Growth problems in children
Physical growth is an essential part of childhood. A child’s most dramatic growth occurs in three periods:
- While the child is a fetus
- During the first few years of life
- During puberty
Each child grows at his/her own individual rate. Growth can be influenced by heredity, gender, environmental factors, and nutrition. Growth can also be affected and even severely slowed by other factors such as:
- Hormone deficiencies
- Intestinal disorders
- Kidney diseases, lung and heart diseases
- Bone disorders
- Diabetes or other blood sugar disorders
- Any severe form of a disease, severe stress, or emotional trauma
As children grow older, those with delayed or limited growth may feel a loss of self-confidence and be emotionally hurt by the teasing from other children. Building a healthy self-esteem helps children cope with these challenges. Family, friends, and teachers who are realistic, positive, and affectionate help promote a positive self-concept in children and adolescents.
Growth not only involves the length and weight of a body, but also includes internal growth and development. A child's brain grows the most during the first five years of life, reaching 90 percent of its final size. Growth also affects different parts of the body at different rates. For example, the head reaches almost its entire size by age one. Throughout childhood, a child's body becomes more proportional to other parts of his/her body. Growth is typically complete between the ages of 16 and 18.
Important measurements of a child's growth and development are height, weight, and head circumference. During a doctor’s visit, these measurements are plotted on graph called the growth chart. The growth chart helps the doctor determine how closely the child’s measurements match normal for age. It also helps the doctor see if the child is growing normally from visit to visit. If you suspect your child is not growing properly, always consult your child's physician.
Growth problems resulting in small stature
Some growth problems are genetic, while others may be caused by hormonal disorders or poor absorption of food. Causes for growth problems usually fall into the following categories:
Genetic short stature
This is the most common reason for short stature. Most short stature is familial meaning the child has inherited shortness for one or both parents. There are other genetic causes for short stature including things like abnormal bone development and some syndromes (Down, Turner, Noonan and Prader-Willi to name a few).
Constitutional growth delay with delayed adolescence or delayed maturation
A child who is shorter than average for age and begins puberty later than average may have a growth delay, but not a disorder. Most of these children eventually grow to approximately the same height as their parents. A key distinction between a short child with a growth delay and a short child with a growth disorder is that the rate of growth in a child with growth delay is usually normal (at least 2 inches a year).
Abnormal (or attenuated) growth
Illnesses that affect the whole body (also called systemic diseases) that can cause growth problems include constant malnutrition, digestive tract diseases, kidney disease, heart disease, lung disease, uncontrolled diabetes, or severe stress. Some children are abnormally small at birth and fail to ‘catch-up.’ Endocrine disorders that can result in abnormal growth include the following:
- Untreated hypothyroidism
- Growth hormone deficiency
- Absence of puberty
- Excess cortisol hormone production.
Symptoms of growth problems
A few growth problems can be diagnosed shortly after birth. Most growth problems are not noticed until much later, when the child appears smaller than his classmates, or when growth is less than expected. In general, after the age of 3 and up until the time of puberty a child should grow at least 2 inches per year. A slower growth rate can be the result of many causes and warrants an evaluation. If a child is not growing normally, the child’s doctor may order blood tests, a hand x-ray (called a bone age, to determine bone maturation and growth potential) and a consultation with a pediatric endocrinologist.
Always consult your child's physician if you feel he is not growing normally.