I. Is my child’s height normal? –Assessment of height
Second, is my child growing slowly? –Evaluate the growth rate.
3. Is it always good for my child to grow fast? –Evaluate the developmental age.
How to detect abnormalities in the growth process of children early? –How to monitor the growth of children.
V. What are the factors related to height? — Factors affecting height.
How to change the environmental factors to increase the height of children? — Measures for children to grow taller
1.Adequate nutrition.
2.Physical activity
3.Adequate sleep
4.Prevent and control acute and chronic diseases.
Seven, the 4 misconceptions of children’s height — early growth, late growth, and
Eight, how to correctly measure height? –the basis of everything
Nine, how can we know whether the child can still grow? –Bone age and height
How does the body regulate and control height growth? –Growth hormone is the only hormone that promotes linear growth of bones
XI. What is dwarfism (short stature)
XII. What are the causes of dwarfism?
XIII. Growth hormone deficiency
XIV. Precocious puberty
XV. Idiopathic dwarfism
I. Is my child’s height normal? –Evaluation of height
A person’s height is 175cm, is it high or short? For today’s Chinese Han Chinese men 175cm is a medium size, for women it is quite tall. For developed countries in Europe and America, 175cm may be on the short side, and for a tribe called Pygmy in South Africa 175cm is a giant. Therefore, to evaluate whether a person’s height as well as weight, head circumference, chest circumference, etc. are normal, a standard reference population needs to be selected, i.e., a normal population of the same race, sex and age in a similar living environment for comparison. The commonly used evaluation methods are the standard deviation method and the percentile method.
The image is expressed as a growth curve. By marking your height at the intersection of the growth curve corresponding to your age height, you can see whether you are tall or short. For example, Ming is a 10-year-old boy with a height of 140 cm, marked on the growth curve (percentile method) can be seen exactly at the 50th percentile, which means that this boy’s height is moderate, not too tall and not too short. If it is the standard deviation method, it is exactly 0SD.
Second, is my child growing slowly? –Evaluate growth rate.
Besides looking at whether the child is currently tall or short, parents are actually more concerned about whether their child will grow taller in the future. This requires the evaluation of growth rate to evaluate how fast your child grows. Growth rate is the value of the growth of the body and its parts per unit of time. For height the growth rate can be expressed by the annual height growth value, i.e. cm/year. For example, if Ming is 134 cm at age 9 and 140 cm at age 10, the growth rate is 6 cm/year. It is in line with the pattern of children in this age group.
Third, is it always good for children to grow fast? — Evaluate the age of development.
In fact, when parents are happy that their children are growing fast and taller than other children, they need to be alert to one thing, which is precocious sexual maturity. If the developmental age (the level of certain developmental indicators made into a “standard age” to evaluate the development of individual children, is the developmental age) is greater than the actual age, you need to be alert to precocious puberty. Although children with precocious puberty grow earlier and taller than other children, they tend to be favored in adulthood, even to the extent of short stature. The so-called “early growth of children is not high” is the truth.
The commonly used method for evaluating developmental age is bone age (BA). The so-called bone age is the age of the skeleton, which refers to the maturity of the calcification of the skeletal development, usually expressed by the calcification of a certain part of the child’s bones (often the left wrist bone) as shown by X-ray (such as the time, order, number and size of the ossification centers), the development of the bone mass (such as the size of the bone mass, changes in shape, the emergence of joint surfaces, etc.) and the healing process of the epiphysis and the bone stem. If the bone age is greater than the actual age, it suggests little growth potential. It is mostly seen in early sexual development. The growth space and final height (FH) can also be inferred from the bone age.
Fourth, how to detect abnormalities in children’s growth process early? — How to monitor the growth of children.
Growth monitoring is a method of child health care in which certain growth indicators (weight, height, etc.) of individual children are measured regularly and continuously, and marked on a monitoring chart based on the standard values of a specific reference population, so that early detection of growth deviations can be compared and evaluated, and the causes can be further clarified and timely intervention can be made. It is the most important and fundamental part of child health care as proposed by UNICEF. The monitoring chart mentioned is the Child Growth Monitoring Chart, which is available on the market as “0~36 months baby growth monitoring chart”. Other children can draw their own growth monitoring charts with relevant growth curves.
