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Short Stature In Children Explained

Common Growth Concerns

Short Stature In Children Explained

Every parent worries about their child’s growth and how it may or may not affect their height, but some parents may have more of a reason to worry than others. A child who appears to be significantly shorter than other children who are the same age and gender may have a problem.

A child can be significantly shorter than their friends and still be perfectly healthy, particularly if both parents are also shorter than average as genetics are a major determinant of height. It is also possible that your child has what is commonly known as idiopathic short stature. Short stature refers to people whose height is significantly shorter compared to the height of their peers. The term is applied to those children whose height falls below the third percentile on a growth chart.

Pediatricians use growth charts to compare the height of your child to the average growth pattern for a child of the same sex, age, and height. For example, a girl with a height that is plotted on the 50th percentile line, indicates that approximately 50 out of 100 girls her age are shorter than her.

How is Short Stature Determined?

Your child’s pediatrician will take various factors into account when assessing your child's growth pattern. One of the main factors doctors look at when determining growth is the height of both parents. Since genetics plays such a large role in height, a child who has parents that are below average in height will also likely have below average height.

Other factors that doctors will consider are your child’s growth velocity, or rate of growth. One warning sign of an underlying medical condition is the slowing of your child’s growth velocity. This means that your child will continue to drop lower on the growth curve. If you are worried about your child’s height and growth patterns it is important to have regular check-ups with your doctor to see if there is any underlying cause.

Signs to Look For

In addition to taking your child to routine doctor check-ups, there are certain signs you can look for at home. If you notice any of the things below it may be a sign that your child isn’t growing at an appropriate weight.

  • Large height difference between your child and their peers who are the same gender and age
  • If you notice that your child is constantly tired
  • A decrease in the growth of your child
  • Clothing that still fits your child even if it is a year old

How Does Short Stature Differ From Dwarfism?

When first learning about short stature, it is easy and not uncommon to see it as a form of dwarfism. However, the two conditions are very different and distinct. While short stature is defined as an individual falling at or below the 3rd percentile for height, dwarfism is a person whose mature adult height is four feet, ten inches or less.

An important distinction between the two conditions is that most cases of short stature are the result of an underlying medical problem that can be treated and the short stature reversed. Dwarfism on the other hand, is most commonly the result of a genetic mutation which affects bone growth and generally cannot be treated.

Your pediatrician can help confirm whether your child’s height is the result of short stature or dwarfism. However, dwarfism is extremely rare occurring between a rate of 1 in 15,000 and 1 in 40,000 births. If the parents have dwarfism, there is a 25% chance their child will inherit the gene mutation. It is far more likely that your child is experiencing short stature as opposed to dwarfism.

Causes of Short Stature

There are many different causes of short stature in children, but there are four main reasons to be aware of. These four reasons are constitutional growth delay, idiopathic short stature, genetics, and diseases.

Constitutional Growth Delay

Also referred to as “late bloomers,” children with constitutional growth delay develop later than others. These children will generally enter puberty later than their classmates or peers and are small for their age. Even though these children develop later, they will usually catch up in height by adulthood.

Idiopathic Short Stature

Another cause for short stature in children is idiopathic short stature. This means that there is no known cause for the short stature that affects your child. Sometimes children will just be shorter than others without any reason behind it. In this case, your child is perfectly healthy, but has slower growth than other children of their same age and sex.

Familial Short Stature

One of the main reasons of short stature is genetics. If a child has one or both parents who are short, it is very likely that the child will also be of short stature. Again, like idiopathic short stature, a child is perfectly healthy but will be shorter than their peers.


In addition to the three causes above, various diseases can result in short stature. These diseases fall into several categories:

  • Endocrine Diseases - These diseases affect hormone production, and in association will often influence height as well. Such diseases include growth hormone deficiency (GHD), hypothyroidism, or low thyroid hormone levels, and Cushing’s syndrome.
  • Chronic Diseases -These can also decrease height through their effects on a child’s overall health or medications for chronic diseases, which may decrease growth rate. Examples of such diseases include heart disease, asthma, inflammatory bowel disease, diabetes, kidney problems, sickle cell anemia, and juvenile rheumatoid arthritis.
  • Genetic Conditions - Conditions such as Down syndrome, Turner syndrome, and Williams syndrome also affect the height of children.
  • Bone and Skeletal Dysplasia- These conditions may change stature through their effects on bone growth, such as achondroplasia.

Short Stature Diagnosed

There are a number of ways your pediatrician can determine whether or not your child has short stature. To start, she will measure your child’s height, weight and limb length. In addition, she may choose to administer certain medical tests. You should also be prepared to answer specific questions about your family’s medical history. The topics may include the following:

  • History of genetic conditions
  • History of endocrine, chronic or skeletal disease
  • Time of puberty for both parents
  • Complications during your child’s birth or the preceding pregnancy
  • Peculiar patterns of your child’s growth
  • Your child’s typical diet
  • Your child’s physical activity
  • Other notable symptoms

If your pediatrician suspects that your child is experiencing short stature as the result of a particular medical condition, she will need to order additional medical tests in order to diagnose. If it is determined that your child has short stature, your pediatrician can review the treatment options with you and develop an appropriate plan of intervention for the determined cause.

Treatment Options For Short Stature

The treatment plan for your child’s short stature will depend on the specific cause determined by your pediatrician. For example, if it is caused by hypothyroidism, thyroid hormone replacement can be used to supplement your child’s natural production of the hormone.

Not all cases of short stature will require intervention. Children who have short parents will most likely also be short and lead perfectly healthy lives without the need for a treatment plan from a doctor.

Working Through Confidence Issues

Whether or not your child has short stature, they may face confidence or self-esteem issues as a result of short height. Many children tend to become more self-conscious about their appearance around age nine, particularly if other kids single them out for significant physical differences.

Parents can help their children through this period by emphasizing acceptance and loving of one’s body. In addition, below is a list of tips to aid your child in coping with his differences and building his confidence, regardless of their height:

  • Treat Them Normally - Many adults, probably unknowingly, treat short children as younger than their age or limit their physical activity for fear of injury. However, you should treat your child normally and encourage participation in any activity they desire to participate in. Doing so will show them that their height is not a factor and help instill confidence.
  • Don’t Over-Praise - Similarly, do not over-praise your child. This may seem counterintuitive, but over-praising children gave have the opposite effect than desired. Part of confidence and self-esteem comes from developing competency in specific skills or activities, but doing so takes time and patience. If you over-praise your child’s efforts, you may in fact lower the standard for their performance. However, when praise is specific and earned, it can be a valuable self-esteem builder.
  • Encourage Pursuit of Interests - Encouraging your child to pursue activities they enjoy is a great way to help boost confidence as long as you make sure they follow through to completion. Despite what the task or activity is, the point is for you child to stick with what they start. Doing so will give them a sense of accomplishment once finished.
  • Provide Unconditional Love - A big part of your child’s confidence is tied to feeling loved and secure enough to take risks. Let your child know you love them in spite of their successes or failures. If all you talk about is performance, they may begin to think your love from them is dependent on his success.

  • While most of your child’s height is predetermined by genetics, it is important to monitor their growth in order to spot the early signs of short stature or irregular growth patterns. If you become concerned that your child is not growing properly it is best not to jump to conclusions as there are many factors that can influence height and growth.

    Instead, talk to your pediatrician in order to determine if there might be an underlying medical explanation. If your child is found to have an underlying cause for his short stature, remember that most cases are usually reversible. Proper treatment will allow your child to continue to grow, reaching their natural mature height without incidence.

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