Growth charts and development milestones are standard equipment for every parent, so it is normal for parents to be concerned if they notice their child is growing less than other children of the same age.

Most children who are shorter in height than their peers are growing at a normal rate rather than due to a medical condition. However, in a small percentage of short stature children, a child’s growth delay or growth failure can be traced to a condition such as a hormonal deficiency or poor nutrition.

Defining short stature

Pediatricians apply a measurement formula to determine whether a child fits the definition of short stature, as follows: the child’s height is at least two standard deviations below the mean height for children of the same age and gender, which is equivalent to a height below the third percentile.

Possible causes and explanations

While short stature can result from both medical and non-medical causes, most short stature situations in children can be traced to a non-medical cause. The most common medical and non-medical causes include:

• Familial short stature/family history: Healthy children born with genes that indicate shorter height, likely due to having short parents.
• Constitutional growth delay: A non-medical cause that applies to delayed growth and/or puberty in children who are small for their age but who have been growing at a normal growth rate.
• Hormone-related disorders: Usually the result of a deficiency in growth hormone (GH) or thyroid hormone .
• Early puberty onset: Early puberty produces an initial growth spurt, but puberty ends earlier as well, leading to shorter adult height. Early puberty produces breast development in girls before age eight; for boys, early puberty produces testicular growth before age nine and a half.
• Malnutrition or disease-specific causes : Includes disorders of the digestive system, heart, kidneys or lungs.

Familial short stature and constitutional growth delay are not medical conditions, so treatment is typically not warranted unless additional health factors come into play. The vast majority of children considered short have normal growth rates and patterns.

Diagnostic assessment

The pediatrician will examine the child’s growth chart and family history as part of the diagnostic process. Specific tests may be carried out to check for hormonal or vitamin deficiencies, and a bone age x-ray of the child’s wrist can help determine the maturity of the child’s bone growth and how it compares to the child’s age group.

Treatment options

As with most other health conditions, treatment for children of short stature is more likely to be successful when it begins earlier — before a child’s growth process has been completed. Treatment options to reverse slow growth include growth hormone therapy (usually involving nightly hormone injections), thyroid hormone therapy, vitamin D therapy, and medication for treating early puberty.

Hormone replacement therapy (HRT) is commonly recommended for children who are diagnosed with hypothyroidism or growth hormone (GH) deficiency. HRT typically produces a period of significant catch-up growth, followed by a subsequent period of normal growth until the child’s growth process has been completed. As with all medical treatments, HRT involves certain risks and potential side-effects and may not be suited for your child’s particular situation. Your pediatrician will discuss the risks and possible side effects before recommending an appropriate course of treatment for your child.

Healthy pro-growth habits

The best way to avoid future growth-related problems is to make sure your child adopts healthy nutrition, exercise, and sleep habits. A diet rich in nutrients, 60 minutes of exercise five days each week, and at least nine hours of sleep each night will help promote healthy growth and development in children.

Short Stature Package at The Children’s Center

The Children’s Center at Bumrungrad International Hospital is staffed by a team of pediatricians and healthcare professionals dedicated to the well-being of all children. Along with pediatric medical treatments, check-ups and vaccinations, and expert care for children with special needs, the center offers a customized package for testing and diagnosis of short stature in children.
The center’s Short Stature Package includes a BONE survey for bone age, thyroid function tests, and Vitamin D level screening, to determine how your child’s growth rate compares with the normal rate for children of the same age.

For details on the Short Stature Package, click here. Or contact the Children’s Center by calling +66 (0) 2011 3791, send us your inquiry, or request an appointment online.

Editor’s Note: This article has been reprinted here with permission of Bumrungrad International Hospital.