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Improving children's growth?


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We have three children (of five) who, since about nine months of age, have been consistantly off the bottoms of the growth charts for their age. Our nine year old had a "million dollar workup" at Hopkins when she was about 18 months old; their findings were that she's small, but fine.

 

 

We had a checkup for our now five year old a month ago. He was 26.4 pounds at that visit. The doctor mentioned that because being very small can be tough for boys, that we might want to talk about growth hormones as he gets older. People usually think that he's two or three years old.

 

 

Does anyone have ideas for improving growth rates? Our three "small" children all get plenty to eat. They don't have any allergies that we're aware of, though all three have had cradle cap since infancy that hasn't gone away.

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Were they checked for immune issues? Celiac? Food allergies and sensitivities?

 

A friend's ds was very short and had numerous food allergies and sensitivities. Removing the offending foods helped his other symptoms, but that did nothing for his growth. A doctor finally figured out there was an immune system problem and he needed IVIG treatments. Once he had those, he shot up and is now almost 6' tall. He doesn't need a special diet anymore, either.

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Sounds like it could be allergy related partly because allergies tend to run in families and the cradle cap issue.

 

Have you considered seeing a naturopath?

 

My son had failure to thrive and when I took him off gluten and dairy (under the care of a naturopath) he shot up. Before seeing the naturopath he was sent to the big Children's hospital in our area (3 hours away) and they were clueless. Doctors do not understand dietary issues.

 

I hope you find a solution quickly. I know how stressful it can be.

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I've BTDT with my DD, but certainly not with 3 kids....

 

Have you seen a geneticist? Gastroenterologist? Endocrinologist? Have any of your children had a bone age scan? Blood tests? Stool tests?

 

Do your smaller kids take any sort of daily nutritional supplement?

 

What is the variety in the children's diets? Nutritional quality?

 

When a child is "under weight" they need extra calories every day to help boost weight gain. You can try high-fat/high-calorie foods to get extra calories in them (cook with EXTRA butter, WHOLE milk, etc.) We tr

 

My daughter is in the "less than 3%" and is being seen at a feeding clinic to help her improve her weight gain- it took us a year to get there..... For my daughter, this means that she needs about 300 extra calories a day. She gets 2 regular Pediasure a day, but for almost a year she was drinking 3 a day. When we started seeing the Dr. at the feeding clinic we changed the third Pediasure (before bed) for a higher calorie Pediasure 1.5 (not available in grocery stores- has to be specially ordered) Anyway, this Dr. at the feeding clinic is GREAT and works will all sorts of kids to resolve ANY eating issue and weight gain!!

 

Just in case you are wondering, we currently drink 2% milk and my GI Dr. recommended I switch to whole just to get the extra fat even with the three Pediasures a day!

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My off-the-charts small child tested negative twice for celiac and food allergies, but had a dramatic "catch-up" weight and height gain after we switched her to gluten- and dairy-free. She wore a size 18 mos. at not-quite-3 back in December but by April she had shot up into a 4T. Our pediatrician says that she sees this kind of catch up gain all the time in gluten intolerant kids who go GF.

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I've BTDT with my DD, but certainly not with 3 kids....

 

Have you seen a geneticist? Gastroenterologist? Endocrinologist? Have any of your children had a bone age scan? Blood tests? Stool tests?

 

Do your smaller kids take any sort of daily nutritional supplement?

 

What is the variety in the children's diets? Nutritional quality?

 

When a child is "under weight" they need extra calories every day to help boost weight gain. You can try high-fat/high-calorie foods to get extra calories in them (cook with EXTRA butter, WHOLE milk, etc.) We tr

 

My daughter is in the "less than 3%" and is being seen at a feeding clinic to help her improve her weight gain- it took us a year to get there..... For my daughter, this means that she needs about 300 extra calories a day. She gets 2 regular Pediasure a day, but for almost a year she was drinking 3 a day. When we started seeing the Dr. at the feeding clinic we changed the third Pediasure (before bed) for a higher calorie Pediasure 1.5 (not available in grocery stores- has to be specially ordered) Anyway, this Dr. at the feeding clinic is GREAT and works will all sorts of kids to resolve ANY eating issue and weight gain!!

