8 m.o. over 99th%ile on growth curve- what will endocrinologist do?

[Anonymous]

Anonymous wrote:Mine was literally off the charts at that age. He skimmed down once he started crawling and started running about a month after that. He’s a teen now and on the taller/muscular side but no thuge.
IME, the endos at children’s won’t even see you unless you’ve already had the blood work done to justify a referral. They have too many potential patients.

I thought that too but I already have an appointment, so we’ll see what happens. Thanks- he isn’t crawling yet.

[Anonymous]

Why are PPs questioning the pediatrician’s referral? It seems prudent to have your baby seen by an endocrinologist. Hopefully, there’s nothing wrong but you want to make sure, especially since his size is not consistent with everyone else in the family’s.

[Anonymous]

I don’t think the additional testing will harm your baby and will be good to get some peace of mind.

My son was the same- 99% in height and weight. I’m very short (5’1”) and DH is only 5’10”. He’s three now, still a big kid. No issues as far as I know.

[Anonymous]

I would find a new pediatrician after blood work. DS1 has always been 99% for height and weight (EBF 2 years, never had a bottle). He's 12 now and super tall, his weight % dropped to 80% somewhere around 3. It's never been an issue with any pediatrician we've seen, but of course every situation is different. He's still 99% for height FWIW.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I haven't heard of such thing and mine have always been huge. They are 6'3 now. Are there any other health problems?

I’m OP. No, the baby has been totally healthy- he’s not crawling yet, and he was a little slower to roll over, but I would think because of his size. No gestational diabetes either, and he was 8.5 lbs at birth so not a world record, but I was induced at 39 weeks. I do suspect he is just going to be a big guy.

SO how big is he right now? My 99th percentile 2 year old was born at 38 weeks (spontaneous) and weighed 8 pounds 12 oz. He is now 2 and weighs 38 pounds and is 37" tall. So big. But I never thought to take him to an endo! Nor has my pediatrician said anything. DH and I are relatively normal size (5'10" and 5'7" respectively).

[Anonymous]

There might be something your pediatrician saw that was concerning in addition to you being petite and your baby being in the 99th percentile and wants to make sure everything is ok so don’t listen to people who say change pediatricians.

[Anonymous]

Anonymous wrote:My pediatrician made a referral for my son to see an endocrinologist just as a precaution. He’s consistently been at the 98-99th %ile for length and weight since he was about 1 month old, but he went through another little growth spurt since 6 months so she wanted to make a referral just to get things checked out. She was expecting him to level off a little and he hasn’t. He seems normal and healthy, but definitely very big. Like he wears 2T. I see people going to the pediatric endocrinologist for falling off the growth curve but not for skyrocketing above it- any feedback on what to expect, what to ask?

No clue why your ped would do that. It really doesn't matter where they are on the chart % wise. They are looking for changes in the percentages. So if he was 99% and then dropped to 50% that could be something to watch. Or the other way around where they shoot up. Sending an 8 month old for additional testing from an endocrinologist because he is consistently at the same % is strange.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I haven't heard of such thing and mine have always been huge. They are 6'3 now. Are there any other health problems?

I’m OP. No, the baby has been totally healthy- he’s not crawling yet, and he was a little slower to roll over, but I would think because of his size. No gestational diabetes either, and he was 8.5 lbs at birth so not a world record, but I was induced at 39 weeks. I do suspect he is just going to be a big guy.

SO how big is he right now? My 99th percentile 2 year old was born at 38 weeks (spontaneous) and weighed 8 pounds 12 oz. He is now 2 and weighs 38 pounds and is 37" tall. So big. But I never thought to take him to an endo! Nor has my pediatrician said anything. DH and I are relatively normal size (5'10" and 5'7" respectively).

But OP mentioned her baby is increasing on the growth curve- so not just staying at 95% but going to higher percentiles for height and weight as he gets older. That could indicate a pituitary issue or a growth hormone issue. I don't get all the defensive responses here about switching doctors. The doctor is literally doing her job- sees something that could be outside the norm, refers for more screening (which will hopefully all be normal), and then that's it. Would you rather the pediatrician not even screen for potential issues?

[Anonymous]

Anonymous wrote:

Anonymous wrote:My pediatrician made a referral for my son to see an endocrinologist just as a precaution. He’s consistently been at the 98-99th %ile for length and weight since he was about 1 month old, but he went through another little growth spurt since 6 months so she wanted to make a referral just to get things checked out. She was expecting him to level off a little and he hasn’t. He seems normal and healthy, but definitely very big. Like he wears 2T. I see people going to the pediatric endocrinologist for falling off the growth curve but not for skyrocketing above it- any feedback on what to expect, what to ask?

