Pre-growth Syndrome
Description of the normal, subjective experience of growth is largely marginalized
to internet forums and blogs where hundreds of observations reflect parental doc-
umentation of behaviors that accompany saltatory growth events. Within these
mediums, there has developed a commentary regarding“Pre-growth Syndrome”or
PGS: a phrase emerging for the discordant appearance of behavioral symptoms that
seem to accompany a growth spurt—a time when pants and shoes suddenly no
longerfit—seemingly overnight. The catchphrase PGS is an adaptation of pre-
menstrual syndrome (PMS) , a widely referenced expression for the subjective
experiences of many women (Rodin 1992 ) associated with the hormonal milieu and
neurophysiological circuitry associated with menstruation (Rapkin and Akopians
2012 ). While debate ensues over the reality of PMS (Shaughn O’Brien et al. 2007 ),
it is recognized with an ICD-9-CM diagnostic code and by pharmaceutical
approaches in randomized clinical trials (Yonkers et al. 2013 ). Like other condi-
tions that have arisen in an era of medicalization, PMS as a syndrome is defined to
encapsulate correlated signs and symptoms. The attribution of syndromic nomen-
clature to the seemingly erratic changes in children’s behaviors likewise reflects a
need to articulate and bring meaning to these common experiences.
While the reported phenotype of PGS is variable across public forums, several
popular magazines that garner the attention of parents describe that these bouts of
erratic behavior seem to last about 2–7 days and occur relatively predictably around
10 days, 3 weeks, 6 weeks, 3 months, and 6 months of age. The source for these
commentaries includes popularized versions (Ogden 2005 ) of the original saltatory
growth study (Lampl et al. 1992 ; Lampl 1995 ). While not entirely accurate accounts
of the scientific evidence, the PGS narratives are attempting to make meaning out of
the developmental stories that parents are experiencing. A survey of magazine
sources and internet-based parental reports reveals three primary behavioral phe-
notypes that surround growth events: (1) insatiable hunger despite frequent feeding,
(2) increased naps or duration of sleeping, and (3) inexplicable crankiness or
irritability.
Insatiable Hunger
I thought surely she can’t still be hungry, it’s only been ten minutes since I fed her last...Laments such as these are repeated frequently across public venues from parents.
The seemingly insatiable hunger that infants experience at sporadic intervals that
drives constant breastfeeding led the La Leche League decades ago to advise that
these feeding bursts were related to sudden“growth spurts” and required“cluster
feeding.”This breastfeeding advice has been essential in supporting many new
mothers through these experiences. More recently, parental concerns involve not
only the physical drain they experience in the growth-related, demanding long
56 M. Lampl et al.