Is my son too small?

[Katherine]

To answer my own question - I don't think so - but my health visitor does and I sense a battle coming on.

My son is 2.8, fairly stocky but only 81cm tall (he's still in 12-18 month clothes - he and his 13 month sister share nappies and clothes!)

I am only 5'2 and dad is only 5'3 so I'm not surprised he's diddy. But now they want to start doing x-rays and stuff to see if theres a problem. "His height is below the acceptable level!"

My husband was pressured about growth hormones as a child (thankfully he refused) and I'm dreading a battle which will make it look like I don't care but does it really matter how big he is?

Am I being a bad mother here or should I stand my gound?

Katherine, you know that your son is not too small, don't be pressured by the health visitor. Where would they be without their charts? My son a "big baby" at birth, 9lbs 9 oz, didn't reach the expected point on the chart on encountering the health visitor despite being 'stocky and long' she put it down to my vegetarianism and my not producing enough milk (as I leaked everywhere!!!) Her answer was that he eat meat sooner rather than later! Although my daughter was a smaller baby at birth, 6lbs 3oz, exactly the same thing happened eleven years ago! My so called lack of milk continued and she was fed until she was almost 2 and a half! She is now almost 5'2 and wears womens size 12 clothes, she has a gorgeous body, never been ill beyond the usual childhood colds etc., she is fit and extremely happy. Needless to say when I was told my son needed meat I only needed to look at his sister to have faith in my own judgement. Believe in your own judgement too. Good luck...

My son is 7 months old and I have had this problem since he was born. He was 6lb 6oz and born on his due date (I was 5lb 12 at birth). He has always been under the 'acceptable line'. He has always put on weight but only between 1 and 5 ozs a week. Our own preference was we did not want to put him onto any formula as we believed he was getting enough from being breast feed (I too leaked everywhere). Had I not been so strong they would have had me off breastfeeding Im sure. He had every blood test under the sun which broke my heart, which all came back fine. I never had any doubts that he was OK. He is now on solids and a real little chub and is as healthy as can be (touch wood). I was alot smaller than my son, my sister and brother were the same, though they did not seem to want to take this into consideration. You have to stick by your guns, you know your children better than anyone and every one is different. I would like to see a chart just for breast feed babies. On the vegetarian subject, I am a vegetarian although my son is not, my midwife said they trust vegetarian mothers to have a better diet than most because we are more aware of what we need to eat.

Once again the scourge of the HV strikes again - do these people go on a special course on how to worry parents? Mine had a thing about head circumference (our little boy always had a tiny head, on one of the lower centiles, but it was in proportion with the rest of his body). I know one HV that sent a child to hospital because her head size went off the top centile and thought she might have cystic fibrosis - worried her parents to death - and of course, there was nothing wrong.

Like you say, you've got to take into account how tall you and your husband are - I'm surprised the HV didn't consider this. As long as he is showing growth and following a centile line - whether its 5th, 50th or 99th (or whatever they are) then everythings OK. When they slide over a couple of centiles then that can be cause for concern - but again, because of different growth spurts this does happen and just needs to be monitored.

My nephew is a little stocky lad - he's 2yrs 5mths and he's around 88cm. Whereas my little lad has just turned 2 and he's 87cm.

If you feel OK about your child's height and growth, don't let the HV worry you or pressurise you. You watch, by the time your son is 16 he'll be 6ft 5"!!

Coincidentally, my son is still in some 12 to 18 mth clothing and some stuff at 18 to 24 mths is so enormous I think he will be 3 by the time he fits into it.

I think you instinctively know if something is not as it should be, so trust your own judgement.

My HV rang me up yesterday to see why I hadnt been to my appointment for weigh in, she only backed off when I told her my nana had just died. My son has always been active, not sleeping much during the day (not because he was hungry as the doctor tried to tell me), very alert and very strong. I still get comments 'isnt he tiny'. I reply 'no, he is just perfect'. It does seem, from babies I have meet, breastfed babies do grow very differently and it is about time the charts were revised and mothers listened to. This is my first child. I'll be more prepared for the HV's next time round.

