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will pass. Science, however, has a more critical view. Some pediatric advisors state


their opinion that, while“‘growing pains’are the commonest musculoskeletal


problem of children and the phrase is an accepted medical term, the pains are not


due to growing”(Manners 1999 ). A more evidence-based approach is taken by


others who note that the etiology of the“growing pain”experience is unknown and


have proffered views relating causality to low pain thresholds,fibromyalgia, restless


leg syndrome, reduced bone strength, and overuse pain, as well as emotional factors


involving the child’s family and social stress—all with the clinical assurance that


the syndrome self-resolves with time (Friedland et al. 2005 ; Lowe and Hashkes


2008 ; Walters 2002 ; Oberklaid et al. 1997 ). As in many situations where limitations


in current medical knowledge lead to diagnostic dilemmas, clinical reframing of a


lived experience tofit known causal pathways and/or a denial by medical authority


of the reality of an individual’s experience is not uncommon. The lack of definitive


support for growing pains at the present time is not surprising given the rare data


documenting saltatory growth events and the difficulty with objectively measuring


the hallmark symptom, pain. It is difficult to envision what a convincing body of


evidence might look like. Nonetheless, given the commonality of the narratives,


seeking a way forward so that the experience is both acknowledged and managed


appropriately is recognized as clinically important (Evans 2008 ).


All parents want to support their children’s growth, health, and well-being. How do
they actualize this? Ethnographic work conducted among American mothers by


Reifsnider et al. ( 2000 ) aimed to document parental concepts of normal growth and


captured a range of maternal concerns over the healthy growth of their children.


Mothers’explanatory models (Kleinman 1980 ) for appropriate child size and growth


patterns reflected attention to medicalized approaches focused on nutritional recom-


mendations and eating behaviors, as well as the ubiquitous application of clinical


growth monitoring. Mothers attended to pediatric reports of their child’s normality in


terms of size and worried about the potential for growth problems arising from illness


and heredity. On an everyday level, they described wanting to help their child grow by


providing foods that are“right”or healthy, and expressed attention to clothing size and


relativefit as indicators of their children’s growth in real time (Reifsnider et al. 2000 ).


Parents rely on medical authority to help them interface with their children’s


biological needs. There is presently a scientific gap in the medical model of normal


growth. There is little pediatric acknowledgment of growth spurts, and this void


inhibits parents from acquiring information that would be helpful in interpreting


their children’s experience. The reality of saltatory growth events corresponds to


the everyday language overheard among parents at the playground, who relate to


one another with statements such as,“he shot up overnight”and“her pants were


long enough yesterday.”The lack of correspondence between the smooth lines on


growth charts, the traditional biomarkers summarizing growth, and parents’actual


experience watching the quick bursts of length accrual, all likely contribute to


confusion about what healthy growth truly means. This is exacerbated by the lived


experience of both physical“growing pains”and by outbursts that erupt suddenly in


daily behaviors—irritability and tantrums that are coincident with“pants no longer
fitting.”


4 The Lived Experience of Growing 55

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