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 sometimes 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.
The assessment of height will vary depending on the population your child is from. Exact cutoff points can vary between country and growth charts.
Based on an evaluation of tall and short stature children, doctors consider a child to be of short stature if their height is less than 2 standard deviations below the rest of the population.
The 3 major reasons for short stature are constitutional growth delay, genetics, and disease.
Constitutional growth delay
Some children simply develop later than others. 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 perfectly healthy.
A number of diseases may cause unusually short stature. These diseases fall into several categories.
- Endocrine diseases.Endocrine diseases affect hormone production and often height. These include:
- growth hormone deficiency (GHD)
- hypothyroidism (low thyroid hormone levels)
- Cushing’s disease
- Chronic diseases. Some chronic diseases can also decrease height through their effects on overall health. Examples include:
- Genetic conditions. Genetic conditions that affect height include Down syndrome, Turner syndrome, and Williams syndrome.
- Bone and skeletal diseases. These diseases, like rickets or achondroplasia, may change stature through their effects on bone growth.
Problems during pregnancy can also affect the height of a child. Malnutrition can lead to short stature as well. Growth problems caused by malnutrition are uncommon in the United States, however.
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?
- Do last year’s clothes 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.
The doctor will measure your child’s height, weight, and limb length. They’ll also ask about your family’s and child’s medical history.
Questions you should be prepared to answer include:
- What’s 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’s 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 (CBC) to check for abnormalities in red blood cells
- 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 to look for tumors
Treatment for short stature depends on the cause.
Thyroid hormone replacement can be used to treat hypothyroidism. Growth hormone injections can treat GHD and may be given to children with Turner syndrome or chronic kidney disease to improve height and bone growth.
Limb lengthening surgery may be an option in some cases of achondroplasia and hypochondroplasia. This procedure requires cutting the leg bones and placement of hardware (rods and screws) inside and outside the legs.
The bones are very gradually pulled apart by the hardware, as new bone is allowed to grow between cut segments.
Not all short stature needs treatment though. 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.
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.