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Vertically Challenged

I'm like Stacy, short in stature.  What gives?  But certainly, Stacy needs some perspective on this unique question.  She emails:

Any mamas out there with really short kids?  My son is 4 1/2, and just over 36 inches tall.  According to the growth charts, he doesn't exist.  He is active, strong, articulate, and has a very healthy, varied diet.  At last year's well child check-up, pediatrician sent his growth charts to an endocrinologist.  We had blood tests (hormones, thyroid).  He was healthy, there was no more discussion.  Last week we went again, and go through the same questions.  Was I a late bloomer? Yes. Was my husband a late bloomer? Yes.  My boy has certainly grown in the last year, just not very much.  Pediatrician sent us for a bone age x-ray (and
gave me no interpretation of the results) and now I've been instructed to set up an appointment with a pediatric endocrinologist.  My husband thinks that being short is really hard for boys and has much less distrust than I do of whatever medical intervention might follow.

Of course I'll take my son to this appointment, but part of me just thinks, "He's short.  I'm short.  I'm 5'2''.  My husband is maybe 5'8".  The pediatrician is 5'6"! Can't someone just be short?"

Any experience with endocrinologists?  Perspective?


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My oldest is also small for her age - at 6 she is around 42 inches tall and weighs 36 pounds. We are an adoptive family so we can't compare her to us. We do know that her birthmom is quite small but nutrition plays a part in that - in fact at 6 she is not much smaller than her birthmom. When she was a baby/toddler we actually had people say to us that she could not possibly be able to walk/talk/etc. because she was too small to be as old as we say she is.

We never saw an endocrinologist because her pediatrician (who is also somewhat small) says she is healthy. Like your son, she is bright, active, social - despite acting out after eating too much Easter candy she is an all round great kid. A few years ago the New York Times did a great article on the use of growth hormones and some of the many issues - are they necessary, safe, etc.

Instead of the drugs we decided to focus on all the great things about being almost 5 feet tall as an adult. Her passion is monkey bars and Do Jump so we do everything we can do to support this. We have indoor and outdoor monkey bars. She takes classes and one of her favorite instructors is around 5' 2". She is learning that being smaller makes it harder to do some things but easier to do others.

Public school has also helped - she is not the only one her size in the class. Another mom (who is small herself) and I confided in each other that we were really happy the first day to see each other's kid. My daughter was by far the smallest in her preschool class so it was a really nice change.

We also work with her on responses to people who tell her that she is too small to do things. Last summer we were at a park and she was doing some amazing things on some rings. I was focused on our younger one when some older girls came over and kept the rings out of our oldest daughter's reach. I saw it and told them they needed to give her a turn. She then does these amazing moves, I looked and the older girls' jaws had dropped. The leader said to the others, "Don't you even think of trying that, you could hurt yourself." They had a new respect for my daughter and she had a lot of pride.

Isn't there some formula to predict how tall your child will be? I forget it right now (pregnant brain), but it has something to do with the height of the parents.

Which makes sense. Short parents will probably have short kids. I can understand that your doc may just want to make sure it's genetics and not a growth problem, but your son will probably never be NBA height.

On the flip-side, DH and I are both on the tall side. When my older son was about 2 1/2 we were looking at fish at a pet store. He mistook another woman for me, tugged on her sleeve and said something about the "tishes." She answered him, and then said something snotty to me about how someone his age should have better pronunciation. I asked her how old she thought he was and she said 4 or 5. I (snottily) responded that he was still 2 and she understood him just fine, so what's the problem, thank you very much.

I was a tiny child (and am a fairly tiny adult) and although at 5'3", I've caught up quite a bit, I remember laughing at the weight limit on my daughter's toddler car seat, realizing that I could have ridden in it until I was about 12! Being petite as a child had it's ups and downs. I got a few unkind nicknames in grade school, but, if it wasn't my height, it would have been something else. Being small just became part of what made me me. I was all prepared to help my daughter navigate the trials of being tiny and was surprised to realize that she was average and probably will continue to be until she's an adult.
As far as the doctor is concerned, they are trained to be thorough rather than get sued for missing something. If your son is progressing at a normal rate in all other areas of development and you know that he has an obvious genetic predisposition for being smaller than average, he is probably just a little guy. Follow your gut about doing further testing, but if you're going to do it, go ahead and do it now before he's old enough to make the connection that there's something wrong with being small.
I think generally, your husband is right to think he might have issues as a smaller boy, but everyone's got issues. That's part of growing up, isn't it? Learning to overcome obstacles and to love yourself for who you are, not in spite of it?

There is a height predictor online that was developed by the University of Sasketchewan's Department of Kinesiology (http://athena.usask.ca/growthutility/phv_ui.cfm?type=2), that is supposed to be reasonably reliable, as far as these things go. It says: "To predict adult height the following variables are required: gender, date of birth, date of measurement, height, sitting height and weight." Fun to play with, if nothing else. My daughter calculated out at 5'6", although that would make her the shortest person on either side of the family since her great grandparent's generation.

we are in a similar boat but not quite as far along as you are. my son is 3.5 and barely on the growth chart, the smallest of anyone his age we have ever encountered. he is otherwise perfectly healthy. our doctor mentioned checking his thyroid at 4 but there is simply no other indication this is an issue. i am 5'2" but my husband is 6' and most of his family is even taller. it's one of those weird things that kind of bug me but i am trying to let it go since i really don't think health is an issue. as he develops physically by leaps and bounds (equal to, an in many cases beyond, his peers) in his coordination, balance, fine motor skills, etc. lately i am feeling less bothered by the issue. like you say, he is growing but just very slowly. at this point we are taking a wait and see approach and would be very hesitant to pursue any intervention unless there was a real health issue. i guess only time will tell.

