Decreased Growth in Height for 4Yo

1- This can be totally normal.
2- This can be incredibly complicated.

My younger daughter dropped from >50th percentile to off the growth charts and the doctors ran labs and said she was fine. She wasn't. But it was complicated. Sometimes endocrine problems can fluctuate so more than one test time should have been done (but one blood draw was hugely traumatic enough!) Also if the child has some major sleep issues, the timing of their growth hormone release can be reversed and the usual testing (morning) won't show the huge decrease at night. Another problem that can arise with testing for a thyroid issue is that they concentrate on TSH (which is not actually a thyroid hormone) and miss that the thyroid problem can be hypothalamic, pituitary, or peripheral. Although this is about thyroid and the brain, it links to wonderful information about multiple testing which should be done (I wish it had been done right away on my child instead of it being delayed by a decade!) http://itsnotmental.blogspot.com/2011/01/brain-health-thy...

Even vitamin D and omega-3 status can interfere with the body's usage of the thyroid hormone.

Another issue can be intestinal malabsorption, such as can happen with gluten sensitivity. This is not always obvious, and did happen to my younger daughter. Did this affect her endocrine system? Her sleep? Vice versa? We don't know which came first.

But 47th percentile is not bad at all! Like I said, my daughter's height fell rapidly to below the bottom of the growth chart..... and yes, we were still told it must be normal for HER, since they didn't find anything wrong.... initially....

Did your pediatrician note anything else wrong? Just changing where he is in the pack is not by itself a cause for alarm. In reality your son just went from a little taller than average to pretty much average. My son started off in the 90th percentile for height and at age 6 is pretty much just above average. His pediatrician has never been the least bit concerned. Are you and your partner tall or short? Most kids end up being similar in height to their parents (actually a little closer to the average - if both are tall, they are often a little shorter than the parents, if both are short, they are often a little taller than the parents).

This just happened to my 9 yo nephew. He went from the 50th percentile to the 15th. All test came back fine. They x-rayed his hands, and took 4 vials of blood. I know they checked his hormones and thyroid but I am not sure what else.
I know quite a few kids that had to be tested and not one of them actually had a problem.

He's practically in the 50% group, which I would consider very average for his age. Don't stress.
It means 50% are heavier/taller and 50% are lighter/shorter.
So your kid is fine. Dont let docs probe and prod when it's really not necessary.

they like to make money on our fears.

I am surprised your pediatrician is concerned. That happens all the time with nothing being wrong.

My youngest bounced around a lot, nothing wrong with her.

Most children grow in spurts, so if he is measured just before or just after a growth spurt, the charts will be quite different. Of, course it does not hurt to run tests, but I just don't see the percentage differences as a big deal.

By the way, my children were very small and grew up to be over average in height. One time they told me my youngest was not even on the chart for weight. Did that mean she did not exist? See how silly the charts are. Well, I ignored the charts because she was healthy happy and active, just small at the time.

My son is only 17 months, but has been in a different percentile everytime he goes in for those well checks. When he was born he was in the 98th percentile, dropped to the 50th, back up to the 75th, back down to the 50th. I don't know but I would think unless there is some other reason for concern, they just fluctuate.

I am 6' tall, and I also have a hypothyroid condition. My older daughter is (has always been) above the 95% for height. So it was something of a shock when my younger daughter went from above average height at birth to the 15% for height by the time she was 3. Her pedi ran every test under the sun, and it turns out that she's just short. Apparently it happens, even in Amazon families like mine. Sometimes perfectly healthy kids happen to grow a little slower than other kids of the same age. Provided that the tests come back normal, try not to stress out about this. My daughter is now 7, and has finally (finally!) hit a growth spurt. She's edging toward the 50% in height! (Alert the media! LOL)

One test that did give us some peace of mind was a bone age scan. Basically, they x-ray the child's hand, and from the growth plates, the radiologist can see if the child's bone age is ahead of or behind average. For instance, our daughter was 4.5 when the test was done, but the test showed a bone age of 2 years. From this, the doctor surmised that she has as much growing left to do as a 2 year old would (in other words, she will probably be of average height, it will just take her a long time to get there!). This test can be notoriously unpredictable in very young children (it's more accurate the older the child gets), but in our case it did make us feel better.

Good luck.

That's really not that much of a decline. i'm surprised your pediatrician is too concerned. I have a 4 year old, too and by my calculations, he's grown a half inch in the past year. (my older one had grown 2.5" between 4 and 5 years old)

I'm another one who is surprised your pediatrician is concerned when your son is only 4 years old and dropped only to 47th %-tile. It's very normal for growth rates to fluctuate. My daughters each did this at whichever percentile was normal for them to suddenly drop at one appointment and then "pick up again" at their next appointment or the one after that. Or they established a new growth rate and stayed steady.

Hopefully your son is like most other children and is going through something that really is completely normal, although if it eases your mind then it's worth checking out. If they find something then it's worth finding out now.

Maybe he's just....short for his age.

It blows my mind when parents freak about this stuff. My boys are both super skinny. They're active. 15th percentile for weight. They eat like horses and are healthy.

I think your ped is jumping to conclusions a bit too quickly.

My 3 yo had a decrease as well and they are just having me come in for another check in 3 months to see if there is a continued decline. The truth is, it's pretty tricky to get an accurate measurement for wiggly little kids and wrong stats happen an awful lot.