Have you ever taken your child to play at the park and found yourself sizing him up to the other children playing or wondered why he’s shorter than the other kids in his class at school or on a sports team? Starting from the moment they are born and continuing with healthy baby and annual check-ups, height and weight are measures of a child’s health we hear about most often. So it’s no surprise that parents’ concerns about a child’s growth and development are among the most common questions I’m asked as an endocrinologist. In this column, I will address some of the concerns I hear most often.
What is “normal” growth?
Growth rates are different at different stages of development. The most rapid growth is in the first three years of life. Growth rates continue at a steady but less dramatic rate until adolescence, when growth once again becomes quite rapid. As the skeletal growth plates begin to fuse in late adolescence, the child’s growth rate slows rather dramatically. Girls have an earlier adolescent growth spurt than boys and achieve their final adult height by age 16, on average, with boy’s growth continuing until age 18.
What can affect a child’s growth?
Many factors affect a child’s growth and final adult height. Family history is very important, and final adult height can be estimated base on the heights of the mother and father. Poor nutrition and serious or chronic illnesses can slow growth, and there are many genetic and metabolic disorders that are associated with short stature. Finally, deficiency of thyroid hormone and growth hormone can cause significant growth delay.
When should a parent be concerned?
If a child’s growth rate starts normal then dramatically slows, it can be seen on a pediatric growth chart. A normal growth curve that begins to drop into lower height percentiles is reason to cause to be concerned. Can slow growth be a sign of other health conditions? Many health conditions affect a child’s growth. Overeating can stimulate excessive growth, possibly leading to a child to be tall for his age. Any serious illness, such as kidney disease or malabsorption, can cause a rather dramatic slowing of growth. Growth hormone and thyroid hormone are essential to normal growth and development.
How can an endocrinologist help and what treatment is available?
An endocrinologist can determine if a child’s growth pattern is normal and if a child’s height is compatible with his parental height. If growth is abnormal, blood tests and X-rays can be used to determine potential causes and treat illnesses that may be contributing to delayed growth. If growth hormone deficiency is suspected, other testing is available. Recombinant growth hormone is an FDA-approved treatment for growth hormone deficiency, and if started early enough, can help a child achieve his or her predicted final adult height. If you have questions about your child’s growth, talk to your child’s doctor or make an appointment with my office.
