He is a 14-year-old boy who is studying in a key middle school, with top grades, smart and understanding, and is a child who can save his parents’ worries. His father is 1 meter 72 and his mother is 1 meter 63, so he should be at least 1 meter 6 by now!
In fact, when he was in kindergarten, everyone noticed that he was growing slower than the other kids, and he sat in the first row in elementary and junior high school. Winter parents also once wanted to take him to the hospital to check, but the family of older people said that the child is not growing now, to the development of the natural growth. “Twenty-three, but also scamper a scamper it!” And so it was delayed.
Last week, through an acquaintance, Dongdong’s parents brought their child to me at Dongfang Hospital, No. 96 Chemical Road, Yiwu. I found that the child’s development was delayed in all aspects of the examination, and took a bone age of only 11 years old. Through a series of blood tests, it was finally found that DongDong was suffering from congenital growth hormone deficiency! I advised DongDong’s parents to give him growth hormone injections as soon as possible. However, due to Dongdong’s age and heavy weight, it was estimated that the injections would be more expensive and less effective than for children who started treatment before the age of 7-8.
Dongdong’s parents were remorseful: they should have come to the hospital earlier if they knew that!
The sooner you pay attention to your child’s height, the better. It is still common in society to see cases like Dongdong’s. When should you pay attention to your child’s height? Exactly when to pay attention to the child’s height, when to go to the hospital to check it?
When a child is born, a normal newborn is usually about 50 centimeters, and can increase in height by an average of 25 centimeters in the first year. This is the first growth spurt in life and has a great impact on the whole life. During this year, parents usually take their children to children’s health care institutions for regular physical examinations, which should be taken seriously if the assessment results are at the lower or lower-middle level. 1 to 3 years old, a normal child can grow 7 to 8 centimeters per year, and from the age of 3 to the pre-pubertal development is generally above 5 centimeters per year. After the start of puberty, children will usher in a second growth spurt, growing at least 6 centimeters per year, and some will even grow more than 10 centimeters. If your child’s growth rate in these stages is lower than the above low limit, then it is growth retardation, and you should go to the hospital growth and development specialist or pediatric endocrinology specialist for examination in time.
If you want your child to grow taller, it is important to check the bone age. After going to the growth and development specialist or pediatric endocrinologist, the doctor will ask your child to take a bone age film (left hand orthopantomograph) after understanding the medical history and physical examination. This is very important. This is because the child grows taller mainly by the continuous ossification of cartilage in the epiphysis of the long bones. When all the cartilage in the epiphysis ossifies and fuses with the bone stem, the person will not grow taller. As the cartilage ossifies, different centers of ossification appear at different ages, and these centers of ossification can be examined in X-rays. This is commonly referred to as bone age.
Bone age should be consistent with age, and being too old or too young is not conducive to growing taller. Too small is often due to congenital deficiencies, malnutrition, rickets or lack of thyroxine or growth hormone, which can cause growth to lag. And if the bone age is too old, it is often due to excessive ossification due to overdevelopment of sex or some other endocrine problem. This kind of children will grow faster than other children at first, but due to the high level of sex hormones in the body, the epiphysis will close early, making the growth terminate early, and eventually they will be shorter than other children instead. This is the reason why children with precocious puberty end up being short in height.
Therefore, whether a child grows too slowly or too fast, it is best to go to the hospital to check the bone age. If there is nothing abnormal, parents can take their children to the hospital to have a bone age taken at 4 weeks, 8 weeks and 12 weeks of age respectively. It is important to determine if the child is behind or ahead of the bone age because this is the transition period between early childhood, school age and adolescence. Of course, if it is already clear that the child is short or premature, it is more important to check early and review for a short period of time.
The first thing you need to do is to wait until the girl is menstruating. When it comes to precocious puberty, I’ll cite another case that came to the clinic a few days ago. This girl is Xiao Li, 12 years old. The company’s main business is to provide a wide range of products and services to the market. At that time, the bone age was already 10 years old, and the doctor had suggested that she do a sex hormone stimulation test, but Xiao Li and her mother were a little scared, so they did not check. As a result, last month Xiao Li suddenly found coffee-colored blood below. Mom brought her to Yiwu Oriental Hospital to see me, and the bone age was 13 and a half years old! According to Xiao Li’s current height of 1 meter 43 to project, her final height may not reach 1 meter 50.
Adolescent development is a gradual process. The normal girl 9-11 years old first appear breast hard, enlarged, after which then successively appear vulva development, and finally menstruation. Boys generally appear testicular enlargement at the age of 11-13, and then appear penis thickening, voice change, beard, throat knot and other sexual signs. If breast development occurs before the age of 8 for girls and testicular enlargement for boys before the age of 9, it should be considered precocious sexual development. This is the time to take intervention measures, whether to delay sexual development, or to promote the growth of height can be done. But like Xiao Li, it is too late to intervene when menstruation arrives.
Many parents want to take their children to the hospital for checkups, but they are not available. When the child is free, the parents themselves are too busy with business and work to take the child for a checkup. Therefore, many parents want to wait until their children are on summer or winter vacation before going to the hospital for a checkup. Unbeknownst to them, children who are in the budding or progressing stage of puberty can grow 1-2 years older in age in half a year or a year! In order to allow school-age and adolescent children to be treated in a timely manner, and to avoid conflicts between growth and development examinations and school study time, many hospitals have opened weekend or night clinics for growth and development specialists. In Yiwu Oriental Hospital, I sit on Wednesday evenings and all day every other week on Saturdays. In the future, if the number of children’s growth and development patients increases, I also plan to open more night clinics in Yiwu Oriental Hospital. Therefore, parents should take advantage of such weekends and nights, when there is no conflict with their children’s studies, to bring their children to the hospital in time.
Children are our future, and their growth needs the joint efforts of family members, school teachers and medical staff. We should all try to reduce the burden of our children, increase their free time, and pay attention to their growth and development as early as possible, which is what we should and can do for their growth.