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Child looking tiny for his age. Tests show growth hormone deficiency. Suffering from chronic cold, cough. Suggestions?

Hi. My nephew is 3.5 years old and has been in the 0% weight category since he was 1.5 years. He has grown maybe an inch and a half and maybe 3 pounds in the last three years. My sister has taken him to their paediatrician, and an endocrinologist . But in the last two years, they have only given him approximately one appointment every six months, ruled out celiac and CF, and one test showed close to no growth hormones. All the endocrinologist said, is that they will check up on him next year, to see if his levels are changed. Other than that, they have offered no diagnosis other than a possible Growth Hormone deficiency , have not ordered any more tests, and offered no other information. I want to know what type of questions should be asked at the next visit. Two doctors he has seen don t seem to take him that seriously, maybe because he is a bright, intelligent kid who is only slowly becoming visibly smaller than his peers. He was born 8 pounds, but after about 9 months, pretty much stopped growing. But he never wanted to eat, from breastfeeding to solid food. Even now, my sister has to force him to eat, and two bites of a sandwich at lunch is a big deal. He looks proportionate, just tiny. He was about 20 pounds when my own daughter was born. That was almost two years ago. Now he is 22-23 pounds, and my own daughter is 30 pounds and two inches taller than him. He has also has chronic colds, coughs for about two years straight. What else can my sister do or follow up on? She lives in Vancouver, BC, Canada.
Asked On : Mon, 7 Jan 2013
Answers:  1 Views:  48
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Pediatrician 's  Response

Thank you for your query.

I can understand your concern. However I would like you to properly record his height and weight every 3 months to know the growth pattern. The doctor must be monitoring these parameters and that is why they must have called your nephew after 6 months to review. If the doctors are suspecting growth hormone deficiency then they shall be doing an assessment of the growth hormone. Hence your sister should ask the following questions:
1. How does the child fare in the growth graph?
2. When will the doctors be ordering growth hormone assessment?

You mentioned that your sister has to force feed the child. I suggest that force feeding be stopped and food be offered at the designated time for meals or when the child demands. The child is going to demand food when he is hungry.

I hope I have answered your query to your satisfaction.

Wishing your nephew all the best.


Answered: Tue, 8 Jan 2013
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