H O R M O N E

Growth Disorders

Mom, why am I shorter than my friends?

This is one of the famous statements in television commercials, which has been used since decades in an attempt to promote their growth supplements and products. By now, I am sure that many of such did cross your mind.

It is not that every child’s growth should be similar with others. Your child being shorter or taller compared to his age could be normal. However, it is important for you to know that growth is a measure of over-all wellbeing of your child. Any abnormalities in growth may indicate an underlying conditionthat is preventing your child from developing as expected.

Growth disorders can be defined as the conditions that affect your child’s height, weight and sexual development. These conditions may either accelerate or hamper your child’s growth.

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What is the normal growth pattern in children?

Children do not have a steady growth rate during their childhood. No child grows with the same growth pattern. During their childhood, the child experiences a constant annual growth that is depended on growth hormone. Later during puberty, the growth is primarily dependent on sex hormones (estrogen or androgen). Additionally, healthy eating habits and physical activity do play a major role in the growth rate during childhood.

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How do altered levels of growth hormone affectthe body?

Decreased level of growth hormone results in poor growth in children both in their early and later childhood. Usually, the child may look plump, short and young when compared with their age. It may also lead to poor bone development, especially in the middle of the face, but the overall body proportions and intelligence remains unaffected.

Overproduction of growth hormone may lead to gigantism. It is a rare condition in which the child’s bones grow enormously leading to great stature, along with long arms and legs. It may also lead to delayed puberty and underdeveloped sex organs.

What are the conditions that may lead to growth disorders?

Growth disorders can be caused due to the following conditions:

  • Familial short stature: A tendency to follow family’s short stature.

  • Constitutional growth delay: A condition in which the child’s puberty is delayed and tends to be shorter than his age, but is growing at a normal rate.

  • Intrauterine growth restriction (IUGR): A condition where the fetus growth slows down during pregnancy and the baby’s weight and length is lower than normal after birth. However, they look proportional to their short stature.

  • Genetic disorders: Certain genetic disorders such as Cushing’s syndrome, Turner syndrome, Down syndrome, Prader-Willi syndrome, Noonan syndrome etc. may lead to growth problems.

  • Bone growth disorders: Skeletal abnormalities such as achondroplasia leads to dwarfism in which the child’s arms and legs are short compared to his body with a bigger head.

  • Endocrine diseases: Endocrine diseases such as diabetes and thyroid hormone deficiency may also lead to growth failure.

  • Other causes: Other conditions, such as severe stress, prolonged malnutrition, digestive tract diseases, kidney, heart or lung diseases may affect the whole bodyand hamper normal growth.

How are growth disorders identified?

The pediatrician observes the development ofchild throughout theirchildhood by using growth charts, especiallyinchildren who are shorter than their normal age. If a child is noticed to be growing more slowly than expected orhas stopped growing or having disproportionate features may need additional testing. These tests include:

  • General examinations may include measurement of length, height, weight and head circumference, body proportions, unusual physical features etc.

  • Blood teststo identify underlying hormonal, chromosomal or other disorders associated with the condition.

  • A bone age X-ray (hand and wrist) might be done to assess the skeletal maturity of the child.

  • Pituitary glandfunctioning tests to determine how well the gland is producing and secreting the growth hormone.

What is the treatment approach for growth disorders?

Growth disorders are treated based on the underlying cause. If the cause is malnutrition or other treatable disease, the treatment is targeted towards correcting them. Once they are rectified, the growth abnormalities are corrected. However, earlier diagnosis and treatment have more positive outcome on thechild’s height and development.

Growth hormone injections help in attaining normal height in children with growth hormone deficiency and Turner syndrome. Other treatment options may include surgical approach(leg extension surgery) and replacing sex hormones as required.

Does the child with family history of short stature always remain short?

Familial or genetic short stature is a condition in which the shortness of the parents may lead to shorter children. Kids with genetic short stature may still have growth spurts and enter puberty at normal ages. However, they tend to grow a height similar to their parents.

How to help a child to cope up with their growth issues?

It is a tough challenge for the child to face growth disorders. It can affect both child’s body image and self-esteem. Hence, it is important to watch and address their emotional and social issues. Shifting their attention towards other abilities, such as intelligence, personality and their talent could be of great help. Additionally, talking to the mental health professionals could help in handling their feelings about the growth concerns.

How can we ascertain that our kids health is appropriate?

Check the following links to understand the appropriate growth of your child according to his/ her height/ weight/ BMI

https://www.iapindia.org/iap-growth-charts/

Growth Rate Calculator