Reduced Bone Age

lanwenyi · Oct 13, 2013

I'm caught in a conundrum. We've always let our kids choose the direction their carseat faces at 4yo. However, we've been worried about DS's growth for some time (grew 0.5" from 1yo-2yo, then averaged about 1-1.5" for the last 2y). I've been blown off by drs b/c DH and I are small people (I'm a 15%ile female and my DH is an 8th%ile male). DS dropped from the 40%ile in height at 1 to the 0.05%ile by 3yo.

I *finally* got the endocrinologist's report on my son and his bone age is 2yo. His actual age is 4y3m (4y1m when the test was done). Do I make him stay rfing? He has room in his radian (his torso puts him on the 4th slots rfing).

We have to buy another car (this would be the secondary car). If I make him stay rfing, it severely limits our choices as we had planned to buy a 4 seat convertible that would only fit ffing carseats in the back. What should I do? What would you do?

katymyers · Oct 13, 2013

I would keep him rear facing personally. I'm usually pretty relaxed. (compared to some people anyway) when it comes to rear facing, I was comfortable with turning both my older children at 3.5. However when it comes to children who are very small, have low muscle tone, or especially immature skeletal development I would do anything I could to keep that child rear facing as long as possible. My two year old daughter is pretty small, she's about the size of most one year olds I see and unlike my boys I will be rear facing her past four due to her size.

Baylor · Oct 13, 2013

I think this your choice but at four he is absolutely age appropriate for forward facing based on the recommendations.
I think this is really about what works for you.

auto correct hates me

krasota · Oct 13, 2013

I personally would not FF a two year old if I had options for RF. A four year old whose bone age is half the actual age? I might want to investigate a bit more before FF.

This is something we are potentially facing with my daughter. I intend to ask for a bone age study before FF, but I also plan to RF her for at least four years. If her bone age at 4y is 2y . . . she'll stay RF while we talk about prognosis, diagnosis, treatment, and all that other stuff with her doctors. It's a situation where I would opt for the conservative choice, namely staying rear-facing.

Oh, and what do the docs think about the two year discrepancy? I know there's natural variety when it comes to bone age.

TechnoGranola · Oct 13, 2013

Okay, you said you give them a choice at 4. Has he been presented with this choice yet? (if not, I'd leave it for now until you decide what needs to be done) If he chose RF, you'd have to work with that in your new car or buy a different new car, right? So, for starters, let's just pretend he chose RF. LOL

Also, I know my DD at 4 would have said FF if I gave her a choice, but she would have meant in the seatbelt alone like her big sister, not in a seat at all.

She just wanted to copy others in the car, she didn't really know what the difference was. When she did flip forward at close to 5, several weeks later she told me she wished she could sit the other way so she had a place for her legs.

I'd probably figure out what car you want to get, then post back and we can help you find a RF seat that would work in it.

carseatcoach · Oct 13, 2013

Baylor said:
I think this your choice but at four he is absolutely age appropriate for forward facing based on the recommendations.

The recommendations are meant for typical children. This child is not typical. We say that even small 4yos are fine forward-facing because of skeletal development (bone age). That doesn't apply here.

I would try to keep him RFing. As others have written, we can try to help come up with seats that fit in a particular vehicle.

lanwenyi · Oct 13, 2013

TechnoGranola said:
Okay, you said you give them a choice at 4. Has he been presented with this choice yet? (if not, I'd leave it for now until you decide what needs to be done) If he chose RF, you'd have to work with that in your new car or buy a different new car, right?

He's known about it for a while. He's been asking to ff since 3yo and to booster since 3.5. We've held him off by reminding him that he gets to choose at 4yo. Then once the endocrinologist started tests we told him he had to wait until the results came back. We org told him booster would have to wait until kinder. Now I think it might be longer. I'm not looking forward to the tears when I have to explain it to him.

