As long as the height is lower than two standard deviations from the average height of the same region, race, age and gender or lower than the third percentile of the height curve of the population (in layman’s terms, it is the last three of a hundred such children in line according to their size), it is medically called dwarfism. If the cause is found and treated effectively, the child can grow taller and reach a normal size.
How do we know what percentile of the height curve our child is in? This requires regular and accurate measurements of your child’s height (length for children under 3 years old). Marking the values on the growth curve allows you to see both your child’s current height level and to dynamically monitor your child’s growth rate. If the height is below the third percentile, or the annual growth rate is too low, the child needs to be further examined for the presence of dwarfism.
For example, by plotting the growth curve of a young boy for two years, we found that although this child was within the normal range for height at age 5, the growth rate was too low, growing only about 3 cm per year, so the child’s height dropped into the dwarf range after 2 years. You can see how important it is to plot the growth curve!
What are the causes of children’s short stature?
I. Endocrine dwarfism.
Such as growth hormone deficiency, low thyroid hormone, etc. The diagnosis can be confirmed by growth hormone stimulation test and detection of thyroid hormone. The application of growth hormone or thyroxine can achieve good results. Low adult height due to precocious puberty also falls into this category. Precocious puberty is different from general dwarfism. Due to early development, the height during the growth period can be higher than that of the same age group, but growth stops early and the final height is often shorter. The application of gonadotropin-releasing hormone analogues can allow pubertal development to stop rapidly for more time to grow taller, thus improving adult height.
II. Idiopathic dwarfism.
It is a severe growth disorder of currently unknown cause. It is characterized by significant short stature due to undergrowth in childhood, with normal or low growth rate.
C. Nutritional dwarfism.
It is now rare. General “picky eating” does not cause short stature and is only seen in patients with long-term chronic diseases. These patients do not need to be treated for height increase, as long as the primary disease is effectively treated and nutrition is adjusted, they can grow taller. The longer duration of the disease often does not reach normal height.
IV. Intrauterine growth retardation.
Children with low length and weight at birth, fail to achieve effective catch-up within six months after birth, and have low adult height. Growth hormone has a certain effect on such patients to improve adult height.
V. Chromosomal disorders.
Such as Turner syndrome, Down syndrome, etc., the diagnosis can be confirmed by chromosome examination. Depending on the type of disease, treatment methods and effects are different.
Sixth, genetic metabolic diseases.
Such as stupid acetonuria, mucopolysaccharidosis. Such patients are currently increasing the treatment effect is poor.
Seven, physical puberty delay.
That is, the so-called “late growth”, this category of people often have a family history, generally do not need treatment, and eventually can reach normal height. If you suspect this type, you should regularly check your bone age and make annual height predictions.
VIII. Skeletal system diseases.
Such as chondrodysplasia, osteogenesis imperfecta, etc. There is a lack of effective treatment.
Psychosomatic dwarfism.
It often occurs in parents’ emotional discord, divorced families or single-parent families, and the child’s psycho-psychological frustration has affected the endocrine function.
How to treat dwarfism when it is diagnosed?
Depending on the cause, different treatments need to be given.
In case of hypothyroidism, thyroxine treatment needs to be given; in case of precocious puberty, gonadotropin-releasing hormone analogs need to be given; the presence of chronic nutritional diseases requires active treatment of the primary disease and improvement of nutritional status; growth hormone deficiency, idiopathic dwarfism, intrauterine growth retardation, Turner syndrome and other diseases require application of growth hormone treatment; there are also some diseases such as chondrodysplasia, some There are no good treatment methods for these diseases. Therefore, the first thing to do is to find out the cause of the disease in order to treat it.
Some parents may ask, “My child is not considered dwarf, but I want him to grow taller, is there any good way?
Then let’s talk about the factors affecting height.
Growth, as it is called, is both a continuous process and has certain stages. This means that a child is gradually growing taller and taller, but the speed of growth varies from period to period. There are two very important growth spurts in life: the first growth spurt: length and weight grow rapidly in the first year after birth, and the second spurt: rapid growth in height and weight as the child enters puberty.
