Concerns about Childrens' Growth

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  • Hi - my son, who had historically been at the 25% percentile for height, fell off the growth curve a few years ago and is currently around the 1st percentile for height.  He is nearly 14, but not close to puberty.  His HGH levels are normal, and everything else seems to be normal (his bone age is 12 3/4, which apparently is in the normal range).  According to predictions based on bone age, he will be in the 5'4" - 5'6" range as an adult.  His father is 5'10" and the men in his family tend to be tall (there's also height on the female side of the family), and his twin brother is 5" taller than he is.  He is desperate to get taller, and keeps asking about HGH.  Leaving aside the issue of HGH (we are going to get a second opinion about whether or not this is advisable; specialist recommendations appreciated), has anyone else been told that their son or daughter would be very short based on a prediction from bone age or growth curves, and then had him or her turn out to be taller?  I'm trying to get him to eat more calories and a more nutritional diet in case this has been a factor (he's a vegetarian and very food-averse generally, except as to sugar), but I don't want to promise him he'll get taller if he does.  He's about to start 8th grade, and is acutely aware that he is the smallest boy in his middle school (he looks like he's in the 8-10 range).  Alternatively, are there any parents of young men who are 5'4" - 5'6" and who are ok with it? 

    Thanks in advance, 

    Anon

    Hi. My son is the exact age. He will be 14 very soon.  He has always been below the 5th percentile since birth.  He has always had an upward growth, so pediatrician has never worried.  We did have him tested. We wanted to know if he was hormone delayed or deficient. Test showed he is hormone delayed.  If he was hormone deficient, then getting hormones shots would have helped him.  Being delayed, you don't want to do hormone shots since it can affect his real growth.  Men on my side of the family are all very tall 6.1-6.5. But delayed growth has been a pattern.  He sees Dr. Bhatia, a pediatric endocrinologist. I can highly recommend her. She is with Standords Children's Health in Emeryville. 510-587-9600.  Dr. Bhatia did a good job explaining to my son why he shouldn't get the hormone shots.  My recommendation would be to get the test on delayed vs deficient.  If deficient, getting the hormones will help.  

    I hope this helps.

    My husband is just under 5'5" and doesn't have hang ups about being short. He's very athletic and is confident. He's a good person, a caring father and husband, and cares about others. Would he be a better person if he were taller? Our younger son is your son's age. He's also on the very short end of the chart. He's healthy, smart, loving, funny, and an exceptional soccer player. I know he'd like to be taller. Height is valued in our society, especially for men.  But we really need to help our children learn that their value is in their character. Please try to help your son love eho he is on the inside. And by the way, I bet he gets taller at puberty. 

    The responses you've gotten seem excellent, and I don't want to be alarmist, but you might want to get him a celiac test just to be sure. My nephew was very small and when they finally tested him for celiac it turned out he had it. As soon as he cut out gluten he grew (to be clear this isn't gluten "sensitivity," it's an auto immmune disease and can be easily identified with a blood test).

    I second the celiac test recommendation, particularly since he has some food issues. My picky 13-year-old son grew 5 inches and gained 15 pounds in the 5 months after his diagnosis when he switched to a gluten free diet. This took him from the 5th percentile to completely normal. About half of all people with celiac don't have clear symptoms. He probably doesn't have it, but it's worth checking! 

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Questions Related Pages

Growth Hormones for undersized teen?

Sept 2009

Am considering growth hormones for my 13-1/2 year old, high school freshman. He is 67lbs and could easily pass for fifth grade. Looking for feedback from anyone who has used growth hormones personally or their child. Our pediatrician mentioned that there could be side effects, such as cancer. Would like to know the name of dr. (if known), the type of hormone you used, side effects you experienced, and any other info worth sharing. And, ultimately, are you glad you did it? -Anon.


