By Dr. Hon Mun Cheng
My name is Dr. Hon Mun Cheng and I’m a practising paediatrician. I am also an attending physician to many babies. It is always a delight to see these babies grow up healthy and see the smiles on the faces of their parents.
From my personal observation, most parents are understandably worried for their baby’s growth and health. There is a fear that something may go wrong. I am always there to reassure them and hold their hands. I have always been the one offering medical advice and counsel.
13 years ago, the tables turned on me when I became pregnant.
Being a paediatrician, I knew what I had to do to ensure a normal pregnancy. Everything would be smooth sailing. I just needed to utilise my medical knowledge to my benefit. But that was not to be…
I was floored when my son, Gabriel, was diagnosed with Small for Gestational Age (SGA) in my last trimester of pregnancy! How could that be?
I had the best prenatal care possible. I practised the essentials of good nutrition. I ate well and even ensured adequate weight gain. I did not have any unusual pregnancy symptoms that warranted medical care. Everything had gone on smoothly, until …. that fateful diagnosis.
Although I am on the shorter side at 143cm, my husband is tall and stands at 178cm. It didn’t even cross my mind that my baby would be diagnosed as SGA although I understood that short stature moms were at risk of having SGA babies.
When the paediatrician weighed Gabriel at birth, he was only 2kg! Upon checking his blood sugar, the doctor advised us to monitor Gabriel’s feeding and weight gain. Undeniably, I was worried for Gabriel’s condition, but I knew I could handle it. As a paediatrician myself, I also understood that SGA is a health condition that can be treated.
As the years passed, we regularly measured and plotted Gabriel’s growth and monitored his nutrition intake. Unfortunately, Gabriel was very selective of what he ate. Despite our best efforts, we observed that Gabriel was always the shortest among his peers. We then attributed it to genetic short stature and poor nutritional intake due to his eating habits. Also, since my husband had constitutional delay of growth and puberty as a child, we were hopeful that Gabriel would grow taller in his teenage years.
Unfortunately, that did not happen. When Gabriel turned 10 and was still not at the height he should be at, I then consulted a paediatric endocrinologist who recommended a high calorie diet and growth hormone treatment for Gabriel. The decision to pursue this treatment did not come easy. My husband and I discussed it at length. Even though I was worried, I did my research and was very much assured by the success of growth hormone treatments.
At age 10, Gabriel began his first growth hormone treatment. It’s now three years later and it has been a great relief that Gabriel has responded well to the treatment. Today, Gabriel is almost as tall as I am at 142cm. I certainly hope he will be able to achieve a height of at least 165 – 170cm.
As I look back now, there are several things I would have done differently. For starters, I would have consulted a paediatric endocrinologist after Gabriel turned five when his height and weight were still below the 3rd centile as 10% of SGA babies don’t achieve catch-up growth. Paediatric endocrinologists are specialised to diagnose and treat medical related short stature children and offer advice to parents on their child’s growth.
Parents, if you have concerns that your child is not growing as tall as they should, please monitor their growth. Start a high calorie diet during pre-school years. If your child still has not fully achieved the desired height in primary school, do visit a paediatric endocrinologist to discuss treatment options if tested positive.
Personally, it has been a very educational and inspirational journey for me as a parent and as a paediatrician. I am also very proud of Gabriel who bravely went through his treatment regime.
I am now sharing my story so that parents in a similar situation will know that they are not alone. Help is available. In the early years, I was very much alone and didn’t have the support of other parents going through similar situations. However, with the support of my husband, family and close friends, I overcame the difficult early years.
I now happily look forward to Gabriel’s growing up years.
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