I know my DD at 4 would have said FF if I gave her a choice, but she would have meant in the seatbelt alone like her big sister, not in a seat at all. She just wanted to copy others in the car, she didn't really know what the difference was. When she did flip forward at close to 5, several weeks later she told me she wished she could sit the other way so she had a place for her legs.

My dd did the same thing until she switched to a booster. She went ffing for 1 week, asked to go back rfing, and remained rfing until going straight to a hbb.

I'd probably figure out what car you want to get, then post back and we can help you find a RF seat that would work in it.

The most likely candidate is a vw Beatle convertible (smaller front to back in the back seat than the non-convertible), bc it's one of the few 4 seat convertibles that actually has 4 usable seats. However, we sincerely doubt that any lg rfing seat will fit in there. DS has outgrown the britax seats by torso height. He rides in a radian with angle adjuster right now.

on my phone, please forgive my autocorrect

TechnoGranola · Oct 13, 2013

We have a member here who is a nanny and drives a VW convertible! So she's tried and used many different seats in it. Disneyworldnanny is her username if I'm recalling correctly. Does she still post here, anyone?

lanwenyi · Oct 13, 2013

krasota said:
Oh, and what do the docs think about the two year discrepancy? I know there's natural variety when it comes to bone age.

I don't really know. As I said, I've been blown off by the drs bc of my DH and my small size. This is the first report I've gotten and it took 2 months, an email, and 3 phone calls to get any results from his tests. He has a follow up appt on the 29th, so I'll find out more then. All I know right now is that the major concern is that his bone age is 2yrs behind where it should be.

on my phone, please forgive my autocorrect

Patriot201 · Oct 13, 2013

TechnoGranola said:
Disneyworldnanny is her username if I'm recalling correctly. Does she still post here, anyone?

Not very often. I've seen her "pop up" a few times, but I think she's pretty much gone, now.

lanwenyi · Oct 13, 2013

TechnoGranola said:
We have a member here who is a nanny and drives a VW convertible! So she's tried and used many different seats in it. Disneyworldnanny is her username if I'm recalling correctly. Does she still post here, anyone?

Yes, but I need a front seat passenger. I don't believe that she did. I could be wrong though. I have 2 adults and 2 kids who need to be able to ride in the car. I can't use a seat that pushes the front passenger into the dash.

on my phone, please forgive my autocorrect

babyherder · Oct 13, 2013

I'm sorry you didn't get good news from his test results and that it took so long for any doctors to take your concerns seriously. Unfortunately, I think your ds is going to have to figure out how to deal with things being different than he expected. This is in terms of car seats and others things in life. I would explain in an age appropriate way why it is not safe for him to ff yet.

For your potential second car I would hold off on any decisions until you get more information about your son's tests results and potential treatment options. Even if he ends up ff in your second car I would still leave him rf in any car where he fits.

MommaMia · Oct 13, 2013

I asked this question of a tech and our doctor a about a year ago. Our daughter has a growth hormone disorder (have they talked to you about that? STIM test yet?). Her variance between chronological age and bone age isn't as pronounced, but still there. At nearly 4, she's shown significant growth since starting treatment and we've allowed her to turn FF this past week. However, if they rescan her next month and find the bone age to have remained the same, we will turn her back to RFing. Our Endo said the bone age is more about size, not strength, formation... So at 4, her bones are supposedly fusing and solid like a 4 yo, just not the size of a 4 year old.

Sorry for the rambling.. There is a private FB group dedicated to kids with growth hormone disorders. Send me a PM and I'll be happy to give you the info and answer any questions you might have. We've spent the past 2 years seeking answers about our daughters growth. Finally got answers over the summer and were amazed with the changes we've seen

MommaMia · Oct 13, 2013

Ps. You need a new endo. Growth velocity has slowed, 40% to 0.05%, in addition to delayed bone age... They should have called you right away. There is no excuse for having to go searching for the answers. Where are you located?

munchkin · Oct 13, 2013

Patriot201 said:
Not very often. I've seen her "pop up" a few times, but I think she's pretty much gone, now.