Have your son tested for celiac disease, or even better, take him off of gluten for a year. In susceptible people it can stunt development because it blunts the villi that absorb nutrition. Also, feed him lots of meat and if he's not allergic, lots of fish. I have a friend who was called Tiny her whole life, she's now 5'8'', when puberty hit she grew quickly. The same thing happened to my nephew. I would stay away from growth hormones. The cancer risk is not worth the extra inches. My nephew started growing taller at around 14. Wishing you and your son well.
If there is a chance of cancer don't do it! And the right place to go to study this is peer-reviewed articles in recognized medical journals, not a poll on BPN. If your doctor is right and this can cause cancer some time down the line, this is a very serious decision and needs to be taken more seriously than it can be using a few posts from a few people. don't mess with cancer
I can only share my husband's experience. He was on the small side in his youth, then when all his friends grew, he did not. When he was 16, he was only 5 feet 3 inches and looked about 11 years old. His family are all of average height. His parents took him to many doctors and ultimately decided to wait on any hormone treatments. Finally, he started growing on his own, when he was close to 17 years old. He grew a few inches in his senior year, then he really took off. He is now a gorgeous 6-foot 2-inch man.

My son is a late bloomer, too. He has height, but at 14 has very few signs of puberty. I think 13.5 years is still a little young to start the hormones. Kids develop at such different rates and start at such different times.


I have not done this, but a good friend of mine did for her son who was very very small and had some sort of pituitary issue. If you want, I am sure she would tell you all about it. I don't know the specifics except that he did grow a bit and has had no side effects whatsoever. (they probably did it about 3 yrs ago when he was 11 or 12?) GD
My son is small too. He's 14 and up till last year could pass for 10. He's just started to grow and look a little more mature. My husband and I are not giants. 5'3'' and 5'5''. My 18 yo (2 boys) didn't start to grow till he was 15. He's thrilled that now, at 18 he's a little taller then I am(mom).

So...I went to see a pediatric endocrinologist at Kaiser Oakland. Dr. Tam I think her name is...Really wonderful and kind woman. My son had a blood test to determine if he was deficient in growth hormones. He wasn't...just a small guy. She said 2 important things...Feed him more...he needs more bulk on his body...more fat....milk shakes, high calorie foods, etc. (having a picky eater doesn't help in this department). Secondly, she said we could try growth hormones. We got a lot of info. There was no guarantee they'd work, and they have to be given subcutaneously every day...ie: a shot under the skin. While side affects are rare, there are some very serious negative ones. My son chose not to do this. While he'll never be a basketball player (though he loves playing basketball), he'd rather just be what he's supposed to be. He is eating more now and has grown over the summer. He was thrilled to tell me that there's a kid in his class this year (new school) who is smaller then he is. That's my 2 cents. Hope it helps. I'm really glad my son decided against growth hormones. not a giant mom


5-year-old's growth has slowed significantly

June 2009

My almost 5 year old boy seems to have slowed way down in his growth. We switched pediatricians when he was 3 yrs. and at that visit there was no previous growth chart to compare to - the records were being transferred. At the 4 year check up, there was no mention of a problem with his growth. now I am noticing that he is much shorter than most of the kids in his class. For the first three years of his life, he was 75% height and 50th % weight. Now I have charted him from an on-line chart and he is 25% height and around 15% weight. We are due for his yearly check up in 8 weeks, so I guess I can just wait, but it has been weighing on my mind. He is very healthy, physically active and does really well socially and academically at school, so there seem to be no obvious issues. He looks totally proportional and healthy. He does like quite a bit of sleep.

Has anyone else had a child who has changed in their growth pattern like this? Do I need to make an appointment early to have him checked out? Also, he had a CBC blood work up done a few months ago to address the excessive sleep issue(he was taking 3 hour naps) and all that came back normal. What else could be the problem? concerned mom


Sleep apnea comes to mind - have you had that checked out? It requires a sleep test. It meets the symptoms of a slowing of growth and need for sleep you mentioned in your son. Other symptoms can include: snoring, small size, slow down in growth, night sweating, sleeping in strange positions (such as with the head bent backwards at the neck so as to open the air passage which closes even more when asleep with muscles relex or with the knees tucked under the body and the butt up etc), night time bedwetting (or if still in diapers - excessive urination - this is because the lack of oxygen changes the hormones causing too much urine to be produced), lots of movement when sleeping, mouth breathing, hyperactivity etc.

There are 2 types of sleep apnea - Obstructive (caused by too large tonsils, adenoids, jaw shape etc) or Central (lapses in breathing), I have read that many children have a combination of both types. There's a sleep apnea org http://www.sleepapnea.org that has a pediatric forum.

