Growth is a complex process that can be influenced by many internal and external factors.
When kids are shorter than average, they likely come from families where one or both parents are short. The onset of puberty and the rapid growth and body changes associated with it are also tied to genetics.
“For kids we consider late bloomers, it’s common to find out that dad continued to grow while in college, or that mom didn’t get her period until age 15 or 16,” said Dr. Cydney Fenton, a pediatric endocrinologist at Akron Children’s Hospital.
“Sometimes parents and kids just need reassurance that they are growing normally, or that they can expect to catch up with others their age,” Dr. Fenton said.
When kids have been growing normally, and then slow down or “fall off the chart,” this can signal a growth problem.
Testing can usually determine what’s going on, including blood tests and x-rays of the left hand and wrist. These x-rays indicate bone age and the potential for further growth.
A thorough medical exam and complete family history are also obtained.
Growth hormone or somatropin is released into the body by the pituitary gland. Many factors, ranging from nutrition, sleep and exercise to illness, severe stress and certain prescription medications, can affect the production of growth hormone.
Typical treatment is growth hormone replacement therapy, where the child receives injections of synthetic somatropin to replace what the body is missing.
“Most kids need growth hormone therapy for several years, until they reach full adult height or their bones have matured,” Dr. Fenton said. “A small percentage may need lifelong treatment.”
Growth hormone therapy is also used to treat growth problems in kids who were born small for their gestational age, but aren’t catching up as expected.
It may also be used to help kids who aren’t growing normally, but the exact reasons are unclear.
Another cause of delayed growth is a lack of thyroid hormone. Like growth hormone, thyroid hormone can also be replaced, usually in a pill form.
“Growth disorders in children are highly treatable, particularly when diagnosed early,” Dr. Fenton said. “They also underscore the importance of an annual well visit with a pediatrician, so growth can be tracked from year to year and any problems can be quickly identified.”
Is my child growing normally?
If you’re worried about your child’s growth, ask yourself these questions:
- Is he the shortest or tallest in his class?
- Is she still wearing last year’s clothes or shoes, or outgrowing them much faster than usual?
- Is he unable to keep up with other kids his age at play?
- Is she growing less than 2 inches per year?
- Does he complain about his size?
- Are there signs of early sexual development (before age 8 in girls or age 9 in boys)?
- Has my 13-year-old girl or 15-year-old boy not shown any signs of sexual development?
If you answered “yes” to any of these questions, talk to your pediatrician or doctor about your concerns. Your doctor will determine if your child should be referred to a pediatric endocrinologist for further evaluation.
If your child is struggling with psychological issues related to his size, discuss them with your doctor. A psychologist can help your child cope with issues surrounding body image or persistent teasing.