3 year old only 82cm tall

[azzurra]

Hello DS will be 3 in Jan. He has always been small. At previous pediatric checks he has been found to be healthy and following his growth curve. I have always been reassured that although, small he was doing fine and that there was nothing to worry about. This until last week when at the last check I was told that his growth rate has dropped below 2nd centille. We were referred to an endocrinologist . We are waiting for the appointment to be confirmed. In the meantime I am worrying sick about what all this may be. Anyone out there who has had similar issues and can offer some advice?
Many thanks

My ds2 was small, started off fairly average at birth, was around 25% at a year, fluctuated between 9th and 2nd centile through most of childhood. He is 17 now, and around 25th centile - still growing (people on low centiles often keep growing longer). He was a bit underweight for height from about 1 year old to present day.

Had various checks/advice from nutritionists - he was a "good eater", but needed more calories - was told to use full fat milk, spreads, cheese, and add a spoon of olive oil to "everything", age him to eat nut butters and other high fat/protein foods (good food, not rubbish!). I was a little strange trying to watch his brothers were not overeating at the same time! DS2 still eats more, but struggles to maintain weight. He is MUCH shorter than his 3 brothers.

In DS case, they checked his heart and did a number of other tests, but nothing was found - but he has recently been diagnosed with a very subltle form of Collagen disorder - OI (Brittle bone), and the unexpected short stature/poor growth is part of that. I suspect it also affects how his gut absorbs nutrients.

Disappearing letters! ENCOURage him to eat, and IT was strange.

Bumping because I am in same boat. ds 3.5 and on 0.4 centile having been 25th at birth. has slowly moved down centiles, not a great eater and plagued with chest infections which don't help. awaiting referral to community paed.in the meantime will be upping the lard thanks oldmum

Thanks to both for replying to me. We went to see a specilist yesterday. We had DS's left wrist ex-rayed. It shows that althought he is 3, his bones' age does not match his biological age. His bones' development is around 21 months. He also had some blood tests done, which showed low levels in growth hormone.. Growth Hormone level however varies throughtout the day and it reaches its peak during the night when child is asleep. To have a more accurate assessment of his growth hormone level we were advised to have this tested throughout the day, which implies staying in the hospital for a day. The specialist thought that it is highly likely that the slow growth rate is due to growth hormone deficiency. There is a treatment for it and this is the bit that I still have difficulties with: it means injecting hormone every day from now till DS is 17/18 years. Although I was reassured that after a while this becomes as normal as brushing your teeth in the morning, I still need time to prepare myself for this AND most importantly to try and find the right words to explain to a happy 3 year old why we need to stick a needle into his leg every day of his life.

Im so sorry Azzurra i am sure he will hate you for it short term but as he gets older will appreciate its for his own good. We are not at the injection stage but my DS is 3 and only 86cm tall.
We have had so many blood tests done and his whole body has been xrayed and yet we have no conclusive answer. He is now having memory issues and will be seeing his 4th specialist.
Is there a nurse that will be coming to help give him his injection for the first few weeks? I know it sounds silly but it may be easier if its not you doing it so he doesnt associate you with pain.

Good luck

I wonder if theres a type 1 diabetics forum for parents that you could get some advice on re daily injections? As I know thats what they have to do no matter what, parents of youngster with type1 may have some tips for you... I have some youngsters in my family with it and they have to inject daily, but was not privy to how they have managed, just know that they have. best wishes, don't know if that is at all helpful, probably not...

It's good you know the cause, and in plenty of time to ensure he reaches his full potential for height. He will soon learn to do his own injections - some quite young kids with type 1 diabetes manage it themselves, and in the meantime you will manage just fine The hormone treatment is now synthetic and as such, really safe and effective (as I'm sure you will have been told already). You will not be hurting him by injecting, you will be HELPING him and he will thank you for it when he's 18 and a big strapping lad!

I had to inject Fragmin daily (preg related), and honest, the needles are tiny and you barely feel it. For a 3 year old..... would it be terrible to suggest a chocolate button standing by for after each injection?

Could you do the injection when he is deeply asleep?The chances are that he wont even be aware of it.

OP - interested to hear that they decided to test growth hormones.

my ds has been under paed since aged 2 as below 0.04 percentile for height. Now age 7 he is 1 meter tall and well below bottom line. they have tested bone age with wrist xray and said it is 2 years behind but never wanted to test growth hormone.

do you know why they decied to test growth hormone? Is it NHS? Do you know what final centile he should be based on you and your DH? My DS should be 25th centile based on our combined heights.

My 3.7 year old ds2 is also only about 88 cm tall and less than 12kg in weight. He is regularly mistaken for being 1-2 years younger than he is (and then people express surprise when he spells out his name and ds1's name and counts to 40 out loud ).

Actually, he has never had his hormone levels tested, despite being under a paediatrician since 7 months old (which was when his growth slowed from the 9th centile he was born on to the 0.4th centile where having dropped 2 centile lines, he was officially classed as "failure to thrive" ).

He eats little and food is an issue for ds2, as he has several allergies and long term reflux, which mean he doesn't associate eating with something positive. However, the effect is still the same, to have a tiny boy, who despite best efforts doesn't grow and especially in a culture where people congratulate themselves on what good eaters their children are and a big baby is widely considered a sign of good parenting.