Aw come on guys, give the HVs a chance. They are doing what they think is right. How many of us are the first to complain when social workers and HVs fail to spot a child's 'obvious in hindsight' problems.
Just for the record. The height a child reaches at 2yrs old can be doubled to give their final adult height. This is A1 fact in medical books not old wives tales!. So I really suggest Katherine that you do the sums, and if you're happy about your childs final height, then that's fine - tell the HV.

When my mother measured me at 87cm at 2 yrs old, she thought that the calculation didn't work. But here I am 5'10" - she'd never have thought it!

I agree they have to do their job and I went and had all the test they wanted, they would have been negligent if they hadnt advised this. But, the whole time I didnt feel they listened to me, after all they were only seeing my son for a very short period of time. My mum went through all the same with me, my sister and brother (the stress with my sister reduced her milk and my sister had to be bottlefed which devastated my mum). We are all healthy and very rarely ill. Im 5'7, my sister 5'5 and my brother 6'2ish. The stress could have affected my son and my milk had I let it. I wouldnt like them to stop doing their job, there are some children that need their help.

Katherine - would it do any harm to check him out anyway? Yes you and your husband are both small but there could be an underlying problem and you may just be making an assumption that this is the reason why he is small. If this is the case then why is his sister not small too? I would be concerned if a 13 month child shared clothes of the same size as a child so much older but that is only my view - if you are happy with him then fair enough.

Regarding HV in general - well they are only there for advice and they do refer to more qualified staff when needed. I am sure a pediatrician could tell you if you have any need for concern in a consultation before any invasive treatment such as X-rays are requried.

Joe - I had the same problem at birth with my boy (6lbs 2oz and 8 days late) - he kept getting blood glucose tests and bottle pushed onto me. He has always been small and it has taken 18 months for him to grow to just under average height/weight.

Emmam - same here on the head circumference. My son is on the 0.2 centile for this but I too am very small. Fortunately this has not been an issue for concern for my HV.

I think you should listen to HV but the ultimate decision lies with you about how to take their opinions. On the whole I feel quite pleased with the level of care our children get (compared to old people for example)

katherine - you are not being a bad mother - stand your ground definitely - you don't want them messing about with x-rays at this stage!!! if he's healthy and growing steadily (if slowly) and in proportion then surely he's fine?

some hv's are better, freer thinkers than others. you've obviously got one of the others! what does your doctor say?

my first child was born in america, and apart from telling you when you leave the maternity ward that you can ring them if you're worried, there is no home support. i know hv's can be fussy old fusspots but boy could i have done with one!!!

growth charts are a useful guideline for the majority of children but for anybody unaverage they are not 100%. i have quoted this on another board, but my elder daughter - a 5.11 baby (i am 6', this was the american baby, they got in a major stress about this although apparently her dad was a 6lb baby but they never asked - HIS mother is 5'!!!) - anyway she was under the 10th centile throughout childhood. her sister was 7.4, and above the 75th centile throughout her childhood. now they are 16 and 19 and the same height...5'7...the double the 2yr-old-height would not have worked with both of them!!!

actually i always understood it was 2 for boys and 2 and a quarter for girls? or 1 and three quarters...and it didn't work for me - i don't know what my height was, but my mother - who was also 6' - never ceased to complain about how the formula had let her down - according to it i was supposed to be about 5'8 i think! (maybe she had it wrong.) i shot up from 5'3 at 13 to 5'9 at 14 and went on slowly for another 3 years/inches.

there is another "rule" that boys are always taller than their mothers. this is not true either. most men are taller than most women of course, so logically it generally is true, but in our case, with 6' genes one side but also 5' genes on both sides i am not predicting anything! (i have sons of 12 and 8 - the elder on the 50th centile, the younger on the 90th - totally different build and body type.)

