Small Packages


The other morning, as we hurried to get out the door for school, I attempted to brush the morass that is my fourth- grader’s hair. Ethan tensed and bristled in that way that only 9-year-old boys can. He rolled his eyes dramatically.

“Why do I need to brush my hair?” he asked, aggrieved.

“Because you need to look nice for school,” I answered straightforwardly.

“But I thought it doesn’t matter what you look like on the outside. You always say it only matters what you look like on the inside,” he complained.

Well, touché, my boy. Touché.

I paused for a moment to think how best to explain the distinction. But secretly I was thrilled to know that he had absorbed the lesson we’ve been so pointed in conveying about the insignificance of external appearance.

That’s because Ethan has always been unusually small. He was born a little bit early, weighing just shy of 6 pounds, due to a somewhat mysterious condition called IUGR, or intrauterine growth restriction. Getting him to grow during his first few years was torturous. I held my breath at every weigh-in and familiarized myself with every weight gain trick in the book. One handout from his doctor’s office read like some sort of diet parody. “Never eat vegetables plain!” it warns ominously. “Add butter, margarine, cream sauce, hollandaise, cheese sauce, salad dressings, sour cream and mayonnaise.” (Not all at once, I hope.)

“Plain crackers should have cream cheese, cheese spread, peanut butter, jelly or margarine to increase calories,” it goes on. It recommends canned fruit in heavy syrup over fresh. And my personal favorite, “Choose meats breaded, fried and sauteed in oil or butter.” (Well, who wouldn’t?) There’s also a recipe for a chocolate peanut butter milkshake that has—I kid you not—1,070 calories a cup. And that’s seen as a good thing.

But I was unprepared to learn that having a small child carries an unspoken stigma in Momville. On the parenting message board I used to frequent, it was standard practice to return from well visits and post your baby’s “stats.” And though few might admit it out loud, ironically, in a culture where thinness is obsessively prized by adults, when it comes to babies, bigger is most definitely seen as better. “Isabella is in the 95th percentile for weight AGAIN,” a mother would crow. Those damned percentiles felt like scores, as if a baby in the 90th percentile for weight was somehow being given a higher grade than one in the 30th. The mothers of babies who were “only” in the 50th percentile or less often posted nervously about what could be wrong with their children. It was hard not to feel defensive, or make self-mocking jokes about our featherweights. My son finally hit 20 pounds at his two-year well check. “Is there such a thing as a 20-pound 2-year old?” I asked the pediatrician, only half kidding.

I know where this comes from, of course. In the beginning, when they bring so little else to the table, our babies’ size can feel like the only tangible, measurable manifestation of the quality of our parenting. Those who grow big and, well, fat, are clearly doing fine, their plump bodies a physical emblem that all is well. And those like Ethan? Their charts are stamped with the gloomy “failure to thrive” label, with all the implications therein.

I watched with great interest, as both a mother and a journalist who’s written about science and health, as the doctors walked the fine line between “He’s just small” and “There’s something amiss.” We tried desperately not to intervene unless it was truly warranted. But one test led to another and another. Poor little—literally!—Ethan was poked and prodded and schlepped to myriad doctors, one all the way in Philadelphia. At 14 months, after an endoscopy suggested he might have a rare form of food allergy, Ethan was put on a so-called “elemental” diet. For two months, he wasn’t allowed to eat or drink anything—nothing—but a foul smelling prescription formula. We propped him in his high chair that Thanksgiving with books and toys, hoping he might not notice the feast he couldn’t take part in.

For one horrific week I have mostly blocked out of my memory, he had a feeding tube in his nose. Until a doctor at Hopkins, one of the most respected pediatric allergists in the country, stopped the madness. He was certain Ethan had been misdiagnosed. “There are only so many ways you can torture an essentially healthy child,” the doctor told us in his measured, reassuring tones. “Let him eat.”

So in our case, it was all a bad dream. Though doctors still monitor his growth carefully, Ethan is perfectly healthy. He doesn’t have food allergies. He’s not growth hormone deficient. He’s just very small and thin. Like lots of kids. Like lots of adults. It’s nothing for us to be ashamed of. Or apologize for. Or feel the need to explain defensively to random strangers who ask about it. (“Oh my!” said a well-meaning mother at the pool, eyeing my two boys, who are almost exactly three years apart but very close in size. “You sure had them close together, didn’t you?” Well, no. I didn’t, actually. Not at all.)

There’s nothing wrong with Ethan. The vessel my amazing, precious son came in is just…small. Not bad. Or diminished. Or lesser. He’s anything but failing to thrive in the things that matter.

Saccharine aphorisms are hardly my strong suit, but there is one I repeat over and over, like a mantra. When it comes to Ethan, I always say, we like to focus on the things about him that are big: his heart and his brain.

I’m so relieved to know that despite all the noise of daily living, the multiple lessons we try to impart about everything from morality to dental health to playing fair, that he really has gotten the message that his size doesn’t matter. Although I’m not going to back down on its corollary: He still needs to brush his hair.

Jennifer Mendelsohn lives in Mount Washington with her husband and their two boys. Her work has appeared inThe New York Times, People, Slate and,USA Weekend. She also serves as one of Us Weekly’s Fashion Police “Top Cops.”

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