Abnormally short or tall stature in babies and children due to a number of causes
- Age, gender, genetics and lifestyle as risk factors depend on the type
Children of the same age vary greatly in height due to factors such as diet, genetics, and ethnic background. In most cases, tall or short stature is not abnormal and is due to a family tendency to be taller or shorter than average or to reach final height later than usual. Tall or short stature is a cause for concern only if the child’s height is well outside the average range for his or her age Abnormally short or tall stature may be caused by a number of disorders.
What are the types?
Normal growth depends on a nutritionally adequate diet and good general health and is controlled by specific hormones. Disruption of any of these three important factors may lead to a growth disorder that results in a child having abnormally short or tall stature.
A child may be shorter than normal if his or her diet is inadequate. A long-term illness, such as cystic fibrosis or severe asthma (see Asthma in children), may also result in poor growth. Crohn’s disease, an inflammatory bowel condition, is another example of a long-term illness that may lead to short stature. Some babies who have severe intra-uterine growth retardation may be slightly below average height in later life.
Sometimes, short stature is caused by insufficient production of the hormones that are necessary for normal growth. In some children, the pituitary gland does not produce enough growth hormone (see Hypopituitarism). Insufficient production of thyroid hormones is another cause of poor growth (see Hypothyroidism).
Short stature is also a characteristic feature of Turner’s syndrome, a genetic disorder that only affects girls. In addition, short stature may occur as a result of a skeletal abnormality such as achondroplasia, an inherited disorder in which the bones of the legs and arms are shorter than normal.
Children may be temporarily taller than others of the same age and sex if puberty occurs early (see Abnormal puberty in males, and Abnormal puberty in females). However, in these children, final height is usually slightly shorter than normal. In rare cases, exaggerated growth caused by the overproduction of growth hormone results in excessive height, called gigantism. The overproduction may be due to a tumour in the pituitary gland (see Pituitary tumours). Boys who have the chromosome disorder known as Klinefelter’s syndrome may also grow taller than normal.
How is it diagnosed?
Your child’s height will be measured during routine checkups. If his or her height is consistently either lower or higher than would be expected, he or she will be measured more frequently. If growth rates continue to be abnormal, tests may be performed to check hormone levels and to look for underlying disorders. In some cases, maturity of a child’s bones may be assessed by taking X-rays of the hand and wrist.
What is the treatment?
Treatment for growth disorders is most successful if started well before puberty when bones still have the potential for normal growth. Slow growth due to an inadequate diet in infancy usually improves if the diet is modified. Later in childhood, a growth disorder is likely to be the result of long-term illness, and careful control of the illness sometimes results in normal growth. Growth hormone deficiency is usually treated by hormone replacement. Hypothyroidism is treated by replacing thyroid hormone.
Abnormal early puberty is sometimes treated using drugs to halt the advancement of puberty. Gigantism caused by a pituitary gland tumour may be treated by surgical removal of the tumour.
If treated early, most children reach a relatively normal height, but, if treatment is delayed until puberty, normal height is more difficult to achieve. Abnormal stature may cause a child to be self-conscious and unhappy, and he or she may need support such as counselling.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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