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What Does A Slow Growth Rate In A 4 Year Old Indicate?
Question:
Hi,
My 4 year old daughter has been growing at a very slow rate as per growth curve. She is 9.5kgs at 4 yrs. We have ruled out gluten,lactose,thyroid and other various conditions. First two yrs she was off gluten suspected for sensitivity . recently her TTG andIga Igm and IGg all were normal. we also did stool test for malabsorption. Recently she was tested for growth harmone and found out to be borderline.she also has hypertrophic adenoids but Dr has ruled out her surgery and recommends mometosome spray.For grwoth harmone dr has suggested 5drops twice daily cyproheptadine HCl, elixir neogadine and cal vit d supplements for 3 months. I have been reading a lot about cyproheptadine HCl and side affects and many DRs don't recommend. She also has allergic rhinitis and on and off gets cold amd wheezing. Would like to know Any further investigation is required as she is too low on weight and height now (89cm)?. Also cyproheptadine HCl should be continued or stopped?
Hi,
My 4 year old daughter has been growing at a very slow rate as per growth curve. She is 9.5kgs at 4 yrs. We have ruled out gluten,lactose,thyroid and other various conditions. First two yrs she was off gluten suspected for sensitivity . recently her TTG andIga Igm and IGg all were normal. we also did stool test for malabsorption. Recently she was tested for growth harmone and found out to be borderline.she also has hypertrophic adenoids but Dr has ruled out her surgery and recommends mometosome spray.For grwoth harmone dr has suggested 5drops twice daily cyproheptadine HCl, elixir neogadine and cal vit d supplements for 3 months. I have been reading a lot about cyproheptadine HCl and side affects and many DRs don't recommend. She also has allergic rhinitis and on and off gets cold amd wheezing. Would like to know Any further investigation is required as she is too low on weight and height now (89cm)?. Also cyproheptadine HCl should be continued or stopped?
Brief Answer:
Uploading the growth chart should help.
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have carefully considered every detail mentioned. The first thing to ask is whether she is cutting percentile lines on the growth curve. If the growth just following a lower percentile line, it is to be considered normal and not a cause for concern. But if the plotting of her weight is gradually moving downward by cutting percentile lines, something seems to be wrong and needs to be investigated.
I would not prefer giving cyproheptidine. Although it might have some stimulatory effect on the sense of hunger, the rewards are not worth the risk and I would speak strictly against its use.
I do not consider Elixir neogadine to be of any use. But at least it is not harmful. Enzyme supplements are not useful since the enzymes are proteins and get denatured by stomach acids.
The allergic rhinitis and the hypertrophic adenoids could have an adverse effect on the health. Mometasonen spray can help. You may give her Montair LC Kid (monteleukast + levocetirizine) off and on as required during the episodes of cold but that is a prescription medicine and you might need to get it written down by your doctor.
Regards
Uploading the growth chart should help.
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have carefully considered every detail mentioned. The first thing to ask is whether she is cutting percentile lines on the growth curve. If the growth just following a lower percentile line, it is to be considered normal and not a cause for concern. But if the plotting of her weight is gradually moving downward by cutting percentile lines, something seems to be wrong and needs to be investigated.
I would not prefer giving cyproheptidine. Although it might have some stimulatory effect on the sense of hunger, the rewards are not worth the risk and I would speak strictly against its use.
I do not consider Elixir neogadine to be of any use. But at least it is not harmful. Enzyme supplements are not useful since the enzymes are proteins and get denatured by stomach acids.
The allergic rhinitis and the hypertrophic adenoids could have an adverse effect on the health. Mometasonen spray can help. You may give her Montair LC Kid (monteleukast + levocetirizine) off and on as required during the episodes of cold but that is a prescription medicine and you might need to get it written down by your doctor.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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