Other mums with small children (3yo, 23.9lb, 86cm)

[Vicki1981]

Hi,

Does anyone else here have small children? Our little one was 5lb3 when born at 37 weeks and for the first couple of weeks she really thrived on breast milk. Since then, things have got worse and over the last two years feeding has been an issue. She just doesn't seem hungry often.

Following a hospital appointment yesterday I've spent hours upon hours finding high cal recipes for her and food that can help. I'm going to have to import a few bits from America as quite frankly, their high cal stuff is much higher cal than ours! Plus lots of recipes have American ingredients.

She has two Frebini drinks per day, each packing 300 cals. She has lunch with me apart from Mondays, Tuesdays and Fridays when she's at nursery and playgroup. On the other days she also has dinner with us so we eat together as a family most nights.

Dinnertimes can continue way past an hour by which time I'm tired of it. We stopped making a big deal of it when this first started, so there's no shouting and telling off, although we do try to encourage eating with nice desserts which sometimes works.

She has had blood tests, seen a gene specialist and has been back and forwards from the hospital for so long now. They do want to send her for more blood tests in case of Russell-Silver Syndrome, but there aren't any further symptoms displayed so I don't really expect it to be that. Despite her looking strikingly like a little girl who was on TV with it a while back.

People tell me 'oh she will catch up', I believed this but now she's hit 3 it's like it's a bigger issue. To only gain 9oz in 6 months isn't good and she isn't catching up. We can't go another 6 months, then another 6 months and see her turn 4 and not weighing any more than she does now.

I think we need to look at increasing her appetite. Has anyone any experience of medicine/vitamins that can do this?

The next step is hormone treatment, injections daily that can change her mood, we want to avoid such drastic measures if we can.

So, has anyone here experienced a similar thing or does anyone have any ideas that could help please?

Thanks.

Vicki

Just checked back in my DS red book and he was 24lb at age 3 and 84cm. He was referred to a paed at his 2 year check because under the 0.04 centile line and continues to see the paed every 6 months but the paed has never been worried and he stays on this line and I have never really been concerned either.

Paed always explained to me that if child sleeps through the night then they are getting enough food so no concerns. I was told that this weight was correct for this height so not actually underweight and no one every suggested giving extra high calorie food. Paed always told us it would not make the child taller to eat more just heavier. We have seen dietician and my DS eats less than half calories for his age but he is never hungry but is well and as short will need to eat less in my opinion

My DD is 2 and measures 78cm but far less of a concern for a girl as generally they suffer more with teasing when they grow very early whereas boys can become agressive when the smallest. I have never every considered it a problem for a girl, just think she looks really cute and I know how tough she is and healthy.

If your Dd is healthy no idea why you would be worried unless you and your DH are very tall then it would be strange but still not worth considering growth hormone and all the side effects. Even if she should be taller she is not underweight is she? My DS has always been well below 0.04 centile line for height but up to 1 percent line for weight which means he is above average weight for his height. Is your DD not the same?

If hospital have other concerns and are worrying you then that would make you concerned but in our case no paed every had any concerns about heights below the bottom line in red book hence my lack of concern.

Have you had her bone age checked as that may well be late so she may continue to grow for longer?

We have never made mealtimes stressful at all as it always had the absolutely opposite effect - little and often rather than one hour battles with lots of healthy snacks. My DS used to be filled up if he drank any milk at all so we had to really cut it down before we got any food into him.

Hi,

Her bone age hasn't been checked, maybe that's something they're considering? I agree with stressy mealtimes being counter-productive. Sometimes I've had to leave the room so I don't get overly annoyed or stressed in front of her!

My daughter has a 'larger-than-average' head and a pronounced forehead. A while back she had checks on her head but all came back clear regarding that. When I buy clothes, I'm looking at 18-24 months, when I buy hats, I'm on to 3-6! She has elfin looks too which is another concern regarding Russell-Silver. They're the only signs though, she doesn't have any others which is why it was left-alone until now.

I hate seeing every rib when she is naked, she looks underweight, you know? She usually sleeps through the night, well...other than waking with her chronic and severe eczema, poor thing.

