Child growth (short), bone scan and questions to ask GP?

[janesterlingandme]

My DD(9) is very small for her age -- pretty consistently in the 5-7 percentile for height and weight. Even in utero her femur measured below the fifth percentile, but she ended up being a large baby (over 9 pounds.)

Now she is the smallest in her class by a good measure, and very skinny as well. Just the kind of child you might call tiny -- or think was much younger than she is. Otherwise, she seems like a normal child, no SEN. Me and DH are fairly normal height, my DH perhaps a bit short at 5'8.

Her GP sent us to a pediatrician who took a blood test but was not concerned. We then took her to a private endocrinologist, who also did a bone scan that showed her bone age was about two years younger than she was. This apparently is on the cusp of normal. All we were told was to make sure she eats well and that we keep her (mild) asthma in check.

Is there anything else I should be doing? I don't want to be pushy (or give her a complex by constantly measuring her) but I also don't want to miss out on a key window to help. I'm taking her to the GP to get measured for the first time in a few months, and thought I'd ask if anyone who has been through this has suggestions of anything else to do or ask.

Also, I often hear stories of kids who are tiny in primary but shoot up in secondary -- but these always seem like stories of boys! Is this true of any girls?

I am going to follow this as my little one (2yr)is small <3rd percentile and we have a docs appt this week.
xx

None age being a couple of years younger is excellent news and reassuring. It means that your child’s body thinks it’s younger than it actually is, so will carry on growing longer and do some catching up. It’s always the result I’m hoping for in these circumstances.

Have you checked iron levels? Has she had a celiac test? How is her sleep?

My daughter was tiny, never got over 5ft. We are a family of small females though, the tallest being 5ft 2in. Her daughter at 16 is only 5ft 2in and has stopped growing.

Has she been tested for coeliac's?

I looked into this when I was your daughter's age - had the scans etc, was given the talk on what they can do, and I'm endlessly grateful that I decided the side-effects just weren't worth it. (I know this sounds a bit weird - maybe I was a couple of years older, but I was definitely still at primary school - my mum supported me going to the doctor and asking, although, being short herself looking back clearly just wanted me to get it out of my system rather than her thinking there was anything actively wrong with me)

I'm currently 2nd centile height for a UK woman (lets not talk about weight ;) ) and life is fine.

Of course, do what you can to check there's nothing really wrong, but if she'd just short, I'd just let her be short - the interventions that are possible all have disproportionately awful risks.

I was a tiddler at that age, clearly remember being massively offended by a woman who when I said it was my birthday that day thought I was going to be 5! I was in fact 9. My Mother had to take me to be weighed and measured often, no drugs given at any point.

I made 5ft 4, my Mother was 5ft 4 and my Father was 5ft 6, he was East Asian so was a fine height for that country of origin.

5ft 7 for a guy that’s of European descent is under average, assuming he is. Some of my women relatives only made 4ft 11. As long as she is healthy I wouldn’t worry too much, being a short woman never held my sister back. It is more of an issue for boys, as much as people get annoyed about it when they have a small partner or small boys. Doesn’t mean the end of the world obviously but I look as DS very nice mate who is 5ft 5, he has a difficult time dating.

I should add the growth hormone naturally released in humans is released while we sleep only. I was quite a poor sleeper when young, I’m a very light sleeper to this day.

Thank you everyone so much! Yes has been tested for coeliac (negative). Not sure about iron but I assume so as it seemed a standard panel of tests? I will ask!

Sleep is only OK but we are working on it so this is a good reminder to focus on it. (She is a night owl.) She is definitely a picky eater and "eats to live rather than lives to eat" but I wouldn't think to malnutrition levels as she eats things like chicken and noodles, spaghetti bolognese, fruit. Does love sweets to an absurd degree! Also has a vitamin every day.

I was regularly taken to hospital to be measured. Lots of options discussed but ultimately nothing wrong except being short. I am 4foot 10. My 13 year old is already 5 foot 3 so it hasn’t passed on.

Asking to be referred to a dietitian might be a next step with the fussy eating in mind. If you get a good one you might be able to work together on a meal plan with the goal of increasing her calories.

The fact her bone age is 2 years younger is great news. My child had the opposite and was extremely tall, their bone scan was 2 years older. All other tests normal so doctor unconcerned and said they'd stop growing 2 years before most their peers. You may find your child continuesntongrow long after everyone else.

Has she had any genetic testing carried out?

Was she eating plenty of gluten prior to the coeliac test? It can be negative if they don’t eat enough of it.