A complete growth monitoring should include the following 3 steps.
(1) Determine the date of monitoring: usually 5 times in the first year after birth (once each at 1, 2, 3, 5 and 8 months), 4 times in the second year (once every 3 months) and 2 times in the third year (once every 6 months). The number of monitoring sessions can be increased when necessary (when the child develops or suspects a health problem).
(2) Weigh and measure accurately for weight and height.
(3) Plot growth curves. Pay attention to recording special events such as illness, dietary changes, and environmental changes.
The course of the growth curve reflects the trend of growth changes in the pediatric population.
A rise parallel to the normal reference curve is normal (when Xiao Ming is 2~5 years old), and a rise below the rising trend of the normal reference curve (when Xiao Ming is 5~7 years old) is abnormal and the cause needs to be found. The original Xiaoming in the two years of poor health, repeatedly sick, repeatedly hospitalized, do not like to eat, so the growth is slow. 7 pairs of good health later, no longer sick, adequate and balanced nutrition, there is a catch-up growth, growth curve back to the original growth track.
If the growth curve is flat or declining, it often suggests that there is a serious problem with growth and development, and the cause needs to be actively created and appropriate measures taken. Otherwise, if the time is too long, it is likely that the growth curve will not return to the original growth track, resulting in short height in adulthood.
V. What are the factors related to height? –Factors affecting height.
Factors that affect the growth and development of children, including height, include biological and environmental factors. These factors come into play from the time of fertilization of the egg. Genetics is the basis and environment is the condition, and the joint action of both determines the speed of children’s growth and development and the degree they finally reach.
1. Genetic factors
The genes of both parents determine the growth potential, development trend and limit of children, forming the difference between individuals. Different races, parents’ height, size and personality have a significant impact on children. Therefore, the likelihood that a child will grow taller if the parents grow taller is high. Genetic factors determine about 70% of a person’s height. not obvious within 5 years old, after 5 years old gradually show the characteristics of genetic.
2.Environmental factors
Environmental factors are also important, and are part of what we can change through our own efforts. If a person’s genetic target height is 175cm, environmental factors determine 30%, that is, 52cm, if this part of the height control, even if the change of ± 5%, that is 10cm change ah! 170cm and 180cm how big the difference is imaginable. So we must pay attention to environmental factors.
(1) Nutrition
Nutrition is the material basis to ensure the growth and development of children. The younger the age, the greater the impact. Malnutrition of pregnant mothers during the fetal period often causes intrauterine growth retardation and growth disorders, resulting in an increased incidence of low birth weight babies and premature babies. Long-term lack of energy, protein and various nutrients in infants not only affects growth and development, but also leads to a decrease in the body’s resistance to diseases. Therefore, we should pay attention to the nutrition of our children, which includes both adequate and comprehensive meals. Specifically, we should pay attention to nutrition during pregnancy, breastfeed as much as possible, add complementary foods at the right time (around 6 months), and do not lack trace elements and vitamins (iron, zinc, calcium, iodine, vitamin A, B group, D, etc.). Do not eat foreign fast food, eat less snacks, avoid picky and anorexic food. You can consult the feeding method and evaluate the dietary structure at the child health department of the hospital.
(2) Diseases
Various acute and chronic diseases have a direct impact on the growth and development of children. Diseases can lead to and energy metabolism and organ dysfunction, which can lead to growth retardation. Vitamin D deficiency rickets (commonly known as “calcium deficiency”, which is inaccurate), hypothyroidism, and chondrodysplasia can directly hinder bone growth. Endocrine disorders such as growth hormone deficiency, hypothyroidism, and precocious puberty can affect growth abnormalities and lead to short stature. Early treatment of these diseases is necessary to promote the growth of children well.
