I. The child has been short for many years, and we have been waiting patiently for the child to “grow late”, but only when the height gap between the child and others is getting bigger, we are anxious to see.
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, it is medically called dwarfism. Generally speaking, “late growth” and “twenty-three scurrying” refer to delayed puberty development, which is a kind of idiopathic dwarfism and is one of the many causes of dwarfism. It is a retrospective diagnosis, which means that such children need to undergo specialist examination, several years of continuous height monitoring and follow-up before a judgment can be made. In life, we find that children with short stature are generally shorter than their peers at the age of 2-3 years, and it becomes more and more obvious as they grow older, and they are significantly shorter than their peers by more than half a head after the age of 4-5 years, or their height is shorter than their actual age by more than one year. If the child goes to a specialist at this time for consultation and treatment, because the child’s skeletal age is young, the growth potential of the epiphyseal cartilage plate is very large, and the room for height improvement is also very large. However, as age and bone age increase, the effect of treatment gradually decreases, and the cost of treatment doubles as the weight increases. Therefore, it can be said that the “golden period” for treatment of dwarfism is from 4-5 years old to before puberty, and the younger the age, the better the effect and the lower the cost. Here, Dr. Wang again reminds parents that once they find that their children are short or have growth retardation (annual height growth less than 5cm), they should take their children to a specialist clinic in time to have their height accurately measured to calculate whether they are short, to have an X-ray bone age assessment and other specialist examinations to clarify the cause, and to have regular follow-ups and tests to intervene and treat them early according to the cause. The following are the causes of short stature If you believe in “late growth”, you may miss the best time for treatment and bring great physical and mental pain to your child.
Two, usually do not pay much attention to the child’s height and puberty development, until after the boy changed his voice or after the girl’s first menstruation for a few years does not increase in height before coming to the clinic for consultation.
The epiphysis of these children has basically healed or completely healed after the bone age assessment, which means that the height growth of these children is close to the end and the opportunity to treat and promote the growth of height is lost. We should know that with the development of puberty, the child’s head will grow rapidly, usually for 2-3 years, the first year will be 6-8cm, the second year will be 8-12cm, the third year 6-8cm, but for the whole puberty, the total height growth is basically fixed, the total height growth for boys is 27-30cm, the total height growth for girls is 22-25cm, once the girl menstruation Obviously, we find that a child’s base height before puberty determines his or her lifetime height. This also says that if a girl is less than 135 cm before breast development and a boy is less than 140 cm before testicular enlargement (4 ml), they are likely to end up less than 160 cm (female) or 170 cm (male) tall. Therefore, children with premature development of secondary sexual characteristics (usually breast development before the age of 8 for girls, testicular enlargement before the age of 9 for boys or the first menstruation before the age of 10 for girls is called precocious puberty) and short height when secondary sexual characteristics first appear need to be examined, monitored and, if necessary, intervened and treated as early as possible in order to achieve the desired height. Another type of children with delayed puberty (generally girls develop at the age of 9-10 and boys at the age of 11-13) also need to be further examined.
Third, every year lead the child to check the trace elements and bone density, to see if nutrition is enough, the results are not lack of anything no longer care, or long-term calcium supplements, protein powder and other supplements.
The most important thing is that “short stature” is not caused by the obvious “picky eating” and nutritional deficiencies, but only in patients with serious chronic diseases, which require effective treatment to remove the original disease. The most critical point is that the examination of “dwarfism” is not a routine health examination or growth test, but a series of standardized consultations, physical examinations and special examinations by endocrinologists, pediatricians or specialists with professional knowledge and ability are required to further clarify the cause of the disease. For example, in the consultation of dwarfism, we need to understand the mother’s pregnancy, birth, growth and development history, family history, disease history, etc.; in the physical examination of the child, we will focus on the physical proportion, upper and lower volume, development of secondary sexual characteristics, presence of special signs, intellectual development, etc.; special examinations include bone age assessment, ultrasound, thyroid function measurement, growth hormone stimulation test, and even chromosomal examination and MRI. Special tests include bone age assessment, ultrasound, thyroid function test, growth hormone stimulation test, chromosome test, MRI, etc. These are some very standardized and professional tests. We remind our parents that it is not terrible to be short, but it is crucial to see the right department early, get regular treatment early and receive regular follow-up and monitoring, so that we can definitely keep away from short and promote the growth of height.