Q: My 3.5 years old son weighs only 11 kg and is 92.5 cm in height. His birth weight was 1.9 kg. Why is he not growing like other children? Although he is very active and his mental growth is fine, he looks very tiny and skinny in front of his friends of his age. I give him calcium and multivitamins regularly. Can anything be done for this? Secondly his hair is very light and grows very spiky so it has to be cut very short every time. Everyone in the family has dense hair. Why is this?

A:Your son is short and underweight for his age. The most likely reason is that he is born small and his potential for height and weight gain is less than normal. It could be a familial problem if there are other children with similar problems in the family and if the parents are also short. Some children grow at a rate slower than others especially in the first few years but catch up later in puberty. There may be additional nutritional deficiencies especially for protein and calories. Supplements of vitamins and calcium especially zinc is helpful in some children who have deficiencies, but continuous therapy with them does not help. The abnormalities of the hair are likely to be of genetic origin and there is no definite treatment for them. It shall be prudent to get the child checked by a paediatric endocrinologist/geneticist to look for signs and symptoms of a genetic or endocrine cause for poor growth.