Being Short

Every mother worries about her children – it’s a completely normal part of parenthood – but if your child is short, should it be a cause for concern? And how short is too short?

Average Growth Rates
Every child will develop at her own pace. 95% of children who are of short stature have no endocrine problems and will likely reach normal height as an adult. Children who were born small for their gestational age may also be of short stature, as well as children of one or more short parents. Average rates of growth for children are:

  • Birth to 12 months: 23 - 28 cm/year, or 9 - 11 inches/year
  • One to 3 years: 7.5 – 13 cm/year, or 3 to 5 inches/year
  • 3 years to puberty: 4.5 to 7 cm/year, or 1.8 to 2.7 inches/year, up until just prior to the beginning of puberty, when the rate of growth slows to about 4 cm/year (1.5 inches/year)
  • During puberty, peak growth of about 8-9cm/year (3 – 3.5 inches/year) for girls and 10.3 cm/yeah (4 inches/year) for boys.
  • For girls, at the onset of menstruation, growth slows to 7 cm/year (2.8 inches/year), until adult height is reached
  • Growth usually stops at 14 – 16 years of age for both sexes, but can go later if the onset of puberty was late

It is important to remember that the average growth rates are just that, an average. It is completely common for a child’s growth to deviate from the norm. A child who is considered short in stature will be in the bottom third to fifth percentile of the normal growth curve for her height. It is also important to consider your child’s weight in proportion to her height. Children who are overweight may grow faster and reach puberty sooner than children who are average weight, and children who are very thin may grow more slowly and reach puberty later.

There is also a perfectly normal condition knows as constitutional delay that could be what’s causing your child’s short stature. Children with constitutional delay usually start puberty late, and the usual pre-pubescent pause in growth may be prolonged. These children may also have a lower bone age than their chronological age, meaning that they will continue to grow after most other children their age have stopped, but will eventually reach a normal, adult height. Your doctor can check your child’s bone age, usually by x-raying the wrist.

What You Should Do
In most cases, there’s nothing you can do if your child is short. If you are concerned that there may be a more serious issue at the root of her small stature, talk to your doctor about tests you can do to check whether or not everything is normal. If your child is being teased about being short, remind them that everyone gets teased about something as a child and there are worse things to get teased about than being short!

More Serious Problems
While it is rare for the underlying cause of short stature in a child to be anything serious, it is possible. Most will be caught by your doctor during you child’s routine, physical examinations, however, if you are concerned that your child may have any of the following problems, you can ask to have her tested. Problematic causes of short stature include:

  • Hyperthyroidism: Usually caught during infancy, if left untreated, hyperthyroidism can cause developmental delays and delays in growth. A blood test is needed to test for hyperthyroidism. Once treated, the affected child will likely experience catch-up growth.
  • Turner syndrome (Occurs only in girls): Caused by an incomplete X chromosome, Turner syndrome causes short stature and lack of ovarian development. While there is no cure, injections of growth hormones can help affected girls grow taller. Diagnosed by a blood test.
  • Growth Hormone Deficiency: Is sometimes the cause of proportionate dwarfism. It may be congenital or acquired, usually from a brain tumor or severe head injury. Injections of growth hormone are available, however, most short children do not need them. Growth hormone deficiency can be tested for with a blood test.
  • Dwarfism: There are two types of dwarfism, proportionate dwarfism, usually caused by hormonal or metabolic disorders, and disproportionate dwarfism, caused by a genetic mutation or gene passed down from the parents. Proportionate dwarfism can sometimes be treated, but disproportionate dwarfism cannot.