I am 5'8, My husband is maybe 5'6. My son is a little shorter than his friends but they vary the scale from much taller to shorter. I really don't expect my son to be taller than 5'8 and he might be shorter than his father. My side of the family is tall and my husbands side of the family is shorter. Both side of the family are healthy, happy and intellectual adults.
That being said unless my son had a endocrine/growth disorder we would not intervene.
I do wonder what the repercussions of using synthetic growth hormone on "normal" kids will be in the future??

Here are some thoughts from a short pediatrician (myself):
I didnt find the predictor above to be that helpful for a younger child.
the formula to predict adult height based on parents height is:
for a boy:
Moms height + five inches added to father's height, that total divided by 2. so mom would be 5 ft 7 in if she was a man+ dads height of 5 ft 8 in and divided by 2 is 5 ft 7.5 inches, which is a reasonably normal height.
for a girl:
moms height added to fathers height minus 5 inches and that total divided by 2.
(then remember standard deviations or "fudge factor" of an inch or two.

Looking at your son's height of 36 inches at 4.5 years of age on the growth charts from the CDC (which is for standard US-Caucasian children- so if you are of a different ethnicity- you can look those up on google), he is significantly below the 5%ile. However, his predicted height would put him at about the 15%ile. So, something isnt jiving. If he truly continues at the under the 5%ile, that would put him at about 5 ft 2in as an adult male, which is quite short and wouldn't make sense based on you and your husbands heights.
Could be that he will be a late bloomer like both of you (which would be the so-called "constitutional short stature", but he is significantly under the curve and there are medical conditions that could cause that like thyroid probs, or hormone problems, that he has been screened for. My take on it is to meet with the endocrinologist- they are usually very smart, articulate people, and see what s/he has to say, but you're right, the bottom line is that your son is healthy, smart, strong and will be loved and can do anything no matter how tall he is and generally speaking, unless he has growth hormone deficieincy (which is exceedingly rare) you wouldn't give him any meds or treat him any differently than you are now.
Sorry to be long winded, but was trying to be helpful.

my husband & I are the same size (and I'm small for a woman!) and he's the tallest in his family. I laugh when I see the billboards that advertise the new laws for booster seats: 4 foot 9 inches! I'm gonna have to buy booster seats for my parents in law next time they come to visit!

Amazingly we have a daughter who has always been 90%--she has almost always worn clothes one size bigger than her age (she's 4 & wears 5T pants). Our second child, although largish at birth (over 8 pounds) now hovers between 10% and 25% for weight & height. At first I was worried but then my father in law's words (as repeated by my husband) came back to me:

Do you have two legs? Two arms? Two eyes? A good head? Then there's nothing wrong with you!

It's probably good to get some things checked out, maybe talk to a nutritionist to make sure you're getting in a good diet but don't let yourself get drawn into the trap of worry.

My nephew is going through this. Last year he was 9 yrs old and he was just a little bit bigger than my 4 yr old. There is nothing wrong with him. Just short parents. My sister is 5'2" and I think his father is just a little taller than that. And my dad was just telling me that when he was growing up, my grandmother used to sit and cry thinking that my dad was a midget (his parents were also very short). But he finally hit a growth spurt in high school and is 5'8". Not tall, but normal. Anyways, back to my nephew, the only problem with him is that he gets teased terribly at school. He looks like a kindergartener who is in 4th grade. So he is dealing with a lot of emotional/anger issues. So if your son is physically healthy, just be aware that you might have to keep an eye on his emotional health later on - especially if he's being teased.

My son is also small for his age. He started life in the 40th percentile and hovered around the 50th for awhile, then went down below the 5th after introducing solid food. I later discovered his problems were food allergies and sensitivities. Now he has inched back to the 25th. Last I checked conventional medicine wasn't big on food allergies and sensitivities so you may not have checked into this yet but you could ask a naturopath about getting him tested for food sensitivities and allergies as a compromise instead of synthetic hormone treatment.
As a bonus, the rest of our family was so happy with the results that we all got tested, found sensitivities, cut them out and now get sick much less often.

It's always good to get another opinion, especially if it's in a specific area of expertise. I would recommend Dr. Hanna at OHSU she is a pediatric endocrinologist. http://www.ohsu.edu/health/meet-our-staff/doctors/doctor.cfm?id=10801

My brother was failure to thrive as a little kid. He was an active rapscallion who got more than his share of bad colds. He wasn't thirty pounds when the doctors took his tonsels out at five years old. Now he's 5'11 and 180lb of muscle when hes in shape. He's got HUGE shoulders and is very barrel chested like my dad. You never know what someone will grow into.

Oh my dad is short too, and taught my brother a lot of tricks on the sports fields for effectively taking down and tackling bigger boys in contact sports. Just make sure your sons can hold there own. What a small boy lacks in physical mass he can make up in tenacity. But, especially for boys, its important they have that physical strength to compete with their larger peers. Men are judged on physical strength. Small women are attractive and fiesty and sexy. Small men are just weak. So the boys need some way of fighting back against the negative stereotype, by being able to use their physical strength when they need too.

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