How do I know if my child is short? Every time a child has a physical examination from birth, a height measurement is an essential item. This is then assessed against the appropriate age and gender criteria. If the child’s height is lower than the average height of children of the same age and gender minus two standard deviations or shorter than the 3rd percentile, then the doctor or health care provider will inform the parents that the child is short and may need to be evaluated. In addition to height, you should also look at the child’s growth rate. Sometimes the height is still within the normal range, but the growth rate has decreased significantly, and this is not a time to take it lightly. Under normal circumstances, a child’s growth rate is the fastest in the first two years after birth (an average of 25cm in the first year and 10cm in the second year), after which it begins to gradually decline, but should not be less than 5cm per year. After entering puberty, the growth rate begins to accelerate again, but lasts for a shorter period of time, after which the height growth gradually slows down until it stops. If the growth rate of the child is found to start decreasing too much during the physical examination (for example, the percentile level of height decreases more than 2 major percentile lines) that is also not normal. Is there something wrong with a child who is short? There are so many children who are normal in every way except for being short, so just some of these short children may have a problem, which requires careful identification by the doctor. Usually, when short, or if there are multiple organ abnormalities, there is a more specific body shape or physical appearance. Why are you short? (These are the main reasons) 1. Genetics The growth and developmental trajectory of a child and its characteristics and potential can be determined by the genetics of the parents. Previous scientific studies have determined that about 80% of a person’s final height is determined by heredity, so the parents’ height is closely related to the child’s final adult height, but it only determines the child’s potential for growth and development. Whether this potential is fully realized depends on acquired factors. In addition, there are some single gene genetic disorders, sometimes the parents are only carriers, and their height can be normal, but the child may appear very short. 2. Diet and nutrition From the beginning of life, when the fertilized egg is born, until after birth, the growth and development of the child requires adequate nutrition supply. When the required nutrients are supplied in adequate and appropriate proportions, the growth potential of the child can be maximized. Malnutrition in utero during the fetal period and within 2 years after birth not only hinders the growth of height and weight of the child, but also causes dysfunction of other systems of the body. The growth and development of the fetus in the womb is not only related to nutrition, but also closely related to the mother’s living environment, nutrition, emotions, diseases, and bad habits. If the mother in early pregnancy by radiation, viral infections, certain teratogenic drugs, toxins, major trauma, can cause intrauterine fetal development delay, which further affects the growth of the child after birth. 3, the impact of disease Generally speaking, chronic diseases can seriously affect the height of children, such as congenital heart disease, chronic kidney disease, etc.; because the growth of bones need to be regulated by a variety of endocrine hormones and genetic influence, so some endocrine diseases, chromosomal diseases and genetic diseases can seriously affect the height of children; precocious puberty because it can make the development of bones significantly earlier than the actual age, so that the growth period of bones become shorter Although the child’s height is even once higher, the final height may be significantly shorter than normal. 4, living environment Good living environment and habits are important factors to promote the growth and development of children to reach a good state. The reduction of activities, too short sleep as well as too late, bad family relationship, psychological stress and trauma can hinder the height growth of children. What tests are needed for a child with short stature? 1.Hematological examination: It can help to understand the child’s important organs and nutrition. 2.Imaging examination: Bone age can help doctors understand the child’s bone development and help to make treatment plan, and the comparison of multiple bone age films at different times can also determine the child’s growth potential and treatment effect. 3.Hereditary examination: For some specific children, chromosomal or even genetic testing is needed to determine if the disease is hereditary. Does a child with short stature need treatment? This depends on the degree of the child’s short stature and the cause of the short stature as well as the timing of the intervention. For children diagnosed with growth hormone deficiency, long-term injections of exogenous recombinant human growth hormone are particularly important. Not only can it significantly promote height growth, but it also helps to improve the disorders of sugar and lipid metabolism in the body and protect the heart function. In addition, for short stature caused by other diseases, depending on the situation, treatment with recombinant human growth hormone is sometimes possible, but more careful monitoring and evaluation is needed. For children who have reached puberty and are too old for their bones, and for children who are normal in all other aspects of testing (especially annual growth rate), treatment with recombinant human growth hormone is generally not recommended. In addition, for children with dwarfism, the timing of intervention is particularly important, and the general principle is that it is better to intervene early rather than late, as much as possible before puberty. For children who are significantly thinner at birth, evaluation and treatment can be done after the age of 4 years. And already in the United States, pediatric endocrinologists recommend bringing this age forward to 2 weeks of age.