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Small, slow-growing kids -- any advice?

post #1 of 22
Thread Starter 
I am asking this in the general parents' forum so that I can get some perspective from parents who've been through this AND who might be going through it right now. Mods, please let me know if you'd rather I x-post it in the age forums...

My DD2 is three years old now and is below the 3rd percentile in weight and height (23.75 pounds and 32.5 inches). She's had some health problems that interfered with her ability to eat well, but in the last five months, that has improved greatly and she has put on a lot of weight (3.5 pounds -- only half a pound in the 7 months before that!). Before then, she was in something like the 5th percentile for height and below the charts for weight; now she is proportionate.

The biggest problem is that she has only added two inches of height in the last year, dropping her height percentile. Her pediatrician says that two inches is the cutoff for endocrine study, so she would probably be dismissed by an endocrinologist anyway, but if she'd grown less than 2 inches, that would be a cause for concern. The fact that she's at the very lowest end of normal bothers me only because we were told, over and over, that she'd "catch up" after her other health problems resolved. That hasn't really happened.

My questions for you all, especially those of you who've been through this sort of thing, are:

1. If you had a child that grew slowly like this, did s/he eventually have a big growth spurt? If so, when was that?

2. In my situation, how many of you out there would go to an endocrinologist right now anyway? If she has a hormonal problem, is it at all helpful to "catch" it early? The pediatrician recommended waiting one more year.

TIA, everyone. I'm kind of a worried mama right now.:
post #2 of 22
My DS was below the 3rd percentile for height and weight at birth. His weight came up but he stayed very short for a very long time -- tracking right below the 3rd percentile line.

He did have significant medical issues (silent reflux to the degree that it damaged his lungs via aspiration, and he needed a feeding tube) and they told me that the issue was either that he wasn't taking in enough calories, or that he wasn't oxygenating well. However even after his breathing was under good control, he was definitely getting more than enough calories (via tube) and he was off the oral steroids that often delay growth, his height stayed below the 3rd. At 2 his doctor told me that he'd probably be there forever and predicted an adult height of 5'1". He said it wasn't due to his medication issues and was probably genetics (he's adopted) and that undoubtedly it ran in his family.

At around 4 he took a break from his inhaled steroids (which are not supposed to cause growth suppression) over the summer and in one summer went from 3rd to 25th. He then went back on them and slipped down to like 10th. The next summer he took another break and went from 10th to 30th.

This pattern has continued -- we started taking a second break in the winter (his bigger asthma triggers are leaf mold in the fall and grass pollen in the spring) and he started having 2 growth spurts a year instead of one. The doctors tell me this is a coincidence, that the steroids have not impact on his growth.

He's now able to get by on a much lower dose of inhaled steroids. He's 9 and 95th percentile for weight (we're working on that ) and between 75th and 95th for height.

I don't know how helpful that is to you, or whether the medical issues you've had are similar, but I thought I'd tell you our story.
post #3 of 22
My youngest was not on the charts until she was 3. She is 6 now & 43lbs, only 2lbs lighter than her 7yo sister. She started catching up last year when she entered kindergarten. I don't know why but she did. She's still small & is the 2nd smallest in her class.

The only testing we had done on her was at 9months to look for anemia(she wasn't). She was sent to a ped at 12months & he labelled her FTT but never tested anything, his solution was for me to stop bf'ing asap & put fat in everything she ate(I did neither).
post #4 of 22
How is she developing? Any regression?

How's her health otherwise?
post #5 of 22
I have a 33lb 5 year old and I'm not concerned.

-Vijay
post #6 of 22
My dd is 29 months, and weighs about 24lbs and is 33 inches. She, too, is below the charts. She has no health problems, and is has amazing motor skills. Her language has suddenly blossomed to constant sentences, so I have not been too concerned. She has a WIC check up next month, so we will see then if she has grown any this summer.

