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Thread: Very small toddler - 21 months/18lbs

  1. #1
    Join Date
    Nov 2012
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    Utah
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    Default Very small toddler - 21 months/18lbs

    At what point do you decide to do growth hormone testing on a kid? My little seems to be following a curve - but it's so much more shallow than the curves on the growth charts and he has continually fallen farther below the 3rd percentile curve. He is only 29.25" and 18.5lbs at 21 months old and seems to be severely "off the charts", especially for height (I feel like his low weight is directly correlated to his short height - so weight is less worrisome - but it seems to be the only thing that everyone focuses on - perhaps because it's the only thing we can attempt to "control"). He's always been little.. Not sure where to turn, but I've always posted here and got good peace of mind.

    His pediatrician seems okay with it, and I am okay with it for the most part. We've never been asked to do extra weigh-ins or extra testing. I'm not sure if it's something I should be suggesting? Occasionally I get very freaked out when I see 4 month olds that are bigger than he is at almost two years old! We very frequently get comments on how well he can walk/talk/etc. because people think he is a lot younger than he is (he's got a baby face and still very thin hair which doesn't help his cause).

    Birth - 5lbs 15oz, 20"
    3mo - 10lbs 5oz, 22.5"
    6mo - 14lbs 6oz, 25"
    9mo - 15lbs 11oz, 26.5"
    12mo - 17lbs 0oz, 27.5"
    18mo - 18lbs 1oz, 29"
    21mo - 18lbs 8oz, 29.25"

    Also, I am 5'2" and hubby is 5'9" - so we are not tall but we are not extremely short like our boy is.

    Still nursing at least 4 times per 24 hours, sleeps through the night occasionally, but more often than not he wakes at least ones for nursies. He eats solids well and has regular BM and wet diapers. We are working on potty training when we are at home.

    I like that his pediatrician is not pushy or labeling him as "failure to thrive" but I don't know if I should just go along with the passiveness that the doc has - or if I should be pushing for testing to rule out (I don't even know what). I don't feel like it could possibly be a food allergy or celiac's disease...but should I be concerned about a growth hormone deficiency at this point? I have done small amounts of research and at this point I would not be on board with giving him growth hormones - so is there a reason to have him tested? I think if I expressed concern his pediatrician would see it as valid and not argue.. I just want to make sure I am doing the right thing by not pushing it with my ped?

    It's stressing me out today. Here's my sweet baby:
    kevin12.8.13.jpg

    Advice please?
    Last edited by @llli*kevins-mom; December 27th, 2013 at 06:17 PM. Reason: corrected chart stats
    Nursling: Kevin (March 2012)

  2. #2
    Join Date
    Dec 2011
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    359

    Default Re: Very small toddler - 21 months/18lbs

    Your son is adorable! I think a good policy is to inquire with your son's paed if an issue feels like it merits discussion. If you are even slightly concerned, I think an open conversation can only help in securing you peace of mind.

    How I would phrase my inquiry would depend on two other factors:
    1. How is your son doing reaching cognitive, socio-emotional, etc. milestones?
    2. What growth pattern have your son's extended family members (grandparents, aunts/uncles) taken? I mention this because my string bean son has a very similar physique to my maternal uncle.

    I referenced the WHO charts and see that while your son is < 1%ile for both height and weight for age, he is still very proportional on the weight for length charts (~15th %ile on the one attached).

    http://www.who.int/childgrowth/stand...ercentiles.pdf

    I'd also like to share a positive anecdote about HGH supplementation in adolescence. A personal friend and colleague was 5'3" in a tall family after puberty and successfully grew into a lean, muscular 6'1" frame after hormone therapy in his teens. He was delighted with the results more than a decade later, with no perceived ill effects. You're on top of your son's health from a muh earlier age, so I can only assume that your son would have equally, if not better, outcomes than my friend had.

    I mention this to say that not all decisions need to be made now, and that options are available down the road that can be very successful in supporting growth at other critical junctures.

    Sending you and your treasure love, Mama. Parenting well is a heart-wrenching journey, and I wish you and your family peace and good health!

  3. #3
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    Default Re: Very small toddler - 21 months/18lbs

    Thank you for your response!! He's very well on track emotionally and developmentally. He's speaking well and is very strong and has good motor skills, etc. He was kind of a late walker (14 months) but runs and jumps and climbs and swings and throws lots of tantrums like most almost two year olds do.

    I was little growing up but bigger than him by at least a few pounds (my moms records show I was 19lbs at 12 months).

    I agree that his weight is very proportionate to his height (also considering that by putting a percentile on his weight to height ratio- he is being compared to mostly babies who are not walking yet and do not eat as much solids as he does. I think he is perfect and doesn't even look remotely skinny to me.

    Today he was with his friend who is only 12 weeks older and a whole head taller. He's so short! He doesn't see his doctor until his 2 year check....but aside from being super little, he seems perfect to me!

    Thanks for the insight about h HGH too! That's very reassuring!

  4. #4
    Join Date
    Apr 2009
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    Default Re: Very small toddler - 21 months/18lbs

    my DD was very tiny off the charts, smaller then your DS at a year. by 2 she got to the bottom of the charts, but she was 24lbs by 2. We had many tests and food diaries, and nothing came thru an issue. She is now near 5 and average height and weight. Sometimes they just grow at their own rate/pace and all is fine. I would have it looked into casue it seems he has really stalled in his weight gain, My DD gained about a lb a month from 18 months on, at 18 months she was 18 lbs and by 24 months she was 24 lbs.

    keep us posted! He looks adorable!!!
    Mommy of 4,
    3 who I watch over, 1 who watches over all of us

    J- 8/20/05 pumped breastmilk for 11 months due to his cleft lip and palate!

