Low size

In cases where there is a decrease in growth speed, they should also be studied. It can affect boys and girls. During the first years, the growth can be normal, and the alteration appear later. An isolated measurement of the height in a child has no value, the growth curve must always be carried out. Height is one of the aspects that most concern parents, along with weight gain. The comparison with the rest of the children in the class is inevitable. Children of the same age can measure centimeters apart and be within normality; cases where short stature is a clearly pathological situation are detected in the systematic reviews of the Pediatrician.

The factors that influence the final height of an individual are:

• Genetic factors: heredity is essential, the height of the two parents equally influences the height that their children will reach.
• Hormonal factors: several hormones are involved in growth, the balance between them is essential. The best known hormone is called "growth hormone" (GH).
• Sex and age of onset of puberty: at puberty, the child accelerates growth and, in turn, matures sexually, appearing secondary sexual characteristics: hair, breast development, testicular maturation ... In girls, puberty appears earlier than in children make the "stretch" earlier. Boys start puberty later and grow more inches.
• Nutrition and illnesses of the child: the correct nutrition ensures a suitable growth to the child. Chronic disease can affect growth.

Causes of short stature

• Family short stature: in this case the parents are short and genetic factors are fundamental. At birth they are already a little smaller and follow a growth curve below p3 parallel to normal, with good progression. Its growth rate is normal and bone age (age according to bone maturation) corresponds to its chronological age (in years). When they reach adulthood they are still short but there is no disease that justifies it, only the inheritance of their parents.
• The constitutional delay of development: in this case there is a delay in the onset of puberty and the "stretch". The child may appear shorter for a time but will reach good height in adulthood. Genetic factors also play a role: either or both parents started puberty very late. In these cases, the bone age is behind the chronological age of the child. Hormonal tests are normal. In the end, adult height is within normal limits.
• Growth hormone disorders: the complete absence of this hormone is a very rare disease. The most frequent is that small deficits are detected, alterations in its production, of the quality or of the sites where the hormone acts.

Treatment

To achieve the genetic size of the individual, he must be properly nourished and not have any disease that alters the process. The only treatment that exists is the administration of growth hormone in the event that this is the problem. Other types of hormonal deficits must be ruled out.

To administer this treatment, the child must be studied extensively and the child must be really short. The administration of GH (growth hormone) is done through daily injections given by the parents or the child himself at home and should always be supervised by a pediatric endocrinologist.