Today, she has eaten a grand total of...some crispy bacon fat when I was making a pie! I know that's unhealthy and fatty (obviously), she hasn't eaten it before and wanted to try it. That's it. She didn't touch the pie, didn't eat her cheese and ham pasta for lunch and didn't want to know her fried caramelised banana.

Our daughter's dietician told us she should eat 1000 cals/day. We kept a food diary for a few months to hand to the dietician and she was way under. That was mainly to keep check on nutrients and vitamins etc.

Thanks for your reply, it is reassuring to know people haven't had worries about their small ones!

Can see that you may be concerned if there is a possible condition but dont think you should be worried if this has been eliminated. According to my red book your dd is on 1st centile for height and 2nd for weight so she is not underweight and is similar to my kids being in proportion to her height. Have to say my eldest looks thin too but according to the chart he is not underweight for his height as like your dd he is on higher centile for weight compared to height. It is probably because so many children look so much chunkier than the recommended in the UK that ours look so thin here.

Did they advise if she was getting adequte nutrients despite not having enough calories? Our Ds was apparently getting enough despite only eating half the calories. He rarely even touches even one mouthful of his dinner but often eats a weetabix or two for breakfast with lots of milk and snacks on fruit and may have a slice of bread at lunch on occasion and that apparently gave him his nutrients!

Presume they have calculated an esimated height based on yours and your husbands. We calculated ours using HV red books and our kids should be on 25th centile but our paed explained that anything between the 2nd and 75th centile for our heights is accepted norm ie 2 lines above and below. Whilst our kids our not estimated to reach 2nd centile as moment if we factor in the delayed bone age then they will most likely be above 2nd centile. If this is the same for yourselves then that would be reassuring. If of course you and your husband should have children at 75th centile plus or minus two lines for example then that might be a concern. Also you are meant to be able to double their height age 2 to estimate final height but again if you grow late then it gives an underestimate. I was estimated to be under 5 foot age 2 but grew to just over 5 foot 3. Do you have other children?

Although our paed tested bone age we knew that my DH and DB both had late puberty and I was not very early so we always felt that would be the case as it is hereditary and was coming from both sides of family. I would much rather my sons were taller as I have seen it cause huge agression problems and now alcoholism in male family members but have no concerns with small females. In the sexist world we live in I dont see any prejudice towards short females and have found girls who grow very early often suffer most at school.

Hope this helps.

Hi, I am short (5'2) and my partner is tallish (5'9/10) so I expect her to be short or average! It's not that she is just short though, she isn't growing.

They haven't ruled out everything, which is why they want to test again - they had initially ruled out a gene problem based on appearance.

She wasn't getting the nutrients so her dietician had her on multivitamins for a few months. We have stopped that now as she's having her prescribed drink twice a day and don't want to overdo certain vits.

With my total focus and attention she has done better in the last 3 days and that's great, so pleasing. She even ate a whole piece of cheese on toast for lunch yesterday, never heard of before. I spread avocado butter on first to bump up the cals. She had all of that (with my constant interaction and making it a game) and two slices of wafer thin ham. Happy, happy mummy.

Oh, we have no other children although ttc at the moment.

Her cousin was prem at 24 weeks, 1lb 9oz and is now 6 and doing great, I don't think she is small anymore. She had caught up to be average by the time she was 3. She was bigger than our daughter at this age! I'm not really comparing, just giving the info.

Hi Vicki we have a v small ds2, he is 22m and 9kg, has always been on or just below 0.4th centile, at 20wk scan he wasn't even on the chart - drs expected this was due to placental insufficency and he was induced at 37wks weighing 1.95kg and has showed no catch up.

The geneticist we saw recently at GOSH tested first for RS, even though he has absolutely no characteristics other than little dimples in his shoulders (no elfin look, not thin, no asymmetry). Came back negative. We too expect to have to give him growth hormone in a couple of years....I would push them to test for this as it sounds like a possibility and once you know that is the case, they know how to treat it. Also you can then take some comfort from there not usually being any serious health complications associated with RS?

Thank you so much sleepwhenidie. It is a worry and people don't understand how hearing 'ooh isn't she a doll' and 'wow she walks well how old is she' gets very tiring after this long even if it is meant as a compliment.

She has size 4 shoes still and such tiny heels I have to go to a special child's shoe shop and get expensive shoes! Dreading school uniform/shoes already.

