Your child’s pediatrician or physician must identify a growth problem. Once the growth problem is identified, your child may be referred to a Pediatric Endocrinologist, for further investigations and management. The method used for diagnosis will depend on the type of growth disorder presented. In addition to a complete medical history and physical examination, diagnostic tests may include:

• Observing the child's health and growth over a period of time
• Blood tests (to rule out hormone, chromosomal, or other disorders associated with growth failure)
• X-ray of the wrist and hand for Bone age - to determine maturity and growth potential of bones.
• Examining the functions of the pituitary gland, which produces and secretes the growth hormone.

What causes growth problems?

The commonest growth problem that is encountered is short stature. Causes for short stature usually fall into the following categories:

• Familial short stature
  Familial short stature is a tendency to follow the family's inherited short stature (shortness).
• Constitutional growth delay with delayed adolescence or delayed maturation
  A child who tends to be shorter than average and who enters puberty later than average, but is growing at a normal rate. Most of these children tend to eventually grow to approximately the same height as their parents.
• Illnesses that affect the whole body (Also called systemic diseases.)

  malnutrition Constant malnutrition prevents children from attaining their full growth potential; a well-balanced diet generally prevents or corrects this disorder. Malnutrition is the most common cause of growth failure around the world. digestive tract diseases kidney disease heart disease lung disease diabetes severe stress

• Endocrine (hormone) diseases
• Hypothyroidism: The thyroid hormone is very important for normal growth and the body’s metabolism. Underactivity of the thyroid gland results in slowing of growth.
• Growth Hormone deficiency: Growth hormone is a hormone produced by the pituitary gland in the brain. It is mostly secreted in pulses during sleep. Deficiency of growth hormone results in slow growth and short final height.
• Intrauterine growth retardation (IUGR)
  In this condition, slow growth occurs within the uterus during pregnancy. The baby is born smaller in weight and length than normal, in proportion to his/her short stature. Some of these babies show catch-up growth in the first 3 years of life, whereas others may remain short and end up having a final height that is short for their family. This defect in growth has been attributed to a defect in the growth hormone axis. Growth hormone is used for these children if they do not show catch-up growth till 3 years of age so that they achieve a height that is normal for their family.
• Genetic abnormalities
  Health problems can occur if there are too many or too few chromosomes. This includes problems with growth. One chromosome abnormality that results from too few chromosomes:

  Turner syndrome Turner syndrome is a genetic disorder seen in girls that causes them to be shorter than others and to not mature sexually as they grow into adulthood. The severity of these problems varies among affected individuals. Other health problems may also be present involving the heart or renal system (kidneys, etc.) Many conditions can be managed or corrected by medical treatment. Turner syndrome occurs in one in 2,500 females born. The features of Turner syndrome result from having a missing X chromosome in each of the body's cells. Skeletal abnormalities (bone diseases or skeletal dysplasias) There are many bone diseases that affect height and growth, many of which are genetic. The most common is achondroplasia, a type of dwarfism in which the child's arms and legs are short in proportion to his/her body length. And the head is often large.

• Idiopathic
  There are several growth disorders that are idiopathic - with no known cause for the growth problem.

1. Treatment of short stature

Treatment of short stature will depend on the cause. If a medical condition is responsible for short stature, treatment of that condition may alleviate the problem.

2. What are the treatments?

The treatment for short stature depends on the nature of the cause. Some children will achieve a height that is normal for the height of their parents without any treatment, whereas others may need to be treated under the supervision of a Pediatric endocrinologist.
If a medical condition is responsible for the poor growth of your child, then it must be treated. If a hormonal problem is responsible for poor growth, appropriate therapy is given.
Growth Hormone is a hormone that is produced by the pituitary gland. This hormone is very important for normal growth. A recombinant form of this hormone is available in India too. It helps to improve the height of children in certain specific conditions. The conditions, which are approved for use of Growth Hormone, are:
Growth Hormone Deficiency
Turner Syndrome
Chronic Renal Failure
Intrauterine growth retardation
Prader Willi Syndrome
Idiopathic short stature

Among the tests that are commonly performed to evaluate the growth of a child with short stature include determining a bone age, which is the chronological age of your child's bones. This is determined by taking an xray, usually of his left wrist and hand. If your child's bone age is much less

Back