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ENDOCRINOLOGY

Short Stature and Growth Disorders

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What is short stature?

Short stature means that a child is shorter than 95% to 97% of other children of the same age and sex. If your child is growing at a normal rate, this is not necessarily a concern. Most children who have short stature but a normal growth rate show no medical problem. They may have parents who are short and inherit that trait. We call this "familial" short stature.

However, some children with short stature show below-average growth over the course of a year. They may also fall farther behind other children their age as they get older. This can be a sign of a growth problem.

Typical growth is:

  • About 10 inches from age 0 to 1
  • About 5 inches from age 1 to 2
  • About 3.5 inches from age 2 to 3
  • About 2 inches per year from age 3 until puberty

If you are concerned about your child's height, we can provide an evaluation.

What causes growth disorders in children?

Growth disorders often result from other health conditions. We can treat many of these conditions so your child can grow to a typical adult height. These include:

  • Conditions that a child is born with, such as intrauterine growth restriction, which causes babies to be born smaller than average
  • Nutritional deficiencies, sometimes called failure to thrive, which can cause babies to have a very low weight compared to their length
  • Malnutrition from not eating enough healthy foods, or having difficulty absorbing or using food
  • Endocrine diseases that affect hormone production like hypothyroidism, diabetes and growth hormone deficiency
  • Delayed puberty, which causes children to mature slower than their peers
  • Early puberty, which causes an early growth spurt and early end to growth
  • Genetic disorders and chromosome abnormalities such as Down syndrome, Turner syndrome and Prader-Willi syndrome
  • Bone problems like skeletal dysplasia or achondroplasia, which is a form of dwarfism
  • Serious asthma, because of the medicines used to manage it
  • Chronic conditions such as cystic fibrosis, diabetes, celiac disease, or other health problems that affect digestion

In other cases, short stature may run in families or there may not be a known cause.

There are also some conditions that can cause tall stature, such as Klinefelter syndrome and Marfan syndrome.

What is growth hormone deficiency?

Growth hormone deficiency is one of the most treatable causes of short stature in children. It happens when the pituitary gland does not produce enough growth hormone or it produces no growth hormone at all. The pituitary gland is attached to the base of the brain, just below the area called the hypothalamus. The hypothalamus controls the pituitary gland.

Growth hormone deficiency can occur if there is a problem with the pituitary gland or hypothalamus or if they get damaged. A deficiency can also happen for unknown reasons. We can treat children with growth hormone deficiency to help them grow, as long as we start before or during the early stages of puberty. Growth typically ends around 14 years old in girls and around 17 years old in boys. However, their age when they started puberty can impact this timing.

Who gets growth disorders?

Short stature can happen at any age. In young children, we often discover it during a routine health exam. We will notice it when we record your child's measurements for height, weight and head size. If the measurements fall outside the typical range for your child's age and sex, we may recommend further evaluation.

Older children often notice their short stature when they approach puberty and see their friends surpassing them in height and physical maturity. Puberty usually begins between ages 8 to 13 for girls and ages 9 to 14 for boys. It should include a growth spurt. If children aren't experiencing puberty and a growth spurt during that time, we recommend an evaluation.

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