Short Stature In Children
Short stature refers to any child whose height is well below the average for age and sex. It is commonly applied to children whose height when plotted on the growth curve are below the third or fifth percentile.
A growth chart uses lines to display an average growth path for a child of a certain age, sex and height. Each line represents a certain percentage of the population that would be that particular height at a particular age. If a girl is for example plotted on the 25th percentile line, it means that approximately 25 out of 100 girls her age are shorter than her.
Children do not usually follow these lines exactly , but most of the time their growth over time is roughly parallel to these lines.
What causes short stature ?
Short stature may be a sign of medical problem. However most children have short stature and do not have any health problems.
Causes of short stature that is due to a disease
- Familial Short Stature – One or both parents are short but the child’s growth rate is normal.
- Constitutional delay in growth and puberty -The child is short during childhood but will have late puberty and end in the normal height range as an adult.
- Idiopathic short stature – No identifiable source but the child is healthy .
When short stature suggests thats the child has a serious medical problem, there are usually clear symptoms that suggest that something is not right . Medical condition that may affect your child’s growth include the following :
- Chronic medical condition affecting nearly any major organ such as heart disease, asthma, celiac disease, inflammatory bowel disease, kidney disease, anemia and bone disorder.
- Hormone deficiency : It includes the following hypothyroidism, growth hormone deficiency, diabetes, and Cushing disease, in which the body makes too much hydrocortisone.
- Poor nutrition
- Babies with a history of being born small : That is babies who were born small for their gestational age or with a history of intrauterine growth delays.
- Genetic conditions : These include conditions such as Down syndrome, Turner syndrome, Russell-Silver syndrome, Noonan syndrome and rare bone problems, such as achondroplasia. There are standardized growth charts available for some syndromes such as Down syndrome, Noonan syndrome, Turner syndrome, Russell-Silver syndrome and others.
- Medications such as those used to treat ADHD Attention deficient Hyperactivity Disorder and inhaled steroid used for asthma.
If you are worried about your child growth , it is important to monitor the child’s growth over time using the growth chart. Six months is a typical time frame for older children, and if the rate of growth is clearly normal, no additional testing may be needed. Your doctor may check your child’s bone age (x-ray of left hand/wrist), which may help in a child older than 7 years predict how tall the child will be as an adult. Blood tests are rarely helpful in a mildly short but healthy child who is growing at a normal growth rate.However, if the child is below the third percentile or is growing more slowly than normal, doctors will usually do some tests to look for signs of one or more of the medical conditions.
Childhood Growth and Height Issues. Children’s Hospital of Philadelphia. https://www.chop.edu/health-resources/childhood-growth-and-height-issues. Accessed September 16th, 2020
Pediatric Short Stature. Children’s National. https://childrensnational.org/visit/conditions-and-treatments/diabetes-hormonal-disorders/short-stature . Accessed September 16, 2020