Although people always mean well, and I appreciate it, it's nice to talk to someone who doesn't just say 'oh she'll grow' etc.

My princess has an appointment with dietician and her consultant at the start of December so I'll see what happens then.

Sorry I don't answer everything in one go. I'm on iPhone which doesn't make it easy to flick back to see what you said.

I think perhaps in December there will be blood tests for rs - really don't know why they didn't do that along with gene specialist opinion. I fear for bullying, lack of confidence, social exclusion etc if she doesn't grow much. Right now she is as boisterous as any 3yo but the height and confidence issues are beginning to appear. For example, at gymnastics she can't reach things others can.

My DS2 was the size you mention in your title at age three and is still small now at five, but "normal" health and development wise. He was around 7lb at birth but was dropped steadily down the growth charts, settling in the shady area by six months. He has stayed there, or below, since.

Although he appeared fine, I stayed in close contact with the HV in the first year or so due to his size. His size alone was not a medical issue, and isn't now. He eats normally, apart from being a fussy bugger, and needing small meals often, rather than three large meals a day. That's annoying for me but a perfectly healthy way to eat.

He does lots of sport and particularly enjoys gymnastics. His height is not a problem with this - he can spring as high as he needs to on the spring board. He can't quite vault over the horse as some of them can but 1. he is only five and 2. some people can never do it.

I take a low-key positive approach to being tiny. He's going to have to deal with it all his life so needs a realistic attitude. I never take the "poor you" approach with him. It is annoying that he can't win at running at school even though he is incredibly fast - the other boys are so much taller with longer legs. But he has to accept that and not feel sorry for himself. There isn't anything we can do to make him taller. We're all shorter than average and he just looks like being he shortest of us all.

Of course people do make judgements about height, just as they do about weigh, hair colour and accent. It is real, I acknowledge that. I too am 5'2 and was recently at a meeting with a man of nearly 7'. I was in the position of authority and he just made a joke about it and we sat down.

The confidence has to come from within.

OP - has your dd always followed the same line or is she dropping if you say she is not growing? Are you in England as it is odd you are being given such totally different advice to us? We have been told there are no concerns with our DS despite his being smaller than your DD and boys charts are taller and heavier. My DD is smaller than yours and was not even referred as no concerns. Does your DD have any developmental issues that would raise concerns as it worries me that I am being given such different advice and whether I should be concerned? I really think the stress will pass to the child even if not discussed and that will undermine confidence.

Also those of you who have mentioned growth hormone not sure if you know about it but there was a post about it a few months ago including someone who works in the area and it is certainly not something to be taken lightly. People have to cope with far far worse things than being the smallest, far more important to work on confidence and friendships than the trauma of such a horrendous and risky procedure. Having said that I think the poster did explain that it was extremely difficult to get the treatment as it costs 20k per year and has to be continued with when started.

Sorry but I just cannot see the problem of a girl being under five foot. I can see issues with a boy finishing so small but still not enough to risk such treatment. My brother had injections to bring on puberty which meant he reached his final height earlier although didnt get any taller than he would have done anyway but it did reduce his problems as he was under five foot at 16 but even that was quite traumatic but at least was his choice unlike when a decision is made for a young child.

Vicki I understand your concerns. My biggest issue is listening to all the stories from people who know a child who was tiny (always really tiny in the story ) for ages then suddenly, at 5/10/14 grew to be 6ft plus! It does make me wonder whether things are best left alone and maybe he will suddenly grow at some point...balanced against if he doesn't, will he resent us for not intervening with growth hormones when we could have done? . This was why I was not over the moon to hear Ds2 does not have RS...good news, but at least if we knew he did have it we would know for sure that he wouldn't suddenly spurt at some point and also how to address that (or not).

I take your point Glam, about confidence, but each child will cope differently with what is, essentially, a handicap (albeit mostly a social one). For some it won't be an issue, for others it could seem like it colours their whole life. You can help them as much as you can by teaching and example how to deal with it, but it will be their problem, not yours. Why would you not try to help make your child's lfe as easy as you can if you are able to? If ds2 stays on same centile he would end up about the same height as you and bearing in mind you sound like you consider yourself short, I would argue, like November that being 5ft 2" would be much more of an issue for a boy/man than for a girl.

