Being short is not easy in this tall world. Studies show that shortness in children is correlated with teasing, bullying, and social exclusion, while studies in adults have linked short stature to social isolation, reduced marriage rates, and adverse effects in finding or sustaining one's career. Moreover, a short child may have altered body composition, delayed puberty, abnormality in blood cholesterol and increase risk of heart disease when they are growth hormone-deficient.
Growth means the increase in height and weight and other body changes that happens with the age. Growth is influenced by many factors, such as hormones, illness, medications, nutrition and psychosocial environment.
After birth, the body grows at the highest rate in a lifetime of 25 centimetres in length. By age 4, growth in height usually continues at a steady rate of about 5 centimetres per year until adolescence. But growth may vary from child to child throughout this period of childhood. During puberty, a major growth spurt happens, usually between 8-13 years of age in girls and 10-15 years in boys. Early signs of abnormal growth include fitting into the same clothes or shoes for more than one year, younger siblings catching up or surpassing your child's height, gradually falling behind the peers.
There are so many causes that can affect your child's growth. Most of the cases are physiological. The most common causes are having a family history of short stature; constitutional growth delay; growth hormone deficiency; genetic causes like Turner Syndrome; slow foetal growth; poor nutrition and emotional deprivation etc.
Growth hormone (GH) deficiency is when the master endocrine gland (the pituitary gland) does not make enough growth hormone. GH is needed to stimulate the growth of bone and other tissues. In addition to growth, growth hormone regulates the body's metabolism. The main sign of GH deficiency is slow height gain each year which can be identified after the child's 3rd birthday. A child with GH deficiency may also have a younger-looking face, high pitched voice, a chubby body build and delayed puberty.
There are many conditions where GH therapy can be given. Your child may need to see a paediatric endocrinologist who will consider his or her age, overall health and other factors when advising treatment. Treatment is done with daily injections of synthetic growth hormone. This treatment will likely continue for several years as your child continues to grow. Your child's doctor will monitor the effectiveness of the GH treatment and adjust the dosage accordingly. The earlier the treatment is started, the better chances that a child will have a normal or near-normal adult height that matches his or her family pattern.
Since early treatment may help your child reach a normal adult height, talk to your doctor as soon as you notice any signs or symptoms of delayed growth. The extra inches would also open up an array of social and economic opportunities, ranging from better social inclusion to greater professional achievement. A child should not be disadvantaged due to having growth hormone deficiency.
The writer is a Consultant Paediatric Endocrinologist at the Department of Paediatrics and CDIC Paediatric Diabetes Centre, BIRDEM 2, Diabetic Association of Bangladesh.