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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Shall Be Normal Growth Of Five Years Old Child?

I am concerned with a child in my class. She is 5 years old, very thin, and pale - sickly looking, but doesn't get ill very often other than a runny nose which is almost constant. When she stands, walks, or runs, she keeps her knees bent and draws her elbows back so her hands hang limply by her ribs. She can straighten her legs, throw a ball, hop, etc., but I am concerned about her development and wonder if this is still within the "normal" range. There is a difficult family situation and the mother and daughter are vegetarians which concerns me as well, because she is so small. Any advise?
Mon, 15 Feb 2016
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Pediatrician, Infectious Diseases,  's  Response
Hello and welcome.
Thank you for your query.
I suspect that the child has failure to thrive and associated vitamin D deficiency. With similar presentations in the clinic, I usually advise evaluation for underlying causes of failure to thrive like mal-absorption, disorders of the gastrointestinal tract like celiac disease, kidney disorders, genetic-metabolic, endocrine (hormonal) problems, immune system defects. In this situation, given the difficult family situation, poor intake of food and psychosocial stressors might be playing a role too. Other systemic causes will need evaluation depending on the examination findings.
In my opinion, the child would need blood tests like complete blood count, complete metabolic profile to begin with and evaluation by your local pediatrician. In the meanwhile, I would also suggest intake of balanced diet, exposure to the sun, calcium and vitamin D supplementation.
Hope this helps. Please do write to us if you have any further questions and I would be happy to answer.
Best wishes and regards.
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What Shall Be Normal Growth Of Five Years Old Child?

Hello and welcome. Thank you for your query. I suspect that the child has failure to thrive and associated vitamin D deficiency. With similar presentations in the clinic, I usually advise evaluation for underlying causes of failure to thrive like mal-absorption, disorders of the gastrointestinal tract like celiac disease, kidney disorders, genetic-metabolic, endocrine (hormonal) problems, immune system defects. In this situation, given the difficult family situation, poor intake of food and psychosocial stressors might be playing a role too. Other systemic causes will need evaluation depending on the examination findings. In my opinion, the child would need blood tests like complete blood count, complete metabolic profile to begin with and evaluation by your local pediatrician. In the meanwhile, I would also suggest intake of balanced diet, exposure to the sun, calcium and vitamin D supplementation. Hope this helps. Please do write to us if you have any further questions and I would be happy to answer. Best wishes and regards.