 

Just in case you are wondering, we currently drink 2% milk and my GI Dr. recommended I switch to whole just to get the extra fat even with the three Pediasures a day!

 

My son had all the tests that you mentioned and they all came back negative (though he does have allergies and food sensitivities that didn't show up on the numerous hospital tests). The doctor's at the children's hospital also told us to boost caloric intake and reccomended lots of sugary treats and dairy.

 

I believe their advice was completely the opposite of what we ought to do and I told them this. Adding calories is not addressing the underlying issue it is just trying to slap some sort of band-aid on the problem while leaving the underlying issue completely untouched. With the real issue being overlooked the body is still undergoing damage. The gut needs to be healed. The root cause needs to be sought out.

 

To the original poster, I really recommend searching out the root cause (it often has to do with what your children are ingesting daily).

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Cradle cap in older children & adults is also called seborrheic dermatitis. It's sometimes linked to deficiency of vitamin D (among other things), which could also be a factor in slow growth. If they haven't had their levels checked, you might want to do that.

 

Also, consider whether or not they might be getting too much fiber. It's easy to overdo it, as many foods that are considered healthy for adults (raw vegetables, legumes, etc.) are hard for little ones to digest, and also tend to fill them up quickly, so they don't have room for more calorie-dense foods. The current recommendation for fiber is the child's age + 5 grams, e.g. 10 grams for a 5 year old. This makes sense to me, because frankly, with the little folks, high fiber foods have a tendency to come out more or less the way they went in. :ack2:

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What's the family pattern? In my family, I'm 5'4", Husband is 5'6" but one of my brothers is 6'2" and the other is 5'10". Both of my parents are/were average height; both of Husband's parents were short.

 

Out of that we have one child who is at the top of the height charts but only just crept onto the bottom of the BMI chart, and another child who has come out consistently low for height and weight (balanced).

 

Laura

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What's the family pattern? In my family, I'm 5'4", Husband is 5'6" but one of my brothers is 6'2" and the other is 5'10". Both of my parents are/were average height; both of Husband's parents were short.

 

My youngest DD's gluten intolerance was missed for a while because of this. I'm petite and my whole family is small as well. When all the lab tests came back negative, our pediatrician wrote off DD's small size as just being genetic. My other two kids are petite, but they were never <3rd percentile.

 

After going GF, my DD had a dramatic "catch-up" gain but she's still small for her age. However, it's a normal small rather than off-the-charts small.

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Familial small size or not I think I would be investigating further. I have small kids and there no where near that small.

 

A lady I know has a super small girl and found out this summer at 6 that her dd has allergies to wheat, eggs and milk. Not a few months before that she would talk about how none of them have food issues. Not to say it is for sure allergies but I'd certainly be thinking more about food for sure.

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Another for ignoring the test results and going gluten free dairy free for at least a year! The growth my children underwent that one test year was more than enough to convince the ped and my hubby that gluten and diary causes some kind of problem that current testing can't detect. you simply can't justify a growth of 5-6 inches in 2 year old or 6 inches in a 10 year old not in puberty as anything else. And we do have petite people in my family. My response to the ped was always what if it is because they have this problem too?? Their height is 4'10 because they never grew. NOT because their genes topped out at 4'10

 

Food issues do so much damage to our bodies without us even realizing. Kids don't grow, they have rashes, itchy dry patches of skin, crazy attitudes, just a number of things that just go away when the food bothering is taken out.

 

I can't recommend enough a gluten free diary free diet to start with , detox their bodies,and let them heal.

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Do your smaller kids take any sort of daily nutritional supplement?

 

They take gummy vitamins, Vitamin D and fish oil gummies.

