Short stature is a general term for people whose height is
considerably below average compared to the height of their peers. While it can
apply to adults, the term is more commonly used to refer to children.
A child can be significantly shorter than their 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.
Your child’s doctor will measure your child’s height and
then refer to a growth chart. This chart shows the average height of other children
of the same age and sex. Based on guidelines set by the American Association of
Clinical Endocrinologists, doctors consider a child to be of short stature if
their height falls within the lowest two percentiles of their peer group.
What Causes Short Stature?
The three major reasons for short stature are constitutional
growth delay, genetics, and disease.
Constitutional Growth Delay
Some children simply develop later than others. These
children are often referred to as “late bloomers.” These kids are small for
their age and often enter puberty later. However, they’ll continue to grow after
their friends have stopped. They usually catch up by adulthood.
If one or both parents are short, there’s 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
A number of diseases may cause unusually short stature.
These diseases fall into several categories.
diseases affect hormone production, and often height. These include
growth hormone deficiency (GHD), hypothyroidism, or low thyroid hormone levels,
and Cushing’s disease.
diseases can also decrease height through their effects on overall
health. Examples of chronic disease are heart disease, asthma, inflammatory
bowel disease, diabetes, kidney problems, sickle cell anemia, and juvenile
conditions that affect height include Down syndrome, Turner
syndrome, and Williams syndrome.
- Bone and
skeletal diseases, such as rickets or achondroplasia, may change stature
through their effects on bone growth.
pregnancy can affect the height of a child. Malnutrition can also lead to short stature.
Growth problems caused by malnutrition are uncommon in the United States.
When Should I Seek Medical Attention?
Only a doctor can determine whether your child’s short
stature has a medical cause. This process 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 ask yourself are:
- Is my child significantly shorter than
classmates who are the same age and gender?
- Has my child’s growth started to decrease?
- Does last year’s clothing still fit my child comfortably?
- Is my child frequently tired?
Providing the answers to these questions will give your
doctor a head start in diagnosing any issues.
How Is the Cause of Short Stature Diagnosed?
Your doctor will measure your child’s height, weight, and
limb length. Your doctor will also ask about your family’s and child’s medical
history. Questions you should be prepared to answer include:
- What is the average height of past and current
- 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?
Your doctor may order medical tests if they suspect a
medical condition. These tests can include:
- an X-ray of the growth plates in the left hand to
check that your child’s growth corresponds to their age
- a screening for GHD
- a complete blood count to check for any blood
- a DNA analysis to check for Turner syndrome in
girls and other genetic diseases
- blood tests to check for thyroid, liver, kidney,
and other problems
- imaging scans can look for tumors
What Are the Treatment Options for Short Stature?
Treatment for short stature depends on the cause.
Thyroid hormone replacement can be used to treat hypothyroidism.
Growth hormone injections can treat GHD and a number of other conditions,
including Turner syndrome and chronic kidney failure.
Not all short stature needs treatment. For children who are
naturally short, no treatment is necessary. However, it can be challenging if a
child is dealing with teasing from other kids. Parents can provide reassurance
and emphasis on acceptance and loving one’s body.
What Is the Long-Term Outlook?
People who have a naturally short stature that’s not due to
a medical condition or disease can expect to lead normal and healthy 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.