(3) Physical and chemical factors
Drugs, X-ray exposure, environmental toxic pollution, and smoking and alcohol addiction can all adversely affect the growth and development of the fetus and child. An obvious example is the long-term application of glucocorticoids in children with nephrotic syndrome (although there are many kinds of hormones in the human body, what we usually call “hormones” mainly refers to glucocorticoids), which can cause significant short stature and even height stagnation. Children with lead poisoning will also suffer from growth retardation.
(4) Social factors
A favorable social environment can provide a good environment for children to grow and develop. Regions and countries with better socio-economic, health care, cultural and educational aspects have higher levels of child growth and development. Children in urban areas are higher than children in rural areas, and children in economically developed areas are higher than children in poor areas. In addition, the family is the smallest social unit to which children are exposed. The emotional ties of family members, parents’ occupation, education level, family income and childcare conditions can play a crucial role in children’s physical and mental development and character formation.
(5) Other factors
Daylight, fresh air, clean water, physical exercise, reasonable living system, good hygiene habits and upbringing, and cheerful character can all have an impact on children’s growth and development level.
VI. How to change the environmental factors to increase the height of children? — Measures for children to grow taller
1.Adequate nutrition.
2.Physical activity
3.Adequate sleep
4.Prevent and control acute and chronic diseases.
Diet.
Many parents of dwarf children often think that their children are short because they usually eat too little or are too picky about their food. In fact, nowadays, children who are short because of insufficient nutrition almost do not exist anymore. Instead, over-nutrition is common. Over-nutrition is one of the main reasons why the incidence of precocious puberty is increasing year by year. Children who are short in stature need less than other children because of their slow growth, and most do not eat much. From time to time, we also find that children who were eating smaller amounts of food grow significantly if they develop puberty, for this reason.
Whether it is dwarf or precocious children, it is better to have a balanced diet, that is, a reasonable mix of meat and vegetarian dishes, and a balanced intake of coarse and fine grains.
Overall, over-nutrition is more common in domestic children at present. Many parents, especially the elderly, because they did not eat well in the past, now do everything possible to make their children eat more and better, always worried about the lack of nutrition in the formative years, and even try to supplement all kinds of health products, trace elements or vitamins, this idea is obviously wrong. Those who have been to Japan may know that Japanese adults often have only six or seven sushi for Chinese food, and Chinese students often do not have enough to eat when they first go there. However, the Japanese do not suffer from malnutrition, but rather their average height is already higher than that of the Chinese, and the proportion of obesity is significantly lower than in other developed countries. Thus, the total amount of food, the amount of non-vegetarian dishes and unhealthy foods need to be appropriately limited.
However, it is also not good for some parents to restrict their children’s diet excessively after discovering precocious puberty. Since they are growing children, basic nutrients still need to be ensured. It is recommended to be able to stick to 1~2 bags of milk and 1 egg per day (regardless of the cooking method used, and regardless of whether it is consumed alone or by adding it to the dish or soup, as long as it is cooked), other meat dishes need to be appropriately limited. Although milk and eggs are not guaranteed to be safe, too much restriction is certainly not beneficial.
For some of the fatter children, it is better to eat some fruit or have some soup or the like before eating and slow down the pace of eating. Although this is not a very reasonable way to eat. Because, our feeling of stomach fullness and hunger is not felt by the empty or full stomach, but by the high or low blood sugar. When the blood sugar is low, the stomach feels empty. If you eat too fast, although you have reached the normal serving size, but because blood sugar has not yet come to rise sharply to the normal level, you will also feel that you have not eaten enough, you will eat more.
Due to various advertising campaigns and other reasons, there are also often parents who believe that their children will be deficient in zinc, calcium and so on. In fact, except for the need for proper vitamin D supplementation during infancy to prevent calcium deficiency, a normal diet will not cause micronutrient deficiency. Moreover, since it is a micronutrient, more is not always better! Too much can cause other harm. I often give parents the analogy: “An egg, without any external factors, can hatch chicks, but if the nutrients needed for life are less, the chicks will not hatch”. Other foods are also composed of cells and have various nutrients, but the content and ratio of various nutrients vary from food to food. Please remember: medicine is better than food! Humans cannot synthesize their own proteins, and no health food is comparable to natural food!