Although there is a certain pattern of growth and development in children, there are considerable individual differences within a certain range of genetic and environmental influences. Each child has its own growth “trajectory” and will not be identical. When there are no significant changes in external environmental conditions, the measured growth of each child remains relatively stable in the same developmental class from period to period, generally not exceeding the next class. Dynamic tracking for more than 6 months is necessary to determine if the growth rate is normal. If the growth rate is below the 3rd percentile after more than 1 year of continuous follow-up, the chance that the growth rate will return to the 50th percentile the following year is only 3%. In other words, if you find that your child is growing slowly, you must go to the hospital and not blindly hope that he or she will grow taller in the future. Through the growth curve is to see that a child’s growth process is mostly a curve shows a gentle change, and will not change as drastically as the second curve.
The factors that affect the growth and development of children are
I. Environmental factors
Level of economic development: The development level of urban children is significantly better than that of rural children.
Social system: China provides for a 9-year compulsory education system for children, which has a positive effect on promoting children’s development.
Culture: Parents with different levels of education have different expectations for their children and have an impact on children’s academic and character development.
Environmental health: those located in the north or coastal areas are taller than those in the south or mountainous areas; height growth is faster in spring and summer than in autumn and winter, which is related to abundant light; chromosomal mutations caused by environmental pollution affect fetal development.
Family environment: socio-economic conditions, family structure, family atmosphere, etc.
Second, genetic factors
Race: The average height of Caucasian people is higher than that of Chinese people.
Parental height and offspring height are closely correlated.
Parental consanguineous marriage affects offspring’s intelligence development.
The external environment changes the chromosome structure and affects the offspring.
Third, nutritional factors
Poor intrauterine nutrition during pregnancy affects the physical and neurological development of the fetus.
After birth, protein-calorie deficiency affects weight, height and intelligent development.
Excess nutrition can lead to obesity, thus affecting growth and psychological.
Effect of micronutrient deficiency on physical and mental development.
Iron deficiency: poor concentration, memory loss and personality changes
Zinc deficiency: affects pediatric intelligence
Iodine deficiency: low thyroid function, resulting in backward physical and neuropsychological development
Fourth, disease factors
Pregnancy diseases: rubella, herpes zoster, cytomegalovirus and toxoplasma infection can affect fetal development; the incidence of malformation in the offspring of diabetic patients is 2-6 times higher than normal; untreated phenylketonuria results in poor fetal intelligence development; in the offspring of pregnant women with hyperthyroidism, microcephaly is 13 times higher than normal.
Perinatal diseases: severe birth injuries can lead to brain, spinal cord, brachial plexus and other injuries resulting in GHD.
Postnatal diseases: poor gastrointestinal function, precardiac disease, chronic kidney disease, pituitary tumors, and low A function affect growth and development.
Medications: Maternal medication during pregnancy and child medication after birth affect the physical development of children.
V. Educational factors
Early mother-infant contact promotes infant appetite, weight gain, and is closely related to the future good character and emotion of the child.
The mother’s motivation, ability and motivation to educate the child are significantly related to the development of the child.
Good parental actions and words have a positive influence on the development of the child’s mental processes.
According to the above influencing factors, how can we promote the healthy and natural growth of children?
1, reasonable nutrition: food selection diversification, meat and vegetarian, main and secondary food with; should be coarse rather than fine, not the pursuit of “expensive” “fine”, but the pursuit of natural green. Avoid bad eating habits, such as overeating, picky eating, eating too fast, lack of dietary rules, do not eat breakfast, love snacking, etc.
2, adequate sleep: sleep can promote the secretion of growth hormone in children. Because growth hormone is released every day, but 80% of growth hormone is secreted during sleep (“children who can sleep grow up”), and growth hormone is secreted more in the first half of the night (the golden sleep period).
Normal daily sleep time for children
Newborns
No less than 16~18 hours
1~3 months
No less than 15 hours
3~12 months
No less than 13~14 hours
1~3 years
No less than 12 hours
3 years old and above
No less than 10 hours