 

ALSO: My husband is 5'3" and I'm 5'2.5" The kids aren't going to be huge people, but I still don't want to end up tinier than they need to be.

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If your kids are eating well, it could really be just genetics. It sounds like you have "small" genes in your family! My husband is 6' and I'm 5'6", and our first four children were average or above. Our #5 was smaller at birth than all all the others, and slowly fell off the growth chart. She was well below 0% for a number of years. We too had an expensive work up at Mayo Clinic. At first we were told she needed to eat through a feeding tube she was so tiny (this was at 18 months!). She was happy and healthy and energetic, and actually had a good appetite. Mayo Clinic docs came to the same conclusion that she was just very petite.

 

My mother is petite (in fact when she was in kindergarten, the principal would pull her out of class every day to give her an extra glass of milk), and I am too, though taller.

 

She did have the test for celiac, and we kept her off of gluten and dairy off and on for months at a time. Nothing ever made a difference.

 

In about 9th grade she started growing more and putting on more girlish weight. She is now 17 and about 100 pounds, 5'5"!

 

That being said, I'd trust your instinct if you think something else is behind it, and I'm not certainly not opposed to at least looking into growth hormones, especially for your son. I think being small is a lot harder on a boy.

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My youngest is very small for his age. He just recently (at 6 yrs) grew out of size 2 clothing. We had some testing with our family doctor a few years ago and everything checked out ok. This past year we went to a pediatric endocrinologist who tested his growth hormone levels using a stimulation test. The results showed he is deficient in growth hormone and a follow up MRI showed he has an under-developed pituitary gland.

 

We began growth hormone injections in the spring and finally ds is growing! I can't explain how happy I was to need to buy him new shoes, twice, this summer because he grew out of them. Previously he had been in the same size (toddler sz 7) since he was around 3 yrs old. He has also gained around 5 lbs and grew 2" since late spring.

 

Some things I learned form the endo -

- My ds was way off the growth charts, abnormally small. DH and I are short people and you would expect our children to be on the small size but not that small. He explained that though we are small we are still at normal heights for adults. I am 5'2 and dh is 5'7.

- Children should be growing about 2" per year.

- If a child is way below normal for growth and it is expected that they will be abnormally small in adulthood growth hormone can still be prescribed even if lab tests come back normal. The diagnosis is idiopathic short stature.

- Untreated low growth hormone can lead to adulthood bone issues and cardiovascular problems.

- The single blood test for growth hormone is not accurate, you must request the stimulation test which is done over a couple of hours.

- ETA - When a child needs growth hormones the earlier you start the better they work. If a child is diagnosed with idiopathic short stature the growth hormones will be used only until the child reaches the growth curve the doctor's predict he should be on based off of the parents' heights. If a child is diagnosed with low growth hormone they will continue the treatment until predicted adult height is reached.

 

That is my story but everyone's is different. What does your gut tell you? Follow your instincts.

Edited by SJ.
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If your kids are eating well, it could really be just genetics. It sounds like you have "small" genes in your family! My husband is 6' and I'm 5'6", and our first four children were average or above. Our #5 was smaller at birth than all all the others, and slowly fell off the growth chart. She was well below 0% for a number of years. We too had an expensive work up at Mayo Clinic. At first we were told she needed to eat through a feeding tube she was so tiny (this was at 18 months!). She was happy and healthy and energetic, and actually had a good appetite. Mayo Clinic docs came to the same conclusion that she was just very petite.

 

My mother is petite (in fact when she was in kindergarten, the principal would pull her out of class every day to give her an extra glass of milk), and I am too, though taller.

Or it could that there is a family reason why there is short stature. I had a friend whose husband who was only 5'6" with Dr. confirmed Celiac, yet the kids small stature was blamed on genetics and no thought that perhaps it was the Celiac that was passed and not just some propensity for shortness. Although officially diagnosed he didn't follow the diet past early childhood, it's no wonder he had bad teeth and was short.

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