Delayed Growth

Written by Holly McGurgan
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What Is Delayed Growth?

Growth delays happen when your child does not grow at the normal rate for his or her age. Delayed growth may be noticed by a parent or during an examination at the doctor’s office.

According to the Magic Foundation (a non-profit organization that provides support to families of children afflicted with growth disorders), failure to grow by at least 2 ½ inches per year can be an early warning sign that something is wrong (Magic Foundation, 2011).

What Causes Delayed Growth?

Delayed growth can be caused by a variety of problems, including:

  • poor nutrition
  • lack of growth hormone
  • hormone imbalances (such as low levels of thyroxine due to hypothyroidism)
  • Turner syndrome (genetic condition in females who are missing some or all of one X chromosome)
  • Down syndrome (genetic condition in which individuals have 47 chromosomes instead of the usual 46)
  • family history of growth delays
  • pituitary gland tumor
  • smaller birth and fetal weight
  • kidney, heart, digestive, or lung diseases
  • severe stress
  • long-term use of certain drugs by pregnant mother
  • dwarfism
  • certain anemias such as sickle cell anemia (JOPON, 2011)

Recognizing the Signs of Delayed Growth in Children

If your child is smaller than other children his or her size, he or she may have a growth problem. Typically, if a child is the size of other children two or more years younger than they are, then it is considered a medical issue.

The size of your child’s arms and legs may not be in proportion to size of the torso, particularly if he or she has dwarfism.

Additional symptoms depend on what is causing the delayed growth.

For example, hormonal imbalances can cause many other symptoms in addition to delayed growth. Thyroxine, for example, is an important hormone that is secreted by the thyroid gland and is responsible for cell metabolism. Low levels of thyroxine can lead to delayed growth—and can also cause loss of energy, constipation, dry skin, dry hair, and trouble staying warm. Low amounts of growth hormone can affect growth of the face, which can make a child look abnormally young.

Children who have delayed growth because of stomach or bowel disease also may have gas, diarrhea, constipation, vomiting, nausea, and may have trouble gaining weight.

How Is Delayed Growth Diagnosed?

Diagnosis starts with getting information on the child’s health history, details about the mother’s pregnancy, the child’s height and weight at birth, the heights of others in the family, and information on family members who have had growth delays. Your doctor may suggest charting your child’s growth for six months to one year to determine if there is a medical problem.

Certain tests can help determine if your child has a delay. A hand and wrist X-ray can provide important information regarding your child’s bone development in relationship to his or her age. Blood tests can pick up problems with hormone production or detect stomach, bowel, kidney, or bone disease. In some cases, your doctor may recommend that your child stay overnight in the hospital for blood testing because about two-thirds of growth hormone production happens while your child sleeps.

How Is Delayed Growth Treated?

Treatment for delayed growth depends on the cause of the problem. Children who have a growth hormone deficiency may have to take injections of growth hormone at home. Shots may be given three times per week or as often as every day, depending on your doctor’s instructions. Treatment continues for several years until the child reaches a normal adult height.

If testing shows that your child has an underlying problem, such as kidney or gastrointestinal disease, poor nutrition, or a pituitary gland tumor, treating the disease or condition may help him or her start growing normally.

In some cases, delayed growth and lower height may be an expected part of a syndrome, such as Down syndrome or Turner syndrome. Adult males with Down syndrome have an average height of 5 feet, 2 inches, while women have an average height of 4 feet, 6 inches, according to the Down Syndrome Association of Los Angeles (DSALA).

What Is the Outlook for a Child Diagnosed With Delayed Growth?

The prognosis for growth depends on the cause of the problem, when it is diagnosed, and when treatment is started. Children who have underlying conditions causing delayed growth can expect to reach normal or near normal height if treatment is begun as soon as the problem is noticed. Waiting too long can complicate the problem, particularly if the child has a growth hormone deficiency. Once the growth plates at the end of the bones close in young adulthood, no further growth is possible.

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