Our child was extremely small and entered puberty much later than her peers (first period at 16). She had something called constitutional growth delay: https://www.massgeneral.org/children/growth-disorders/constitutional-delay-in-growth-and-puberty#:~:text=Constitutional%20delay%20in%20growth%20and%20puberty%20is%20a%20condition%20in,and%20a%20delayed%20bone%20age.

When we were growing up, this was just referred to as: being a late bloomer. Both my husband and I had kind of delayed puberty, and our other kids had it as well but not as pronounced. The point is that once puberty starts, the kid starts growing normally and often reaches the same height as her peers. It's apparently a thing in my family. My dad grew taller while in college as did my son. They didn't really stop growing until they were 21 or so.

Anonymous wrote:

Anonymous wrote:If she is eating and drinking normally and otherwise developing appropriately and not having GI issues, there is nothing drs will do. Sure they can refer you to a pediatric endocrinologist who will run a bunch of tests and charge your insurance $$$ but that is all that will come of it. The tests will be normal. Even if growth hormone is low (which is probably isn’t), giving growth hormone is highly risky and you are better off with a short normal child.

You have no idea what you're talking about lol. You have no way to know if the tests will be normal or show a serious deficiency it celiac. Good armchair doctor ing though

Lol. Ok, go and get a bunch of tests then. Maybe add on a bone density screening, gi scope, and a full body mri just in case. You don’t want to miss anything. Drs love parents like you.

Anonymous wrote:If she is eating and drinking normally and otherwise developing appropriately and not having GI issues, there is nothing drs will do. Sure they can refer you to a pediatric endocrinologist who will run a bunch of tests and charge your insurance $$$ but that is all that will come of it. The tests will be normal. Even if growth hormone is low (which is probably isn’t), giving growth hormone is highly risky and you are better off with a short normal child.

You have no idea what you're talking about lol. You have no way to know if the tests will be normal or show a serious deficiency it celiac. Good armchair doctor ing though

If she is eating and drinking normally and otherwise developing appropriately and not having GI issues, there is nothing drs will do. Sure they can refer you to a pediatric endocrinologist who will run a bunch of tests and charge your insurance $$$ but that is all that will come of it. The tests will be normal. Even if growth hormone is low (which is probably isn’t), giving growth hormone is highly risky and you are better off with a short normal child.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes, this happened to me. My child had gastroparesis.

Definitely something to take to a specialist.

I hate to hijack, but my kid is struggling with gastroparesis. Did you find some solutions?

Qian Yuan in MGH in Boston is the person to go to. My child responded well to appetite stimulant medication. Have you tried it yet?

We haven't. Did the appetite stimulant medication increase the gastric emptying? Can you tell me which meds.

My kid has a feeding tube, so I don't need to increase appetite, but if worked by increasing emptying that could be good. I need him to not throw up what we put in the tube, so I'm not sure whether that would work.

Yes cyproheptadine increases emptying as well as appetite. We were lucky the first medication we tried worked.

I was telling the doctir for months it was pulling teeth to get him to eat or drink, and hes immune compromised so i was terrified his next cold would land us in the hospital. He stayed 18 lbs from 9 to 20 months. For us cyproheptadine was the miracle drug. We were told he'll take it for 3 years.

Any time we skip doses its immediate he stops eating and drinking except very minimal amounts.

Thanks! That's helpful. I'm glad you've found something that works!

All pediatric specialists tend to have a long wait, so I'd just make the appointment with the endocrinologist and go from there. Our endo intake was totally painless - we even did it as a telemedicine appointment. She took a bunch of family history and had DD come in for a hand X-ray, but no blood work. Based on family history and results of X-ray, she did not recommend any additional interventions, but if she had, they would still be just that - recommendations. It never hurts to have more info and it helps a ton to be an established patient if you need additional appointments down the road.

I was born an average weight/height, but was extremely tiny as a kid. In fact I was not even on a growth chart. I was projected to be around 4’12... Once I hit puberty around 12 I started to grow really fast and ended up 5’6 as an adult female.

Also we had taken him to a different GI who insisted he was fine even though he was losing about an oz a day. I am so glad we went for a second opinion.

He is over 2 now btw and he is doing amazing. He used to not sleep and as soon as he started eating and drinking he became a perfect sleeper (I know, shocking lol)

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes, this happened to me. My child had gastroparesis.

Definitely something to take to a specialist.

I hate to hijack, but my kid is struggling with gastroparesis. Did you find some solutions?