My experience is NOT recommended but I’ll add it anyway. Both children had some bowel issues when eating high gluten foods, and were falling very rapidly down the percentiles (think 75th down to 2nd), we had two negative coeliac tests for both of them. Decided we didn’t want to put them through a scope, but went gluten free. Since then they’re both up to the 25th percentile and have noticeably more energy. The consultant signed them off to continue with the gluten free diet as it was clearly working, with a bit of an unknown as to why if they weren’t coeliac.

Again, not recommended pathway, but just wanted to highlight the coeliac test is not necessarily accurate always as it depends on diet.

Hope you get some answers soon!

My DC are late developers, particularly the boys. Both have always looked very young, ds2 is 15 in 2 weeks but could pass for 12. He is currently 9th centile for height and weight. I'm not worried though as we went through the same with DS1.

He was very similar - at nearly 20 he has only just had his teenage braces off because he was 3 years behind dentally so they couldn't start treatment until he was much older. On his last day of school he has a photo where he is bang in the middle of his year group with his arms around the shoulders of his peers and his feet dangling off the floor. He is now 6ft 2. It's funny to see people he went to school with when they haven't seen him for a while as he was always tiny.

@janesterlingandme the reason I ask about sleep is my dc had issues with sleep apnea. I hadnt realised how it could affect growth but he was 2nd centile height having been 50th at 2. We had adenoids out and the 3 months after the op he grew 5 cm.

It's interesting to read about the asthma... is she on a steroid inhaler? My dd is and her growth fell off when she started on it but we can't get the doctors to give a single shit. She is similarly tiny compared to her peers.

Thanks everyone, really helpful. Neither the pediatrician or endocrinologist pushed for genetic testing, but I can ask again.

@PaganOfTheYuleTimes Yes she IS on a steroid inhaler! I wonder if that's part of the problem but the endo thought that uncontrolled asthma was worse for growth than the steroid.

And @Smoronic that is fascinating re sleep as she has a lot of trouble getting to sleep at night. We definitely need to focus on this.

Oh and @Zapx I've thought about going no gluten but have balked as that will be very difficult as so much of what she eats has gluten! But maybe we should try it over the summer when I'll have more control over what she eats. Thanks!

I just had an appointment with paediatric consultant today. My little girl is below the 3rd percentile for growth so we are monitoring that and was iron defient so we were having her bloods checked after being on a supplement to check its working.

Today the consultant referred us for a bone xray and have a referral into a endocrinoligist.. her iron was recently low so now that its sorted they are finally checking her growth properly. I am a bit worried but nothing I can do except keep getting good food into her to help her keep up calories, weight is between 9th and 25 percentile so want to keep up her weight. I am worried tho. Me and her dad arent the tallest.. so had been passed off as genetics until now its being checked. Could still be genetics! Everyone comments on how "cute" and "dainty" she is... wish she would take a little growth spurt soon.

Get iron checked, they need to be fasting bloods.. consultant said today her lack of proper night sleep was probably down to her iron levels being low. Only normal now after 3 months of galfer and she was sleeping through the night consistently after taking it a few weeks. And her appetite improved too. Iron can effect so much.

Also, my little one was on an inhaler... i hear it being mentioned here. She had a lot of steroids before she was 1.5 for croup.. then we were told by a respiratory consultant to keep an eye on her growth since she was short that steroid can stunt growth in a small number of cases but it is a side effect..

Get iron checked. My 3 year olds ferretin was low and now after a decent iron supplement she is sleeping through the night, she is not as cranky, more energetic and her appetite is much better. Iron effects so much. Consultant told me today that poor sleep can be indicator of iron deficiency.

Both my boys tested 2 years younger in bone age. Means they will grow for an extra 2 years. My son now is 16 and first time in his life he actually looks his age. He’s about 5 foot 6 already and still growing. When he was 13 he looks like he was about 10

Anecdotal evidence obvs but DD was v similar in size to yours OP, she was still in a booster seat when she started secondary school - we would joke about whether she would get to 135cm or 12 first (she got to 135 when she was about 11.5). She’s now 15 and a smidge under 160cm (5ft 3-ish?), which is not particularly tall but she doesn’t look out of place among her friends anymore.

We went to the doctor about it, mostly because 100% of people we met would pass comment about how small she was, which I found quite upsetting actually. Doctor was happy with a watch and wait approach and as long as she didn’t fall on the centiles, then it just meant she was small.

Don’t forget, SOMEBODY has to be on the lower centiles!

My daughter is21 now but has always been on a very low centile for weight.