When I had my first daughter six years ago I believed everything the HV told me, I believed she must know more than me. I was wrong! I regret listening to my HV, my daughter went very sleepy and unable to easily waken due to lack of milk, I had been trying to breastfeed but after my caesarean my milk dried up, which I had mentioned but which was not listened to. At that time they accused my daughter of being a crying baby just wanting perpetual nurturing so they suggested I went out and bought a dummy, I was not keen so they showed me how to curl her hand into a thumbsucking position and told me to put it into her mouth. Now at 6 I wish I had used a dummy or more to the point wish they had noticed the lack of milk before the trouble waking her and her fontanel sagging. Hence the crying would've ceased so no need for thumb or dummy, my 2nd daughter is now 4 and has never even touched a dummy or used her thumb. Thumbsucking is a terrible habit to stop.Also HV look down on you in my experience if you suggest bottle feeding, with my 2nd I decided not to attempt breastfeeding as again I had caesarean and noticed less milk and not wanting the same trouble put my foot down, whilst in hospital I felt very uneasy requesting bottles and was glad to get out. Please stand your own ground, you know best, it is YOUR child.

jillxx - my 4 were all caesarians and all terrible feeders!!! all early electives too, except the first who was 10 days late and might have managed if we hadn't been in the US and lacking support except for the la leche league and they tend to the barmy...

it makes me so cross looking back that i got so upset trying to breastfeed; the books say everybody can do it - well everybody can't, for various reasons, and with early electives the babies certainly weren't ready to be born (they were up to 3 weeks early by dates and who's to say they wouldn't have gone 2 or 3 weeks over...?)

the very worst was the 3rd - biggest (8.3) but 2 weeks early, they practically had to dig him out because he was so reluctant to emerge! i tried everything, after every feeding attempt in the hospital i used a breast pump and produced no more milk after 6 days than after 3 - so much for the more you empty your breasts the more they will produce. he went on bottles much sooner than the others but it used to take about an hour of suck/sleep/shake awake to get 4 ounces down him. nightmare stuff. NONE of them would contemplate a dummy - they were the most unsucky babies anyone had ever come across!

but in my fairness to my own HV (mother of 3, 10 years older than me, very sweet and kind) she never criticised about the breast/bottle business and always said "thank goodness" every time i capitulated. is this very unusual???

Janh, it sounds awful what you went thru' with nos 2-4! I mean having such early caesarians each time. And you're right about them coming out too early, it can't be good for them can it. A friend of mine refused to be induced when she was 10 days late. She said that as long as the placenta was healthy she would wait 'til the baby was ready. Sure enough it came out about a week later, no induction, quick birth and healthy. Compared to the stress of induction you have to wonder.

I've never met anyone else who was so prepared to stand her ground - actually most mums would be dying to get rid of the bump by then! But considering how last period dates are often out by a week or 2 it makes you think!

Hi Everyone, thanks so much for your support. I have decided not to have x-rays and tests and so on as my husband and I are both adament that we would not undertake any "treatment" to make our son grow even if it was offered so having tests seems pointless. After all I can't imagine getting a 2 year old to sit still for an x-ray will be a very happy expereince for any of us.

I have always had problems with my health visitor. I breastfed both my children but at 6 weeks was told if I didn't "introduce a bottle NOW then he's never take one" (I never did and we've never needed one!). At 4 months when I started weaning she constantly implied I was moving too slow and I'll never forget her most famous line "Have you tried pizza or sausages. The average 9 month old can manage MacDonalds!"

Although it is easy to moan about HV's (I've never actually met anyone who had a trully happy relationship with one) I find the whole situation very sad. They could be such a wonderful resource for us. A few simple words from someone in the know works wonders to set your mind at ease. So why aren't they doing this essential job? After a series of confrontations about my son I never went once with my daughter (except for jabs and essential check-ups) and it was at my daughters MMR that the issue of my sons size flared up. And it would have been nice to feel it would have been worthwhile to go.

Instead I feel I've got to hide things from my HV and I if it wasn't for discussion boards I'd never get my questions answered. What a sad loss for us all. And what a huge waste of resources.

