Short stature is a general term for people whose height is considerably below average, as compared to the height of their peers. While it can apply to adults, the term is most often used in reference to children.
A child can be significantly shorter than his or her friends and still be perfectly healthy. This is particularly true if both parents are also shorter than average. Genetics is a major determinant of height.
However, short stature can indicate an underlying medical problem. In these cases, many children can grow to a normal height with proper treatment. For others, short stature may be permanent.
Doctors measure your child’s height using a growth chart. This chart shows the average height of other kids of the same age and sex. Based on guidelines set by the American Association of Clinical Endocrinologists, children are considered to be of short stature if their height falls within the lowest two percentiles of their peer group.
There are three major reasons for short stature: constitutional growth delay, genetics, and disease.
Constitutional growth delay
Otherwise known as late bloomers, some children simply develop later than others. These kids are small for their age and often enter puberty later. However, they will continue to grow once their friends have stopped. They usually catch up by adulthood.
If one or both parents are short, there is a strong possibility that their child will also be short. If there are no underlying medical reasons why either parent is short, their child’s short stature may be perfectly healthy.
A number of diseases may cause unusually short stature. These diseases fall into several categories.
Endocrine diseases affect hormone production, and often height. These include:
- growth hormone deficiency (GHD)
- hypothyroidism (low thyroid hormone levels)
- Cushing’s disease
Chronic diseases can also decrease height through their effects on overall health. These include:
- heart disease
- inflammatory bowel disease
- kidney problems
- sickle cell anemia
- juvenile rheumatoid arthritis
Genetic conditions that affect height include:
- Down syndrome
- Turner syndrome
- Williams syndrome
Bone and skeletal diseases, such as rickets or achondroplasia, may change stature through their effects on bone growth.
Problems during pregnancy can also affect the height of a child. So can malnutrition. However, growth problems caused by malnutrition are uncommon in the U.S.
Only a doctor can determine whether your child’s short stature has a medical cause. This determination takes time. That’s why it’s very important to have regular checkups with a family doctor or pediatrician.
You can also monitor your child’s height and overall health at home. Some questions to keep in mind:
- Is your child significantly shorter than classmates who are the same age and gender?
- Has your child’s growth started to decrease?
- Does last year’s clothing still fit comfortably?
- Is your child frequently tired?
Your doctor will measure your child’s height, weight, and limb length. Your family and child’s medical history will also be reviewed. Questions you should be prepared to answer include:
- What is the average height of past and current relatives?
- Do you have any history of disease?
- When did puberty start for both parents?
- How was your child’s birth?
- Are there any patterns in your child’s growth?
- What is your child’s normal diet?
- Are there any other symptoms present?
If a medical condition is suspected, your doctor may do the following tests:
- X-ray of the growth plates in the left hand, to check that your child’s growth corresponds to his or her age
- screening for growth hormone deficiency (GHD)
- complete blood count to check for any blood diseases
- DNA analysis to check for Turner’s syndrome (in girls) and other genetic diseases
- blood tests to check for thyroid, liver, kidney, and other problems
- imaging scans to check for tumors
Treatment for short stature depends on the cause.
For example, hypothyroidism can be fixed with thyroid hormone replacement. Growth hormone injections can be used to treat GHD and a number of other conditions, including Turner syndrome and chronic kidney failure.
Not all short stature needs to be treated. For children who are naturally short, no treatment is recommended. However, it can be challenging to deal with teasing from other kids. Parents can provide their own “home remedy” in the form of reassurance and emphasis on their child’s other strengths.
People who come by their short stature naturally can expect to lead completely normal lives.
Children with GHD and other hormone-related conditions generally reach average height, or a height similar to their parents if they receive treatment before puberty. For those with genetic or skeletal diseases, short stature will likely be a lifelong issue.