Very small 5 year old

[Tournesol]

Hello,

Just trying to work out if I need to worry and should be seeing a doctor for my DS. He is 5 and is 102 cm tall, quite markedly the shortest in his class.

He has always been small and we have seen dieticians to see if it was a diet problem (he has diary and nut allergy) but his diet is fine. His hormone levels were tested a couple of years ago and were fine and they also checked him for coeliac, which came back negative.

I keep telling myself he is in proportion and will grow eventually but then I start getting worried again. We just measured all the kids and his brother and sister both grew about 5 or 6 cm in the last year but DS2 only grew 1cm, and if I am reading the charts right has gone from 25th centile down to 2nd.

Thing is I was a small and skinny child too, but I really don't think I was this extreme and ultimately I was a late developer but am now 5 foot 10 and DH is 6 foot, so I just feel like he should be taller.

Sorry this is so long! Does anyone have any words of advice or reassurance?

I would see a doctor if he has only grown 1cm and fallen centiles just to rule out any underlying cause and have him monitored by them.

I think if you were small as a child before shooting up, he's probably just following your pattern but be good to check it out.

No advice we are currently going threw this with to 4.5 year old, he also has a milk allergy and they think slightly wheat intolerant.
He's not growing in a year and has lost weight, we've had no tests done as they think he's just active and doesn't sleep enough but we are due to go back.
We've also started a high calorie diet for him so we offer two portions at each meal time, extra snack ect

I don't think there would be any harm in the Dr, even though we've been seen and he's been monitored it doesn't stop me worrying but is slightly reassuring to know they don't think it's anything serious which did go threw my mind at first.

Thanks for your responses! We have tried upping calories but it is quite hard with dairy allergy as dairy is such an easy way to add fat and he can't have it!

He is a healthy child but just at the back of my mind I worry that we are missing something and I would feel so bad if his growth was stunted because I ignored my gut. I think I'll take him back to the GP and see what she says.

Another one with a short DS (9th centile, although I'm above average height and DP is average) and some allergies (respiratory ones for DS). I have no tips, and like you have always been a bit perplexed, although the doctors just don't seem concerned. In our case, DS is quite stocky so it doesn't seem like energy intake is a problem. He's just short.

I was reading your post thinking yup, normal, nothing to worry about, same size as my son was (also shortest in the class) UNTIL I read that your son has only grown 1 cm in the last year and has dropped down the centiles. This is definately a red flag and something you need to speak to the doctor about. When you do emphasise his lack of growth over the past year and his dropping down through the centiles rather than you just being worried he's short. Children should grow about 6cm a year at that age, so only growing 1cm is a worry. They should also stick (roughly) to their centile lines.

Good luck with the doctor.

Always follow up, go with your gut - the doctors won't push you to find answers for your child, you are your child's advocate, no one else. Our son stopped growing (though we didn't notice it), it was only in retrospect, after we discovered he had a pituitary tumour, that it turned out he had stopped producing growth hormone. Push for tests. There's any number of things it could be. Also see the child growth foundation page on Facebook. Lots of information to be found there.

This was my son. He hovered between the 9th and the 2nd centile all the way through, and never seemed to grow more than a cm or two a year. He always wore shoes out long before he grew out of them, and he had drawers full of hand-me-downs from people 2 years younger than him that were way too big for him. He was babied and adored and carried around by all the giraffe-type girls in his classes at primary school. Everyone thought he must be some kind of genius, as he was bright and articulate for his age as it was, but people always thought he was around 2-3 years younger. He never had the growth spurt people promised me he'd have and I wondered if I should have investigated growth hormones until the school nurse (a friend) told me that you don't muck about with those things. And another acquaintance then said they'd discovered her son had a problem with his pituitary gland (?) or something, which had stunted his growth. That was fixed, but I wondered if I'd missed something similar.

He had a group of friends round for his 15th birthday to swim, and all around us were massive shoes, hairy chests and legs and deep voices. Ds looked about 12. I took him to the doctor at that point, to see whether puberty had started. Ds was furious with me, but later admitted relief to be be told that yes, it had. And then.... he grew like the bloody clappers. Suddenly, at 16, he caught up with everyone, and overtook many too. He had one friend who was 5'10" in Year 7 and ds came up to just above his elbow, but this boy never grew after that, and I noticed performing at a concert in Year 13 they were near enough the same height.

So now he's 19, and 5'9+ and bloody handsome, if I say so myself! I just wish I had believed the graph on the red book that told me he'd be this height as an adult and that I'd not spent all those years stressing about it. He was never bullied about it, and we taught him early on not to react if teased, and to bat away any comments with humour, which he did. He developed an outwardly thick skin, but did a lot of drama/music which helped his confidence.

That said, see the doctor anyway, if it might help rule out anything sinister and put your mind at rest.

clam had your son only been growing a cm or 2 each year, he would not have stayed between 2nd and 9th centile, but would have rapidly fallen off the chart. My son is between 2nd and 9th centiles and grows about 6 cm a year on average. Unfortuantly so do all the others so he stays the shortest.

The difference between our sons and the OP son is that ours are holding/held their centile lines, albeit at the bottom of the chart. Her son is dropping down the chart which is when it changes from being worried your child is the smallest to there being a problem which needs investigating.

