Microcephaly? | Imamother

amother

Babyblue

Thu, Jun 21 2018, 8:42 am

My daughter is 5 months old, and since her first month or two of life her head has measured very small. She has been in the 0.5 percentile in head circumference and has been growing along her own curve each month. She has also met all of her milestones so far (lifting herself up during tummy time, smiling, babbling/squealing, reaching and grasping for objects, etc.). The doctor said not to worry, but how can I not worry?? Supposedly anything below 3rd percentile is cause for concern, and she is well below that. Does anyone have any experience with this? Is there any chance that she will truly be ok, or should I expect her to fall behind at some point soon?

amother

Indigo

Thu, Jun 21 2018, 11:00 am

Where is her height and weight on the charts? If it is proportionate and she is meeting her milestones, she might just have a small head and that is all. My daughter also measured off the charts and was tested for microcephalies. But Bh results came out negative and she met her milestones. By 6 months she was seen by a top pediatric neurologist who told us not to bother making another appointment as she is totally fine. Bh I see this to be true.

rydys

Thu, Jun 21 2018, 2:59 pm

When evaluating a child's height, weight and head circumferences it is important to take into consideration not just the actual numbers but also the rate of growth as well as the family history including the parents and grandparents and the developmental milestones.

While a head circumference below the 3rd percentile is technically microcephaly that does not necessarily mean that the child will have any issues because of that. If the child is reaching milestones and developing normally otherwise and the rate of growth is normal I would be less concerned than a child with average head circumference whose rate of growth is slowing.

amother

Babyblue

Thu, Jun 21 2018, 3:29 pm

Thank you everyone! I'm located in Israel, and part of the concern I'm feeling is probably also due to my lack of familiarity with the medical system here and difficulty communicating with all of her care providers. My current pediatrician is already the second opinion that I sought out, and he seems to be one of the most highly respected doctors in our area. However, he's adopted the "let's wait and see" approach, which doesn't help a nervous mom like me!

She is in the 5th percentile for height, which was definitely reassuring in comparison to her head. Her weight percentile is much higher. We also recently had a head ultrasound done through the soft spot on her head which came back normal. So is that a good sign? What sort of referral should I be pushing for with the pediatrician?

amother

Babyblue

Thu, Jun 21 2018, 3:57 pm

The ultrasound lasted two minutes and the report afterwards just said something vague like “the tissue and structures are normal.” I had figured they would have provided measurements, but that wasn’t part of the report. But BH we were so, so incredibly thankful for the positive report that we did receive!

I’m not sure if you’re familiar with Israel’s medical system, but we have repeatedly been requested to make special appointments with the Tipat Chalav nurses to monitor her head growth on a monthly basis. Every month it (obviously) measures small, just as it did the month before, and every month the nurses express concern. So I was just hoping to maybe hear from other moms who have experience with this and who can guide me, so that each month when I continue to hear concern from the nurses, I can at least feel good about knowing that we have done whatever should have reasonably been done to check for anything wrong. And to provide me with hope that our precious baby won’t suddenly fall behind developmentally or lose her already acquired skills, as I have read online about microcephaly.

amother

Scarlet

Thu, Jun 21 2018, 4:07 pm

Number one IGNORE TIPAT CHALAV! they are not doctors. I have eight kids and I have NEVER gone there without being told : too fat, too thin, too tall, too short, too advanced (!), too behind, head too big, head growing too fast, head growing too slow or my favorite - strap him in his crib so he shouldn't sit before he crawls (how is he supposed to crawl if he is strapped?)

Get yourself a good english speaking pediatrician. Which kupat cholim are you and wehre do you live?
I take my babies to the pediatrician at 6 weeks for a check up and follow that. When tipat chalav want their doctor to check, I say no thank you he has already seen my doctor and finished.

If after the pediatrician has checked you are still nervous, tell the pediatrican that you want to follow this up! but it sounds like you have done what you need to do.

amother

Babyblue

Thu, Jun 21 2018, 4:15 pm

Thank you for that!! It’s so funny how advanced Israel is yet how old-fashioned their nurses’ mentality is. But that made me feel better Smile

I am happy with her pediatrician, and thankfully he also speaks perfect English. As long as he’s not glaringly missing an additional screening that I should be asking for, then I’ll just continue to daven and love on our beautiful baby. Heart

amother

Scarlet

Thu, Jun 21 2018, 4:26 pm

when my second child was sixth months the dr in tipat chalav gave me EIGHT referrals for him. I didn't know what to do at all so I went to my dr with them. He laughed until he almost cried. Then he told me to just let the child be.

