Slow to grow

Q: My one-year-old is very small. She was average size at birth, but started dropping on her growth chart when she was four months old. She has been tested for cystic fibrosis and the paediatrician seems to think everything is fine, but I’m still worried.

A: Doctors closely follow children’s height and weight, as these tell us in a general way if a child is healthy and her body is working properly. If these measurements are consistent with your family’s growth pattern, and the child generally remains on the same percentile and is active and developing normally, it’s a good sign she’s just fine. If that’s the case, we can blame her small size on genetics.

On the other hand, the list of causes for slow growth is a long one, but many are treatable. Falling off these expected percentiles can be due to poor intake; too much output (lots of loose or fatty stools, or vomiting); or her body not correctly using its fuel. Your doctor should have a clear idea of how many calories your child takes in each day as well as her output. If your daughter is taking in sufficient amounts and is still not gaining weight, further assessment needs to be done, perhaps by a specialist.

If you’ve communicated your concern to the paediatrician and he can’t explain the situation, it may be time for a second opinion.