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Forum Name: Endocrinology Topics

Question: Daughter dropped from 50th percentile to 7th percentile


 Catherine Tietschert - Thu May 03, 2007 1:37 pm

have a daughter about to turn 8 years old. She has mild funnel chest and a small bony growth on the lower part of the sternum that didn't cause any alarm after a chest x-ray. She has nocturnal enuresis. At age 3 she was 37.5 inches in the 50 percentile for growth and at age 4 dropped to the 10th percentile at 38 inches and diagnosed with failure to thrive. She was checked for lead poisioning, diabetes, and TSH levels all normal. Her growth curve seems to have normalized over the last few years but she is currently at 47 inches which by some growth charts puts her at the 7th percentile. She has sometimes complained about her 'heart' hurting. She seems to sweat from the head more than usual producing a sweaty smell within hours of bathing. Should I get a referral from her primary doctor to a specialist? If so what kind of specialist?
 Dr. Chan Lowe - Fri May 04, 2007 3:33 pm

User avatar When assessing child height, the height of the parents is considered. The estimated height of the child is the average of both parents' height + 2.5 inches for boys or - 2.5 inches for girls. This gives a target plus or minus 4 inches.

I would recommend that your daughter have a bone age x-ray done to see if her bones are "growing" faster or slower than her actual age.

I would also recommend that she see a pediatric endocrinologist. She should probably also have her growth hormone tested.

Best wishes.
 Catherine Tietschert - Tue May 08, 2007 8:41 am

Thank you for your response regarding my daughter's drop from the 50th percentile to the 7th. I have been concerned about her growth for sometime now and her primary doctor seems unconcerned and doesn't seem to think anything needs to be looked at. I felt differently but wanted a Dr.'s opinion to make sure I'm not just an overwrought mother. I very much appreciate you confiming my suspicions. I will take the next step and have her see a pediatric endocrionologist.
 Catherine Tietschert - Tue May 08, 2007 8:59 am

Regarding the height of the parents in calculating and predicting a child's height, I've checked this out and the normal projected height for her would be 5'5" as I am 5'6" and her father is 5'11" tall. I have another daughter 2 years younger who is growing normally and has always been in the 50-60th percentiles as my older daughter used to be until age 4.
 Dr. Chan Lowe - Sun May 13, 2007 9:39 pm

User avatar Based on the mid-parental height, your daughter is not following her expected curve. 5'5" puts her in the 60th percentile for adult height. (This height is generally plus or minus 4 inches) Even with the extreme of 5'1" she should be in the 10th percentile.

When children cross two percentile lines on their growth curves a work up to be sure nothing else is going on is warranted.

Best wishes.

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