They wanted me to check his hip joints, his hearing, his kidneys because his ears are not symmetrical, I don't remember off hand what else. bH today he is almost bar mitzva and live and kicking (kicking hard! LOL

)

I have discovered over the years that no experienced israeli mother takes tipat chalav seriously. Only us chutznikim!

Go to tipat chalav for his shots and just make sure that your dr sees him once every couple of months and that whenever you are by the dr, he measures the head as well.

tweety1

Thu, Jun 21 2018, 4:28 pm

tweety1 wrote:

If she had an ultrasound done and it came back normal what else do you want??
your worries should be thrown out the window and enjoy your little Precious bundle

Reading my post now I see that it may sound a little harsh. Read it with a compassionate tone plz. I meant to say that an ultrasound is advanced testing enough for you to rule out microcephaly ch"v.

amother

Babyblue

Thu, Jun 21 2018, 4:38 pm

Thank you for the compassion and reassurance!

(I didn’t mention the other referrals they gave me for hip concerns and high muscle tone. So far I’ve chosen to not be concerned about those, as we additionally had a hip ultrasound done and she’s been cleared for the next year.)

I’ve been learning that motherhood comes along with lots of concerns that we can either dwell on or choose to move past! So now I just need to move past this one until the next one comes along LOL

amother

Cerulean

Fri, Jun 22 2018, 11:08 am

If your child is small to begin with percentile wise for height, that is reassuring. My daughter's doctor actually measured my head and my husband's head to see if ours were smaller than average too (they were slightly, but not as much as dd's. DD did not have microcephaly in the end). So ask for that as well. If one or both of you has an unusually small head, then it is most likely from that. If you don't though, it doesn't mean anything.

Also, once you have had an ultrasound, the only follow up test they can do for you is an MRI - which has to be done with anesthesia for a child or baby. This really isn't recommended unless it is necessary and there are clear indicators that it is needed (of which you don't seem to have).

As long as your child is continually growing on the same curve and developing normally, and the brain ultrasound came back normal, it is probably nothing. That being said, you can
push for further evaluation - ask for a referral to a pediatric neurologist. Note that it can take 4 months to get an appt here is Israel. If your doctor won't give you a referral, you can see doctors in some of the hospitals without a referral and hitchayvut (agreement from the health fund to pay) for a flat rate of 100 or 200 shekels (at least in shaarei tsedek and hadassah, but call and make sure).

amother

Babyblue

Fri, Jun 22 2018, 12:05 pm

Thank you so much! Our pediatrician did have us measure our head circumferences, and they were both average. Other than doing an MRI, which sounds unnecessary at this point, would a neurologist do anything else? Or would getting a referral right now just jump-start the waiting process if we do need an MRI between now and ~4 months from now?

Thank you for your help--all of that info was very reassuring and informative!!

amother

Cerulean

Sat, Jun 23 2018, 2:11 pm

I would make an appt with a neurologist as a just in case - if you do need it, you don't want to wait 4 months! But it will also be good for your peace of mind to go and find out things are ok and cross it off your list. The neurologist may do a more comprehensive physical exam (dd saw 3 different ones, they did extensive testing of her reflexes and other developmental things, much more than the pediatrician), and they also have an eye for what is and is not a problem based on more extensive experience with neurological issues (dd had one really unusual symptom as a very little baby, and our pediatrician who had been practicing for well over 30 years in both America and Israel had never seen it. The neurologist had seen a handful of cases of the symptom and diagnosed it in just a few minutes - turned out it was nothing).

Just a useful thing to know, from our pediatrician - if you ever need to see a neurologist quickly (I.e., in case of loss of skills, or seizures, or something else equally alarming), get a referral from your pediatrician to go to the children's emergency room - you'll see a neurologist the day you go in (and I recommend Shaare Tsedek highly for this, if you are in the Jerusalem area).

As for the high muscle tone, I strongly recommend you get a referral for PT at hitpatchut hayeled (child development centers). Push hard for this from your doctor if you don't have it already - the earlier they help this, the better! Hitpatchut hayeled also has pediatric neurologists, and you will probably be able see one much sooner there than you would elsewhere if you are already in the system doing PT. We love hitpatchut hayeled (dd had low muscle tone. They have been amazing). It can also take a few weeks to actually get things started there once you submit the paperwork, so now is always a great time to start the process.