DS is way off the bottom of the height charts. Should I be concerned?

[minkajane]

DS will be 6 in January. He is 40 inches high, which puts him way off the bottom of the height charts. He weighs 40 pounds, which according to BMI calculators means he's overweight, but the kid doesn't have an ounce of fat on him. He's all muscle. He's been tiny from the start, but until the past year and a half or so, he's always stayed right around the 3-5%. He's been wearing 3T clothes for two years. They were a bit long at first and they're just now starting to get a bit short. But if I put him in 4T pants, they are really long and usually slip down off his skinny butt when he walks.

He is not the greatest eater, but he tends to alternate the non-eating days with a day or two of never-stop-eating so it tends to even out. He looks perfectly healthy, rarely gets sick, and has a ton of energy, so I don't feel like he's not getting adequate nutrition. At what point should I start to think about getting him checked for some sort of growth disorder? His dad and I aren't tall people, but we're not terribly short either - I'm 5'3" and he's 5'10". Would it be a good idea to get him evaluated?

ETA: I re-measured him today and he's actually about 41 inches, so he's not as far off the charts as I thought, but he's still just off the bottom of the chart.

[deditus]

I think I would be concerned at this point and pursue some noninvasive or minimally invasive testing first. Maybe a bone age scan and some bloodwork. I am not alarmist about size at all, I have a very petite dd. But petite at 4 yo and 39" doesn't freak me out too bad except feeling a little weird when people think she's 3. I think 40" at almost 6 yo would be starting to freak me out.

[phathui5]

My short 7yo dd is about 35 pounds. She's always been small, and I've always encouraged her to eat as much as she wants, not limiting fats or protein foods.

We did do some bloodwork when she was 18 months, and nothing popped up as being off.

[minkajane]

He did get checked for cystic fibrosis when he was 8 months old (negative) and they also drew blood, but I'm not sure what else they checked for. He had a leveling out of his growth and the ped was a bit concerned. He turned out to be fine and I never heard of anything abnormal on the bloodwork. But I don't know if there could be something that wouldn't show up or develop until later.

[mazajo]

Some kids are just little. If he seems completely healthy otherwise, I wouldn't worry about it. My oldest DS was always below the bottom of the charts. I can't recall exact height/weight off the top of my head, but I know he was always wearing clothes at least two sizes behind his age, and his kindergarten class photo shows that he's an entire head shorter than everybody else. He's 18 now and 5'4, and he's also US Marine.

[amcal]

Have you discussed your concerns with your ped? Does you DS have regular checkups? For me, I would be very concerned if my 6 yo were wearing 3T clothing. That seems very small to me. He may just be small but, I absolutely would be discussing this with a pediatrician to ensure it's nothing more than that.

[PrincessWinnie]

It might be nothing, he could just be a small guy. But some testing might at least alleviate your concerns and let you know if there is something going on or not. My cousin's son is 13 and is the size of a 7/8 year old. My 6-year old is going to lap their son in height if he doesn't have a growth spurt soon. He has plateaued on his height for YEARS and my cousin and his wife have started some testing on him. Even though they are not sure if they would actually *do* anything about it it helps them know for sure if there is something wrong or if he's just going to be a small kid. However for now it does cause some stress because he gets teased at school and he's essentially wearing the same size clothes as his 8-year old brother.

[nextcommercial]

It's worth starting to check into. I don't think I would just ignore it. Maybe ask at his next appt. Also, do your own research first. But, I wouldn't rush in either. Just learn what you can, and get some knowledge for the future. (in case you need it)

Our neighbor boy is 11, and he's shorter than his six year old sister, but he's stout...not an ounce of fat on him either, he just has a strong sturdy body.

But, he's very, short. He is going to start growth hormone shots (if he hasn't already) He'll have to take them every day. But, he really, really wants this.

Even WITH the growth hormone, they don't think he'll grow any taller than 5ft or 5'.2. without the growth hormone, he will be well below five feet.

[eclipse]

I've been sort of wondering the same thing. My 5 year old (boy) is about 9 months younger than your son, but is just under 40 inches. He also has some 3T pants that still fit him. He likes his shirts baggy, so he wears 4s and 5s, but he wouldn't look like he was in too small clothes in most 3T shirts. He also wore the same clothes for years. I finally had to get more because the old ones were wearing out! I mostly got 4s in pants but they need elastic waists or adjustable waists to stay up and most need to be cuffed at the bottom. I worry, too, because my older two children are tall - my 7 year old is generally off the charts for height and my 9 year old used to be too, though he has slowed down and is probably around the 75th percentile. I'm short, but dh is 6ft3. Doctors have not been concerned so far, but it's been over a year since he's been to the doctor. Considering that my oldest son was 40 inches before his third birthday (and Dd was pushing 40 inches around her 2nd birthday), it does make me wonder a bit. But BIL (dh's brother) was always a small child and he's a perfectly normal grown man, though a bit on the short side, especially when standing next to his brother!

[minkajane]

We're definitely going to be getting him checked out. Just waiting to see if we qualify for Medicaid, since it will probably be a decent cost if we have to pay out-of-pocket. I honestly don't know if I'd want to give him growth hormones or not if it turned out to be something, I'd definitely have to do some research of side effects and long-term issues and talk to DS about it. Here's hoping it's nothing and he's going to have a growth spurt soon!

