Failure to thrive, short stature and macrocephaly are common findings that pediatricians deal with on a regular basis. If a child is failing to thrive and of short stature and if the parents are not short and not small and this is not constitutional and not familial short stature, other clues have to be considered. Could this be an LSD? Do they have dysmorphic features? Even if they look fine now could the pediatrician ask for pictures from the parents of the child when they were born, when the child was one, when the child was two to determine if the child’s features are changing or not. Can pictures of the family be examined, or Can the child compared with the other siblings? Does the child really look normal or do they look very different from the rest of the family?