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Does my short child have a growth problem? How much does a child usually grow in a year? How is a growth problem diagnosed? What is a growth disorder? Is there anything I should keep in mind caring for a child with a growth disorder? How do children grow? What is an endocrinologist? What is the endocrine system? What do endocrinologists do? What are the diagnostic tests for growth disorders? What is the pituitary gland? Does my short child have a growth problem? While there are many medical conditions that can cause children to be short, or have short stature, most children who are short are normal. There is a wide range of what's normal in terms of height. Most children are short because they have short parents. Genetics plays a very big role in how tall a person will be. It is also possible for a child to be a late bloomer who will shoot up to a more average height at puberty (which may come later for him or her than for the average child). There is a simple formula that doctors use to calculate a child's target height or their genetic potential for growth using parental heights. This is important to figure out, because if a child is much below his or her genetic potential then that may be a sign of a problem. If you are worried that your child is too small or if your child’s growth suddenly seems to have slowed down or stopped, make an appointment with his or her doctor. The doctor will look for any health problems that could be causing this.
How much does a child usually grow in a year? Children in early childhood usually grow at a rate of about 5 – 6 centimetres per year, up until they begin puberty, when their growth will slow to about 4 cm per year. There is acceleration in growth as they hit their peak growth velocity in puberty, to about 7.5 – 8cm per year for girls and 10 cm per year for boys. Growth then slows again in girls to about 6 cm per year after menarche (the first period) until they reach their adult height. Boys and girls usually continue to grow until they are 14-16 years old, but this depends on when they started puberty. Remember that girls reach their pubertal growth spurt about two years earlier than boys.
How is a growth problem diagnosed? Because short stature is most often just a matter of genetics, your child's doctor will want to get a thorough family history from you, including the approximate height of his or her siblings, parents, grandparents, aunts, and uncles. She'll want to know if anyone in the family has had a health problem associated with short stature since these can also be inherited. You'll need to provide the doctor with your child’s height and weight records, if she doesn't have them already, so she can figure out whether his or her growth has slowed recently and if s/he's always been shorter than his or her peers. She'll ask if your child is showing any signs of puberty and, if so, at what age puberty began. She'll probably carry out a physical exam as well, possibly weighing and measuring his or her arms and legs separately. In addition to a complete medical history and physical examination, diagnostic tests may include:
A growth disorder is any type of problem in infants, kids, or teens that prevents them from meeting realistic expectations of growth. Disorders may include failure to thrive in infancy, failure to gain height and weight in young children, and short stature or delayed sexual development in teens.
Is there anything I should keep in mind caring for a child with a growth disorder?
Many factors influence the rate and pattern of growth in children. Genes, nutrition, exercise, sleep, present overall health, and hormones all help children grow from infants to adults. Additionally, past and present childhood illness and injury can influence a child’s rate of growth and overall growth potential. Many variations in the normal pattern of growth exist, and all are influenced by both environmental and genetic considerations, as well as overall health status. Genes, which children inherit from their parents, usually dictate growth potential. However, good nutrition ensures that the body has the protein and other nutrients needed for growth. Exercise helps build muscle and stimulates the release of hormones. Sleep also stimulates hormone release, and it restores energy. All of these are necessary components for maximizing a child’s natural growth potential. Several hormones, which include growth hormone (GH) and growth hormone releasing hormone (GHRH), play a critical role in a child's growth. Here's how the process works:
Source: www.emedguides.com/growth
What is an endocrinologist? An endocrinologist is a specially trained doctor. Endocrinologists diagnose diseases that affect your glands. They know how to treat these conditions, which are often complex and involve many systems and structures within your body. Your regular doctor refers you to an endocrinologist when you have a problem with your endocrine system. A paediatric endocrinologist treats children with endocrine problems.
What is the endocrine system? Your endocrine system is a system of glands. Glands are organs that make hormones. These are substances that help to control activities in your body. Hormones control reproduction, metabolism (food burning and waste elimination), and growth and development. Hormones also control the way you respond to your surroundings. They help to provide the proper amount of energy and nutrition. The endocrine glands include the thyroid, parathyroid, pancreas, ovaries, testes, adrenal, pituitary and hypothalamus.
What do endocrinologists do? Endocrinologists are trained to recognise and uncover hormone problems. They help to restore the natural balance of hormones in your system. Endocrinologists also conduct research to learn the secrets of the glands. Clinical research helps them learn the best ways to treat patients and leads to the development of new treatments for hormone problems. Endocrinologists take care of many functions and problems:
What are the diagnostic tests for growth disorders? Not all causes of short stature are abnormal, and many variations in normal growth patterns exist. A thorough evaluation by your child’s pediatrician or pediatric endocrinologist is necessary in order to assess whether a child’s size or growth pattern is a genuine cause of concern. A complete history and present information on the child’s health, diet and appetite, and growth rate need to be gathered. One of the most valuable tools in the assessment of a child’s growth is a well-made growth chart, which records a child’s height and weight measurements throughout childhood. With this tool, your physician can see how your child’s height compares with other children of the same age. Likewise, any changes in a child’s usual rate of growth can be quickly recognized. Your child's doctor or pediatric endocrinologist will probably conduct several tests to diagnose a growth disorder: Bone Age X-ray The doctor may order a hand and wrist X-ray to determine your child's bone age. A child with a delayed bone age (younger than his or her chronological age) has more growth potential, or "room to grow," than other children the same age. Blood Tests The doctor may want to do a blood test to determine whether your child has a thyroid deficiency or kidney, bone, or gastrointestinal disease that is affecting his or her growth. The Growth Hormone Stimulation Test Growth hormone is released by the pituitary gland in bursts, and does not last long in the blood. To measure it accurately, the doctor will give your child an agent to release the hormone, then measure the amount in the blood over time. There are several types of agents available, and your doctor may use more than one to evaluate your child. Agents include Geref® Diagnostic (sermorelin acetate for injection) from Serono, l-dopa, clonidine, arginine, glucagon, and insulin. Vigorous exercise and sleep are natural stimulants of growth hormone that your doctor may include in testing. Most stimulation tests are given on an outpatient basis. Depending on which agents your doctor uses, your child may have to fast for several hours before the test. Your doctor will probably insert an IV (intravenous line) into your child's arm or hand vein for drawing blood samples. Blood samples are usually taken every 15-30 minutes for up to about 3 hours. Your child's condition, blood pressure, and pulse will be checked as needed throughout testing. Let your child know what to expect during a stimulation test, and reassure him or her that, while it may not be fun to have a three-hour test, it won't be painful. The prick of the IV needle may cause your child anxiety, but it only lasts a second. It's a good idea to bring along small toys or games to keep your child occupied during testing. Understanding the Results You will probably get test results in about a week. The results may be definite—they may show that your child's GH is normal or that GH is absent and treatment is needed. They may not be definite—your child's GH level may be borderline or the results may be unclear. When this happens, more testing and follow-up are often required. Although this can be frustrating for families, it is important to accurately diagnose the problem in order to make treatment as effective as possible. Source: www.emedguides.com/growth
What is the pituitary gland? The pituitary gland is often called the master gland of the body because it controls other glands. The pituitary makes several vital hormones. Over- or under- production of pituitary hormones can lead to infertility, menstrual disorders, growth disorders (acromegaly or short stature) and too much cortisol (Cushing's syndrome). Endocrinologists control these conditions with medications and refer patients who need surgery.
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