[northwoods1995]

My son recently turned 7 and he is 43 inches and below the chart. He sounds very similar to your son with regards to eating habits and he is very energetic, etc. DH and I are average height (5'10" and 5'4"). I'm not sure what is going on. We have a new Dr but he hasn't seen her yet...I'm wondering if she has a differing opinion from our old Dr (who didn't recommend testing or anything). I'm really starting to wonder if there is more going on. I wish he'd catch up some more.

[Tjej]

It could be a thyroid issue.

Not saying it is, but there was a boy in my family who didn't grow and didn't grow and once he was checked for thryoid function and got on meds he get growing.

Tjej

[provocativa]

other than thyroid, could also be food allergies, which don't usually show up on tests. i was always tiny, now i'm 5'2" and intolerant to wheat and casein. the problem with allopathic tests for food allergies and sensitivities is that a blood test tests for certain circulating antibodies, but much of the action of the allergy is in the gut. so i don't know if i test positive on the gliaden test- common one for wheat- but i am definitely allergic to it- i get a rash, and heartburn. you can check out the allergy forum here for more info. anything that bothers the gut can cause malabsorbtion of nutrients, and then short stature. also, thyroid function can be lowered by food sensitivities-

[Cascadian]

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Edited by Cascadian - 6/2/11 at 8:42pm

[Island Mommy]

Cascadian, I'd be interested in what you hear. My dd on her 7th birthday was 44.5" tall and weighed about 42 lbs. She'll be 8 in 3 months and is now 46.5" tall and 45 lbs. She's the smallest of all her peers although there is a girl in grade 3 who is about the same height.

I'm almost 5'5" and DH is about 5'10" so we're not on the tall side. Interestingly, I was looking around at a party the other night and noting the huge range in heights amongst the adults. Women as short as 5'1" up to men as tall as 6"6". That's a huge range when you think about it and yet we're concerned when our children are more than a couple of inches different in height from their peers.

DH also says that he was always the smallest kid in his class all the way through until grade 11 when he finally grew so I keep that in mind too.

Of course, if their growth rate slows or they're really, really falling behind their peers then one should of course look into it. I was heartened yesterday to see that DD has grown as much in 9 months this year as she grew in the full year before that but it's something I think about a lot.

On a side note, one of my close friends stoops a bit and she says it's a left over habit from her childhood when she was the tallest girl in her class all through elementary school. She says she towered over everyone. Then one day, she stopped growing (as well all do). At the impressive height of 5'2".

[tylerdylan]

My DS was tiny too. He was diagnosed with Constitutional Growth Delay when he was 3. Kids with this grow slower than average kids, but at age 18 when other kids stop growing these kids will continue to grow. As adults they are normal height, they just don't catch up till adulthood. Diagnosis can be confirmed with an x-ray of the wrist to show the growth plates around age 5, before this it is not accurate to assess the bones this way.

In the end my DS had a slow growing brain tumour which he has now been treated for and he is still catching up in height and is now a normal weight. I can tell you that my DS was SEVERE failure thrive (20 pounds at age 3.5 when he was correctly diagnosed). He was so thin that he was literally a walking skeleton. He was sick ALL the time. He didn't eat. He was always tired and worn out. It was very obvious that something was very wrong with him (even though the doctors kept writing everything off as fine). From the sounds of it, your DS sounds like he is probably just going to be small and that's it.

[minkajane]

Originally Posted by tylerdylan

In the end my DS had a slow growing brain tumour which he has now been treated for and he is still catching up in height and is now a normal weight. I can tell you that my DS was SEVERE failure thrive (20 pounds at age 3.5 when he was correctly diagnosed). He was so thin that he was literally a walking skeleton. He was sick ALL the time. He didn't eat. He was always tired and worn out. It was very obvious that something was very wrong with him (even though the doctors kept writing everything off as fine). From the sounds of it, your DS sounds like he is probably just going to be small and that's it.

Let's hope that's all it is. I can tell you that DS is definitely NOT showing symptoms like your DS. He's slender, but muscular and has a ton of energy. I can't remember the last time he was sick. He's an incredibly healthy kid, and all it seems is that he's on the short side. I figure better safe than sorry, just in case it's a growth hormone deficiency or a thyroid disorder.

[mizliz72]

What does your ped say? Do you have shortness in your family or your husband's? Maybe he will be a little kid and then one day BAM! start growing more.

I'm 4'9" or so. My mom is shorter than I am thanks to an aging spine, but I don't think she was ever taller than I am now. My dad was only 5'7" on a good day. My sisters and I weren't even on the growth charts. Our PED said as long as we were growing, not to worry. Granted, looking at who we came from, there was no real reason for worry. My SD has always been very thin. It's hard to find pants that fit unless they have the adjustable eleastic in the waist. But she's growing and healthy. She's actually one of the tallest kids in her class (not just one of the tallest girls). SO is 6' tall. Her birth mother was about 5'4". She's almost 7 and stands about 4' tall and weighs about 50 lbs. I keep saying that I was that size in 7th grade. Seriously, I wore a size 7 in 7th grade and I remember weighing 55 lbs in 8th grade.

[Alison's Mom]

hi there, see my thread on a similar topic http://www.mothering.com/discussions...910&highlight= i got some interesting responses. fwiw, dd has grown about 3 inches since we went off soy at the end of march. i have nothing to compare this with, but it seems not bad.