For the prevention of precocious puberty, there are some foods that you should try to eat less of, such as too much animal foods, fresh borrows Α alcohol distress visit (14) diluted (13) poppy frightened to take S around the boil strong shirt throwing high ×can slow caries shirt throwing zine catching fine jerking off ÌÌ put blinked milk milk = ∑ punishment “ú ash calling door 3 Biao palm take
Excessive application of cosmetics is also not good, and the mother’s excessive use of cosmetics to kiss the child is also not good.
Sleep.
As growth hormone is the most important hormone for human growth, the secretion of growth hormone is mainly secreted during deep sleep. Therefore, it is also important to ensure a more adequate sleep. School-age children generally need 8 to 9 hours of sleep a day. It is better to go to sleep earlier, but it is not necessary to emphasize the early or late sleep, as some people understand that growth hormone is only secreted at what time of the day, but only in relation to the depth and total time of sleep. Modern people fall asleep later than in the past, but not so much shorter, but because of improved nutrition, timely and effective control of diseases, etc. improved.
Exercise.
Since exercise is also a way to promote the secretion of growth hormone, proper exercise is beneficial for growing taller, regardless of treatment. Exercises that are beneficial to growth are aerobic exercises.
Aerobic exercise is defined as.
① moderate intensity (exercise intensity is too large, too small are not good, just stop when the heartbeat in 120 ~ 150 times / min more appropriate), the
② regular, continuous exercise.
③ at least 20 minutes each time (for those who need to lose weight, it is best to reach half an hour each time).
④ try to be outdoors (everything grows by the sun, so does human growth. The reason why people in the north are taller than the south, there are climatic factors, but also the sunshine time factor. The more northern, the less rain over the years, the longer the total time of sunshine).
The way of exercise to jogging, slow jump rope, etc. is good. Ball sports, swimming, etc. can also be, only need to pay attention to maintain the continuity of the movement, the ball is not in hand when you also need to pay attention to run. Too strenuous exercise will cause hypoxia, is anaerobic exercise, but not conducive to growth. There is also a disadvantage to exercise for too long a continuous period of time.
Other aspects.
Children aged 2 to 14 years generally need to be dewormed twice a year for intestinal parasites. It is not necessary to detect the presence of eggs before deworming is required, as long as it is done when they are not sick. Usually, if you are sick, try to go to a regular hospital in time. Some medications such as adrenocorticosteroids and quinolone antibacterials have height inhibiting effects.
Conclusion.
Although proper diet, sleep and exercise are beneficial to growth, do not be too superstitious about these aspects without treating related diseases. If you are found to have a disease related to short stature or precocious growth, treatment is a must. Our adult height prediction includes having a normal diet, sleep, and exercise, and is based on the premise that no serious diseases are born, and we should not refrain from treating related diseases because of strengthening exercise, etc.!
Seven, the child’s height of 4 myths
Myth 1: Children grow early and late are the same
The “early growth” of the child, is likely to be over-nourished, early development, precocious sexual maturity caused. These early adolescent children, compared with children of the same age and gender, growth rate and height increased significantly, but the bone age determines the child’s height potential, bone development too fast, bone age than the actual age, will make the epiphysis close early, the possibility of future growth of children and space will be reduced, easy to cause children to slow growth or stop growing early.
Normal puberty is the peak of a child’s growth, about 10 to 14 years old for girls and between 12 and 16 years old for boys. If a child’s growth is slowed or stopped early, he or she will miss the growth spurt and will not reach the expected height as an adult. A large number of facts show that there is now an excess of nutrition and early development. The phenomenon of early sexual maturity and early arrival of puberty in children is increasing year by year. In this regard, parents should let their children maintain a balanced nutrition, not because of excess nutrition, premature development, and make a big loss of height.
The reason for children’s “late growth” is not always late growth and development, many are caused by disease, if not treated in a timely manner, can not be healthy growth and development. If you find that your child is growing slowly and short, you need to rule out possible disease factors first. Such as endocrine diseases, chronic diseases (hepatitis, asthma, kidney or liver diseases, etc.), genetic metabolic diseases, chromosomal abnormalities, intracranial tumors, trauma, side effects of drugs (such as Ritalin), etc. All of them can affect the height growth of children. Whether a child is growing late or not requires a doctor’s examination and diagnosis. When the child’s annual growth rate is lower than 4 cm/year, parents should promptly take the child to a regular hospital for examination and treatment.
