Small toddler

[Cheesesticks]

We have just measured my 3year old dd, she is just scraping in on the bottom centile, she was 6lb 4oz born so reasonable size but just seems very small, she is fine in every other way. Do you think it's worth a visit to HV or are they just going to say she is fine, she does eat just not great amounts. I'm 5ft 4" hubby 5ft 9" so not massive but not tiny either. Any advice would be great thank you

What do you mean bottom centile? My ds2 is on 0.4th centile which is below the bottom of the 'normal' range (under 2nd centile)

The thing with centiles and averages is that someone has to be at the top end and someone has to be at the bottom end. If you're happy that she's healthy and eating well, then that's fine. Like you've said, she hasn't got particularly big parents. I really wouldn't worry that much.

My twins are three in August and they're teeny weeny, I just tried on some of last years summer dresses, one of them is 12-18 months and they still fit. They're fine in every other way so I've given up measuring / weighing them

Yes the 0.4th.

POP is right that someone will inevitably be at the bottom of the scale but those children will usually have parents whose size is also pretty low down the chart...as you say cheesesticks, you and DH aren't big but you aren't that small either. DH and I are 5'9" and 5'5" so similar. DC's 1 and 2 are between 25-50th centile as expected but ds2 is (and was born) very small.

It's worth getting checked (ask for a referral if necessary, ds2 sees an endocrinologist at GOSH), so they can monitor growth over a period and do any tests they think are necessary. Ds2 is probably going to start growth hormone therapy next year (more common and less scary than you might think) but coeliac disease or other genetic things can also cause failure to thrive, or dd may well have a growth spurt soon and all will be fine . No harm weighing and measuring and even the GH treatment is our choice, it's not being pushed, it's not being done for health reasons. I have to say if ds2 was a dd I'm not sure I'd be so sure of doing it, I think it's easier to be a petite woman than a small man?

Re your twins unintentional, I think that's probably more normal for them to be small and catch up eventually? I'm no expert though, but if you are concerned then of course speak to GP or HV.

Sleep thanks for that, I think I will pop her down to see the HV. We also have two other children out eldest dd is small and on growth hormone since she was 2.5 she is now 8 but she has turners syndrome and was prem (1lb 14oz) so completely different to our youngest, she also is in oxdrolone(sp) to increase her food intake. It's interesting you say dc2 is about to start growth hormone, do you mind me asking if he he is just small or there are any other reasons?

He is just small, wasn't even on the chart at 20wk ante natal scan, it was a pretty scary pregnancy . He's now 4 and height has caught up to 2nd centile but weight still 0.4th. Have checked for coeliac and Russell Silver syndrome but nothing else that seemed worth looking into. Nothing particularly remarkable about bloods etc, one odd thing is that he is missing a couple of teeth, which is apparently rare (not so for adult teeth). Otherwise all very normal, he has a huge personality .

How is the GH therapy going with dd1?

How heavy was he born? Sorry I'm nosey :) it's going good before she started she was no where near the bottom centile now she is just on it she is very lean and I struggle to get clothes to fit her tiny frame she is about 112cm now and in age 6 clothes. The injections themselves are ok she is on geotropin 0.9 daily dose and I do them as we go to bed when she is generally asleep but she is ok if she is awake when I give them to her. I think she will be on them till she is 16 and we see the endo every 6 months.

Just to add my 5 year old is between 9th and 25th so perfectly happy with his height :) although he is smallest in his class but also the youngest.

He was 1.95kg, 4lbs...so sweet, you could pick him up in one hand. Perfectly fine except for a bit of jaundice , such a huge relief after all the speculation during pg about what might be wrong with him to cause the growth restriction! some of that was horrific.

I read you can predict height by average your 2 heights and subtract 3in for girl and add 3 for boy.
I think that would give you about 5'3 and a half maybe 25 percentile.
I would take them as you already have a child on growth hormone just to rule anything out.
Do they have allergies?

What about extended family heights? Any tiny grandparents of Aunts/Uncles? You many have just passed on the short genes from both sides of the family...

Paediatrician told me that the important thing was that a child 'followed their line' on the chart. So if DC has been 0.4 percentile all along that would not be cause for concern on its own but a child suddenly dipping to 0.4 having previously been 3 or 5 or whatever, would merit investigation and intervention.

I grilled more than one paediatrician quite viciously on this point over the years. They all said the same.

HTH

Thank you all I will pop her down to get measured, I actually don't think she has ever been done by the HV, she will be measured when she starts school but that's a long way off :) I think she was born on the 9th centile, she was my biggest baby so I had high hopes of her not being small!

Sleep glad your little boy is ok and good luck if you do take the GH route, the results defiantly worth it.

Thanks cheesesticks, best wishes to you and your dc's too .

My DS1 was way off the bottom of the centile chart - well below the 0.4 line. He's now 20, 5'10 and about 9 stone - he's slim but not skinny and very healthy. We spent several years back and forth to the HV and hospital for weighing and testing - he had a biopsy to test for coelicas, a sweat test to check for cystic fibrosis, chest xrays, blood tests, urine tests, poo samples tested etc - they tested everything it is possible to test I think and in the end they just said he's 'naturally small' He was 5.5 before he hit 2 stones.