Child Small for Age

Hi Stephanie,

I know exactly what you are going through. I have a niece who is extremely small for her age. She is 10 years old, but her bone age is that of a 6 year old. BUT most people guess her to be 4 or 5. She has a 6 year old brother and some people think that they are twins. She has seen an endoconolist (sorry for the misspelling). She's been testing 3 times for growth hormone deficiency 3 times. First 2 times, it was apparent that there is a deficiency. The third time, there was no deficiency. This 3rd time was right before Christmas. The doctor then said that her bones appear to be small and fragile, and that she should see a bone specialist. She might have bone disease. My sister and brother-in-law are divorce, and they too have different opinions on the matter. He wants my niece to be put on hormones, my sister does not want her to be. But my sister did learn that they now can do the shots in the same way that diabetics test their blood - with a machine like that so it's not like a shot.

Anyway, my niece has had problems from day one. She had extreme relux when she was born. She literally threw up everything she ate so she had a feeding tube first in her nose, then it changed to a g-tube in her tummy until she was like 5. She now eats like a champ, though. Always hungry! But she doesn't gain weight (btw, she only weighs 40 some pounds - and she is 10!) My sister and ex-brother-in-law are really thin people - very petite. My poor niece has never even made it on the percintile charts - always below zero percent.

They are now just waiting to get her into to see the bone doctor. I don't have any real advice for you. I just wanted to let you know that I feel your pain and frustration. ( I love my niece like she is my own daughter). I hope that you get some answers soon!

A.
SAHM of 1

I wouldn't worry about getting your son on hormones. I have a friend who has a 6 year old son who is only 34 lbs and very tiny. My 4 year old girl is about the same as my friend's 6 year old son. We have other friends with a 5.5 year old son who is also the same weight and height as my daughter. I wouldn't worry at all. He should catch up.

My son is also 5yrs and is about 40-41 inches tall and 31lbs, so he is also small. Personally, I would wait on starting him on hormones. Children grow at their own pace, and we can not protect them from everything. I also was very small in school., as I have LGH (Low Growth Hormone). I did not reach 5' until adulthood, and was teased unmercifully in school. I think I have better coping skills, my friendships are more imoprtant to me, and I am a stronger person because of the obstacles I had to endure. At 5 years old, your son has a lot of growing left to do. He may hit a growth spurt that will catch him up with his peers, and jumping the gun on hormones now may prevent him from growing normally later. I'd ask your pediatrician what s/he thinks about putting your child on hormones. if the doctor doesn't think it's necessary, then take his word for it.
My child's father is 5'11", yet our son is small. I'm sure my son will grow in his own time, and yours will too.

Hi Stephanie,
My son, Oscar is also very small. He is 8 yrs old and about 52 lbs. His weight is proportionate to his ht., he is only 50 in. tall. I think what is really important is if your sons ht/ wt are proportionate and if he is steadily gaining weight( however slowly)so that he does not show signs of nutritional absorption problems. I am also small as you and your husband are.It is in their genes to be small like us! I often feel bad for my son at times like in basket ball or baseball when he is usually THE smallest kid but that is what helps them shape their personality and the way they cope with problems/life. Hormones ie. steroids are NOT good for your body. I think what would be beneficial is some loving guidance from you and your husband. Has your son verbalized any difficulties regarding his self image? Dont be offended , this is just my opinion. Have a great day, L.

I know exactly how you feel! Before you decide to medicate your son, please read this.

I have 6 kids (8,7,6,4,2,8mos) - no I'm not crazy, I did it on purpose. (Although my husband says that he has put me in retirement:) ) However all of my kids are very small. I was shocked that I could produce a child that small, but you never know what you will get w/ genetics. My brother is 6'7", my dad 6'4", my mom 5'10" & I'm 5'6. My husband is 5'10". Your son is bigger than my son (he just turned 6 & is in kindergarten) & about the same size as my 7 1/2 yr old daughter.

If your Dr doesn't think there is anything to worry about now, don't choose to medicate w/ hormone replacement. (I'm all for medication when it is needed, including shots, etc.) My daughter has the bone density test every 2 years & the blood work-up every few months. She isn't even on the growth chart. - But she is following her own growth curve.

However, we are a little more prepared b/c my husband was also very small as a child. He then grew 7" in one summer during junior high. He did say it was painful b/c he could feel his bones growing. That being said we probably aren't as concerned as you would be not having a family history of being small...

Kaili's (7 1/2) bone density is that of a 5 year old - which is a good thing! It means that she still has a big growth spurt in her. Now if her test had come back as a 7 yr old, we (& the Dr) would be more worried. She did offer to refer us to an endocrinologist if we wanted, but said that we probably didn't need to, b/c they just try to put you on growth hormones.

The big issue is....once they put you on growth hormones, your body stops making the natural growth hormone & becomes dependent upon the hormones. Basically they will need to continue the hormone therapy the rest of their lives (until they are grown).

Obviously you should do whatever you & your ex think is best, but keep in mind that 1. Your Dr. still thinks things are ok, 2. Hormone replacement is a very sticky subject - once you start HGH, your body stops producing its own hormone & relies strictly on HGH. 3. He still has a growth spurt in him, based upon his bone age.

I would just keep monitoring him, praising him, loving him & not making him feel like he is any different b/c he is small. If you don't make too much of an issue about it, he won't. He'll catch up - in his own time.

Even if your ex is in a hurry for him to do so b/c he had a tough time, that doesn't mean your son will also have a tough time. And doens't he want your son to overcome things on his OWN time frame when he is physically and mentally ready to do so - w/out giving him a drug that could potentially cause more harm than good?

I'm sure it is a sticky situation, like any decision we make regarding our children. If you want to talk feel free to email me - or if you have any other questions.

J.

I empathize with you. I just wanted to know that there are a lot of serious side effects with hormone treatment, and it may just make your son grow faster, not make him any taller as an adult.

My husband was also was small for his age as a child. He was only 35 lbs in 1st grade and he was short. Yes, he was teased, but mostly for the fact he was smart (nerdy).

Your son's size may not be an issue for him if he is outgoing and gets along with other children. Kids will tease other kids for just about anything. Being an average size won't necessarily prevent your son from getting teased.

My brother was short for a number of years in elementary school and junior high, but he had lots of friends and was popular, especially with the girls. We used to call him Casanova; he had so many girls with crushes on him. His size just wasn't an issue because no one made it one and he had a personality that others liked.

Hope this helps.

J.

The hormones sound a little extreme to me, but if you want to take him to an endocrinologist just to get checked out, I recommend Dr. Zeller. He is out of Edward Hospital and is excellent. He does have quite a busy schedule though, so you may not be able to get in to see him for a few months.