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Quick reference medical handouts used by Pediatric offices


My 3 1/4 year old son is small for his age, typically falling around the 5th percentile on the growth charts. He has been this way most of his life (no drastic changes). We have monitored him every three months, because our doctor is concerned about his small stature. My husband and I (his biological parents) are not big, nor are we extremely small (5'4" and 5'7"). We have done a bone age test recently, by having an xray done of his hand. That came back normal. We also did a blood test for human growth hormone, which also came back normal. I understand that overweight, and large for age, could be risk factors for later in life. Do I really need to be concerned about my child being small? My doctor wants to "discuss further testing options." I'm not sure this is necessary. Should I be worried about a small child? Should we have further testing done? He has been basically healthy his whole life, all 3+ years, with the exception of otis media which lasted on and off for about a year and a half. Please help me know if we should continue with testing.
    
It sounds to us that you have a good "handle" on this situation and that both you and your son's doctor have taken the conservative approach in determining if there is any medical reason why your son has short stature.

What is most reassuring that your son is normal are the following facts:

  • He has always been in the low percentile for height
  • Normal bone age test - which means he is growing according to his genetic blueprint
  • Normal test for human growth hormone
There is always a chance that your son's doctor thinks you are more concerned than you really are, and therefore plans to suggest more tests to provide reassurance that your son is normal.

Our suggestion: Continue to discuss any concerns you have about your child's height with your pediatrician, and continue to follow your son's growth chart carefully. Make sure you observe whether or not your youngster is growing at a normal rate (even though he is on the lowest channel of the growth chart) and look at the child’s growth curve over time. A healthy rate is about 2 inches per year from age three to puberty, when the adolescent growth spurt occurs.

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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