AIBU to be concerned about 4 year old DS's height?

[Itstheimplication]

DS is 4, will be 4.5 in June. Last year he barely seemed to grow height wise at all - I mentioned it to his paediatrician, as he has low iron despite being on a supplement for nearly two years now (they aren't worried about this as he's otherwise well but they are keeping tabs on it with regular blood tests).

He was 97cm around August and had been the same since the previous January when his height was initially flagged as being short for his age.
I measured him today as he's grown out of some trousers and he's come up to 101cm. I felt quite reassured until I checked the charts and saw that 102.5 is average for a 4 year old and he's closer to the 25th centile than the 50th now. The reason this is concerning me is he used to be 75th centile for height when he was a lot younger so he seems to be slipping down them even if he's still growing.

I have mentioned this again and doctor has said she will monitor, but she also doesn't seem overly concerned. Am I being unduly panicked about this? I think he's grown those extra cm very recently so I'm wondering if it's a growth spurt and we are in the midst of it as he's eating a lot and complaining of being tired at the minute whcih, although he has low iron, he never ever complains of usually. He's the most lively child I know and always on the go!

Just looking for anecdotal stories of similar really or any reassurance? For reference I am short but DH is very tall, which is probably unhelpful on balance!

Kids tend to grow in fits and starts rather than in a linear way. I was a tall toddler, an average height 4 to 7 year old, then I had a mega growth spurt and was 5’8 by the time I was 13. Then I only grew another inch very slowly.

My DD is 5 in a few months and 104cm, which I think is somewhere around the 25th centile. She too didn’t really seem to grow much at all from age 3-4, then she pushed up a few centimetres over the last 6 months or so. I had her measured for new school shoes and she’s exactly the same size she was last September.

Basically don’t worry about it. He’s still well over the bottom centile line and he is actually growing - I would make sure I got the anaemia sorted though, and ensure he gets loads of sleep and good food just to help him along.

Inch?! I meant centimetre. I am not 6 foot!

Thanks for your reply. He's not actually anaemic which is why they are less concerned - I got confused originally as I thought low iron meant anaemia but apparently there are different types of low iron and he's not anaemic. I forget the ins and outs of it but I've got it written down somewhere. It's tricky to get sorted as they aren't sure why it's happening, he's on a supplement three times a day and has been for nearly two years and it increases but never to the normal level. Celiac has been ruled out as he's been screened for it. I find it very stressful and worry about it but the doctors don't seem bothered!

I'm hoping he's just due a big growth spurt, he eats quite well, although has definitely embraced the beige and wanting junk phase! He has got into worse food habits due to becoming fussy but eats a lot of broccoli, carrots, fruit, protein. He's always hungry and pretty stocky/sturdy looking and has plenty of energy, which is why I think none of the doctors are worried!

My dd is 4.5 and 87cm. She has also bounced around a lot of lower centile lines but health visitor etc says they aren't worried. Dh is above average, and i am really short so guess she just takes after me.

Just my own experience, but I remember feeling similarly worried when my DS2 was about 4.
He was noticeably shorter than his classmates in YR, but I assumed he'd catch up soon.

By Y4, I became very concerned. His class photo was ridiculous - DS looked like he'd wandered in from Reception class by mistake.

My late DF and FIL were/are quite short, around 5'7", although DH is 5'11".

I spoke to my GP as DS was on a very low centile on the height chart (I can't remember where exactly) - but she was unconcerned, and just told me that height varies so much.

DS is now nearly 17, and he's an average height, and doesn't stand out in any way. I haven't measured him for a while, but I would estimate that he's likely 5'9" - and, obviously, still growing.

As an aside, DS's close pal is unusually short - I'd say probably 5'2".
He's an excellent footballer, cricketer, and has bags of personality. It definitely hasn't held him back!

Thank you for replies. I'm less concerned about him being short if that's his natural height but more concerned there's an issue that's slowing his growth IYSWIM. I always thought dropping through centiles was a concern but I'll keep an eye over the summer and see what happens.

They have asked how tall we are, I'm only 5'2" but DH is 6'1" so hard to call which way he will go. I think if he didn't have the mysterious low iron I wouldn't worry as much!