Myth 2: Long-term consumption of health care products can make children grow healthily
In recent years, there have been many disclosures in the media about the various hazards of health supplements for children. However, many parents still let their children take health care products for a long time. The approximate reason is that the media reports are thought to be an isolated phenomenon, not enough to believe; “quite authoritative propaganda ads are saying that these health care products are good for the healthy growth of children, my children certainly want to eat”; “children love to eat, people’s children are eating, my children can not not eat “…… As parents climb the love for their children, such a variety of reasons to blindly fall into the misunderstanding of nutritional supplements. However, a large number of research studies have confirmed that long-term eating nutritional supplements are harmful to the healthy growth and development of children.
The additives in health products “three essence” (saccharin, flavor, food coloring), even if it is in line with national standards, but the excess of food, will cause a lot of side effects; health food ingredients and functions of many parents difficult to distinguish, choose to eat improperly will cause gastrointestinal discomfort and other symptoms, affecting children’s health; a variety of nutritional supplements for children The caloric energy, protein, vitamins and various minerals required for growth and development are limited in content, and very little is really beneficial to the body, which can easily cause malnutrition, body fat and various diseases in children. For example, B vitamin deficiency will prevent the normal development of the nervous system, chromium deficiency will affect vision, leading to myopia. Children who take nutritional supplements for a long period of time are prone to partial eating. About 30% of food allergies in children are caused by partial eating.
Parents use calcium milk, fruit milk and other health products instead of milk, juice drinks instead of fruit, thinking they are giving children increased nutrition, but in fact they can not replace the rich nutrition in milk and fruit; sweet drinks to quench children’s thirst, drink before meals with a sense of satiety, so that children’s appetite for meals is greatly reduced. Such practices are difficult to ensure that the child’s growth and development needs. Nutritional supplements that appeal to children rely heavily on sweetness and additives. Sweetness is a human instinctive favorite, other taste sensations are formed later in life. Some parents give their children a lot of chocolate, desserts and cold drinks and other favorite things, if so grown up in sweet products, the child’s sense of taste will be stunted, it is difficult to feel the light taste of natural food, and even affect brain development. Parents often give their children glucocorticoid hormones or kidney and qi, enhance immunity and other aspects of nutritional supplements containing Chinese medicine, which may lead to premature maturity, and affect the height of the child.
Myth 3: Parents are tall, children’s height is not a concern
A child’s height is not entirely determined by the height of his or her parents. Scientific research has confirmed that genetics accounts for one-third of the factors that determine height, and acquired conditions account for two-thirds. Although, genetics determines the growth potential of a child’s height or short, the child’s height is largely influenced by the genes of the parents. However, various acquired factors (such as nutrition, disease, exercise, living environment, etc.) determine whether the growth potential can be fully realized. Parents who do not seize the opportunity to prevent and eliminate the factors that adversely affect their child’s height later in life, so that the potential can be fully realized, even if the parents are high, the child will have difficulty growing to their genetic target height. Therefore, parents should correct misconceptions about their children’s height and should understand and pay attention to the laws of height change during the development of their children. Generally speaking, in the first year of life, a child’s height grows about 25 cm; in the second year, it grows about 10-12 cm; after two years of age until puberty, it grows about 5-8 cm per year; puberty is a growth peak for children, and the annual growth of height can reach 8-10 cm for boys and about 7-9 cm for girls; after that, the growth of children’s height will gradually slow down. Parents who suspect or find that their children’s height growth is not quite normal, go to the hospital to find the relevant experts to see, in time to eliminate some adverse factors affecting the growth of children’s height.