I think it is important with all this to draw the distinction between children who are small because they are genetically meant to be and those who aren't...growth hormone would do nothing for the former so there is not a decision on that to be taken by parents, nor any reason for concern about why they may be small. My DH and I are not particularly tall, but not short either and this, with our family history means that it is odd (to the doctors) that he is so little.

November maybe the doctors aren't so concerned about your children because of the family history making it look like this is just the way they are meant to be and/or you are looking at 2nd centile point, which is within what is considered "normal" as opposed to 0.4th or below, which is not? Where are you?

Having said all this, I agree with November that being small is definitely not the worst thing a child could have to deal with. There were all sorts of horrific possibilities associated with his size discussed with doctors before DS2 was born but he is fine, has a gorgeous, feisty personality and is developmentally on track. Visits to GOSH also bring it home to us hard that in the scheme of things we are really very lucky.

Sleep - we were told that whilst ours should be on 25th centile according to HV red books actually anywhere within 2nd to 75th is acceptable range. Thikn this would be the same range as Vickis?

My DS has never reached 0.04 line but factoring in the late bone age he may reach 2nd centile if he grows late. Agree that my family history makes me more accepting as I had one brother who had the late puberty and growth problem and one who was 6 foot with both the same parents.

Also think I am more relaxed about it not just because of the professionals attitude but also because of the other horrendous medical problems we have encountered which puts things like this into perspective. There are far far worse things and having a child who has real health problems is just not comparable with wishing a child to be taller for social reasons.

I still maintain I would prefer my daughter to be under five foot than near 6 foot and really believe the issues are far greater for tall girls especially those who grow early.

My DS is just 1 meter and just turning 7 but is now fit and healthy and his weight is in proportion to his height. Many of this class mates are 30cm taller but I am so proud of him especially when he stands up to them.

Hi my dd was never on the chart and like yours was wearing 12-18 month clothes at age 3. We had all the tests and saw the dietician and everything was normal. Like your dd meal times were a struggle so we just used to leave snacky food out all day long which she used to graze on, the dieticians advice was as long as she was getting a varied mixed diet to just forget about specific meal times.

DD had a growth spurt in height when she was 5 but has never really caught up on weight (yet). She is now nearly 7 and weighs 2 stone 4 but is healthy and happy and very active. She has just started finishing meals and over the summer holidays has developed a very healthy appetite, so I am hoping she starts to fill out.

Hormone injections were never mentioned. She did have all bloods took a few times for various diseases etc and sweat tests for cf but all negative.

I would say have the bloods etc they are recomending to rule out things but if everything comes back ok try not to worry (easier said than done) I am sure she will catch up eventually. Has the dietician given her high calorie milk shake as my dd used to enjoy these?

Hi. I just wanted to add my 2 pennies worth. Mydd2 is 3, she weighs 21.9lb and is 81cm. She is in 9-12month clothes.
She is very tiny featured but has the biggest personality of my 3 children.
When she was 18 months or so i was reffered onto peads, whom said about esting for reasons for small size etc. I asked them if they honestly thought she had any of them and they said no.
She had bloods taken once when ill and admitted for hospital, so due to her size they ran a test for something (honestly cant remember what) came back clear.
She started pre school in sep, she is miles smaller and is very popular. she rides scooters/ bikes etc like everyone else, and apart from having to have help on and off the toilet (she falls in alot) she is just the same as other children there.
There has been no more mention of tests, and we have just accepted she is smaller than the average child.
she eats like a horse, (3 adult sausages, 1 jacket pot and beans for tea tonight) she has just put on some weight since may, but before that had stayed the same for 6 months.

There are lots of replies here and I'll try to reply to everyone but haven't got time to sit and do it at the moment I'm afraid. So two very quick comments. Yes, she has a high cal milky drink called Frebini. I'm popping a scoop of vanilla Complan into that now, which my lo is LOVING! She has two a day.

I can relate to the falling in toilets thing - dd's nursery had to get a seat for her as the others were unsuitable. Luckily, she found this very funny! :)

Oh an HalloweenDuck, if our dd ate that for dinner I would be ringing everyone I know to tell them - it would be amazing!