Off topic but yeah she stole from a couple of us members and refuses to respond or pay for items so I think she lurks but doesn't post.

TechnoGranola · Oct 13, 2013

munchkin said:
Off topic but yeah she stole from a couple of us members and refuses to respond or pay for items so I think she lurks but doesn't post.

Wait...what? I totally missed that. I thought she had a friend on here that did that and left the group? Anyway, that's too bad.

lanwenyi · Oct 13, 2013

babyherder said:
I'm sorry you didn't get good news from his test results and that it took so long for any doctors to take your concerns seriously. Unfortunately, I think your ds is going to have to figure out how to deal with things being different than he expected. This is in terms of car seats and others things in life. I would explain in an age appropriate way why it is not safe for him to ff yet.

That's the plan. It's just hard on it. It's one more disappointment in a long string of disappointments. He's been taking it well so far, but does ride ffing in dh's miata and in his carpool to preschool. There is no way to change those.

For your potential second car I would hold off on any decisions until you get more information about your son's tests results and potential treatment options. Even if he ends up ff in your second car I would still leave him rf in any car where he fits.

Unfortunately, waiting is not possible. Our second car was totaled in an accident and we've been surviving in one car that seats all 4 of us plus dh's miata, but we are reaching the point where it is just not feasible anymore.

No matter what we choose for the second car, he will stay rfing in the main car due to this info.

on my phone, please forgive my autocorrect

lanwenyi · Oct 13, 2013

MommaMia said:
Ps. You need a new endo. Growth velocity has slowed, 40% to 0.05%, in addition to delayed bone age... They should have called you right away. There is no excuse for having to go searching for the answers. Where are you located?

Not really the endo's fault. We changed insurance, which caused us to change drs btw ds's 9mth and 1yr appts, then again btw 18mth and 2yr appts. I've been fighting his pcp since 3yo to see the drop in percentiles and refer him to a specialist. She finally did at his 4yo appt (she's a very hands off, wait and see ped, which, most of the time, I love, but this time, worked against me).

These results are from the first round of tests by the endocrinologist after ds's first appt (1 week after the referral). DS has his first follow up at the end of oct. Hopefully we'll get a treatment plan at that time.

The only thing I'm upset with the endo about is promising to call with the results of all the tests and never doing it. I got some of them from kp.org (the ones avail on his electronic record) and I called /emailed enough that they finally gave me the results if his bone age, but I still don't have the results of a bunch of the other tests they ran.

I'm in ca and on kaiser. I don't really have the choice of another ped endo.

on my phone, please forgive my autocorrect

lanwenyi · Oct 13, 2013

MommaMia said:
I asked this question of a tech and our doctor a about a year ago. Our daughter has a growth hormone disorder (have they talked to you about that? STIM test yet?). Her variance between chronological age and bone age isn't as pronounced, but still there. At nearly 4, she's shown significant growth since starting treatment and we've allowed her to turn FF this past week. However, if they rescan her next month and find the bone age to have remained the same, we will turn her back to RFing. Our Endo said the bone age is more about size, not strength, formation... So at 4, her bones are supposedly fusing and solid like a 4 yo, just not the size of a 4 year old. Sorry for the rambling.. There is a private FB group dedicated to kids with growth hormone disorders. Send me a PM and I'll be happy to give you the info and answer any questions you might have. We've spent the past 2 years seeking answers about our daughters growth. Finally got answers over the summer and were amazed with the changes we've seen

I haven't heard of a stim test, but we've only had the initial appt with the endo. First follow up is at the end of the month.

I appreciate the info about the private FB group, I might send you a pm about it for my DH, but I'm not on FB.

I'm so glad you found answers about your daughters growth! I hope to find some about my sons too.

on my phone, please forgive my autocorrect

UlrikeDG · Oct 13, 2013

munchkin said:
Off topic but yeah she stole from a couple of us members and refuses to respond or pay for items so I think she lurks but doesn't post.

I understand why this had come up here now. However, further discussion of the situation should remain in the Problem Swappers thread or on iTrader.

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