Qian Yuan in MGH in Boston is the person to go to. My child responded well to appetite stimulant medication. Have you tried it yet?

We haven't. Did the appetite stimulant medication increase the gastric emptying? Can you tell me which meds.

My kid has a feeding tube, so I don't need to increase appetite, but if worked by increasing emptying that could be good. I need him to not throw up what we put in the tube, so I'm not sure whether that would work.

Yes cyproheptadine increases emptying as well as appetite. We were lucky the first medication we tried worked.

I was telling the doctir for months it was pulling teeth to get him to eat or drink, and hes immune compromised so i was terrified his next cold would land us in the hospital. He stayed 18 lbs from 9 to 20 months. For us cyproheptadine was the miracle drug. We were told he'll take it for 3 years.

Any time we skip doses its immediate he stops eating and drinking except very minimal amounts.

My DD fell from 60-80th in infancy to 25th at age 2, and then to 10th percentile between ages 2 and 3, and the doctor wasn't concerned. We saw a pediatric endocrinologist. He did not recommend testing because he said she otherwise looked healthy and was not having issues with weight gain. So we monitored to make sure she was stable at the 10th percentile. And she was, until age 7, when she fell to the 5th percentile, now she's under that. They did the hand x ray and a few blood tests (celiac), but both were normal. The hand x ray showed her bone age being lower than her biological age, but within a certain number of standard deviations, so it wasn't considered abnormal. The doctor again seemed unconcerned, but we are going to go back to the ped endo to get checked out again.

In our case, DH is 5-9, I'm 5-7, but his mom is 5-2 and aunts are super short, like 4-11. He also has 2 siblings and father with late puberty and growth delay, so my daughter could have any of those issues.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes, this happened to me. My child had gastroparesis.

Definitely something to take to a specialist.

I hate to hijack, but my kid is struggling with gastroparesis. Did you find some solutions?

Qian Yuan in MGH in Boston is the person to go to. My child responded well to appetite stimulant medication. Have you tried it yet?

We haven't. Did the appetite stimulant medication increase the gastric emptying? Can you tell me which meds.

My kid has a feeding tube, so I don't need to increase appetite, but if worked by increasing emptying that could be good. I need him to not throw up what we put in the tube, so I'm not sure whether that would work.

Op I'd always rather check something out and have ir be nothibg rather than miss low growth hormone /celiac etc. Kids can appear healthy except for growth issues

Anonymous wrote:

Anonymous wrote:Yes, this happened to me. My child had gastroparesis.

Definitely something to take to a specialist.

I hate to hijack, but my kid is struggling with gastroparesis. Did you find some solutions?

Qian Yuan in MGH in Boston is the person to go to. My child responded well to appetite stimulant medication. Have you tried it yet?

Anonymous wrote:OP here. I feel I have articulated this wrong. She didn’t go from 20th to 5th percentile in one year. I agree that would be concerning.

I can’t remember what her % was last year but it’s edging down slowly over time. There wasn’t a huge, dramatic drop off I e year. Plus, she still grew 2 inches and gained 5 lbs in the last year which he said is good. My concern is more that her growth chart is not like her siblings.’

Actually I didn’t think anything of it until the doctor mentioned the wrist x ray.

Would you call them back to get more info or assume all is ok for the time being? She eats well, no dietary or digestion problems, no sick visits at all in the last year.

Op, 20th to 5th, even over the course of a few years, is concerning. You should discuss this with your doctor.

Anonymous wrote:OP here. I feel I have articulated this wrong. She didn’t go from 20th to 5th percentile in one year. I agree that would be concerning.

I can’t remember what her % was last year but it’s edging down slowly over time. There wasn’t a huge, dramatic drop off I e year. Plus, she still grew 2 inches and gained 5 lbs in the last year which he said is good. My concern is more that her growth chart is not like her siblings.’

Actually I didn’t think anything of it until the doctor mentioned the wrist x ray.

Would you call them back to get more info or assume all is ok for the time being? She eats well, no dietary or digestion problems, no sick visits at all in the last year.

As I understand it, kids' weight and length at birth isn't predictive of adult weight and height, so changes in curve before about 2 can just be course corrections. However, at some point it is normal for kids to stabilize, at least until puberty.

I would do the wrist xray, because it's painless and not invasive, and just yields information. If it doesn't indicate bone age problems, I'd think about whether there might be something else contributing to the growth issues, but I wouldn't do invasive testing based on just what you describe.

I have a kid with major growth issues, and I'd be thrilled with 2 inches and 5 lbs.