Proper assessment of your child's growth will take into account parental height, if referral to a paeds clinic is recommended then this will be worked out. I agree that HVs ( and lots of other people!!) can be obsessed about growth but in a small minority of cases underlying problems are present. So, don't feel there is an "acceptable height" that your son must reach but decide if you want the reassurance of further investigation. I don't think XRays would often be done in this situation, if they are suggested, make sure to find out why.

lil - thanks for the kind thoughts!

you are so right about the difficulty in standing your ground; i was supposed to have a trial of labour for the second, but due to a string of circumstances including easter and my (nice female) obstetrician being away i was subjected to a not nice male who, i was reliably informed, would keep me in with 12 hourly pessaries until something happened and it could be weeks (because after 3 pessaries nothing was happening!)

as i had an anxious 3-yr-old waiting at home i thought - having allowed things to get that far - another section was the best choice...in fact, having been allowed to escape from the ante-natal to fetch the suitcase i had previously been told to bring in, i should have kept the bottle that prevented me from bringing it in with me...but lost it!!!!

your friend has my profound admiration!

katherine - apologies for hi-jacking your board! i'm glad you have decided to stand your ground too. i think you are unlucky in your HV - are they all like that where you are? i was very lucky with mine - she has retired now though of course we had outgrown her - could you maybe switch to another?

Katherine

your HV sounds a nightmare, but maybe its worth seeing your GP. As Stc says, a paed. would do the calcs and give you a specialists view on the world. They wouldn't push you into anything, but maybe with more info. it'll put your mind at rest. Afterall it sounds like the issue will rear its head again if your son stays as small, especially when he goes to school. Good luck.

I had my son weighed last week and they are very pleased with us both as we are now above the shaded bottom line, good for us, take a good pat on the back mum. Maybe now we will be left in peace to enjoy our very special boy who is a joy. He is also standing, trying to talk and pleases everybody with his happy nature and beaming smile.

hi katherine
i was quite interested to see yr posting, i'v just posted on another thread about big babies...
i hav 6 children and my "biggest" baby just happens to be my smallest child. he was 4.170 kg at birth and tho he looked like a 3 month old when he was newborn, he just didnt seem to grow much - when he was 5 he was wearing 2yr old's clothing and of course, he was incredibly bright and witty and when ppl made noises about how small he was, we used to just laugh it off, because both his dad and i are not tall ppl - dh(ex) is 5"7 and i am just over 5ft. but when he was about 5/6 he came to me one day and sed he didnt want to be cute anymore, he wanted to be bigger... and i realized that this was an issue to him. i told him i thought he was just perfect the way he was, but over the passage of time i saw him change - his personality took a serious knock and he became quite introverted - totally different from the joshua we all know and love.
anyway at the age of 10 i noticed a change in his body, he seemed to be losing muscle tone and his middle suddenly got quite chubby, almost like a middle-aged man; he had always been perfectly proportioned before. so off to the paediatrician we went, with everybody telling me how ridiculous i was being, but i just knew that sumthing wasnt right - had his endocrine system checked out and the growth hormone in his system was virtually non-existant! that was 2 years ago - he has been on growth hormone therapy (daily injections which he gives himself) since then - and i cannot begin to tell u how incredible it has been for josh. he has grown beautifully and so has his confidence, i am sooo glad i went with my instincts and didnt listen to wot ppl said. now while this may not be right for everyone, i would encourage u to firstly, keep an open mind, and secondly, go with yr instincts, trust yrself until u'r proven wrong when u feel strongly about sumthing. hope u do wots right for u and yr son - enjoy him!!!

Well Katherine

I'm with you, my DS is 3 and still has to wear 1 - 1.1/2 year clothes as they make the legs far to long, and the waist like a baby sumo.

I put him in 2-3 yrs trousers today and they swamped him and I had to turn up and over the waist and he had to have turn ups on the legs.

I am 5'7 and DH is 5'8, so we not small, but my mom said I was exactly the same as a baby and I'm tall enough now.

Don't worry about it yet, your child is to young for you too worry.