I dont know anything about endocrine tests, but I do think you should trust your instincts. If you are that concerned, I would say get the test. At least that way you will know one way or the other.
post #7 of 22
Forgot to say that at 24 months she was 22lbs.

-Vijay
post #8 of 22
normally, i woudl not freak about size, but you mention an eating problem..you say it is resolved, but i'm wondering if the time during which she had the problem caused a possible nutrient deficiency...do you have access to a doc who would be willing to do a nutritional evaluation, to see if there is any glaring issue? And I'd maybe check the simple stuff...no need to see an endo for just a simple thyroid test, and that might tell you something..
all in all, i probably wouldnt worry.....are you giving good nutritious food and whole food vitamin supplements? What sizes are other family members...might she just be small?
post #9 of 22
A link to a tribe you might find helpful.

http://www.mothering.com/discussions...716&highlight=

My DS hit the growth "skids" between 1 and 2. Before that he was growing quickly and was a chubby baby. More than tripled his birth weight which was average at birth. (7.1lb)

When he leveled off rather abruptly the doc's were concerned but I really wasn't. I'm small (5'2" 115lbs) as is my entire family. DH's family is on the taller side, but very slim. DS who is 6 foot, was about 139lbs when I met him (he didn't start bulking up--to a whopping 150--until his mid-30's). For me, it just meant that DS started to level off, become more in keeping with the stature of his parents. The doc's wanted to do a blood work up just in case and I went ahead, just to rule out anything, ya know? All was fine.

DS is still small. He is 7 1/2, 3'10" and 45.5 lbs. At present he seems to be lining up with my side of the family for height and DH for weight. He is just in a size 6 now and his feet are between 13 toddler/1 youth.

He's healthy, active (both physically and mentally) and while he hates to take time to eat, he will eat when he's hungry and eats a decent variety of healthy foods. Typically, he'll eat very little for a day or so and then "strap on the feed bag" for a day or so. I've come to trust this process, but in truth, I do at times get a bit pushy about him eating enough.

I hope this helps.

The best,
Em

Edited to correct typo on DH's weight (from 19 to 139). WHOOPES! Now 19lbs would have REALLY been something!
post #10 of 22
Thread Starter 
Kind mamas, thank you for your encouraging and helpful responses!

DD2's feeding problems were related to a structural problem with her esophagus (as it turns out, it was squeezed almost shut in the middle by an extra arm of her aorta -- which is now removed). She also had trouble swallowing and breathing simultaneously due to huge adenoids, which were removed in March. That's when she started eating really well and heartily, and when she started putting on weight. The remaining food issues are mild reflux treated by prescription antacids, and esophageal dysmotility that resulted from her esophagus being squeezed while it was growing and developing (basically, sometimes it doesn't move food down in a coordinated way, and DD2 will suddenly sit up very straight while eating, crane her neck sideways, and ask for a drink). None of these things seem to have much effect on nutrient absorption that I know of, but I'm curious if anyone knows differently or has varying mileage on either issue.

We eat a pretty balanced vegetarian diet around here. She and her sister eat dairy and eggs -- sometimes not every day, but certainly every other day -- and lots of fruit and veggies and good fats like olive oil and seeds and beans, whole grains, etc. I've never given DD2 a vitamin, but plan on starting this winter. I would call her diet balanced and healthy, but her pediatrician gave me some gentle suggestions that vegetarians are known to be about an inch shorter on average. I said I wasn't worried about one inch in the span of her whole lifetime -- that's not worth worrying about for me. I don't really think adding meat is the solution.

As for the rest of us, I am pretty short -- about 5'1" -- and so is my mom. DH is absolutely average for a guy -- 5'9" -- and DD1 is smack dab in the 50th percentile. However, even my bitty little 5'1" is still around the 10th percentile, not 3rd percentile or littler like DD2.

