Long list of possibilities from family growth patterns of short stature, delayed puberty to growth hormone and other hormone deficiencies like underactive thyroid and a long list of genetic conditions like Noonans Syndrome, Celiac Disease and other inflammatory conditions. Key is looking at his eight and height, plot them on the standard charts and see if there is some clue by the pattern. Then get a hand xray called a bone age and compare this to height and weight ages. Physical exam would also be done and likely consultation with a pediatric endocrinologist experienced with growth and short stature conditions with likely screening blood tests such as IGF1, T4, TSH, chemistry profile, celiac testing and whatever else is suggested by detailed systems review, history and physical. If none of this provides a specific diagnosis, more detailed genetic testing and xrays as well as closer followup and plotting the height on the growth charts would then be done as part of the endocrine evaluation.

Could be a medical condition and would require a careful work up. It could also be normal. Read about constitutional growth delay. It’s a normal variant of growth (aka “late bloomer syndrome”).

There are several reasons for a kid to have low growth rate. He deserves to be seen by an endocrinologist to have a complete evaluation

Most children grow close to thier genetic background (roughly 85%of the time). There are several reasons why children may be growing either below biological background, below normal growth channel, or falling off the growth chart(shifting growth centiles down word.