Thanks for all your advice. clam I really hope my son will be like yours and shoot up as a teen. That is, after all what I did.

But yes, this dropping centiles thing is a worry and I shall make a Drs appointment, just in case.

When I said "hovering," I meant that sometimes he was on or around the 9th, and at other times he dropped to around the 2nd. He didn't follow the line exactly, although I suppose it averaged out over the years. At around 3 or 4, I think he was just under the 25th. Then he dropped. For a long time we put it down to dh's family all being small, although my side are taller than average, with all the males being 6ft+.

Anyway, my account was more about saying I understand the worry, but to get him checked out and that it's highly likely he will catch up - although there were times when I wanted to hit people who kept saying that to me.

Just back from doctors. She properly measured him and he is actually 104cm, which is a bit better but still 3rd centile when he was 25th before. So she is referring him to a paedeatrician just to get him properly checked out.

Crossing fingers that he checks out fine and he is just a late bloomer.

Paed can refer to growth Growth clinic will measure run some blood tests and tell you to come back in six months to re measure and check if any growth. If only 1 cm that's a concern. Best to get referred as it's a slow process anyway.

When they tested hormone levels was it a hospital stay and did they do overnight testing? Look at child growth foundation.

My dds growth is due turned out to be coeliac you could re test .

Here to try and reassure. My ds1 has/has cmpa and soya intolerance, diagnosed 6mo when he fell off the charts and had diarrhoea. Was 0.4-2nd centile for weight and height until aged 3.5yrs when off dairy. Had good diet though, inc supplements and lots of homemade dairy free bakes goodies etc packed with calories. Did dairy challenge aged 3.5ish over6mo and is back on cooked dairy and cheese now at 4y2mo. Has grown 5cm last few mo and padded out a little. Still small but improving!

Recommend things like dairy free sauces made with oat milk / cream or similar, cakes, oaty based things, coconut yoghurt, DF ice creams.

I'm sure once your ds is able to tolerate more foods ( ie his intestines get better at absorbing) he will grow. Don't panic yet.

I am glad you have got a referral and they are taking you seriously.

We're having similar issues with 2yo DD at the moment (I've posted a couple of times before about concerns). Her weight has always tracked the middle percentiles, but her height has tailed off and she's gone from average to being on the 1st percentile for a good year or so, although it was actually only a year ago we realised how short she really was!

She has multiple food allergies, and although wheat seems to be the one affecting her the most, she has tested negative for coeliac disease.

We finally had an appointment at a growth clinic last week (referred to a larger hospital from a local paediatrician), and the consultant thinks she has a growth disorder 'look' about her, and so the next step will be another appointment in a few weeks to look at pituitary/growth hormone function, and then if a growth disorder is diagnosed, the next step may be growth hormone treatment.

It's taken so long to get this far - we had concerns about her height for a long time, but everyone said she would definitely catch up in a few months or that she was meant to be small. The growth spurt never happened, and myself and DP are average and tall heights respectively, so why would she be shorter than even a similar-aged child with short parents?

Trying to recall other things which are relevant - feet grow very slowly, and her feet are tiny and have perhaps grown one size this year. Her bones were x-rayed and her bone age was put at nearly a year behind her actual age. Her torso is big in comparison to her arms and legs and her tummy is very rounded, although before we removed wheat from her diet she was practically spherical (and endured a lot of unwelcome comments). Her weight is rather high for her height, but if she was the height we would have expected her to grow to, then she would be very much in proportion! Her diet is restricted but we are pleased to have got to a point where she's not having constant diarrhoea, as she did for a year after weaning.

Here's the weird thing though. I have a pituitary tumour myself, so both DD and I have regular endocrine appts, although no one has ever said the two are at all connected.

I've been mentioning to family members about the outcome being potential growth hormone treatment and was a bit dismayed when it was implied that we were 'interfering with nature' or making some sort of lifestyle choice, ie just trying to make her acceptably taller, but of course a growth disorder is so much more than your height - there are various other developmental issues as well.

OP - I'm glad you've got the referral now - the process of diagnosing anything is very slow, but good that you are in the system and can get DS properly checked out.

@Tournesol I’m having similar concerns about my little bit he’s two - always measured around 75th centile but over the last year, has to 25th. Did your DS go through a growth spurt as he got older? X

Hi @poppet131 my son is 11yo now and still the smallest in his class by a long way and his 9yo sister is taller than him.

But when we saw the specialist they thought he just had delayed growth and would likely shoot up as a teen. It's hard for him being small but if he still hasn't grown by age 14 we'll be going back to the specialist who said that we the age at which they'd intervene.

If you're worried about your child I would see the GP to discuss as it's best to get in the system.

In the meantime we just make being small a good thing! Good luck!

On the flip side my 11yo dd is 99th centile and 5'3 almost. She hates being so tall. We've been under endocrinology since she was 8. She sees him twice a year for a bone X-ray and yearly hormone tests. For her it's been the onset of early-ish puberty and he believes she'll stop growing in two years. But who knows?

How is your son now ?

Hi just wondering how your son is now we are going through similar with our almost 5 year old