Is my DD's height/weight concerning or is HV being overly cautious?

[Bearfrills]

I got 3yo DD weighed at the HV clinic last week, I was getting the baby weighed and she wanted a go. She is 24lbs and 87cm tall.

The HV plotted her on the centile chart. For weight she is on the 0.4th percentile and the HV said this is a concern because she was on the 9th percentile last time she was weighed around 7 months ago.

I said she eats, just not great amounts. The HV asked me to keep a note of what she's having.

Friday

• breakfast: bowl of porridge made with full fat milk
  
• brunch/snack: small pancake, some strawberry and banana pieces, piece of toast, glass of orange juice (this isn't a normal snack, we were doing a Bella Italia review)
  
• lunch: tuna roll with full fat mayo and sweetcorn, snack-bag of apples and grapes, matchbox-sized piece of cheese
  
• snack: strawberry milkshake (again, not a usual snack but DS wanted a BF so stopped at a cafe and that's what she wanted)
  
• dinner: 3 big-ish sweet potato wedges, homemade burger (roughly the size of a mcdonalds one), coleslaw
  

Out of that she ate it all.

Saturday

• breakfast: bowl of cereal with full fat milk, ate it all
  
• snack: a pear (cutted up...) and a yoghurt stick thingie
  
• lunch: veggies and pasta in tomato sauce with grated cheese on top, she also ate half a blueberry muffin
  
• snack: slice of bread with peanut butter
  
• bbq chicken, corn on the cob and savoury rice (she ate all of the corn and a little bit of chicken)
  
• small bar of chocolate
  

Today (so far)

• breakfast: scrambled eggs (cheese grated in) and toast
  
• snack: some avocado and apple slices
  

Her plates and bowls are the colourful Ikea plastic ones, she has a child's portion and she sometimes eats all of it, sometimes very little of it. I use full fat everything and I sneak extra bits in, for example I mash potatoes with butter and milk.

The HV is going to be phoning me to discuss it further but is there a problem if she's eating? She is bright, active and all in proportion. She even has bits of baby chub still, her thighs are squishy and she has little chubby wrists. She does not look either over or underweight. Not sure if it's relevant but my other two children (both boys) are on the other side, DS1 was way up on the 91st line as a baby and DS2 (currently a baby) is on the 75th (I think), he's 20.5lbs.

Does anyone have any experience with a child on the small side of the chart? Are they being concerned over nothing?

[BuckskinnedAstronaut]

The diet doesn't sound bad at all to me.

Looking at the centile charts, your DD's height and weight do seem to be in proportion to each other, so it doesn't sound like a weight problem specifically. How many months past three is she?

There could be a problem (e.g. with growth hormone deficiency) and it's as well to investigate those things now, if her growth pattern suggests a problem. Or she might just be small with no particular underlying reason.

[Bearfrills]

She's two months past three, so 38 months. She was 7lb 10oz at birth so not particularly small weight-wise but she looked a lot smaller (the surgeon who delivered her asked for her to be reweighed because she didn't look that big) and she was in newborn/first size until she was around 10 wks. She's gradually settled onto the 25th line, then the 9th and now the 0.4th but that's been over three years. She wears 18-24m clothes.

[vichill]

I think her diet sounds good. If she is happy, active and meeting milestones then I don't think I would be concerned. Are you and/or her dad petite?

[Bearfrills]

I'm 5'7 and dad is 5'5 so not overly tall.

[Gileswithachainsaw]

her diet sounds perfectly fine. hvs can never see past the charts. someone's got to be at the bottom.

If there are no concerns with her health and energy levels etc I'd pay no attention.

[lunar1]

My boys both fluctuate between the 25th and the bottom of the chart and are 75th for height. They eat well and are very active. I spent years letting the HV panic me every time I saw her.

I would say that if you know your dd is eating and she is full of energy then she is probably just fine. Especially since she is similar for height as well.

If you have other reasons for concern like tiredness then see your gp. Otherwise just smile and nod at the HV.

[Mulderandskully]

Her diet sounds great but doesn't that mean there may be a problem if she's eating well yet losing weight? I couldn't quite tell if she's lost weight or just got taller which has moved her down the percentiles

[Bearfrills]

She weighs the same as she did 7 or 8 months ago which has moved her from the 9th centile to 0.4th. She has gotten taller though, I got last winters clothes out and while the dresses still fit her body they're now knee length rather than mid-calf or ankle length.

[steppemum]

she may just have had a growth spurt, so her height weight ratio looks poor, but she will then fill out a bit again.

[Bearfrills]

HV should be ringing me tomorrow so will see what she says.

She does look younger than she is. We went to a playgroup and one of the other mums thought she was really advanced for her age until I pointed out that she's actually three :o

[Bearfrills]

I've checked her book and she has actually lost weight. She was 24lb 10oz in June and is now 24lb exactly.

Looking like tomorrow for the HV to call me.

[oddsocksmostly]

Has she grown out of any clothes since January? I'm wondering if the scales might have been wrong.

[Georgethesecond]

Her diet sounds great. I am right at the bottom of the charts, always have been, it's just the way I am. I eat! Some people are just like that.

DS2 didn't gain for a year or so at around this age and he got referred for bone age x rays and blood tests. He's 13 now, he's fine - on the short side but growing hairs. Completely normal, sure he'll catch up later. THere's a history in our family of men gaining height at 16-18. Try not to worry, she sounds great!

[Bearfrills]

She's still wearing some of the same clothes I bought back in April/May. She's also wearing dresses she got last Christmas as they still fit on her arms/body but they're now knee length instead of mid-calf or nearly ankle length. So she is growing taller and her feet have grown.

HV is coming out for a home visit and we have to keep a food diary.

[BertieBotts]

Was she weighed naked or clothed? With shoes on or off? I had a load of hassle when a HV thought DS had dropped but neither of us realised for ages that the first weighing was clothed and the second one wasn't.

[Bearfrills]

Both weigh ins were on the same set of scales, bare footed and in just her knickers and vest. She's getting weighed again next week to see if there's any change.

[BarbarianMum]

Not gaining weight wouldn't worry me, if she was otherwise healthy and active. But weight loss - that needs keeping an eye on. Will probably turn out to be nothing much but yes,keep an eye on it.

[westcountrywoman]

As her height and weight are in proportion I wouldn't worry about her diet and how it's affecting just her weight. She's small for her age in both height AND weight but it could be one of those things. My DD is small for her age - at 4yrs 10 months she is 101.5cm tall and weighs about 33lb. She still wears 2-3 in some clothes and never bigger than 3-4. School uniform was a bugger to get! She was 7lb12 oz born (at term +13) so not small. She dropped through the percentiles quite quickly though and settled at around 9th line by 12 ish months. She eats very well, she's just meant to be small!

[Bearfrills]

Thanks for all the replies. I'm 98% certain that on Monday she'll have gained a little weight back and will continue to do so but the other 2% of me seems to wake up around midnight with a list of what ifs a mile long. I'm stubbornly determined not to Google anything.

Someone has to be at the bottom of the charts and it may as well be DD, is my mantra.

[Jolay100]

In all likelyhood your DD is totally fine and takes after her dad, but generally if you cross 2 centime lines ie 25th to 0.4th that warrants an eye being kept on growth. If she's otherwise well and growing along 0.4th that's fine, but you wouldn't thank your health visitor for missing something easily treatable like a growth hormone deficiency. It's highly unlikely but not impossible.

[fatterface]

I'd say weight loss in a child that age, especially as her diet seems fine, is a worry and it's right that the HV wants to check things out.