I Was Afraid of That

March 28, 2007

It was immunization time. I scheduled a doctor's appointment for Kyle so he could stay up-to-date on his immunizations. At the doctor's visit, the doctor began to look into Kyle's growth progress, or lack therof. I knew immediately what was going through the doctor's mind. The time had come. I could ignore the problem no longer. This one wasn't going away. The doctor explained to me his concerns and showed me Kyle's growth chart and pin-pointed where Kyle was on the chart, which indeed was around the 2nd percentile. He explained to me possible reasons why a child could be short: chronic disease (for example, malnutrition), familial short stature, or constitutional delay of growth and development ("late bloomers").

Worldwide, malnutrition is the most common cause of growth failure and is usually related to poverty or anarchy. Nutritional deficiencies in developed countries are more often the result of self-restricted diets. Poor weight gain is often more noticeable than short stature.

Children with familial short stature have short parents. These normal children display normal growth velocity (speed of growth over time), and their bone development is normal (as indicated by the bone age corresponding to the calendar age). Children with familial short stature enter puberty at a normal time and typically complete growth with a height consistent with that of their parents.

Constitutional growth delay is a term used to describe normal children who are small for their age but who have a normal growth rate. Constitutional growth delay is characterized by delayed bone age, normal growth velocity, and a predicted adult height appropriate to the family pattern. Children with constitutional growth delay, often called "late bloomers," typically have a close relative who displayed constitutional growth delay. For example, the relative with late blooming may have had her first menstrual period when she was older than 15 years. A male relative with late blooming may have reached his final adult height after age 18 years.

Although rare, endocrine disorders, such as hypothyroidism (thyroid hormone deficiency) or growth hormone deficiency also cause growth failure. Short stature is commonly associated with genetic diseases, such as a SHOX gene mutation, Down syndrome, or Turner syndrome.

The doctor went on to explain that if there was a problem, we needed to begin treatment immediately because once the window of growth opportunity closes, there's nothing else that can be done. He wanted to refer us to a Pediatric Endocrinologist at a large children's hospital a couple hours from our home.

Before we left his office, he ordered some lab work which included a UA, CBC with differential, Thyroid function tests, IGF-1, IGF Binding Protein 3 and a Bone Age test

Next step, make an appointment with the Pediatric Endocrinologist and provide him with Kyle's test results and growth charts...