Tuesday, February 10, 2009


I can almost count on one hand the times that parents have actually listened to me when I've recommended something that is not a "quick fix." I'm not talking about turning around the car seat when they turn 1 year old and weigh 20 lbs. I'm not talking about switching from formula to whole milk, or not feeding infants and small kids honey. I'm talking about the tough stuff, that requires some significant commitment.

I remember the Dad in my residency who quit smoking when I told him that the risk of SIDS goes up 7 times when a baby is around a parent or caregiver who smokes (even if it's not inside the house). I remember the parents who I mentioned earlier, who stopped babying their 3 year old when I told them they were holding him back. And from this week on, I will always remember my darling D. and her courageous parents.

They don't speak very much English, and are incredibly patient with me as I muddle through with my Spanish. Last time I saw D, her height was 25% and her weight was over the 95%-- she was off the charts. I know their culture is such that chubby is preferable to skinny, and so I try to take that into account, but this was really too much. I advised them that her weight was a real concern-- hard on her bones, hard on her health, hard to start out overweight as a child and change it as an adult. They seemed to understand, but I always wonder how much translates-- they're a jovial couple and always smile and nod when I talk to them.

This week D was my first appointment of the day, and as I walked into the room I skimmed her growth charts, and was stopped in my tracks. Her weight had dropped to the 85%, even lost weight by a pound. I was stunned! I went in with the hugest smile on my face, and couldn't contain my joy. I even got teary-eyed as I told them how proud of all of them I was. They had made some changes in her diet ("red" milk to 2%, less fat, fewer packaged snack foods), and kept her active. She looked so wonderful-- she got three stickers from me, I was so happy.

It made my day-- my week, really. To have a patient begin to be more healthy, make better choices, because of something I said-- that's a huge compliment. It's an even bigger responsibility, and I don't take it lightly.

No comments: