tall parents VERY small two year old? Humour me!

[iclaudius]

My two year old appears to be on the short side. His siblings and parents are all tall people ...

Any one experienced this and it been nothing or they have suddenly shot up? He has been referred to a paediatrician but along with a couple of other little niggly bits we are a bit concerned

Thank you

When you both (child's parents) become tall - can you check with your folks if they are still living? Any family stories of you "shooting up and growing out of ALL your trousers" over one summer?

Good that you have a referral!

Hopefully someone more knowledgeable will be along soon

My two year old is also a bit on the petite side with tall family on both sides. My dad is 6'6" for one! However, my brother was quite small apparently until his early teens when he shot up - he is now 6'5". So all is not lost :)

My dad on the other hand was apparently so long when he was born they didn't have a cot big enough in the hospital [grin ]

Supposedly they are half size at 2 would that make him really small?
Premature?
Small at birth?

Where is he on the growth chart? I'd also ask the questions about family growth patterns as recommended upthread.

My youngest (dc3) has always been very small (not even on chart at 20 wk scan, born 0.4th centile and at 4, only just caught up to 2nd in height, still 0.4th for weight). The rest of us a pretty average height. Because ds2 has always been so tiny he has been monitored since birth and now it looks as though he will need growth hormone therapy, which I understand isn't as scary as it sounds and not uncommon. It's very likely your DS will have a spurt - but there's always a chance that these a hormonal issue, but also consider, especially if he was growing and then seemed to slow down around the time he was weaned, that he may have coeliac disease.

I'm sure the doctors will just monitor his growth for a year or two if they have any concerns, may check bloods for any deficiencies but unlikely to do other tests until he is closer to 4 if he is in good health.

thanks so much for responses spent the whole night on google

he was 'big for dates' in utero and born at 38 weeks at 8 lbs 10 oz

he then hovered around the 25th before slowing down and is now at almost 2 on 0.4

both of us tall ( and with tall siblings) although parents were not particularly tall on either side..
His siblings are all tall
we are thinking there might be some growth hormone issue going on although this is only from our own reading

I should have said, ds was also a big baby at 9lb (40+5) born on 91st centile. He dropped to 2nd centile by 7mo and was monitored by paeds but discharged as nothing obvious. He's slowly climbed back up to 50th centile now at 2.5yo.

One measurement to check for is head circumference - has that been monitored? It's odd having a small child when all family are tall isn't it?! Saying that, my mum is 5'3" and jokes it's about time one of us were evidencing her genes

I believe that once they are below 2nd centile it's considered outside the normal range and would prompt investigation. That does sound unusually low iclaudius, especially if as you say, you and DP are tall. I don't know where you are in the country but we are seeing an endocrinologist at GOSH, Dr Brain, she has been excellent so if you get a referral from your GP you may want to request her . As I said, all that they will probably do for next year or two is measure you and DP, take history and then get DS in every 6 months to monitor growth, any hormone treatment wouldn't usually start until at least child's reception year.

I would have him checked (as our HV would). But it may be perfectly normal and he'll grow late.
I have the opposite with dd2 is very tall but me and dh are small average.

You'll need a referral to an endocrinolgist to diagnose growth hormone deficiency. The Child Growth Foundation facebook page is super helpful and very supportive.

Dh and I are pretty average at 6.1 and 5.3. Both girls are smaller than average. Dd1 on the 0.25 th chart and dd2 on the 0.9 th.

Hv didn't seem too concerned as she is perfectly healthy and ahead of her milestones. She is also very slim and on the 0.9 for weight too. she's hardly put on anything since her 1 yr check 2.5 years ago!

She is growing but very slowly! I'm waiting for that growth spurt where she suddenly shoots up

We are also 6'1 and 5'4 and our DD started 60% for length went up to about 75% and at 20months is i think 50%
I think she should end up 5'6 but may be closer to my 5'4
(But my mum smoked while pg so i may be shorter than i should be , parents are 5'7 and 5'10)

Piglet, ds2 is very healthy and ahead of his milestones too, that doesn't mean hormonally everything is fine. I'm not saying there is anything to worry about, there probably isn't, but I'm not sure I'd rely on a HV opinion...are you sure 0.25th and 0.9th rather than 25th and 9th? Very different, the latter is smaller than average, the former markedly smaller than most if not all of their peers . DS2 has just turned 4 and still wears age 2 clothes a lot of the time for example. He only weights 12kg.

