What is it about ?
Children go through several phases of growth; growth is most marked soon after birth and at the onset of puberty. Growth stops after puberty; the child has then reached his adult height and weight.
The most important parameters for monitoring and evaluating growth are height and weight. They are compared to the average height and weight expected at the child’s age. These values can be read on the growth charts. The height and weight of the parents must also be taken into account. Only extreme deviations are considered abnormal.
Doctors monitor the child’s growth during each scheduled routine check-up, for example at ONE and later in school. By measuring the height and weight of the child at different times, the doctor can plot the growth curve of the child.
If this curve is very far from the average growth curve of a child of the same age, the doctor must follow this child very well in order to be able to detect a possible significant disease.
How to recognize it?
Height too small or too large according to the standard growth charts is noticeable compared to other children of the same age. This is most often a normal hereditary variation. If, for example, both parents are very small, their child will also be rather small. This also applies to children whose parents are very old. So there is no need to worry.
Globally, the main cause of growth disruption is undernutrition. Undernutrition may be due to poverty as well as to disease, including eating disorders and some chronic diseases (for example a anemia due to malaria, infections by worms (helminthic infections), chronic infections…). Undernutrition is associated with deficiencies, especially in proteins and vitamins, which are often responsible for disrupted growth. Sometimes repeated infections can be the reason for temporarily stunted growth. It can also, certainly in children under one year of age, lead to a temporarily poorer development of weight and height, which is then recovered once the infection is cleared. Children born prematurely usually catch up a bit after a few months.
In some cases, however, an underlying disease is responsible for the poor growth or too rapid growth of the child. A waist that is too small may be due, for example, to a chronic disease or a hormonal problem, such as hypothyroidism or insufficient production of growth hormone. In rare cases, a genetic disease can explain too slow or too fast growth. In addition, skeletal diseases often lead to impaired growth. In this case, the doctor will look for other symptoms and signs, such as body disproportion.
How is the diagnosis made?
If, after repeated measurements, the doctor finds an abnormality in the growth, he will start by asking a few questions. If he considers it necessary, he will order additional tests, such as a blood test and an x-ray. An x-ray of the hand is used to assess bone age, with the help of which an estimate of the adult height of the child can be made.
The doctor can then refer you to a specialist, for example an endocrinologist pediatrician, or he will ask for additional examinations, such as a genetic analysis.
What can you do ?
Usually, patience and a healthy, balanced diet are enough to follow a child’s own growth curve, which is genetically determined. A size too small or too large can cause a feeling of inferiority. The child should therefore be offered the necessary support.
What can the doctor do?
The doctor will start by treating the underlying illnesses. He administers the appropriate treatment based on the problem. In case of too small size and, for example,hypothyroidism, the patient is receiving thyroid hormones. In the event of growth hormone deficiency, the patient receives treatment with growth hormones. Chronic diseases are first treated.
Sources