I think we've decided to wait another 6 months and see how she does. If she grows an inch or more in the next 6 months, we'll forget about it. If she doesn't grow at least that much, we'll look into the thyroid panels and hormone levels, etc. I hate to get started with yet ANOTHER specialist whose job it is to find problems, you know?

Thanks, everyone -- and if anything jumps out at you, please do share. We missed her extra aortic arch for a year because doctors kept saying her health problems were colic or floppy larynx tissue or bad colds. I don't want to miss something else.

ETA: Developmentally, DD2 is totally on track. She's active and energetic and smart, and has always met all the milestones. The only one she hasn't met is "pedals her own tricycle" -- because she can't reach the pedals!
post #11 of 22
Quote:
Originally Posted by fiddledebi View Post
The only one she hasn't met is "pedals her own tricycle" -- because she can't reach the pedals!
Hahaha. Either can my little girl.
post #12 of 22
All three of my kids are on the smaller side. Some of it is genetics, I'm 5"3" and my mom is only 4'11. As long as my kids are on the chart, even if it's at the 3rd percentile I don't really worry about it. It's when they drop off the chart that I start to get more concerned and have looked into possible reasons.

Both of my boys have done this with their weight and have seen a ped GI. My 7 yo is still not quite back onto the chart, but is now just under the 3rd percentile for weight. He's had lots of testing that has come back negative, but also has feeding issues due to SPD. I also got concerned about his height when he didn't grow at all in height in 6 months. We saw an endo and everything turned out to be fine. At 7 he is 39 lbs. and 45 in., at three he was 23 lbs. and 35 in. just to give you an idea of how skinny he was.
post #13 of 22
I haven't read all the responses yet, but my dds are tiny, too. Their doc sent them for an endocrine blood panel when they were three, "just in case," and although everything came back fine, I was really glad we did it. The doctor listed her reason for the blood tests as "failure to thrive" which was pretty scary to see written there next to my kids' names, but still . . . If there *were* a problem, I'd want to know as soon as possible.

I do think that if she's hitting her milestones, she's probably okay. My girls are 5 1/2 and one weighs 31, the other 29.
post #14 of 22
Quote:
Originally Posted by fiddledebi View Post

1. If you had a child that grew slowly like this, did s/he eventually have a big growth spurt? If so, when was that?
I haven't read all the responses yet, but I wanted to let you know that they do eventually have growth spurts. My son just turned 11 and apparently just had a big one. He is FINALLY above the 3rd percentile for the first time since he was about 8 months old. He still hasn't hit the 60 pound mark, but he's close and we're pretty excited anyway!

Aidan was followed by an endocrinologist from age 1-4. He was tested for cystic fibrosis and growth hormone deficiencies. I remember them doing a bone age test which showed him to be delayed by about 2.5 years. I was a nervous wreck during those years. Luckily, the tests didn't show anything serious and after a while the doctor diagnosed my son with constitutional growth delay. It's not actually a disorder or a disease, but a variant of a normal growth pattern.

ETA: I know it's hard, but I would suggest trying not to worry so much. I used to drive myself batty imagining the worst for my son, so I can totally relate. Seeing that your daughter is still recovering from her earlier health problems, I would probably take a wait and see approach but I don't know that I would wait an entire year. Sometimes it can take a while to get the whole process started.
post #15 of 22
Quote:
Originally Posted by fiddledebi View Post
ETA: Developmentally, DD2 is totally on track. She's active and energetic and smart, and has always met all the milestones. The only one she hasn't met is "pedals her own tricycle" -- because she can't reach the pedals!
This speaks volumes and at the end of the day, is usually the best barometer for gaging our children's health.

I had to giggle about the trike pedals. DS still has his trike although he is finally too big for it now and has been for sometime. He LOVES it still though and I believe because he hasn't been big enough for it for all THAT long. He was struggling with reaching those pedals for a year! We bought it for him when he was 2 1/2.

