Hi I'm starting to get very worried about my 11 year old daughter's lack of growth, particularly as myself and my husband are 178cm tall. She is only 136cm tall, noticeably shorter than all of her friends and her 7.5 year old sister is already 129cm tall. She was a large baby - 9 pounds 7 oz, breastfed for 12 months and has been pretty healthy and happy with no major illnesses. She has not started her periods yet and is a very keen netballer who is unfortunately falling behind due to her lack of height. I did visit the doctor who did a blood test to check for thyroid function and growth hormone level - thyroid function was fine but growth hormone level was very low. They recommended that i wait another six months but i would really like to do something now if you have any suggestions. Thanks
Person's Gender: Female
Visit to doctor for measurment and blood test
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Hi! I'm sorry to hear of your concern about your daughter. I'll see if I can help a bit.
Hang on a second while I convert cms to inches (I'm American). Be right back.
OK. That puts her at 4ft 5in. You and your husband are 5'10, that puts your daughters' predicted height at 5'8in.
Do you know if she's actually been falling away from her growth chart when her doctor plots it out?
When I plot her on a growth chart she comes out to the 10th %ile.
If she's always grown along that %ile on the growth charts there's nothing to be concerned about. However, if she's been dropping off it's probably time to intervene, especially given the low growth hormone level.
Yes she appears to have been steadily falling since her fourth birthday and is now down to about the 10th percentile by my calculations whereas her sister is the 70th. i have not been keeping particularly accurate height records though as i just assumed she would be tall like me. She has not changed pants size in 3 years
Ok. Yes, that is worrisome. It's great that she hasn't started her period yet as that gives you time to intervene, but if she has been steadily falling off the chart there's no sense in waiting any longer.
She needs to be evaluated by a pediatric endocrinologist (usually associated with a Children's Hospital). They will likely recommend growth hormone injections which should help considerably.
The problem is that once she gets her period she'll only have about 2 years of growth left (and it will be slow, at that), so the time to intervene is now.
That is what i thought. i didn't start my periods until i was nearly 14 but i was much taller as a child than she is now - do i just go back to the doctor and ask for a referral. i also heard that there is a hand xray you can do? i just dont want to wait in limbo for another six months and then be too late to help her
There is a hand xray you can do (called a bone age exam). That tells if her skeleton is maturing at the same rate that she is aging. For example, she might be 11 but she may have a skeleton that is more consistent with a 13 year old and therefore closer to her growth completing. You can ask for it but really, regardless of what it says, it doesn't really change anything.
It won't be too late in 6 months, but it does take some time for the growth hormone to do its job.
Also, (at least here in the states) it can sometimes take months to see an endocrinologist, so its best to set that in motion now. Yes, you should call her physician and ask for the referral. The endocrinologist will likely order the bone age, or you can get it done before you go and take that info with you. There's no great benefit either way.
Anything else I can help you with?
I'm just a bit worried that i'm being a bit of a pedantic mother about her height but it does seem quite unusual compared to all of her peers - will the tests the paediatric endocronolgist do be more conculsive than the simple test the doctor did? Is it likely that she might just be a late bloomer?
Late bloomers don't fall off their growth curves. They might be on the small side and have a delay in puberty, but they grow just fine along their curve. If she's steadily falling off there's something going on. The endocrinologist will likely review what you've had done, review her growth curves, and obtain the bone age film. Then, based on their experience, they'll make recommendations to you about treating or observing. As I mentioned, if she had been growing along her growth curve you'd be ok to watch. But, since she's falling off steadily for 7 years AND has a low growth hormone level there's nothing to suggest she'll right that without help.
Ok thanks very much for your advice
You're quite welcome. Good luck with getting help for your daughter.
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Ok thanks very much i appreciate your help
14 years in private practice in the U.S.