Teenage son with very slow growth - any experiences with hospital referral?

[RedGreenBlueSky]

DS is very small for age. 13 and around 4 foot 8. Has only grown 2.5cm in the last year. He's always been on the small side but the difference between him and his peers is getting more extreme. He finally has hospital appointment at a growth clinic in next couple of months. Does anyone have experience of what to expect?

I'm feeling incredibly guilty about not asking GP earlier (we have always taken approach that his height doesn't matter and if he's happy and it doesn't bother him then all's good) but he's just never really had growth spurts and done any catching up that I was expecting would eventually come. It's started to bother him recently and he's struggling with people's comments at school. I'm 5 7 and his dad is 5 8. I always assumed he'd not be massive but at least get to my height... now I'm not so sure and am worried for him as there's such an emphasis on height being important in men.

How far on through puberty is he? If still early on in puberty, should have a lot of growing time left...

It's hard to say, probably not very - if at all. Voice not dropped. His room sometimes has teenage boy smell though! He goes to a weekly club with children 10-16 & there's only a couple of 10 year olds smaller than him (with 3+ year difference!)

My friend’s DS was similar. Always noticeably smaller than my DS who is 3 years younger. He didn’t start to grow until he was about 16. He’s now 18 and around 5 foot 7 I’d guess. His parents are both around 5 foot 6.

He was very late going through puberty too. I hope you get some reassurance from the clinic.

Thanks Remaker. I'd be so happy if he hit to 5 6!

Anyone know what to expect at hospital? He's already had celiac and thyroid problems ruled out by GP blood tests

Not in the UK but I saw an endocrinologist with my 10 year old. The doctor was most concerned about energy levels - was my DS lethargic, does he get tired easily etc, any dietary or sleep issues. Also wanted note my height, height of my husband. We went for a hand X-ray to check bone development and we will have a blood test taken in a couple of weeks. After that we have a follow up appointment to discuss but he didn't seems too concerned. Both DH and I were smallest in our class as kids and I'm not very tall myself.

My DS has always been small but has always followed the growth curve - even if it is the lowest percentile!

Good luck

They will probably run tests to make sure he has adequate growth hormone levels.

Also, they will probably do a bone age scan, which is an X-ray of his hand to calculate his bone age, which may be different from his chronological age. Generally, if there is nothing else wrong with his health, it is good news if the bone age scan shows less than his actual age (for example if he is 13, but his bone age is 12). In that case, it means his body thinks it is 12, so he will be growing for one year longer than everyone else, assuming his bone age stays one year behind.

They should also look at his growth chart, to see if his growth is consistent, or if it is slowing down. And also the weight gain chart, as that also gives them an indication of what may be going on.

When my DS was referred they did the X-rays and blood tests described, but also checked the size of his testicles using what looked like a string of different sized beads. As he was 14 at the time this was definitely the part he was least thrilled about.
He was diagnosed only with late puberty. It was year 11 before he grew and developed. They estimated he would reach 5ft 9 but in fact he’s 6ft 1. Both DH and I are 5ft 10.

No advice on the hospital. But just to say my DH was super skinny and around 5'2 until he was 16. He was really late hitting puberty. He's now 6'3

Following as I think we will be in a similar position. DS2 is 12.5 and is about 4ft 7. I’m only 4ft 10 so he is clearly taking after me, DH is about 5ft 8 but our 18 year old is over 6ft.
DS2 was born at 32 weeks and had always been tiny but the gap is really noticeable now. He plays football and struggles as the other players are so much bigger than him. The only thing that does seem to be growing is he feet, he is an 7.5.

My DS had a blood test to check his hormone levels and a bone density scan on his wrist. We then saw an Endocrinologist who examined him, in particular his testicles. She said that his bone scan put his age around 2 years behind his chronological age and she was happy to let him carry on as he was.

We are now having some more genetic testing as part of his wider health issues, but that was the crux of the process.

At the time, my son was 14 and 4ft9, very small feet at only size 2, and like a tiny bird because he has ARFID so he was very skinny.

He is now 16 and around 5ft2 and he is wearing a 5.5 shoe. He is still skinny but he feels a bit more solid. He has put around 3kg on in that time.

Hi my DS is 4ft5 inches and has always been small since he was born at 4lb 5. I've been giving him calcium tablets a couple of times as week and I've noticed he is starting to grow at a quicker rate that previously but this could be his age.

