Happy healthy and titchy or in need of further investigation?

[Jennifersrabbit]

DD is 6, 7 in November. She's been solidly on the 9th centile from birth which I've had no concerns about.

However she's lately looking a LOT smaller than her peers and having measured her she is 107 cm and about 17-18 kg. I've just looked the centile charts up and if reading them right she is more like 0.4th centile.

Is this a worry and should I ask for a check up? She is healthy and energetic, enjoys gymnastics, swimming, ballet and winding up her brother. Achieving well at school, loves her teacher, many friends. We have had issues of more challenging behaviour at home which could ? be tiredness or unhappiness although Id put it down to being six and strong minded

Appetite not great but not non existent either. She has had chronic constipation again from babyhood which I felt we were managing OK with Movicol at present. We had a paed referral about 18 months back which raised no significant issues.

So do I just have a happy healthy natural born gymnast or is there something I should be doing? Advice welcome. Thanks.

What's your build like? Does she take after anyone in the family with her size?

It can't hurt to check tbh. The fact she's happy and active is a good sign but best to have these things looked at.

I would get it checked for peace of mind, my 3 nearly 4 year old is 20kg at 105cm and ave height in him peers

Your DD is the same height and weight as my 4.1 year old DD, so she does sound pretty small. Perhaps your GP could check her over just to be on the safe side?

Thanks all. First stop is to check or measured her right and assuming I have I'll book in with GP.

I've measured her right sorry! Wish this thing had an edit function!

My nearly in a month 4yo is 93cm and 13kg. She has fallen off the bottom of the height and weight charts, having always been between the 2nd and 9th centile.
I took her to the dr as people kept commenting about her size. She is happy, healthy and bright as a button, just a pocket rocket!
My dad is incredibly strong for her size and surprises people with what she can do. Dh and I are both average in height and build. Dd is the build of my grandma.

How big are the rest of the family? You would expect to see her in a similar centile range to you, DH and siblings.

You may also want to consider coeliac disease as a possibility because sometimes it causes growth restriction and the constipation may be a sign of an issue in that respect - unlikely but you never know, google other symptoms and see if they ring any bells for you.

0.4 th centile is considered outside the normal range, so unless you are a very small family drs will investigate causes. The drop from 9th to 0.4th sounds odd in particular. Ds2 was born on 0.4th centile and at 5 has slowly caught up to 2nd - the rest of us fall in 25-50th centile. He has low growth hormone so has just begun growth hormone therapy which is a PITA (especially for him, poor little guy) but not too bad

I know the fact they are twins may negate the usefulness of this post but they are 110cm and 15 kg and 7 in November.
Get her checked out by all means to put your mind at rest but it's probably nothing.

Thanks all. I'll get it checked but try not to worry. Wouldn't coeliac lead to a more evidently poorly child? I don't know a lot about it.

She certainly packs a whole lot of personality into a tiny package, bet your tiny DCs do too! Your twins sound great.

kids who feel poorly all the time get used to it and carry on as of there's nothing wrong because it's all They have known.

they are tough little mites

As giles said, if you always feel chronic pain you don't necessarily realise it's not normal. I have a friend who was diagnosed as coeliac at 21 and she said she just thought her gastro symptoms that she's always had were the same for everyone, it was only when they got severe that she sought help and investigation . If you search there are quite a few threads about kids with coeliac on here, they may be of help.

Thanks all. I have just weighed and measured her more meticulously and the answer is a bit more promising - 110 cm in height and 17.8 kg in weight. always check before panicking :)

Which puts her at least over the 2nd centile and hovering up towards 9th. Will still ask GP to check her out as I want to check we are managing the constipation and no underlying issues, but that's a bit more reassuring.

Thanks all. I will ask about coeliac - no family history but you never know. I only know one child with it and he was diagnosed by being dramatically unwell and hospitalised, so a bit different.

Sounds like dd. She's now 13 almost 5' but seems dwarfed by her peers and has done all along. She also one of the youngest on her year which accentuates it. Not sporty but enjoys ballet.

But surely chronic constipation from s young age isn't right? Sorry if I'm stating the obvious but I'd be looking into food intolerances. Your DD shouldn't have to put up with that

No, not stating the obvious and we have had a referral, but the paed advice has been very much 'carry on with the Movicol', and there do seem to be a number of kids on here who 'just' have it. She does have a decent diet, but is a bugger for not drinking and we are working on that too. It has seemed reasonably well managed of late provided she keeps on with taking the Movicol.

I agree the time may have come for another round of 'are you sure there's nothing else we can do about this?'

As long as she continues to be monitored by a paed, I wouldn't worry.

My DDs were both ridiculously tiny from birth wearing clothes for children less than half their age an awful lot of the time.

DD1 was definitely slowed down a bit more by a few months of appendix issues and chronic tonsillitis but caught up with her own natural growth line once they were removed.

DD2 was always just consistently tiny.

They both caught up a fair bit once they reached pre-teen age and are now close enough to average that they no longer stand out at all. it was clearly their natural growth pattern, just a slightly unusual one.

Trust your paed and your gut feeling. If they are both telling you she's fine I really wouldn't worry.

I had this with one of mine. Chunky baby that slimmed down to a very petite and thin girl. Much smaller than her peers, eats like yours. She had a year of recurrent ear infections so I was worried about her health.

Took her to the doc. He looked at me (apparently I am small built and petite, even tho I'm 5 ft 4"!). Knows my husband's build and I told him the females in his family are petite, he was not worried at all.

She is following her curve but is still very thin and petite, but she eats, sleeps well, is happy and has been much better health-wise than in infants (yr 6 now).

Always worth getting check per by GP.

Thanks all. This is very helpful advice. Much appreciated.

Yes in terms of size, all children are different so if you feel she is healthy and well then go with your gut feeling.

It just bothers me that a child should have to go through that, constipation is bloody painful. Having said that I tried everything for DS's eczema and it just disappeared after 2 years. Possibly constipation is one of those things too.

Good luck getting some answers

I agree that it might be worth pushing for some more answers about the constipation, but I wouldn't be too concerned about your DD's size. My DD is very similar- three months older than yours, 112cm and around 18kg. She doesn't seem particularly small compared to her peers and she's slim but not skinny.

Have you already tried eliminating dairy from her diet for a while? And wheat separately? If you do suspect coeliac then you shouldn't do the latter as as I understand it the patient needs to continue eating wheat before testing. But if it is an intolerance causing the problems, rather than coeliac, then elimination is the best way to identify it. Cut it out completely for 2-3 weeks, observe any changes and then reintroduce for a day or two and watch for any reaction.

Just looked at my dds weight and height last year when she was almost exactly the same age as your dd and she was 109cm and 16kg. She looks very much in proportion but is a lot smaller than most of her peers. She eats really well and does a bit of sport, but is just weeny.

Same as Lesley, mine was checked over by a doc when she was much younger who also decided that she was just petite like I am and that she was otherwise perfectly healthy.

She has grown 4.5cms in the last 9 months (apparently average per year is 6cm) so seems to be growing "normally".

9th centile v different from 0.4th ,

Chronic constipation in kids is very common and usually idiopathic (i.e. no known cause). I have a 3.5 year old who's been on Movicol for three years already. She was tested for coeliac though, so it's definitely worth eliminating OP

Yes I agree sleepwhenIdie. Much to be said for using a tape measure correctly Shes in between the 2nd and 9th now I think which is much more like her normal.

I appreciate the advice from both angles though, and will pop along to get it all checked, including the constipation.