Am I overreacting with 3yo?

[Sophieleigh26]

He’s 3 years 8 months
Far below 0.4th centile for height
The doctor says it’s nothing to be worried about, but I am worried, should I keep pushing or not? He’s still in 12-18 months trousers and starting school next year. His development otherwise is fine, he was walking at 12 months. Weight is fine.

Ive been doing some research and it says that the growth hormone can be affected by sleep. He’s never really slept (5-6 hours a night and no naps atm).

AIBU to keep taking him to the doctors even though they’ve told me not to?

Forgot to mention he was born at 40 weeks 9lbs 1oz. Length wasn’t measured and wasn’t until this year.

What do you want the GP to do if you go back?

@FleeUpFreeTime refer to a specialist. If there’s an issue with his growth hormone then it’s important he starts with treatment (injections) asap

also have history of thyroid issues in my family and they won’t even check that

My DS is tiny, very much noticeable with his peers. I had to buy 3 year old trousers when he started school. Dr's don't seem to want to know either (I was worried about his weight too) . He's following his growth chart so unless he's way off there I'm not sure what you can do? Perhaps go private if you are really concerned?

What centile is his weight on? I think I would be pushing to be referred on too. I wouldn't expect a child to nap at his age. You must be bloody exhausted.

Are you and his fellow parent average height? Our DS is short but both DH and I are much shorter than average, so we expected DS to be also. There's graphs in the red book (I think) that show what height a child is expected to achieve based on their parents' heights, have you looked at that?

If you are average or above, I would press for investigation as it would indicate there's something else going on. What is the GP saying is the reason, if they are telling you there's no medical cause and therefore stop bothering them about it?

Unless there is a drip feed that you and DH are under 5foot, or other such petite parents, I think I'd be concerned.
When you say weight isn't an issue, do you mean his weight and height are on similar centiles, or his weight is on the charts (in which case where?).

Have you got other height measurements? Can you track his height every 6 months, and check he is growing along "his" line, or if he is falling off it? Then go back in 6 months?

DS1 tracks between 9th and 2nd. He started secondary in aged 8 trousers, with waists pulled in tight. But ud be concerned if he dropped as dar as yours has - especially from a 9lb start.

Is his height tracking along the same centile or has he dropped?

We are short but he’s not on track to reach his adult potential height based on ours if that makes sense (I’m 5’1 he’s 5’9)
He was first measured 6 months ago and grown 1cm since then
his weight is 9th centile so he’s technically obese according to NHS (he looks normal size)

Is he on the centile chart for height or under it? If he’s on it but at the bottom and following that line I wouldn’t worry. Someone has to be at the bottom!

I’d be more worried about him only sleeping 5/6 hours a night. Is he going to bed but just frequently waking up or is he not going to bed/sleep until really late?

Definitely something not right.

My just turned 3 year old was born at 8lb8oz but 99th percentile for height and has carried on that centile his whole life thats the point of the charts.

What percentile was your son when born for both? Will be in your red book. My 3 year old is in 5-6 clothes.

Had concerns about DS growth/height and he started school in age 3 clothes. Predicted height as an adult was 5' - 5' 2" which was deemed to be within normal range so growth hormone not on offer. Had a growth spurt in late teens and and is now 5' 9"

All of my kids were tiny, all went to school is age 3 trousers. All very slight aswell. I am very short (below 5 foot, OH is 5 11".
My sons are now grown and are 5 6" and 5 7". My girls are 5 foot. They are fine. They do slag me for giving them the short gene though. Each of them were the smallest in their class, every class, every year until they left :)

I have a couple of friends whose DC were very small and ended up taking growth hormones. They weren't offered them until they were much older than your DC though (teens). The doctor won't start down that route until they've had a chance to catch up naturally.

He’s completely off the chart at 85cm
Theres nothing in his red book on height / length
His length on my birth notes are left blank
he will be in 18-24 months clothes when he starts school at age 4

That definitely needs a referral. Can you see another GP? Or health visitor?

I'd push for a referral, I feel like a specialist would be much better suited to tell you if there are any concerns or not.

If be requesting a referral too. Some children are just at the bottom of the chart naturally, someone has to be but for your peace of mind I’d want it checked. Does he have any siblings?

Has he never been measured before at all?
It’s really hard without a picture of what his ‘normal’ is. Some children have sudden growth spurts and dip up and down the centile chart. Others follow their line consistently.
If he’s been gradually slowing down in his growth to the point of coming off the chart or he’s suddenly slowed right down and come off then that’s probably more of a concern. Or has he always been that far under the chart?
I’d start regularly measuring and weighing him.

What’s the reason he’s only getting 5/6 hours sleep a night?

How big are you and his father? My niece is at the bottom of/below charts, always has been. She's year 2 and get peers tower above her and she is in 3-4 uniform at seven. Had years etc but the doctor essentially said she's petite. My SIL is 5' and my brother 5'6/5'7 she read never going to be huge.
Whereas I'm 5'9 and DH 6'4 if DS was petite I'd be concerned. As it is he's tall and slim like his father

I would want a referral too. My DS is 3yrs11mo and something like 104cm which is the top end of the heights on the hangers for age 3 to 4 stuff. I'm 5ft3 and DH 5ft10.

I think you are right to be worried. The measurements you are quoting are potentially consistent with a growth hormone deficiency, and he is in the age range typical for this to be diagnosed.

A quick look at the charts suggests that if he were tracking the 0.4 centile, he'd have grown at least 3 cm in 6 months, not one. Now there is quite an error range measuring height but I'd want to have him seen by a paediatrician who could decide when and what to investigate. Lots of things could be going on but you don't assume he's "fine" until someone experienced in these things has checked why he's off the bottom of the chart!

Keep measuring him every few months as well, but I will cross my fingers you don't have too long to wait once you get a referral.

Go to the GP and request an Enocrine referral.
I have boy/girl twins. My husband and I both slightly above average for height and grand parents both sides average for their generation.
My daughter was on 25 percentile for growth and height up to age 5, my son barely made the 2% and was very light.
I kept saying to the GP I was concerned, I kept getting fobbed off with he will catch up all kids grow at different rates.
Eventually, I suspect to shut me up, I was referred to the Endocrine unit at the hospital. There was a year of monitoring his height and weight, hand x-ray to measure growth, blood count, liver function and thyroid function, an MRI to check no pituitary gland issue.

He then had an exercise test where he exercised for 15 minutes followed by a blood test. He missed the threshold massively for releasing growth hormone.
when this happens they then do a glucagon test they inhibit insulin in the body for 4 hours and keep taking blood through a cannula. He failed massively to produce adequate growth hormone.

He's been on daily growth hormone injections for 4 and a half years now and aged 10 administers them himself and is very independent. He's monitored in clinic twice annually and is now on the 75%.

My advice is if you are worried keep requesting a review, yes your child might turn out to simply by a slow starter but this will show up in the tests and you have nothing to worry about.

However my son turned out to be growth hormone deficient so needed to be on the medication as soon as possible.
We are not under great Ormond Street but if you google they have very good leaflets on growth hormone which explain a lot.

Good luck, be firm!