Growth Problems in Children
A growth problem means that a child falls either below or above the average range
of growth for a child's age, sex, family history, or racial background.
Growth disorders can have many causes. Causes usually fall into one of the following
Familial short stature. This means a
child's height is part of their family's pattern of inherited short height.
Familial tall stature. This means a
child's height is part of their family's pattern of inherited tall height.
Constitutional delay of growth and
This means a child tends to be shorter than average
and enters puberty later than average, while growing at a normal rate. This may be
inherited. These children tend to catch up in time and reach their normal adult
Illnesses that affect the whole body
This includes ongoing malnutrition, digestive tract
diseases, kidney disease, heart disease, lung disease, diabetes, or chronic severe
stress. Any of these conditions can cause growth problems.
Endocrine (hormone) diseases. Growth
can be affected by some conditions that disrupt hormones. Thyroid hormone
is essential for normal bone growth. The pituitary gland at the base of the brain
secretes several hormones, including growth hormone. Growth hormone deficiency can
result from injuries to the pituitary gland or brain. Cushing syndrome can
impair height and cause weight gain. Precocious puberty is a condition caused by
hormone problems. It often causes fast growth and tall height compared with other
children of the same age. But growth stops at an early age. As a result, children
with precocious puberty may be short as adults.
Gigantism. Children will grow faster
than normal if their pituitary gland makes too much growth hormone.
Intrauterine growth restriction (IUGR). This means growth of a baby in the uterus is slowed. This can be caused by many factors, such
as smoking during pregnancy or not enough prenatal care. The baby is born smaller
in weight and length than normal.
Genetic disorders. This includes
Turner syndrome, Down syndrome, and achondroplasia. Turner syndrome happens when
having too many, too few, or disrupted chromosomes results in health problems. It
caused by one missing X chromosome. This genetic disorder occurs only in girls. It
causes poor growth and delayed or no puberty. Down syndrome is another common genetic
disorder causing poor growth and short stature. It results from an extra 21st
chromosome. Achondroplasia is the most common type of dwarfism, resulting in a
problem changing cartilage to bone. It causes a child’s arms and legs to be short.
also causes a large head and other features.
Many disorders that can cause
growth problems are idiopathic. This means their cause may not be fully known or
Risk factors for growth problems include:
- Family history
- Systemic disease
- Genetic disorders
Most growth problems are noticed
when the child appears smaller than their classmates, or when growth slows over several
months. One main sign of a growth problem is slower height growth than expected each
year. This means a yearly growth in height of less than about 2.2 inches (5.5 cm)
between ages 2 and 4, less than about 2 inches (5 cm) between ages 4 and 6, and a
growth of less than 1.6 inches (4 cm) for boys and less than 1.8 inches (4.5 cm) for
girls. In other cases, a baby may be abnormally small for their gestational age at
Growth problems may be part of
other problems or health conditions. Make sure your child sees their healthcare provider
for a diagnosis.
In some cases, a growth problem may
be diagnosed at birth when a baby is abnormally small for their gestational age. In
other cases, a growth problem may be diagnosed when a child's growth is checked during
Diagnosis of a growth disorder must
be made by your child's healthcare provider. They may work with a pediatric specialist.
The healthcare provider will ask about your child’s symptoms and health history. They
may also ask about your family’s health history and do a physical exam. Your child's
health and growth may be checked over several months.
Your child may also have tests, such as:
These are done to check for hormone, chromosomal, or other disorders
that can cause growth problems.
This test uses a small amount of radiation to make images of tissues inside the body.
An X-ray may be done of the left hand and wrist. This can estimate your child's bone
age. With delayed puberty or hormone problems, bone age is often less than calendar
Many conditions that cause growth problems can be managed or corrected with medical
treatment. Treatment for growth problems will be based on:
- What may be causing the growth problem
- How severe the problem is
- The child's current health and health history
- The child's ability to deal with medical procedures and take medicines
- The parents’ wishes about treatment
Some children may have poor self-esteem or depression because of their height.
Children who are shorter or taller
than their peers may have poor self-esteem or depression. It’s important to talk about
these problems with your child and your child's healthcare provider. The provider
recommend support groups for you and your child.
Talk with your child's healthcare provider about your child's potential adult height.
If your child's growth problems are caused by a condition that can be treated, work
with your child's healthcare providers to create an ongoing plan to manage your child’s
When to Call a Healthcare Provider
Talk with your child’s healthcare provider if you are concerned about your child's
- A growth problem means that a child falls either below or above the average range
of growth for a child's age, sex, family history, or racial background.
- Growth disorders have many causes. They can include genes, illness, or problems with
- Most growth problems are noticed when
the child appears smaller than their classmates, or when growth slows over several
- One main sign of a growth problem is
when a child grows less than 3.5 cm (about 1.4 inches) a year after their 3rd
birthday. In other cases, a baby may be abnormally small for their gestational age
- Many conditions that cause growth problems can be managed or corrected with medical
- Children who are shorter or taller
than their peers may have poor self-esteem or depression. It’s important to talk
about these problems with your child's healthcare provider. They can recommend
support groups for you and your child.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a
new diagnosis and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment
is prescribed and how it will help your child. Also know what the side effects
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.