Is my child growing alright?

What is normal growth?

At birth, a child is around 50 cm. Growth is maximum in the first year of life, about 25 cm per year. It gradually declines from birth to about 4 years.

During the second year height gain is half of first year, around 12.5 cm and 6-7cm per year in third and fourth year of life.

From the fifth year till the onset of puberty it is about 5 cm per year. During puberty, girls gain 6-8 cm of height and boys grow about 7-10 cm.

How do I know if my child is growing okay?

Few clues for this are –

• If your child is not outgrowing his /her clothes and / or shoes
• If your child is among short ten children
• If your child looks younger than his classmates
• If your child has developed a complex about height

What is a growth chart?

The best way of confirming normal/abnormal growth is by regular growth monitoring. This can be done by simple height measurement at regular interval of 3 months and plotting them on growth charts. The Indian Academy of Paediatrics has devised growth charts for all age groups which are freely available online.

What are causes for short stature?

• Common cause is nutritional deficiency.
• Genetic or familial short stature
• Constitutional short stature or late bloomer
• Chronic diseases
• Hormonal deficiency
  • Thyroid deficiency
  • Growth hormone (GH) deficiency.
• Rare causes are Turner syndrome, Intrauterine growth retardation and emotional deprivation.

What are the signs of GH deficiency?

Children with GH deficiency are short with normal body proportions and intelligence. Bone development may be delayed causing child to look younger than his actual age. There may be under development of mid facial structure and frontal bossing of the skull. They are often obese/overweight as GH controls fat deposition.

How do you diagnose Growth hormone deficiency?

After all other possibilities of short stature have been ruled out, tests are done for growth hormone deficiency. First analyze growth rate in the growth chart, second, thorough physical examination, X-ray of hand and wrist to see bone development and compare it with height and chronological age.

Confirmation is by giving the child a substance that releases growth hormone burst in normal children. If the release is sub optimal it confirms growth hormone deficiency.

Are there any side effects with the treatment?

Largely this treatment is safe and very effective. It is an expensive medicine. It is given till normal height or maximum height is reached, that is when bones have been fused, thus the child has attained maximum height.

Why an adult cannot grow taller?

Adults cannot grow as their bones are fused. Once puberty is reached the sex hormones, oestrogens in girls and testosterone in boys cause fusion of bones. Once bones are fused we cannot grow any more.