Sorry, I'm probably not helping, but I'm just trying to say, I know how it feels (except for the injections).

Hi my dd is on growth hormone she has been since she was 2.5 she is nearly 6 we do it when she is asleep, it isn't nice injecting but it isn't the end of the world, my husband jabbed himself with needle (no growth hormone attached) and said he couldn't even feel it.

Dear All, Sorry for replying late I am not really a "regular" and check mumsnet as and when I have few minutes to spare. It is really encouraging to hear from you all. Lastdayofterm: I had my son tested for growth hormon at the pediatric hospital in Rome (I am Italian). I had tried to have this done here but the idea was dismissed on the basis that my son was "following his own growth curve and therefore there was no cause for concern". He is under 2nd centille now whereas according to my and his dad's height he should be 25th. From my own experience this is THE TEST that is needed. OldMotherDismass, my son is not a great eater either: we have to cajole him into eating something every day even though I get totally different reports from his nursery where he seems happy with his meals (maybe he is trying to tell me something about my cooking???). Pranma, injecting in his sleep is one of the options which we have also considered. I think I would still want to tell him that we are doing it and why. Googleberry could I possibly ask you whether there have been any side-effects to the therapy? I assume dd is monitored on a regular basis? How often? The reason why I am asking is because I am considering having the treatiment done in Italy but it very much depends on how often I would have to travel back for checks. Many Many thanks for all your postings. It is incredibly helpful to get your views and advice.

op - interesting you say the uk paeds said there was no cause for concern as this is exactly what they say to us and my ds is quite far below the 0.04 percentile line. we have seen several paeds and they all say that no concern as he is following the line and with late bone age will grow for longer. We have been told that anything between the 2 lines above and below the 25th centile would be normal limits for our child so 2nd centile is within normal limits and they are saying that because he will grow for longer he will reach 2nd centile although later than average children finish growing.

I had some interesting PM?s from someone who worked researching growth hormones and she said that it costs £15k per year and you have to continue for about 10 years so it is a huge financial commitment unless they will fund it for you in italy?

Also apparently it will only help to get a child to their genetic potential not make them taller. It sounded quite risky from what she said to even get the full tests done. Based on her advice I would be quite cautious of growth hormone and would research it very carefully as she was saying to me that not just the cost but the risk and it could just give an extra inch or two of height. There are far worse things than being the smallest as we know from other health problems which makes us more accepting of it I think.

googleberry ? Is your dd having the GH in the UK? How did they decide that she were eligible?

Can I add my opposite concern please? My dd is only 19 months and 83cm tall. She's always been noticeably taller than her peers. Is there such a thing as growth problems in this respect?

Ds is 5 and 101.4 cm which puts him at about the 2nd centile where he has been hanging around since he was 6 months. It was only when he fell off the charts for a while after a v nasty tummy that the Paed. Who he was under for other issues did a growth hormone screen which was clear. They also screened for gluten intolerance which was clear too. He subsequently climbed back to the dizzy heights of the 2nd centile where he remains. He's not chubby and I add that observation because I understand that children with a GH issue can appear podgy. He just seems to have his Dads physique, average sized torso with with shorter legs. And Hubby says he didn't stop growing until he was 20 and is shorter than me

first1-Yes there are conditions which cause people to be extra tall.. Was she born long and is she following her centile or has she passed what she was born on? My DD was born on the 50th but dropped down to the 2nd due to her athma and the amount of steroids she was on. She was bone-aged and found to be approximately 2 years behind her chronological age but then sadly stopped growing at 14 so will always be tiny as once her growth plates had fused there was nothing anyone could do to help her.

first1, isn't around 80cm normal for a one year old? I get lots of Danish clothes for my daughter and the labels for age 1 are 80cm (or 82?), can't think. Petit Bateau which do tiny clothes are 74cm for 12 months old so don't think your daughter seems particularly long. You should see my daughter, she's 8 months old and her 12-18month pyjamas fit perfectly!

And Azzura, I am so sorry that you are having such a lot of worry but it's great that things are being investigated properly now. Horrible with injections and I'd be so upset but better than the alternative and like others have said it will soon be just like brushing his teeth for your son (not that that's always easy of course! ). Worse for you. Good luck!

If I was you I would go on to the child growth foundation website there are a lt of people who can give advice on there.

My dd has turners syndrome and lots of girls with turners have the gh and have done for a long time with no side effects.

I've only just found this thread. My son has been small from the beginning, he wasn't growing properly in the womb and was less than 3lbs when he was born 5 weeks early. We've been lucky in that we had medical help from the start, his growth hormone level was fine on basic tests, he was then referred to a geneticist at 12 months as he was still only 14lbs and well below the growth charts but following his own curve. They wanted to rule out Russell-Silver syndrome, he doesn't have RSS but then had chromosome microarray (dna) testing. That test took nearly 6months to comeback but did show he has a microdeletion on one of his hormones and means he is missing his 'growth gene'. This is rare though, but it might be worth asking for a genetic follow up?
DS has already been approved for GH injections from the age of 4.
The Child Growth Foundation is a good informative website.