Parents and children, especially children preadolescents and teenagers often worry when they notice that they are smaller than many of them classmates and colleagues of the same age. While there are many medical conditions that can cause children to be short, most children who are young are typical .
This is a time when children can blame their parents, or at least their eyelashes, for something. Most children are short because their parents are short. Genetics play a very important role in a person’s height.
Parents often ask if their doctor can determine the height of their children. While your pediatrician does not have a crystal ball to see how tall your children will be when they grow up, there is a simple formula that uses a parent’s height to help them estimate the child’s target height or genetic growth potential. 1.
You can also use a height predictor in the line to perform calculations for you However, these predictions have a large margin of error.
In the first year of life, the average child will grow to about 10 inches. In the second year, they will add about four centimeters and then increase at a low rate that will reach about two centimeters per year until the onset of puberty. .
Then, when they reach the peak of growth at puberty, girls grow about three to three and a half inches a year, and boys grow about four inches a year. After the teenagers reach their growth, their growth will constantly slow down until they reach the full height of adults, about four to five years after their growth.
Boys and girls generally continue to grow to the age of 14 to 16, but this depends on when they started puberty, which can start between eight and 13 years for girls and between nine and 14 years for boys. .
For example, if a girl starts puberty at the age of eight, then she may grow up the nine years and no longer grows at the age of 13. On the other hand, if another girl does not start puberty until the age of 12, she can continue to grow until the age of 17.
Also, remember that girls reach puberty about two years earlier than boys, so in early adolescence, many girls are taller than boys. In addition to their parents ‘height, these differences at puberty explain many of the differences in boys’ height in adolescence and adolescence.
Evaluation of younger children
When evaluating young children, more important than where they are on a growth chart is how they grew up. To observe this pattern of growth or the speed of a child’s height, you should generally observe a few years of growth.
Children who grow up normally should follow their growth curve quite carefully, so even if they are in the 5th or 3rd percentile, if they have always been there, then they are probably growing up normally. If your child crosses the percentiles or lines on the growth chart, there may be a medical problem that makes them short.
Keep in mind that children can cross the percentiles in the first few years of life, and this is actually a common finding in children with short parents or a growing constitutional delay. (Sometimes called «late»).
Other warning signs that may indicate a growth problem include a chronic condition or other chronic symptoms, such as vomiting, diarrhea, fever, weight loss, loss of appetite, poor nutrition , headaches and puberty delayed .
Being disproportionately short can be a sign of a chromosomal disorder, such as achondroplastic dwarfism (in which the torso is longer, the head is larger, and the limbs are shorter than normal). Being short and overweight can indicate an endocrine or hormonal problem. The most important part of evaluating a young child is to review their records or growth chart.
If a young child has had more than one pediatrician, then it is a good idea to collect all of the child’s old records for examination by the current pediatrician. If they are simply short but follow their growth curve, no further testing may be required. Your doctor may decide to simply monitor your baby’s growth for the next three to six months to make sure he or she continues to grow on his or her curve.
Lower child test
However, testing young children is sometimes necessary, either to rule out a medical condition that may cause short stature, or to ensure that a child or short parent is healthy.
One of the most important tests is bone age. To determine your child’s bone age, your doctor will order an x-ray of your child’s hand. The radiograph is compared with a series of hand-held radiographs of children of different ages with normal growth. For example, if the x-ray of your child’s hand is more like the standard x-ray of an eight-year-old child, it is said that your child is eight years old.
If your child’s bone age is much younger than their actual or chronological age, then there is probably still room for their bones to grow after the age you would expect them to grow. Girls generally continue to grow to a bone age of about 14 years, and boys stop growing after the bone age of 16 years (with a maximum growth rate at the bone age of 14 years).
However, having a much younger bone age than the child’s chronological age is also an indication that the child may not be growing properly, possibly due to a growth hormone deficiency or another problem that requires medical evaluation and intervention. Having advanced bone age can also be a sign of a problem that needs further evaluation. Sometimes a karyotype is used to look for chromosomal abnormalities.
Other tests may include:
- Blood chemistry (which may include an SMA 20 to examine kidney and liver disease)
- Blood tests for hypothyroidism (T4 and TSH)
- Complete blood count (to check for anemia)
- Growth hormone level (usually by checking IGF-1 and IGF BP3)
- Urine analysis
Causes of short stature
One of the most common reasons why healthy children are short is the small stature of the family, which means that both the child’s parents and other family members are.
These children generally grow at a normal rate, although they are short and follow a growth curve that may be smaller, but parallel to normal growth curves. Testing is not usually necessary, but if a bone age is performed, the result would be normal and not delayed.
Another common cause of short stature in healthy children is constitutional delay. Children with this normal growth variance are short and grow to the third percentile or below their height. Their normal growth rate will be two to two and a half inches a year.
These children will have a delayed bone age, showing that there is still extra room to grow. They also usually have a delay in the onset of puberty. Although small, children with growing constitutional delays will usually continue to grow when other children do not grow up.
It should reach a final adult height close to the target height. These children are sometimes described as “developmental Late «And there are usually other family members who grew up late and followed this pattern of growth.
Although there are many normal reasons why your child is short, there are also some serious conditions that require treatment. Children with these conditions are short, but also do not grow properly, do not follow a growth curve and often cross the percentiles down.
One of these conditions and the one that often worries parents is the growth hormone deficiency. Growth hormone is necessary for normal growth, and children with growth hormone deficiency are short, often appear younger than their chronological age, and may be overweight.
Although they will generally have a delayed bone age, as will children with a constitutional delay, children with growth hormone deficiency will have a slow growth rate and will have a growth curve that deviates from normal curves. growth. Growth hormone deficiency can be congenital (the baby is born with it) or it can be acquired later in life from a head injury or a tumor or brain mass.
If your pediatrician suspects that your child has a growth hormone deficiency, he or she may monitor your child’s IGF-1 and IGF BP3 levels, which will be lowered in a child with a deficiency. A pediatric endocrinologist may also perform a growth hormone stimulation test.
Treatments for growth hormone deficiency include growth hormone replacement. Other conditions for which growth hormone is currently used successfully include Turner syndrome , chronic renal failure and Prader-Willi syndrome.
Growth hormone therapy has also been approved for the long-term treatment of children of short idiopathic stature, Also called short stature of the non-growth hormone, if there are more than 2.25 standard deviations below the average for age and sex or among the shortest 1.2% of children.
It is important to note that growth hormone injections are expensive, usually given to young children six to seven days a week until the end of puberty, and usually only a child grows two to three inches taller. Growth hormone can also be used for children who were born small for gestational age and do not regain growth at the age of two.
A small child who is expected to be 5’6 «tall and short idiopathically will probably not be 6 meters tall just because he is receiving growth hormone injections.
A word from Verywell
Keeping a good record of your child’s height and weight can make it much easier to evaluate a short child. Make sure you go to your child’s regular visits with your pediatrician, and even on a sick visit, ask him or her to measure your child’s height if it hasn’t been done recently.
While most pediatricians can begin the initial assessment of a young child if additional tests are needed or if you or your child needs insurance, a visit to a pediatric endocrinologist can be helpful.