No clue why your ped would do that. It really doesn't matter where they are on the chart % wise. They are looking for changes in the percentages. So if he was 99% and then dropped to 50% that could be something to watch. Or the other way around where they shoot up. Sending an 8 month old for additional testing from an endocrinologist because he is consistently at the same % is strange.

Maybe i read it wrong but I took "another little growth spurt" to mean he went to a higher percentile. A 6-8mo old baby wearing size 2T is abnormal.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I haven't heard of such thing and mine have always been huge. They are 6'3 now. Are there any other health problems?

I’m OP. No, the baby has been totally healthy- he’s not crawling yet, and he was a little slower to roll over, but I would think because of his size. No gestational diabetes either, and he was 8.5 lbs at birth so not a world record, but I was induced at 39 weeks. I do suspect he is just going to be a big guy.

SO how big is he right now? My 99th percentile 2 year old was born at 38 weeks (spontaneous) and weighed 8 pounds 12 oz. He is now 2 and weighs 38 pounds and is 37" tall. So big. But I never thought to take him to an endo! Nor has my pediatrician said anything. DH and I are relatively normal size (5'10" and 5'7" respectively).

OP. Wow, that is big. He is 26.5 lbs and 31 inches at 8 months. I am only 5’2” though.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I haven't heard of such thing and mine have always been huge. They are 6'3 now. Are there any other health problems?

I’m OP. No, the baby has been totally healthy- he’s not crawling yet, and he was a little slower to roll over, but I would think because of his size. No gestational diabetes either, and he was 8.5 lbs at birth so not a world record, but I was induced at 39 weeks. I do suspect he is just going to be a big guy.

SO how big is he right now? My 99th percentile 2 year old was born at 38 weeks (spontaneous) and weighed 8 pounds 12 oz. He is now 2 and weighs 38 pounds and is 37" tall. So big. But I never thought to take him to an endo! Nor has my pediatrician said anything. DH and I are relatively normal size (5'10" and 5'7" respectively).

OP. Wow, that is big. He is 26.5 lbs and 31 inches at 8 months. I am only 5’2” though.

PP here - I wouldn't find that overly concerning. My big 2 year old was 29 pounds by 1. But if you and your ped are concerned its worth getting checked out!

[Anonymous]

They probably want to rule out acromegaly or conditions like that. Worth getting it checked out.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Mine was literally off the charts at that age. He skimmed down once he started crawling and started running about a month after that. He’s a teen now and on the taller/muscular side but no thuge.
IME, the endos at children’s won’t even see you unless you’ve already had the blood work done to justify a referral. They have too many potential patients.

I thought that too but I already have an appointment, so we’ll see what happens. Thanks- he isn’t crawling yet.

We had a bone growth scan and blood tests for one of our kids who on the lower percentiles in height as a baby. They wouldn’t even refer to an endo without it. I was terrified and cried thinking something was really wrong. But the child is totally healthy, just short. Like our ped said: some kid has to be at both ends of the spectrum.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I haven't heard of such thing and mine have always been huge. They are 6'3 now. Are there any other health problems?

I’m OP. No, the baby has been totally healthy- he’s not crawling yet, and he was a little slower to roll over, but I would think because of his size. No gestational diabetes either, and he was 8.5 lbs at birth so not a world record, but I was induced at 39 weeks. I do suspect he is just going to be a big guy.

SO how big is he right now? My 99th percentile 2 year old was born at 38 weeks (spontaneous) and weighed 8 pounds 12 oz. He is now 2 and weighs 38 pounds and is 37" tall. So big. But I never thought to take him to an endo! Nor has my pediatrician said anything. DH and I are relatively normal size (5'10" and 5'7" respectively).

But OP mentioned her baby is increasing on the growth curve- so not just staying at 95% but going to higher percentiles for height and weight as he gets older. That could indicate a pituitary issue or a growth hormone issue. I don't get all the defensive responses here about switching doctors. The doctor is literally doing her job- sees something that could be outside the norm, refers for more screening (which will hopefully all be normal), and then that's it. Would you rather the pediatrician not even screen for potential issues?

I don't get it either. The endo also has better knowledge about what testing might need to be done, so I don't even see why anyone thinks it's odd to refer before testing in some cases.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Could just be big but if he has a pitutuary tumor or Marfan's syndrome or something you'd want to know!

This. The endocrinologist will probably order blood tests.

Blood tests that should all have been done BEFORE the referral.
Either of the above mentioned concerns will have other features that accompany a large child. There's either something missing from the picture that OP wasn't told about or the ped is practicing cover your ass medicine/doesn't know what they are doing.