Myth 4: Children grow up, we need to eat more chicken, duck and fish
Many parents think that to strengthen the nutrition of children to grow, we must eat more chicken, duck and fish, can not eat or eat less grain and other foods. Therefore, they often in the three meals a day can not do a variety of meals, coarse and fine, meat and vegetables, but find ways to let children eat more chicken, duck, fish and other high-protein food. In fact. The energy needed by the body is mainly obtained from carbohydrates, while protein will only be fully utilized by the body if it has sufficient energy. According to the survey, in our living standards continue to improve today, children, especially in the city is not a lot of protein intake, and micronutrients are often insufficient intake due to partial diet, such as zinc, iron, calcium and other trace elements, carbohydrates, various vitamins and dietary fiber. If chicken, duck, fish and meat are the staple food for children, excessive protein intake will not only increase the burden on the liver and kidneys, but also make children suffer from indigestion, constipation, loss of appetite and paranoia. Some children become obese after over-nutrition, which can easily trigger precocious puberty and eventually make short stature. So. Parents should train their children to develop good eating habits from childhood, pay attention to the reasonable mix and diversity of children’s diet, so that children are not picky, not partial food, and do not eat too much snacking and affect the intake of important nutrients.
Eight, how to measure height correctly? -The foundation of everything
Height must be measured accurately, otherwise it cannot be reliably evaluated, especially the growth rate of children in the interval between measurements cannot be correctly calculated.
How to measure height in a standard way? Many people think that measuring height is easy, just use a ruler to measure it, but in fact height measurement is very delicate and has certain requirements for measuring tools. Measure the length of the body (lying length) and the top – hip length can use a standard measuring bed, portable measuring board. Measure the height or sitting height can use height meter or fixed wall ruler or soft ruler. The soft ruler should be made of cloth with lacquer, and should not be made of pure plastic with large stretch.
The measurement of height differs between children under 3 years of age and those over 3. Children under 3 years of age are measured in the prone position due to the difficulty of standing up. A standard measuring bed or a portable measuring board is used. The child removes shoes, socks, and cap, wearing only a single pair of pants, and lies on his or her back on the midline of the measurement bed floor. An assistant holds the child’s head so that it touches the headboard, with the child’s face up and both ears on a horizontal line. The measurer is positioned on the right side of the child, holding both knees in the left hand, is both legs together close to the measuring bed, and the right hand moves the foot plate so that it touches the heels on both sides. When using a bed with scales on both sides, attention should be paid to the consistency of the readings on both sides. If you use a bed without a scaffold or a portable measuring board, you should pay attention to the bottom edge of the footboard and the measuring tape in close contact, so that the footboard is perpendicular to the latter. Read the numbers shown at the footboard.
When measuring the height of children and adolescents over 3 years old, use a vertical height meter or a standing ruler fixed to the wall. Before measurement, remove shoes, socks and hat, wear only an undershirt and shorts, make the child’s back against the height meter column or wall, heel, hips and shoulders in contact with the column or wall, take an upright position, eyes forward, chest slightly raised, abdomen slightly retracted, arms naturally hanging down, fingers together, heels close together. The angular tips are separated by about 60 degrees, and several points between the heels, hips and shoulder blades touch the column at the same time. The measurer’s hand holds the measuring board so that it moves gently downward, taking care to measure with the eyes, to be at a level with the board. Let the bottom of the board read when it touches the cranial vertex exactly.
Some parents ask why the height measurement at night is shorter than that in the morning. That is because the height change during the day is the highest in the morning and the lowest in the evening, usually a difference of 1 to 2 cm, due to the day’s activities and the pressure of weight, which makes the intervertebral discs thinner, the arches shallower, and the spinal curvature increased.
In addition to measuring height, sometimes it is necessary to measure finger distance, sitting height, upper volume and lower volume. The measurement methods are as follows.
Finger spacing, i.e., the distance between the arms, is the distance from fingertip to fingertip when the patient is standing with both hands straight. The distance between the arms should be measured when diagnosing congenital testicular hypoplasia, short limb dwarfism, or other abnormalities in appearance. The upper-lower ratio is the length from the pubic symphysis to the sole of the foot as the lower length, and the entire height minus the lower length as the upper length; this ratio varies with age. In hypogonadism, the upper to lower ratio decreases, while in hypothyroidism the ratio increases significantly.