Health visitor or keep quiet?

[LadyHalesBroach]

My DD is a bit on the short side, but so am I (5’4) and my DH (5’3). She was never destined to be tall!
We’ve started to pick up on the fact that her preschool buddies are picking on her for her height ie. can’t play certain games because she’s a baby (she’s nearly 4 and one of the oldest) and that she can’t go as high as them on the swings etc. Last night during book time she told me that she’s little and she can’t play with her friends anymore because they’re bigger. Yes they are about a full head taller but my DD has an enormous personality and the biggest heart.

Anyway I’ve spoken to her key worker and they’ve been aware of it for a while and will continue to monitor.

It prompted me to look on the red book growth chart and I was really shocked to see that yes, she is indeed, tiny. Image attached.

Given that this has now become an issue with her friends, should I mention it to a health visitor or GP? She’s an otherwise healthy and happy little girl.

Can’t talk about this with my DH because he suffers his own issues with how people regard height.

Given that you and your husband are both on the smaller side, I would think she is taking after you. You could ask the gp to check but if she is following the same centile as she was born more or less then its just the way she is.

We are the opposite, we are both 5"11 and my 3.5 year old has just hit 111cm and is huge!

I think more needs to be done at pre school to prevent this happening and also speak to your daughter about different heights, weights, colour of skin etc..... use it as a learning opportunity.

I don't think that sounds anything but normal in terms of her physical development. My dd was (probably still is, but haven't measured her in awhile) short, between 9th-20th centile, which is not off the charts but small. Her projected adult height is 5'3 according to her red book. Dh and I are quite tall though! I'm 5'9 and dh is 6'5. They grow at all different rates though and it's very normal to have a growth spurt later and catch up. As long as she is eating well and getting all the nutrients she needs, it all sounds fine.

You need to support her in being resilient to other children's unkindness though and help her to find friends who won't be so mean. If it continues to be an issue, I would speak to school about it because it sounds like potential bullying.

What is her weight? Is it at a similar centile? If so, and she is eating well, I can't imagine the HV will have much to say. I would do as others have suggested and talk about differences and celebrate her strengths. It might be good to give her response to say along the lines of she is shorter but she is 4 like them (or older).

This isn’t meant to be unkind, but your Dh is really quite short for a man, does he have any type of medical condition to cause it that your dd might have inherited?

So she’s been bullied “for a while” according to the staff member you spoke to. What is the nursery anti-bullying policy and is it being implemented here? Why weren’t you notified?
Sorry, but I’d be going to town on the nursery in this case.

I'm not sure what a HV or GP could really do tbh, except monitor her growth. Is she developing well otherwise in terms of milestones etc? I think it's more a social issue at this stage, better managed by nursery. Poor thing- the nursery workers need to be pro-active in preventing bullying behaviours.

The School Nurse contacted us in Reception with concerns about DD's height. She was, TBF, tiny compared with her peers but happy, healthy and in proportion. We were encouraged to seek paediatric advice.

The consultant wasn't happy to run invasive tests on a perfectly healthy child and simply had her in every 6 months for calibrated height measurements. She was growing, albeit not a lot, so he diagnosed her as "short but perfect" and discharged us 18 months later.

Both you and your husband are short so I really don't think you should worry too much about the physical implications but definitely chat with nursery about the teasing.

DD is now 20 and has hit the dizzy heights of 5'1.......

Umm I wouldn't go to the HV as they couldn't do anything re the social situation. Pre-school needs to address this - this is bullying and should't be tolerated. They should have strategies for inclusion and celebrating difference.

if you think there is a medical issue here - I would start with the GP but this is going to bring a whole raft of stresses. Remember someone has to be at the bottom of the centile charts!

I had similar issues with my DS as a baby / toddler. Strangers used to comment how small he was for a boy. I had HV after HV monitoring his weight weekly and stressing me out when he was a baby. I went to GP who was most reassuring and said obviously keep an eye on it but his weight was not anything to be particularly concerned about given his parents sizes and builds.Fast forward 5 years, DS is taller than average, still skinny, but strong and catching up with the kids who dwarfed him at pre-school.

@GeorgieTheGorgeousGoat height isn't always linked to a medical condition 🙄 my DH is 5'5" and I'm 5'9"- his mum and dad aren't any taller then him, it's just genetics. My mum is 5'3" and my Dad is 6'. Normal crosses variations on height which are not weird or wrong in any way.

OP, I'd mention it to the HV only in passing, as your daughter is likely to be petite, which you're well aware of of course. If she's otherwise in good health and eating well, then it's a question of the school dealing with this as an education thing - the kids need to be taught that everyone is different and it's normal and not something to pick on anyone for.

Kids can be cruel and will often pick on someone different as many of us will remember.

GeorgieTheGorgeousGoat height isn't always linked to a medical condition 🙄

I didn’t say it was! I was just asking. Calm down.

What does the rest of the page look like op? Is she on her own curve or has she stopped growing? What percentile is she for weight and what m where was she a year ago?
I think it really depends on her journey rather then where she currently is now but given yours and DHs height, I'm not sure if he that shocked she's little

I disagree, there are several reasons why she could be small and they need to be investigated to rule them out.

When I was teaching we had a child who was really tiny compared to her peers. At the start of each year her parents would chat to her teacher and make it very clear that they wanted to work against any sizism (eg please don’t say things without thinking like “I’m looking for some strong children to help my carry these things” and pick a load of bigger boys.)