    M- 10/17/07 my precious baby lives forever in her mommys heart

    M- 3/31/09 my special gift, she helps heal her mommy and daddys heart. Nursed for 4 years and 10 days, self weaned the day her baby brother was born!

    E-, new little miracle born 4/11/13, my BIG baby! Born 8.6 at 38 weeks. At 9 weeks nearly 17lbs, at 12 weeks nearly 20lbs, at 6 months nearly 23lbs, at 8 months nearly 25lbs and all from BREASTMILK


  5. #5
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    Default Re: Very small toddler - 21 months/18lbs

    if it would make you feel better why not do tests, even if you would not treat at this point? as long as they are not too expensive or invasive.

    If your son is destined to be shorter than average, (or even if not!) I suggest consider looking into men’s artistic gymnastics. Smart and focused and yes, shorter than average boys tend to excel in that sport. I think it is a good sport for any size boy to try, both of my boys do gymnastics and love it although it is a very difficult sport-it teaches them patience, perseverance and good sportsmanship.

  6. #6
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    Default Re: Very small toddler - 21 months/18lbs

    Thank you all! We still have three months until his 2 year check. His pediatrician said at his 18 month check that he expects him to be back on the (bottom of the) charts by his next check up....and maybe he will be! Kids grow different sometimes....he eats really well, and I'm sure he is getting at least most of the nutrition he needs from breast milk and solids combined.

    I guess we'll see how it goes! I'm not in a rush to do a bunch of unnecessary testing...but if it IS necessary, I don't want to overlook it. Just trying to do my best and not stress too much. I'm very blessed to have such an amazing, sweet, caring and beautiful little boy
    Last edited by @llli*kevins-mom; December 28th, 2013 at 04:53 PM. Reason: Posted before I was finished

  7. #7

    Default Re: Very small toddler - 21 months/18lbs

    Your pedi sounds awesome. Many of them would have tried to force formula and order you to stop bf totally. My son is very similar to yours. At 21 months now he is about 9.4 kg (around 20 lbs). His 13 month old cousin is heavier than he is. He can still fit into some shirts mean for 3 month olds. My pedi tried to cut us out on bf and told me to put him on formula. I, as usual, ignore him.
    My lo is eating very well and still bf countless times day and night. I give him healthy food. No junk, no sugar, no juice, no cake, no chocolate, no cows milk, no salt added. His occasional treats are very plain organic biscuits. Perhaps that is why he is leaner than his peers, as they are all given artificial juice, formula, and processed food. I do not think it is a handicap to be small. He is super active, happy, curious, talkative, and smart. He seldom falls sick. If he does he recovers quickly. I have never needed to bring him to the doctor apart for vaccination purpose. He does not have any skin problem too. I guess thee are all benefits of extended and exclusive bf.
    Your lo, though light, does have chubby thighs, arms and face. That should mean he has good nutrition. I don't see you have anything to worry about!

  8. #8
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    Default Re: Very small toddler - 21 months/18lbs

    I wouldn't be worried about his nutrition given that he is height-weight proportionate and eats well/nurses a lot, but I would be concerned if there might be something wrong from an endocrine standpoint, given that he is so short and you and your DH are not very short yourselves. Being very short can be hard on a boy emotionally as he gets older and if I were you, I would ask the pedi for a referral to an endocrinologist just to see if there is anything wrong. If he has a growth hormone deficiency, it obviously should be treated, or it could be some other hormonal imbalance (thyroid? who knows). If there is nothing wrong with him and he is just intended to be short, well then, he is. At least you'll be reassured there is nothing medically wrong with him and that nothing needs to be done about it. I do believe growth hormone is sometimes used to treat even children who are perfectly healthy but simply short, even if they don't have a growth hormone deficiency, but you don't have to go that route unless you want to. An endocrinologist would be the best person to advise you on all of this. Good luck! He is a cutie and from the sounds of it, he's well-nourished and healthy, just small.
    First-time mama to Joshua, 10/29/11. 29 months and going strong! for 14 months; now finished with pump weaning!

  9. #9
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    Default Re: Very small toddler - 21 months/18lbs

    Thank you both for your input. I will likely ask for a referral if he doesn't have a good growth spurt in the next few months
    Nursling: Kevin (March 2012)

  10. #10
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    Default Re: Very small toddler - 21 months/18lbs

    Just wanted to update, as I am feeling the anxiety of his 2 year check being only one week away.

    He has grown since I last posted: At 24mo he is 30.3" tall and 19.5lbs (which is about 1lb and 1/2" growth in the past 3 months).
    I measure him standing up, if his pediatrician measures him laying down he might even get a little extra height at his appointment. He's still <1%tile on the WHO charts for both height and weight but still in the 10-15%tile on the weight-for-height chart

    I wish I didn't feel so much anxiety surrounding his doctors appointments. Aside from being teeny, he is perfectly healthy. He is still breastfeeding about 4 times per day, eating tons of food....he just never sits still. He is potty learning (about 90% day trained) and trying nights (but I feel like a crazy person washing sheets every day), is speaking in short sentences, walking/running, building with blocks, he is very social with other kids, etc. I honestly have not a single worry other than his very small stature.

    His pediatrician IS awesome...but I know he expects my little son to be bigger than he will be at his check next week and that upsets me because I feel like I do everything I can to feed him healthy, fattening foods, and continue giving him breast milk, and his growth just doesn't show it.
    Nursling: Kevin (March 2012)

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