My son had the obstructive kind so he showed all the symptoms associated with that - his dr was NO help in dx this - I did if off the internet (and then was lectured by the dr about the hazards of the internet!) Once we removed his adenoids, he had a HUGE growth spurt - which is common! Imagine a growing body and brain spending 12-14 hours a day with greatly reduced oxygen!

There other thing that I've read about that can cause growth to slow is food allergies. If I wanted to check this out, personally I wouldn't take a conventional md allergist dx at their word, I would also go to an alternative type of dr and have a IgG test run and a stool test etc. anon


You didn't mention how tall you and the child's father are. Around age 2 or 3, genetics kicks in. If your child was a big baby, and his genes are for a small adult, he should be moving down the growth chart. Check with your pediatrician to be sure, but I would bet that he is just settling in to his natural size. tall mommy with tall baby

Two-year-old with low levels of HGH

April 2008

Does anyone have experience with human growth hormone (''HGH'') deficiency in young children? Our 24 month old daughter has been a sluggish grower since birth. For the first time last month, she re-appeared on the growth charts at the 5th percentile for weight and height - she had been below the charts since shortly after birth. We have been monitoring her weight since birth with various pediatricians and endocrinologists. Two recent blood tests indicated a significantly lower-than- average presence of HGH in her blood. We are considering subjecting her to the full test, which is incredibly invasive. It involves 4 hours of observation while introducing numerous synthetic agents into her body. This makes us quite nervous - as does the prospect of an untreated dangerous condition! In trying to research HGH deficiency, I have not found much information about this aside from the periodic dumbed-down FAQ on a website somewhere. I am looking for books to read, specialists to contact, personal experiences, etc. Before subjecting my daughter to any procedure, whether it is widely- accepted or experimental or homeopathic - I want to explore it all thoroughly. If you have any information, input, recommendations, or advice, please contact me. Thank you very much! Worried for My Baby


This is a complex issue and I don't pretend to be an expert, but I can share our experience. Our daughter is quite small for her age; smallest in her grade. I never worried about it because she's just about exactly the size I was at her age, but her pediatrician was concerned enough that we finally took our daughter to see a pediatric endocrinologist when she was about 5. The doctor recommended those horrible, invasive tests, to see if she had HGH deficiency. She explained that if our daughter had this, she would never go through puberty, and would remain tiny. We asked if our daughter did have the deficiency and the illness, and we gave her daily shots, if she would then develop normally. The answer was no. She'd grow bigger, but she'd never go through puberty. We decided that putting her through the hell of the tests and daily shots just so she could (if she tested positive) be a ''normal'' size made no sense. We feel we made the right decision. At 10, our daughter is still small, but she's ''on the charts'' now (she wasn't when she was younger) and seems to be developing normally. More importantly, she's bright, happy, and has good self-esteem.

My advice is to think through what your child might gain - or lose - from going through all of this, and make a decision based on your desired goals. Short mom of petite girl


11-year-old son has a growth deficiency

May 2007

I just found out that my very petite 11 year old son has a growth hormone deficiency. A ''bone age'' test shows that his bone age is 7, which shows a deficiency. We have an upcoming appt. with a pediatric endocrinologist at Oakland Kaiser. Dr. Fan. So....anyone with this issue? How did it resolve? Why did your child have a growth hormone deficiency? Are there any risks at taking growth hormones? How many kinds are there? Did they work? Does anyone know of Dr. Fan?

I really can't do much of my own research till I find out why he has this. My son is very strong, coordinated, active, physically in correct proportion for his age....just very petite. He's about the same size as the smallest girl in his class and he's the 2nd oldest in he class. We thought he was just a slow grower adn would be a small guy..my husband and I are 5'4 (mom) and 5'6(dad) so we knew he wouldn't be a giant, but his growth seems to have slowed down at ta time when he should be shooting up. His pediatrician suggested this test as a way to start investigating. Hope to hear from some of you. concerned mom


You are in good hands with Dr. Fan. She is wonderful, kind, patient and no question is too big or small for her to answer. She has a great bedside manner with kids and will include your son on the conversation as to what is going on with his body. She is very through and awesome at follow up.

How do I know? We started seeing her last Sept. when my daughter was newly diagnosed with Hypothyroidism. She was great and by the way- her cousin is Dr. Pelly Fan- a awesome kaiser pediatrician who my daughter also sees! It runs in the family. Good luck with your son. Mary