Looking at girls height charts
25% - 5'3 and half
9% - 5'2 and half
0.4% 5'0
So .25 would be below that
Not sure what 0.4 would be for boy chart

DD was 8lb 4oz at 3 weeks late (91st centile)

She was always 'big' HV estimated her at 5ft 11.5inches

DH is 6ft 1 & I am 5ft 5 (but my baby brother is 6ft 4)

DD is 16 and seems to have topped out at 5ft 3 - although we have recently read (on MN) that as a dancer she might grow a little more

Height is so complicated

thank you all so so much for your responses ( i actually KNOW a couple of you from musmnet years ago!)

sleepwhenidie that is so interststing about not starting any therapy until he is school age as we thought they might start it asap...

ok so do you think that means no rush really?

We have got paediatrician dates and they are not until April so were now considering going private to hasten things but if they would not start any therapy then maybe there is no rush

as i said the little boy has a few more issues which have made us concerned - the slow gross motor milestones which is not familial - is a worry and even v chubby is worrying us as these children always are...

Sleep- Could possibly be 25th and 9th.. we have just moved and their books are still in a box somewhere to check!
DD1 is 5.6 and noticeably smaller than others in her class. They all mother her and look after her which is quite cute.
DD2 is 3.9 and would just pass for 1 meter tall now (in the right shoes!)
and about 28lbs.

According to MIL, DH was tiny as a child and they thought about growth hormones for him but then he shot up all of a sudden.

Iclaudius we considered going private too but after a discussion with a friend who is very experienced through her own dc's with healthcare, advised me to stay within the NHS, it's usually fantastic where children are concerned, typically you would be seeing the same consultants and once you step out as it were it complicates things to get back in - and growth hormone therapy is very expensive! So unless you feel you aren't getting proper attention or being listened to I would be careful about that.

The therapy can be started early, but ds's endocrinologist says it's best when the child has realised he/she is smaller than peers and can have some understanding of the need for injections every day, and hopefully be willing (!) to comply. Of course it also gives a growth spurt a chance to appear .

if your child has a gh deficiency it is not about them being small, but about them not growing properly. There can also be other hormonal problems eg MPHD. If they do not grow properly it can affect puberty, fertility etc. From what you describe your child has really fallen off the growth charts and isn't following a curve, which is concerning e.g they could be bottom 2nd percentile, but as long as they follow that curve it is 'normal' growth to an extent. You can have an enormous battle with the NHS as many parents on the Child Growth Foundation FB page will tell you; many of them have found the only answer has to go private to get diagnosis and treatment after years of worry and fighting. If he is GH deficient there would not necessarily be a reason to wait until he starts reception to begin treatment. There are lots of preschoolers on the CGF page on treatment now. One private endo often highly recommended is Dr. Richard Stanhope. If he gives you a diagnosis of GH deficiency my understanding is the NHS cannot ignore it.

Thank you so much adopt mama
Why is it you think the nhs ignore diagnoses?
He is not following a curve he has pretty much plateaued the last 6-8 months

Dp and myself are both tall and two of his brothers were six foot by 15 ...

As you can see by the time - I am worrying!

from my experience it's very hard to get a diagnosis for endocrine issues from the NHS often symptoms can be waved away with a wait and see attitude and many times it's hard to insist on full screens especially when conditions may be rare.

any other symptoms?

As cafecito says there is often an attitude of wait and see. Many GPs are simply uninformed on GH issues and just think parents are fussing that their child is 'short'. So it can be very difficult to get the referrals for testing with endocrinology that you need. GH deficiency is a very real health issue and shouldn't be ignored. Personally I'd go private (not as expensive as you might imagine to see someone like Dr. Stanhope, Portland hospital) because you get seen more quickly and do not run the risk of being ignored or dismissed as seems to have all too often with NHS.

I'd still try insisting on an NHS referral with GP first iclaudius, our GP was happy to do that when I asked (when ds2 was about 2) and GOSH has been fantastic - to be clear, if we had been keen to start gh therapy earlier, the endocrinologist would have gone with this, but for ds she was happy for us to wait and see a bit longer, which was our preference. She is of the view that she prefers children to be cognisant of the therapy (to the degree they can), but she certainly has patients on it much younger. For DS it wasn't considered a problem to put off starting the therapy until 4/5, but get to see someone - if your GP does brush you off, then certainly go private - get the tests done and see what they say. . Good luck.

Adopt, I wasn't talking about the consultation fees so much in terms of cost, more the years of drugs that are likely to be required . That, afaik is very expensive and I don't know what cover, if any, OP may have for this. As I say, we have been more than happy with NHS though we could have gone private, have insurance.

you would get the drugs on the NHS - you would not have to pay for them yourself