Investigations - small for age

[AmIReallyTheGrownup]

My 4 year old has started reception this week and although summer born, she is absolutely tiny compared to her classmates - by far the smallest excepting another little girl who I know was 2 months premature and correspondingly summer born.

For context she is about 11th centile for height, 30th for weight. She was born on the upper centiles and drifted slowly down in her first few months and stayed there.

We are 5’9” and 5’10” but her 2 year old height suggests she’ll be 5’3”. We don’t have “short genes”, both maternal parents are tall, her maternal aunts are taller than me, only her paternal granny is average height at 5’5” or so.

She is a good eater, her nursery used to report they’d have to stop her going in for third servings and school is reporting likewise that she’s eating her school dinner.

At 2yo the NHS agreed with my worries and we had comprehensive blood tests and a few appointments with a paed consultant with the only factor being slightly low Vit D.

However it’s still nagging at me that she’s so tiny. The only other factor I can think of is that she’s often congested from hay fever and mouth breathes, she has quite dark eye circles.

I’ve got good private insurance. Where would I start if I wanted to have her reviewed again?

Low Vit D - has she been screened for coeliac disease? Being small for her age was one of my daughter's symptoms of CD.

Go back to your GP and ask for a referral to your paediatric dept.

We're in a very similar situation except my daughter has now dropped off the bottom of the growth chart, she is classed as smaller that the very smallest 1 person out of the 100. If that makes sense?! Predicted height of 4ft3 I think.

We've had all sorts done, MRIs, bone density scans, millions of bloods through the endocrinology team.

She's seen a geneticist from addenbrooks most recently who has referred her for whole genome testing, as well as testing for both me and her dad. Also testing for a couple of very specific things.

If you're not happy, push to see someone else.

My son has a rare genetic disorder. Nothing related to his size. He's always been in 0.4 percentile for height. He's under endocrine at Addenbrookes. He sees Dr Thankamony. He is now having growth hormone.

My son is the same, he's 6 next month. We've just found out he has growth hormone deficiency. Waiting on an MRI to find out why and he will be starting on growth hormone injections

Do check but surely 5'3 is average for a woman? Also My grandfather was similarly worried that he had 5 little girls but all his family were tall. Ended up being a throw back to previous generations. (His long lost sister was small.) May be you have some small ancestors ?

If dad is 5’10 thats average/ 50th so if she had been heading to 5’4 thats could make sense. On the charts the combined interparental height would be about 66th percentile so 5’5.

One of dc friends had parents both 5’10. She was average to smallish. And suddenly took off around y8 and has stopped around ’5’7.

were you always tall or late puberty and kept growing?
as my dc is very tall age 10 was off the chart by several cm and around 5’5. But.. started periods so unlikely to grow much more. My other kid was only 104cm age 4 so 50th and again relatively young periods age 11 but grew to 5’6 (so 2inches over the height range age 4 and about 80th centile (was up at 95th age 11-12).

My sister is only 5’1 from parents 5’7 and 5’10.

is she vegan or anything like that?

ai says she should be about 5’7 from parents both height.

How accurate was the measurements as frankly nhs are quite crap and at 4 my eldest was mwasured several cm shorter taking her from 50th to 25th basically not pushing her feet back to wall. AND having measurements for meds and our gp surgery cannot get it accurate at least 2cm error…

my DD is probably around the same percentile and nobody has ever suggested it’s a problem to me. She’s 4 and a half exactly and is about 101cm. No doctor has ever suggested that there is an issue. I think if she’s under the 1st or maybe 2nd percentile they might do investigations, but 5ft3 is a perfectly normal height for a woman no?

This was my thought too.

Thanks everyone, some very useful comments.

She was checked for coeliac when she had her Vit D tests but it has definitely crossed my mind.

She’s been tested for Turners and doesn’t have it.

I wasn’t late to puberty (13) but I vividly recall growing a few centimetres in my first year of university.

Current height is accurate. I looked at her NHS records and she has grown more than usual over the last 2 years (8cm), but the parental discrepancy is still pretty significant.

DGD was at 1 percentile right through. She is sixteen now and petite and slim, about 5’2”. She would love to be tall but I think takes fter her great grandmother.

My daughter started school at 95 cm and her 2-3 aged uniform swamped her. She's August born and was 2nd percentile. She started at 25th percentile for length at 1 but sometime between 1 and 2 she fell down the percentiles and was 0.4th-1st percentile for height at 2. She stabilised around the 1st and moved up to 2nd percentile around 4.

I'm 5ft2 and my partner is 5ft11 however he was always the smallest in the class until he reached puberty. My daughter has a lot of it food allergies and reflux and under paeds and dieticians and they haven't been overly concern by her height.

She is now 6 and has moved up to the 4th percentile. Her predicted adult height at 2 was 4ft10-12 and it's now 5ft1-2. Over the last 2 years, however, her weight gain has plateaued and she had only put on 1kg in 18 months and dropped from 50th percentile for weight to 9th. Her dietician and paediatrician were slightly concerned about this as it's quite a change especially as her height has increased in percentile meaning she has nearly dropped 3 percentiles for BMI. It's the trend they look at more than the absolute values. She's had fortified shakes on prescription for the last 4-5 months and is now following the 9th percentile.

I'd pursue the allergy route and look into "allergy shiners" and see if that fits with the dark circles.

How is she energy wise?

My daughter is very active and throws herself into everything so that has been reassuring for her medical team

My DD was below the lowest level on the charts for weight and height throughout her babyhood and childhood. She was the smallest child at school by a long way and she was sometimes bullied because of it. She did have a lot of investigations but nothing was determined. She was on fortified drinks, prescribed. She’s an adult now and 5’2”.

Please don’t be so concerned about her height if everything else is medically OK. I’m only 4’ 9”. Granted, all my family were considered small here in England (it’s not a thing in Italy where my family is from) but it hasn’t stopped me having a full, successful life. DH is 5’ 7” and so DS 26 is 5’ 6”. I think men suffer more discrimination due to the 6’ 3” or a friend thing on OND, although he did have a long-term relationship with a young woman who was taller than him.

Part of it is being young in the year at that age. My dc are now at their full height. Me and dh are both about average height, although we do have both small and tall genes among our close family.

I had two tall winter babies, who towered over a good amount of their classmates in reception. When they started I remember wondering how it was such complete babies would be in the same year!
One is still tall, but not exceptionally so, other is probably just below average.

I also had a had a small summer baby. Interestingly he always, until when the boys had their growth spurt in about year 9/10, seemed to be in a friendship group that were similar height, although he was normally the smallest it wasn't by much.
I remember the first time I saw someone in his year who was definitely smaller - he'd come out after a school club in year 10 and I asked him what year the younger lad he was with was in - to my surprise they were also year 10.
He's now pretty much average height for a man - and his friendship group that was always within a couple of inches vary between being a bit smaller than him, and very much taller than him.