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11yo boy- how small is too small? When to seek help?

9 replies

haba · 11/02/2020 15:17

My son has just turned 11. He was born on 50th %ile for height and weight, but weight gain didn't match height growth, but within normal bounds.
As a toddler he was chubbyish (not enormous) but he became very restrictive in his food intake around 18mo (after bad ear infections) and essentially weighed the same (on the scales) at 2 as he did at 4.5yo, though obviously his height increased.
Since then he has bumbled along around 50-30th for height, 9th for weight.
His father is v tall and slender (6'2", 12st 8), I am v short and in proportion (5'0", 7st12, 8/10 clothes). His elder sibling has always been 50th height, 30th weight, now at puberty she remains at those proportions, though I think she has got to her full height now.

I weighed him and did his height this week (he needed it for a science class in school)- he is bang on 25th/139cm height but his weight is only 27kg, around 5th %ile.

I am worried that his growth has slowed, and am not sure when it becomes a medical concern.

On the NHS BMI children tool he is "healthy weight"- but the very lowest in healthy category at 4th centile BMI! I am worried that as puberty approaches he will not have laid down enough energy stores for growth, and am not sure when medical input is recommended- is there a cut-off age or weight?

He still has a pretty restricted diet, and he doesn't eat huge amounts. He is pretty active (his school do games twice and pe once a week but he no longer does weekend sports because his interests lie elsewhere) but he has low stamina, and very little reserves. We had to stop his swimming lessons as he was utterly exhausted after, because it was same day as games lesson.
He goes to bed at 8:30 and gets up at 6:45, usually falls asleep about 15 minutes after lights off.
He's a healthy boy, rarely ever ill, but has a bunged up nose often, I think linked to cmp intolerance (his sister has multiple food intolerances, he had bad eczema as a baby, but now almost gone). The ear infections we're sorted by grommets when he was four, no repeat.
The restrictive eating is linked to sensory issues- he hates textures of many foods, and the taste of lots! He doesn't try new things either. He is the child that would rather starve than eat something he "can't". What he eats is reasonably nutritious for British children, and he doesn't eat much salt or sugar, so he's doing ok. (I have introduced a multivit in past six months that he has to take because he won't eat a wider variety, so I'm less stressed about deficiencies than I was).
He tends to choose one thing and eat that exclusively for breakfast for a couple of years. Lunch is at school (compulsory school lunch) and it's hit and miss how much he eats according to daily menu). Supper is 95% home cooked from scratch (to accommodate sister's intolerances) so spag bol, chili, roast, lamb tajine, chicken casserole etc. then an apple (the only fruit he eats) and yoghurt after.
He doesn't snack, the amounts he eats aren't stupidly small but not enormous either. He only drinks water, occasionally milk.

OP posts:
Are your children’s vaccines up to date?
haba · 11/02/2020 15:19

Yikes! Sorry- TLDR: what age should I worry about ds being small?

OP posts:
Londonborncatty · 11/02/2020 15:23

It may be worth visiting the GP who could run tests to check he is not deficient in any vitamins etc but it does sound like he has the same build as his father. It is very difficult to get extra calories in a child with a restrictive diet and maybe some more advice along those lines would be helpful. With regards to centile charts, remember someone has to be at the top and bottom to make an average and it doesn’t always mean there is a problem. I have a healthy DC, with similar centile readings to yours and have explored other avenues etc but they just are built that way with a small appetite.
Remember, to some this will be very unusual; people are often bothered about overweight, but some people are natural small and slim. You may get comments about how unhealthy your child is etc.

PaquitaVariation · 11/02/2020 15:29

My ds was pretty much the same as yours at 11, and grew perfectly normally through teenage years, staying skinny until the last six months or so when the muscle mass has started to develop. It didn’t even occur to me to be concerned about it as he was healthy and didn’t lack energy etc

steppemum · 11/02/2020 15:33

The significant factor for my friends dd (who had health issues) was when she stopped growing heightwise. Until then they monitored but did nothing.

One thing they had to do to was to increase her calorie intake by doing the opposite of all normal health expectations, so double cream, full fat milk and yoghurt, chocolate buttons as a mini snack and so on. She couldn't eat more volume wise, so that had to make each mouthful higher calorie.

haba · 11/02/2020 15:41

Thank you. I do try to increase his calorific intake, but he has stopped eating things like peanut butter, and never eats cream etc. He won't have butter on sandwiches either!
@steppemum I worry that when he stops growing upwards, it will be too late! His father was 6' at 13...
My brother was always small, and similar low appetite, he got to 5'8" eventually, but is v slight still, so I know physical heritage means he's likely to be small.
He's in a school with lots of very big children too, so his small stature stands out!

OP posts:
haba · 11/02/2020 15:43

He honestly doesn't even eat much chocolate- I put lots in his stocking at Christmas, and he was given free reign, but could only manage one chunk of toblerone! (Definitely doesn't take after his father? Grin)

OP posts:
Dontstepinthecowpat · 13/02/2020 21:51

It’s worth a check with GP as I could have written this a year ago. DS was a very similar size to yours. The GP ran bloods and all came back ok. A year on he has gained 12 KILOS grown 15 cm (at least) and 3 shoe sizes. He’s still smaller than his peers but has caught up so much (and cost me a small fortune!)

Quartz2208 · 14/02/2020 08:13

Yes it’s worth a check. Height wise he sounds fine but his weight/restrictive eating is affecting his life with the amount he sleeps (which is not usual at this age) and his stamina

Embracelife · 18/02/2020 20:14

Check for coeliac disease which can restrict growth and cause low stamina and go hand in hand with food issues.
Get height properly checked and monitored over 6 months to check growth rate.
If he s following a line 25th height then no prob8. If he droppedcentiles then check

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