Thanks for all your replies. It's good to hear others have been referred for similar reasons, I literally know no one (even children with smaller parents than us) who are in similar situation. I do keep on hearing stories though of 'x was tiny until he was 16 and is now 6 foot plus' but I struggle to believe they were the height my son is at 13... he needs a growth spurt of 4 inches before he even hits 5 foot!

DS's feet are only size 5 so if that's an indication of his potential height then it's not good! He's also very very skinny.

It's good you re seeing a dr but don't get unduly worried. Dd had a friend who was really tiny at 16, significantly smaller than her (she's only 5'2) and he's nearly 6' now and in the army! Some bits especially but girls too hit puberty later and grow until 20 or so. Both my DD's grew until 18 too, gaining their final inch between 17&18.

I should have said, he was born at term and pretty average weight. I think he used to be around 25th height percentile as baby but probably closer to 9th now.

I think I will need to warn him about the testicle check!

I used to have regular appointments at a growth clinic because there wad a worry I'd be almost 7ft. No kidding. Bone scans and blood tests were the routine. I'm 6ft as an adult.

Anyway, that's not why I'm posting. I'm just wondering about some work on his confidence, to bridge the gap between now and him eventually growing. This must be quite hard for him. I'm thinking of a counsellor that works with self esteem type stuff.

Op, do you know if he has any signs of puberty? Any hair growth? We have been through endocrine with my son who is 4ft 7 and is 14.5. They have ruled out growth hormone deficiency. My DS has some hair public hair growth but nothing else so we are hoping that he still has time for growth although the consultant wasn't sure.

OP I'm in a similar situation with my 13yr old son.
He's 4ft 8 and considerably shorter than his peers, who are all well into puberty yet he is showing no real signs.

Like you, I am 5"7 and my husband is 5"8.

It's starting to really bother him as he is getting left behind, and the older he gets the more noticeable it is.

We've not yet gone down the path of tests etc but I don't think we're far off reaching that decision.

He was a healthy sized baby at 8lb9oz and followed the 25th centile throughout his toddler & early years.

It started to become apparent towards the end of primary that his growth has slowed right down. He's not underweight yet he doesn't eat a great deal and does have some mild gastric issues.

He's also only a size 4 in shoes.

I'll be interested to know the outcome of your sons tests in hospital. I think this is a route we will probably end up taking soon.

Best of luck.

I don't think he's started puberty tbh. GP asked him about pubic hair and he said he has some but I'm not sure about that - no under arm or facial hair anyway. I don't see him walking around naked anymore so not 100% sure!

@ScoobyDoNot I will post back again after he appointment and let you know how he gets on. It's worrying isn't it - hard to walk the line between making sure they know it's fine to be smaller but also wanted it to be investigated in case there is an underlying issue.

@JuneOsborne good idea about building confidence. It's tricky though as he was always unbothered by it until secondary school - used to say he actually liked being smaller! It's other people's reactions to him that bother him, not the fact he's smaller itself. I wish there wasn't such a hand up on height in society - even an ex teacher of his from primary school asked his younger sister the other day 'is X still tiny?' I mean, WTF?!

*hang up

Thank you for this thread OP - the other one with the OP unable to read the room was very upsetting to me. Thank you

Thank you for pointing to and starting this thread @RedGreenBlueSky .
Yes I hate the hang up too-it started with NCT competitiveness over whose child was what height (mine was always the smallest bless him). I do happen to work with 2 shorter men-prob 5 5/6ish -who are very handsome and not short of female admirers though which is reassuring!

Hello 😊 it's really hard as it's so ingrained that to be tall is a positive thing. I know I've had to train myself out of commenting on other people's kids heights and saying positive things about how tall they are.

How do your kids cope with being smaller? Mine is generally ok (when he was younger he used to say it meant he could sneak up on people in the playground!) but is gradually finding it trickier. Teenagers can be horrible to each other

Thank you for starting this thread. My son is 14 and well under 5 feet tall. He saw the GP last week and she said she was concerned about his height/rate of growth so he is having a physical exam with a male GP later this week - if there are not sufficient signs of puberty he will be referred for blood tests and a hand x ray.

I don't know anyone in real life who is going through or who has gone through the same issue so finding it hard to get information. I hoped the other thread would be useful but just seemed to be a stealth boasting competition about tall children.

It's really affecting my son's self confidence and he's a quiet child anyway.

@RedGreenBlueSky if you are offered testosterone for your son please do check the possible consequences first.

As far as I know, if no other medical cause is found it’s either late puberty or a shorter than usual individual. Testosterone can accelerate the growth of someone with late puberty, but it can’t make them grow taller than they would eventually have grown anyway, and it could result in a shorter final height.