I was surprised to read Ione described her 5'8" tall grown son as "smallish"
-- as this is the average height of U.S. males.  Female average height is
5'5.5" to 5'6".  A male who is 5'8" isn't smallish, though he may *wish* he
were taller!

Pediatricians (and people like myself who study growth) are concerned about
growth because growth slow-downs are often the very first sign of something
that is wrong -- whether that is growth hormone deficiency, poor diet,
disease, parasites, anemia, zinc deficiency, or whatever.  It is a
"screening" or "warning" sign.  And people who were genetically *supposed*
to be normal-sized or bigger than average but who end up little as adults
due to childhood environmental stresses (malnutrition, disease, emotional
abuse, parasites) have life-long consequences in the form of: poor
reproductive success (women have more miscarriages and stillbirths, fewer
surviving children), poor endurance work capacity (OK for short bursts of
energy output, but not for the long haul), poorer cognitive performance (on
IQ tests and in school) and more sickness throughout their lives.  So there
are consequences to being "smaller than you should have been".  Studies of
Mayan Indians, Viet Namese, and other people often thought to be
"genetically" small have shown that given adequate nutrition, good medical
care, and no one shooting at them, these kids grow up to be almost as tall,
as adults, as U.S. adults.  We're talking maybe an average male height of
5'2" for Mayan males in Guatemala, but 5'7" for Mayan males born and raised
in the U.S.

So while it IS possible for people to be "small but healthy" if their genes
are coding for small body size, it is still the case that being "small" may
be the early warning sign of a more serious problem.  It is better to screen
a few kids who don't need it than to miss those who do.  IMHO.

Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology
Texas A&M University
Specialist in infant feeding and child health
College Station, TX 77843-4352
e-mail to [log in to unmask]
(409) 845-5256
(409) 778-4513