I’d like to start off with I’m not a doctor and you should discuss this with yours, but I wanted to share my experience with you.
I had a very similar experience with my DS at that age. He hadn’t really grown much in about 12-18 months. They weren’t concerned about his height because he was still average height for his age, but he had been much taller for his age when he was younger. I’m also short and my husband is tall. My DS looked a bit pale and tired so I rang the GP and they did a blood test that showed his iron stores were really low. Despite not having other symptoms as soon as they saw the low iron they rang and said they were testing him for coeliacs disease. Two blood tests later he had a diagnosis. If you’re not familiar with it it’s an autoimmune disease that about 1 in 100 people have that means they can’t eat gluten. Within a few days of going gluten free he was a different child. He needed iron supplements for a few months, but that came right and he started growing again.
It might just be a coincidence, and maybe the doctor has already ruled this out, but I just thought I’d mention it as I think we got lucky that we had a doctor familiar with the condition so it was diagnosed within a few weeks rather than years like some people.

I know plenty of boys/men who followed their mums pattern of height rather than their dads. It sounds like he’s following you!

@Kiwi09 glad you got to the bottom of it! He's already had a blood test screening for celiac which came back as negative so it doesn't sound like that's the case for us but thank you for sharing.

@GoodnightAdeline he very well could be! I'm just concerned his growth seems to have got slower each year but I'm not sure how normal that is as I have nothing to compare him to, he's an only!

Track his growth regularly in his red book and if his growth is still causing you concern ask for a referral to an Endocrinologist. There are a few conditions that cause slow growth and most are treatable. Generally speaking children should reach a mid-parental height - this can be calculated on the red book, but you are best to get more medical advice if the growth doesn’t pick up. Some of my children have growth disorders that are genetic in nature and the first I realised was that a grandparent thought one of them hadn’t grown much since the last visit.

@RaisinforBeing thank you that's really helpful. He's under a paediatrician now so has been measured every twice by them in the last year, our last appointment was by phone so I need to get him officially measured by the GP next week and send over the info. She's then seeing him again in six months, so she is plotting his growth. It's tricky with the centiles in the red book as the bulk of his early measurements were done badly by me due to covid and us not having any health visits in person, so the doctors don't take them as being as accurate as they would have been if they were done properly.
This is my concern, that there's something else going on that could be fixed - if this isn't his natural growth pattern I don't want to just dismiss it as him being short if there is something that can be done.

DS was referred to endocrinology for short stature when he dropped from the 50th percentile to the 2nd. They tend to refer if they cross 2 percentile lines or if they are far off the mid parental percentile (there are online calculators for this) e.g. if mid parental height percentile is 50th they might be concerned if the child drops below the 9th.

Don’t make the mistake of measuring too often (it was every 6 months by the hospital). Keep an eye on things and go back to the GP if he drops down further.

With my child they knew there was an issue as the growth velocity - the speed at which you grow - was declining all the time. Then the diagnosis was after a blood test / a visit to the geneticist after the Endo referred us there. She has SHOX deficiency but there are other conditions such a growth hormone deficiency / pituitary issues that can cause slow growth there are also unknown causes but I think treatments for most. Also things like nutritional deficiencies and celiacs can cause slow growth.

I found it very frustrating when parents say not to worry and there is nothing with being small which is true but it doesn’t negate the fact that there may be a treatable condition causing this. The condition my child has was only discovered in the 1990s.

Thank you, both useful posts. I'll try not to obsess but I won't ignore either. I'm going to keep on it with the iron and push for further investigation, and I'll make sure he's measured properly every six months then I have a decent amount of info to be armed with if he's still dropping through the centiles.

@Itstheimplication it’s good to hear they’ve checked for coeliacs already and it sounds like his pediatrician is continuing to keep an eye on things too.

Kids grow about 6cm per year. So hes grown 4 since august and has 3npm to grow another 2.

I found nurse measurements really inaccurate at hospital as dc went from 50th to 25th according to them where dc didnt put heels to the wall.

Dc1 was about 50th right till 9yo and then has had puberty growth spurt and 98th at 11.10yo and now as tall as me!

@Itstheimplication is he eating lots of protein?

@PollyPut not as much as I’d like but he has lots of Greek yogurt, cheese, sausages, chicken, beef so I’m doing my best to up his intake.

thanks @GelbertG he definitely didn’t grow 6cm in the previous year but hopefully he will catch up.

He'll be in between you. So taller than you, but shorter than your DH. I should think.

Also, you really can't tell until puberty. In DD's class, all the girls were taller than the boys until about 12 yrs old. Then the boys shot up.

thank you - I guess I was just worried if there was an issue with his growth, ie not following his curve and figured it shouldn't be left until puberty if that was the case as I think by then it would be too late to do anything? But he is still growing, just much slower than he previously was. It's like he hit 3 and just massively slowed down!