for prematurity and blue plots are at the actual age.



When we were walking out of the building after Hannah's appointment, Hannah was walking on her own holding my hand. All on her own she said, "I scared." I stopped and got down on her level. "You were scared at the doctor's office?" "Yes." "Are you scared now?" "No. All done."

I had a check-up for myself that afternoon. "Hannah, do you want to go to Mommy's doctor appointment today with Mommy? Mommy is going to be measured, too. It's not for Hannah, it's for Mommy." "Yes, I go too!" Hannah went with me with me to my checkup and was well behaved for a three year old entertaining herself with an iphone. When I was on the exam table and the physician's assistant was listening to my lungs and looking in my ears, Hannah asked over and over "What are you doing?" I think it was a good experience for her to see that Mommy has to do this too, it doesn't hurt, and I wasn't scared.