The best,

Em
post #16 of 22
I hope you're able to ease your mind soon somehow. I hear that there are a few factors that have affected how your dd has grown, the several eating difficulties, genetics, and possibly vegetarianism (for the record, my ds is vegan, as am I, I've never heard of veg*ns being shorter, but I recognize the possibility) all may have had an impact. If there's a hormonal issue as well, I hope you can take care of it, but my first reaction is that you've just got a perfect storm of smallness factors going on and things will sort themselves out in time. I agree with PP that being on track developmentally is an important thing.

My ds is about 5-10th percentile, for weight, and was off the charts (small) during his first few months. His bio-dad is very small, (like 110 soaking wet) but he's not around, so people tend to think I'm starving ds by not giving him animal products.
post #17 of 22
My ds5 has been about 10% for height and below 5% (at times below 3%) for weight. His brother ds8 has long been Mr. 50-50, but at his last checkup he was 50-40.

He had significant allergy issues--I had to eliminate ALL dairy, tomatoes, potatoes, and chocolate while nursing from about 5 months (we started eliminating and allergy testing at 4 months) til I weaned him at 15 months. When I weaned him, my BMI was below 18 (I am usually at 21 or so), and I was losing weight every month, in spite of TRYING to gain.

After weaning, he did gain some weight and got up above 3% weight. But he has stayed small. He was 6#12 at birth.

There has been talk of seeing a nutritionist, but not an endocrinologist. The ped has told us to just let him eat what he wants (within reason) because he is also difficult to feed (there is no way to tell day-to-day what he will eat), and not to turn eating into a battle. He loooooves carbs.

He rarely gets sick and has TONS of energy (too much at times!). He would rather play than eat. I discovered as a toddler that if I gave him twice as much food to start, he would eat it all. But he would never ask for more if I gave him half as much. So I just gave more to start, and often he would eat it all. This is less true now, he will ask for more of--carbs. I too loved carbs as a kid

Per my mil sil was always on the small side, and is now probably 5'4" and a size 4 (I am guessing). DS5 also looks like sil. Dh was always a small kid til high school. He is now on the smaller side of average (I am on the taller side of average).

Since last Oct he has grown almost 2 inches, and has gained over 5 (!) pounds since his 5yr checkup in January! WOOT! I think this may be the year he "catches up".
post #18 of 22
Evan will be 4 in Dec and is 28# and 36". He was 24.5# at 2 and 32", 26.5# at 3 and 34.5". Does she have sleeping problems? Evan just had his tonsils out b/c he has moderate to severe sleep apnea, if a child isn't sleeping well, they're not growing well. We're hoping for a lot of catch up growth once he heals (he just got them out on Wed). He's below the charts now, but at his best he was up to 15% for both so that's what we're hoping for. He'll never be as big as his older brother I don't think, but our dd is much like Evan so that helps reassure us that Evan will be just fine.
post #19 of 22
My son is 7 YO. (Born May 2001) He was really big at birth (10 lbs), but very soon slipped down the charts. He has been at around 5% for height and 3-7% for weight most of his life.

He is now 46" and 45lbs. I sometimes worry a little, because he seems so short compared to other kids his age. And he sometimes gets upset, when kids ask why he is so small, if he is a little person etc. But his doctor isn`t concerned, and he follows his own curve perfectly.

My son has pretty bad anxiety, and possibly a few other things aswell, but nothing that has had any effect on his growing.
post #20 of 22
At 5'2", I'd have to say that being short isn't so bad. Ds's bio-dad is short as well (for a guy) at 5'6" My Ds fell off the bottom of the charts for ages. He's always been small. WHen he was born he was 5 pounds. He's small-boned, and very thin. I don't think there's more than an ounce of fat on him anywhere. He's the oldest in his class, but he's also one of the smallest, and certainly the smallest boy. But if he ever grows into those gunboats he calls feet, he's gonna be taaaalllllllll. Good luck Mommas, and don't worry about your kiddos. They'll be OK
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