pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Growing Up – When Did THAT Happen?

(I wrote this parenting article about growing up some years ago and have had fun realizing that now it seems even more true to me than it did back then)

You know, the mind is at once an amazing and complicated thing – and growing up doesn’t help.

Thank heavens we don’t remember everything, but once in a while in your adult life you are surprised by a memory that occurred so long ago you had completely forgotten about it. Things just seem to “sneak up” on you.

Such a thing occurred to me a short while ago while sewing up a laceration in my office.

I had just finished with the last suture and was taking a close look to see if everything had been aligned correctly when my nurse spoke to me. Looking toward her, I could see my own hands in a very close-up.

Instantaneously, I had a flashback to a time when as a child I was in my own pediatrician’s office and saw his hands in the very same close-up – he was holding on to me, giving me a shot!

From a child’s perspective I remember his hands looking very, very wrinkled and old… and now my hands seemed to look just the same!

It seems that when you are close to something you do not notice the change. Grandparents exclaim, “My he’s grown a foot,” and you realize “yes, indeed he has.”

Pediatricians are in a position to regularly point out some such changes to parents – sometimes in a very sensitive area. Let me point out a few:


A while back a mother of a fourteen-year-old boy brought him in with concerns of: “a sexual problem,” – she had whispered it to me in the hallway. She knew that he was maturing. But she was concerned that he had something which might be a problem because he kept “touching himself.”

Both she and his dad had noticed it; and, although neither had spoken about it to the boy, it seemed like it was getting worse. So, they felt that he might have a problem even if he wasn’t comfortable enough to talk to them about it, and perhaps he might bring it up with me – kids often do – pretty much because I usually just ask them directly.

I examined the boy and sensitively, yet straight-forwardly, asked questions concerning all aspects of maturational development. Using that approach, I found that he very matter-of-factly and without embarrassment, answered all the questions.

I found no issue with gender identification or maturational development. He had a normal physical examination without evidence of irritation from a hygiene problem or other causes.

Well what then was the cause?   He was wearing underwear which was three-year’s-ago size and much, much too small! He nearly couldn’t get them off.

As I explained the problem to his mother, I don’t know how to describe her reaction. She was accepting and relieved, but extremely embarrassed and seemed to take it very personally.

I don’t often find shorts that are so small that they cause this amount of concern; but, it is not infrequently that I notice it.

Other things can also be overlooked because the parent is so close to the situation.  For example:


showering hygeneApproximately 10 percent of children still wet the bed when they start first grade.

If this has been a regular occurrence, the family, and especially the child, usually will not notice the odor of urine unless it is very strong because they have become used to it.

The nice thing is, that if the child changes his clothes and bathes regularly in the morning, the odor is not present… and then he won’t be teased at school.


Before a parent may realize it, a child may become overweight. When a physician mentions it, occasionally the parent becomes extremely uneasy and defensive, indicating they really don’t know how it happened because the “child really doesn’t eat that much.”

Upon careful thought, however, the child may be found to be eating three or four meals himself, sampling some of his mother’s meals when she gets around to eating and then again having a portion of his father’s meals when he returns from work. Without realizing it, the child could be eating eight to ten times a day!

Bottle and Binky

And then there’s the baby with ear infections who isn’t off the bottle by 12 months; and the child with early dental malocclusion because of still being on a “binky” after 15 months.


Another area is personal hygiene.   I’ve had teachers tell me that some children have actually lost friends and become loners because they “stink”.

Sometimes the best thing a caring teacher or physician can do would be to point out that good hygiene requires bathing four to seven times a week for children; and, for teens and adults, every day – with the use of deodorants.


I’ll never forget an incident a teacher friend of mine pointed out about two sisters who went to her school.

The younger sister who had a speech impediment was in her class. During the year she noticed this child to always be dressed very ordinarily. However, her older sister, who was in a different class, was always found to be dressed in bright, pretty colors. Her hair was long and blonde and needed a lot of attention.

When the teacher tactfully talked to the mother about this difference during a parent/teacher conference, the mother began weeping and indicated that she had not really desired the last child. She said, however, that she had no conscious idea that she was treating them so differently.

To her credit, the mother took the observations very well and actually changed the way she treated the second child.

When the younger child began dressing more brightly, it was also noticed that her speech impediments began markedly improving.

Sometimes some of the most basic things can be so close to us that we fail to notice them.

Think about how you respond when your physician points out things that may be a little embarrassing.

Especially in the case of the teacher that I’ve mentioned, it takes someone who cares a great deal to point these things out, especially when the doctor or teacher may be afraid that it might be received badly.

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