My Healthy Child “Too Unhealthy” for Health Care?

Last Friday, when watching the video of the toddler who was denied health care for being "too skinny," I realized that in a set of similar circumstances, my child would end up with the same diagnosis.  Her pre-existing condition? 

A tireless energy and a love of fruit.

Even before she was born Violet was a ceaseless ball of energy.  Born full term at 8lbs 6 oz, that was the highest she ever made it on the percentages curve for weight, at 85% for a baby girl.  Once she was released from the confines of my belly, she began moving constantly, rolling over by four weeks, scooting by 3 months, crawling at 5 months, and cruising at 7.   She was walking by her first birthday, and two weeks later she figured out how to run.

One thing she was less enthused about was new food.  Like many children, she had a delicate gag reflex that made transitioning to solids a little slower.   As her activity level rose, and the rate of acceptance of new varieties of food slowed, her height continued to ride the curve, but her weight began to falter.  By the time we really hit finger foods, she was 14 months old and barely 18 lbs.

The doctors got worried and suggested testing.  It could be gastrointestinal, it could be a hernia, from about 9 months on I got a new theory at every weigh in.   But Violet always ate when she was hungry, only gagging when I’d try to give her extra food once she was full.   And as she was introduced to more food, she developed her own favorites.  She would eat bowls of fruit, munching down strawberries, pineapple, melon and cut grapes. She had a love of spinach I had never heard of in a toddler, in some cases eating it raw.   Some kids ask for cookies for snacks, when Violet saw a banana, she would cry until she could have it.  And although many children would ask their parents for juice, Violet was always a big fan of water, like Mama and Daddy drink, often drinking straight out of our cups.

By the time we brought her in for her 18 month checkup, she was nearly 3 feet tall, and 21lbs.  The doctor once more suggested we do testing.  Instead, we asked Violet to show him how she can hop (with both feet, of course).  Then she told him the alphabet, counted to 10, and named most of her body parts.  (Violet’s ABCs).

The doctor admitted that a child that was failing to thrive would not be able to do those things, and declared her totally fit.

As parents, we spend a lot of time worrying about our children and whether they will grow up to be healthy.  More and more attention is on the childhood obesity epidemic and the eventual health problems caused by it.   My healthy, active, and highly precious child loves fruits, vegetables, and water.  These are things we are supposed to encourage in our children, and instead, we are learning that thin, but otherwise healthy children are considered to be medically uninsurable.  My child is developing rapidly, strongly, and with good healthy lifestyle skills.  Thank god I already have insurance for her, because apparently now that is considered a pre-existing condition.

Does this make sense?

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  • laurakeet

    This is an amazing story, and I hope it will go far toward showing the health care system, and doctors individually, to pay attention to kids’ health indicators other than weight and height. You mention the childhood obesity epidemic – which is based on the same scale that called your daughter dangerously underweight. Are we really so sure that a healthy, happy 18-month-old should be judged by a line graph? Body Mass Index measurements that label children under- and overweight are relatively new, and in my mind not reliable indicators of health. Instead of focusing on whether children should gain or lose weight – after, of course, medical problems that could cause this have been eliminated – let’s focus on healthy behaviors that are good for all kids!

  • crowepps

    It’s very valuable from a public health standpoint to use statistical sampling methods to find indicators of POSSIBLE ill health. This allows the focus of medical intervention to skip over those who are probably okay and direct attention to those who may not be okay. That is not at all the same thing as diagnosing that someone who doesn’t fit the average profile isn’t healthy or won’t continue to be healthy.

    For one thing, before applying a statistical scale to any individual, it would be necessary to sort them into one of the three body types, ectomorph, endomorph or mesomorph. What would be under or overweight for one type might not be for another.

  • equalist

    I’ve never been a believer in the standard, one size fits all weight charts. According to these charts, at 5’10”, I should weigh around 150 lbs, but with my broad shoulders, and natural curves, at anything under 180, I look positively malnourished. At 145-150, I look like a death camp victim, all sharp bones and stretched skin. More important than weight is body type, and bone structure. Fortunately, I’ve seen a lot more doctors that seem to pay attention to this. Growing up, I was often told I was overweight, heavy, or showing signs of becoming obese. Even though for my body type, I was quite healthy, these phrasings had a devastating effect on my self esteem. Although it would be a different type of stereotyping involved, I still worry about these types of generalizations for my two young daughters, who are both around 95% for height and 15-25% for weight. Both are naturally petite in frame (they get it from their biological father, and their height from me) but fortunately I’ve found a pediatrician who can tell the difference between a healthy, active, slim child, and a malnourished or ill one.

    Equal rights, equal responsibilities.