Height measurement has always been an important item in children’s health checkups – normal height is one of the most important indicators to evaluate whether a child is growing up healthy or not. With the development of domestic economy and the increase of parents’ health knowledge, more and more parents bring their children to pediatric endocrinology clinics to consult about their children’s future height. Some children have been short since childhood, while others have a sudden acceleration in height growth during childhood and are significantly taller than children of the same age and gender. Without intervention, it is easy to understand that the former type of child ends up with a significantly shorter than normal height; however, the latter type of child sometimes ends up with a significantly impaired height, so why? What are some of the secrets here? What are the factors that determine height? Height is the length of the human head, spine and lower limbs. Although height is an important indicator to evaluate the healthy growth of a child, it does not mean that the height of the body and the presence of disease can be equated, because there are many factors that determine height, and disease is only one of them. Factor 1 – Heredity: The track of a child’s growth and development and its characteristics, potential, and even susceptibility to disease, nutritional needs and utilization, etc., are all determined by the genetic material of the parents. Height is naturally in the hands of genetics as well. Numerous scientific studies have also found that about 80% to 90% of human height is determined by genetics, so there is a close link between the height of the parents and the eventual adult height of the child. There are many formulas to predict the height of the next generation from the parents’ height, and here is a simple and commonly used method: target height = average parental height +6.5cm (for boys) or -6.5cm (for girls). It is worth noting that the results calculated by this formula have an error of about ±10cm or so. Although genetics has a profound influence on a child’s height, it only determines the potential for growth and development. And whether this potential can be fully realized is subject to various factors as follows Factor 2 – Nutrition: From the fertilized egg at the beginning of life, until after birth, the growth and development of the child requires adequate nutrition supply. When the supply of required nutrients is adequate and in proper proportion, the growth potential of the child can be maximized. Intrauterine malnutrition during fetal life and severe malnutrition within 2 years after birth not only hinders the growth of height and weight of the child, but also makes other systems of the body dysfunctional. This is like having the latest Core i7 computer with an old DOS system, which not only does not bring out the powerful processing power of the processor, but also causes incompatibility between the system and the hardware, which affects its use. Many tracked studies have determined that intrauterine malnourished fetuses are born with lagging physical growth, but about 90 percent can gradually recover to the normal range within four years of birth. In addition these children generally develop sexually at an earlier age and have a higher rate of obesity and diabetes in adulthood than those with normal birth weight. Therefore nutritional supply is crucial for normal growth and development. Factor 3 – Mother’s condition: 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, bad habits and so on. If the mother is exposed to radiation, viral infection, certain teratogenic drugs, toxins, and major trauma in the early stages of pregnancy, it can cause delay in the development of the fetus in utero, which further affects the growth of the child after birth. Factor 4 – Disease impact: Generally speaking, acute diseases do not have a significant impact on a child’s height, while chronic diseases can seriously affect a child’s height, such as congenital heart disease, chronic kidney disease, etc. Since the growth of bones needs to be regulated by various endocrine hormones and genetic influence, certain endocrine diseases, chromosomal diseases and genetic diseases can seriously affect children’s height, such as growth hormone deficiency, hypothyroidism, congenital ovarian dysplasia, congenital chondrodysplasia, etc. can make the affected children short in stature, while increased growth hormone and Mafang syndrome can cause taller stature. Precocious puberty as it can make the development of bones significantly earlier than the actual age, thus making the skeletal growth period shorter, although the child’s height is even once higher, but the final height may be significantly shorter than normal. Factor 6 – Living Environment: Good living environment and habits are important factors to promote children’s growth and development to reach a good state, such as sufficient sunlight, fresh air, reasonable physical exercise and play, easy learning, perfect health care services, etc.; on the contrary, the reduction of activities, poor family relationships, psychological stress and Conversely, reduced activity, poor family relationships, psychological stress and trauma can all hinder a child’s height growth. There is another factor worth noting that does not affect a child’s true height, but can sometimes cause problems for our fellow parents. This is the method of height measurement. For example, there can be a measurement gap of 1 to 2 cm between height (length) measured in the standing and supine positions; between morning measurement and evening measurement of standing height. Therefore, all children under 3 years of age should be measured in the supine position, and secondly, it is best to fix a time period for height measurement to help reduce the error caused by different measurement methods. What is a “scamper”? When a doctor evaluates a child’s height, he or she should not only look at whether the absolute value of height is normal, but also how fast the child’s growth rate is increasing. There are two growth spurts throughout a child’s life: the first is within one year of birth, when the average length increases by 25 cm; thereafter, the growth rate gradually decreases to about 10 cm in the second year, and about 5-7 cm per year from the age of 2 until puberty. -After the growth peak, the general height has reached 83%-89% of the final height, after that the growth rate of both sexes slowed down, before reaching the lifetime height, girls can also increase 15-20cm, boys about 20-25cm or so. After the first menstruation of girls, boys ejaculation or after the change of voice height growth is generally about 5cm, rarely more than 7cm, so the general “scampering child” refers to the rapid increase in height during puberty. Of course, there is another type of “flipping”. If the child is sick so that the growth trajectory deviates from the original track, when the disease is cured or the factors affecting height growth is lifted, the growth rate is accelerated within a certain period of time, making the height gradually return to the track before the disease, this phenomenon is also called catch-up growth. The most obvious is that premature babies or children with low birth weight (length) can catch up after birth, and most premature babies can catch up to the growth of normal full-term babies around 40 months of age. If at 4 years of age, a premature child’s height is still not in the normal range, then a careful evaluation by a professional doctor is needed to identify the cause and further intervention. Is it good to have a premature baby? The most common reason for this is precocious puberty, which means that the child may be developing earlier or more rapidly than the average person. The most common reason for this is precocious puberty, where the skeletal development of the child is significantly earlier than the age of the child, making the growth period shorter, so that some children end up being significantly shorter than their genetic height. In this case, it is necessary to take the child to a medical professional as soon as possible for an examination and assessment of whether the child’s development is normal? If so, what are the causes? Careful examination and follow-up by a clinician will be needed to determine if intervention is needed. Moreover, scampering is not a sign of the beginning of puberty, but a sign of mid-development, and even if intervention is made for height, the best time for treatment is usually missed. What should I pay attention to in my life? 1. Regular physical examination and record. After the age of 2, if the growth rate is consistently less than 5cm/year or suddenly greater than 7cm/year, it is time to pay attention. 2. Understand the development of the child’s secondary sexual characteristics. The development of secondary sexual characteristics is preceded by the scurrying of puberty. Under normal circumstances, girls can first appear breast enlargement after the age of 8, and boys can first appear testicular enlargement after the age of 9. If the order of appearance is not correct, or the time is early, extra attention is also needed. 3, balanced nutrition, reasonable exercise. Due to economic development, it is rare to see children’s growth and development affected by simple malnutrition. But too much nutritional intake and too little outdoor exercise is obviously also not conducive to child growth. Exercise is an important stimulus for bone growth, and sunlight exposure facilitates vitamin D synthesis in the body and promotes bone health. Obesity is not only a burden for bone growth, but in girls, the heavier they are, the earlier the age of puberty; for boys, it delays puberty. Although calcium is the main element of the composition of the bones, but in general do not need additional calcium tablets. 4, create a good living environment. Because the central nervous system and hormone secretion have a close relationship, too short sleep (children should ensure more than 9 hours per night) and bad psychological stimulation can lead to a reduction in growth hormone secretion, thus leading to the occurrence of short stature, avoid bad lifestyle and excessive mental stress.