Height growth in children is closely related to genetics, endocrine, nutrition, exercise, environment, and sleep. Children of different sexes and ages have different height standards, and a height that is 2 standard deviations (equivalent to the third percentile) below the normal average height of the same sex and age is often referred to as short stature. In short, a child’s annual height growth rate is considered abnormal if it is less than the following standards: less than 7 cm under 2 years old, less than 5 cm from 4.5 years old to puberty, and less than 6 cm during puberty.
Abnormal height growth, or short stature, is treatable, but must be timed.
Generally speaking, if the bone age of girls is more than 15 years old, and if the bone age of boys is more than 17 years old, most of the children’s epiphyses will have closed by then, and the chance of growing taller is very small, and many children miss the best treatment period as a result.
The treatment of children with short stature depends on the cause of their condition.
There are many factors that lead to short stature, many of which interact with each other, and there are also many diseases that lead to short stature whose mechanisms are not yet clear. Common causes include familial or idiopathic short stature, delayed somatic puberty, malnutrition including rickets, slow systemic diseases, precocious puberty, pituitary abnormalities, growth hormone defects, and hypothyroidism.
With early detection of the cause and appropriate treatment, children can obtain better catch-up growth and can regain their normal height.
In order to diagnose correctly at an early stage, children with growth retardation must be examined accordingly.
I. Clinical observation.
The main thing is to follow up, measure and assess the child’s growth rate at regular intervals (every 3 months). Measurements need to be taken at the growth clinic using standard instruments and standard methods, and generally require that the measurement time and the person taking the measurements be relatively fixed, preferably at 10:00 a.m. The same person is responsible for each retest to ensure that the measurement values are accurate. In addition to the observation of height and weight, we should also measure the ratio of upper to lower sitting height.
B. Determination of bone age and prediction of adult height
Orthopantomographs of the left hand (including wrist, palm and finger bones) were taken to observe the growth and development of each ossification center to predict adult height. Bone age is the degree of bone maturity at each age. Bone development occurs throughout the growth process and is a good indicator of a child’s physical development. Under normal circumstances, the difference between the bone age and the actual age should be between ±1 year, and being too far behind or too far ahead is considered abnormal.
Third, laboratory tests: according to the specific situation of the child to do relevant tests.
Such as blood and urine routine, liver and kidney function, thyroid hormone test, blood ammonia and electrolyte analysis (for suspected renal tubular acidosis), karyotype analysis (for children with suspected chromosomal aberrations), GH-IGF-I axis function measurement, other endocrine hormone tests, etc.
IV. Imaging examination of hypothalamus and pituitary gland to exclude the possibility of congenital developmental abnormalities or tumors.
After the diagnosis is clear, different treatments should be taken according to different causes of morbidity. For example, hypothyroidism should be promptly supplemented with thyroxine; malnutrition including rickets, slow systemic diseases leading to imbalance in body development should be promptly treated; precocious puberty will make the epiphysis close prematurely and reduce the potential of human growth and development, endocrine regulation should be carried out early; pituitary abnormalities growth hormone defects, familial or idiopathic short stature are mostly accompanied by growth hormone deficiency or insufficiency, supplementation Growth hormone supplementation is the most ideal treatment method.
In addition, we should pay attention to the following in daily life.
First, balanced nutrition adequate and reasonable allocation of nutrients, can make the best use of growth potential.
The meat and vegetarian diet is reasonable. Protein is the basic substance of the human body, animal food such as eggs, meat, fish, dairy contains a complete range of essential amino acids, high nutritional value; beans, peanuts, vegetables and animal food with, can further improve the nutritional value of protein, and can complement each other’s strengths. Calcium and phosphorus are the main components of bones, milk, beans, shrimp, bone broth, etc. are rich in calcium; dairy, meat, beans and grains contain more phosphorus. Trace elements are necessary for the physiological functions of the body, such as iron, zinc, copper, iodine selenium, etc.. Such foods are: animal liver, meat, fish, clams, mussels, oysters, kelp, nori, cereals and beans. Food should be consumed in appropriate amounts and in a balanced manner to avoid partial diet.
Second, sufficient sleep
Sleep time should be guaranteed for 8-10 hours. Growth hormone is secreted 45-90 minutes after falling asleep at night (deep sleep), so sufficient sleep helps height growth and high growth rate during puberty.
Third, sunshine
Sunlight helps children’s growth and development. Therefore, children should be given more time for outdoor activities to promote their growth and development, and May to June is the “golden time” for children to grow taller. Especially in May, children grow the fastest, reaching an average of 7.3 mm.
Fourth, appropriate exercise
Early and vigorous exercise can also affect the growth of children. Because too much physical exertion will affect the supply of nutrients to bones and muscles, and also inhibit the secretion of growth hormone. Exercises that are good for growth include relaxing, free stretching and open programs, such as swimming, dancing, badminton, table tennis, bar, etc. Exercises that are not conducive to growth include weight-bearing, contraction and compression exercises, such as weightlifting, dumbbell lifting, rucking, wrestling, long-distance running, etc.
In conclusion, the growth and development of children is a regular, continuous and stage-by-stage process. The first rapid growth period from birth to 3 years old, the younger the age the faster the growth, such as the first year can grow about 25 cm tall, the second year can grow about 10 cm tall; 3 years old to before puberty is a stable growth period, the period plays an important role in the final height of the person, about 5 to 7 cm growth per year; puberty growth rate and accelerated, the second growth peak, about 8 to 10 cm taller each year.
But human growth is time-limited, generally after puberty once the epiphysis closes, height will stop growing, the height of the body is basically fixed, any method can not make it grow taller again. Early diagnosis and treatment are decisive for the final height of children with dwarfism, and the earlier the effect, the better the treatment.