They also put her into loads of sports clubs, including rock climbing which was her main hobby, and we really bigged up her achievements in those in class assembly/show and tell etc.

She had lots of hobbies. Basically so that other children would have plenty of things to comment on rather than being small. (Eg she’s great at baking, she plays football, she’s got x medal in gymnastics, etc).

Thanks everyone. @GeorgieTheGorgeousGoat no there are no medical issues, he’s just 5’3 in the same way his eyes are brown and his hair is black.

I’ll go back to nursery this afternoon and have another chat with them, reiterate how seriously we’re taking this.

Her weight is normal (though tbh I’ve not weighed her in a while!) and she eats well. I haven’t taken her height in about a year because it just never occurred to me to do so. When she turned 2 I remember standing her next to a growth chart in M&S and she was very very tiny then too but she’s always just been diddy. She was 7lbs when she was born, so average?!

I’ll keep an eye on this and if by school age her growth is slowing down then I’ll seek medical advice. Just sounds like she’s going to be a half pint and that’s fine by me. She’s perfect

Thanks @awsomer that’s a great idea, I’ll mention the sizism thing, even if it’s unconscious sizeism.

My friend was in a very similar situation to you but they went to the GP and it turned out that her dd did have a medical issue which is subsequently being treated with hormones. Both parents are small but the dad particularly so at around 5ft 3. It turned out that it was a genetic disorder and it was never picked up in him as a child.
I would go to the GP and then you will know either way.

Ok thanks @Planetaryexplorer I’ll look into that, really helpful x

In this situation I would speak to the GP, just in case they need to check for underlying causes.

Chances are the GP will say everything is fine but I know it would niggle at me if I didn't raise the issue.

I say this as someone who has been on the tough end of the health visitors being overly concerned by DD's small size when she was a newborn. Constant weigh ins and referrals to paediatrics blighted our first 3–4 months when DD was basically absolutely fine but little.

She is now three and even though I'd be loathe to get back on the surveillance treadmill where growth is concerned, I'd still speak to my GP if she was falling off the bottom of the chart again. I found the GPs much more pragmatic about this sort of thing than the health visitors who leaned towards referring if they had any concerns whatsoever.

My dd is small and has had many comments on it over the years. She’s halfway through secondary now and still smaller than pretty much everyone in her year but she’s able to handle it better now. Like @awsomer we’ve encouraged her to do plenty of sport which has helped.

It could be worth looking into, tbh. My son was also off the bottom of the charts, though this was picked up by a health visitor at his twelve month check, as he’d been quite large at birth. We were sent to GP who referred us to consultant and I delayed doing anything about it for a while because tests were quite invasive, but it turned out that he did have a medical condition. He has growth hormone deficiency and would have been the height of a child as a grown man if I hadn’t eventually gone through with the testing and treatment. It’s not just height which is affected - he was always exhausted and couldn’t walk far, took longer to get over illnesses and so it can lead to heart problems down the line, as at cell level he just does not create new cells as quickly as other people. He was noticeably very small and people thought he was some kind of genius baby when he was around three. Nursery needed to make adjustments for him as he couldn’t reach the toilets and taps properly. He was still wearing toddler size clothing (12-18) when he was almost four.

In terms of the confidence, I was just lucky that he is naturally very confident. He did initially get comments from other children about not being able to play with them because he was a baby. I mentioned it to staff who kept an eye on it, but he never raised it as an ongoing issue. He’s now twelve and has a large group of friends and is very popular and outgoing. Also very popular with girls! He does gymnastics at county level. So his condition isn’t holding him back in any way.

Investigations revealed that his pituitary gland is very small, so other hormones were a concern. His general physical development, such as teeth coming through and puberty, has been delayed. Luckily, he is now naturally going through puberty but there was a chance that he would need to be given hormones for that, too.

I’m very glad I got this looked into because the younger you start treatment, the longer you have to grow and try to catch up somewhat. There is a time limit on growth.

Having said all that, his dad and I are fairly tall, so it was an obvious abnormality. I’m not sure how I would have felt if we were both quite short. It makes sense that a child of shorter parents would be shorter. I was always very short until I went through puberty, so I rationalised his lack of growth as just being similar to me as a young child, initially.

I meant anomaly, not abnormality!

Obviously speak to your GP if you’re worried, and definitely get into preschool about the bullying because that is not on. However - someone has to be at either end of any spectrum - perhaps your DD is just naturally at the petite end (DS is at the opposite, gangly end of the scale!). Both you and your DH are on the smaller side, height wise, so it seems only natural to me that your DD would be too. If she’s otherwise healthy and happy, that seems fair enough to me.

But the bullying needs to stop. Bugger ‘aware and monitoring’ - what are they actually doing about it?

Can you work out her predicted adult height and see what centile that is on. If it is vastly different to the current one ( well under 0.4) then I would definitely get a consultation with the GP.
Also have you got any other height measurements ? Is so is she following the curve or has she got faltering growth?

It's probably genetics but you are actually slightly above average height (54th centile), even though your DH is below average height (2nd centile). Your DD is even further down the charts for her age and has dropped from average at birth. For those reasons, it is worth raising it with the HV and GP just to rule out any other causes but most likely she is just small but perfect like her dad, as another PP said, and there is nothing of any concern.

My DD is small, at around 3 she stopped growing and has not reached her predicted adult height (her lack of growth is thought to be related to poorly controlled asthma/high doses of oral steroids as a child), the indicator of a problem with her height was the fact that she fell off her centile curve completely. She went from 50th centile to almost off the bottom of the charts at one point.