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When a Child is Unusually Short or Tall

Once children reach school age, parents often worry if their otherwise healthy child looks considerably shorter than other children his age. Generally, parents are less concerned if their child is unusually tall for her age. Short girls do not attract as much attention as short boys. In most cases, however, short children are simply following a growth pattern that is "normal" for them.

The Growth Hormone

It is rare that children fail to grow because they do not make enough growth hormone, which is produced by the pituitary gland.

  • If a child appears to be growing outside what is considered normal: Share your concerns with your child's pediatrician. He can check for (and most likely rule out) any medical condition(s) as the cause for the small size.
  • If you have questions about the possible need for growth hormone treatment: Consult with a pediatric endocrinologist, a doctor who specializes in hormonal problems in children and who can best judge whether your child needs growth hormone injections.
  • If your child has a proven growth hormone deficiency: Treatment should start as early as possible, because treatment produces greater growth when given to younger rather than older children.

Parents need to know that growth hormone treatment has some risks and possible side effects and costs thousands of dollars a year. Many health insurance plans do not pay for this treatment, unless there is a true growth hormone deficiency.

The long-term risks of growth hormone injections over a period of years are not yet known. In addition, the need for treatment itself may only reinforce the negative self-image that many children with short stature already have. If you are unsure or uncomfortable treating your child with growth hormone injections, ask your pediatrician for a second opinion with a different pediatric endocrinologist.

Other Causes of Short Stature

Some children are born small because of poor growth while in mom's womb and some never catch up. A baby may be small at birth for many reasons, from decreased blood supply or an infection while in the womb, or just from being born way too early. There are many other causes for children being short; too many to describe here. Although the growth hormone is not recommended for most, parents should speak to their pediatrician in consultation with a pediatric endocrinologist about their concerns with their child's height.

When a Child is Abnormally Tall

On the other hand, some children may be abnormally tall for their age from an early, rapid development of puberty or from an excess production of the growth hormone by the pituitary gland. These and other more rare conditions can stimulate growth, particularly of the jaw and the long bones of the arms and legs. Most of these conditions can be treated. If you feel your child is growing too fast, discuss your concerns with your child's pediatrician.

Height Genes

Height and weight usually run in families. In fact, you can get an idea of how tall a child is likely to be by looking at her parents.

Here is one way to predict a child's probable height when fully grown:

Add together the measured heights of the mother and father in inches and divide by 2.

  • For a boy: add 2½ inches
  • For a girl: subtract 2½ inches

Note: This is just a very rough estimate of the average height, give or take two inches, of how tall a child will be when fully grown. The taller the parents, the taller the child is likely to be; similarly, the shorter the parents, the shorter the children.

Weight Genes

Children also tend to follow their parents', siblings', and even grandparents' thinness. If a child's diet includes large amounts of high-fat, high-calorie foods, and he spends most of his time watching television or playing video games, all bets are off–he is at high risk for being overweight.

Additional Information:

Last Updated
Section on Endocrinology (Copyright © 2014 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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