He is a 14-year-old boy who is studying in a key middle school, with top grades, smart and understanding, and is a child who is a relief to his parents. His father is 1 meter 72 and his mother is 1 meter 63, so he should be at least 1 meter 6 by now!
In fact, when he was in kindergarten, everyone noticed that he was growing slower than the other kids, and he sat in the first row in elementary and junior high school. Winter parents also once wanted to take him to the hospital to check, but the family’s elderly people said that children do not grow now, to the development of the natural growth. “Twenty-three, but also scamper a scamper it!” And so it was delayed.
Last week, through an acquaintance, Dongdong’s parents brought their child to me at Dongfang Hospital, No. 96 Chemical Road, Yiwu. I found that the child’s development was delayed in all aspects of the examination, and took a bone age of only 11 years old. Through a series of blood tests, it was finally found that DongDong was suffering from congenital growth hormone deficiency! I advised DongDong’s parents to give him growth hormone injections as soon as possible. However, due to DongDong’s advanced age and heavy weight, it was estimated that the injection would be more expensive and less effective than for children who started treatment before the age of 7-8.
DongDong’s parents were remorseful: they should have come to the hospital earlier if they knew that!
1, pay attention to the child’s height, the earlier the better
The situation like Dongdong is still very common in the society. Exactly when to pay attention to the child’s height, when to go to the hospital to check it?
When a child is born, a normal newborn is usually about 50 centimeters, and can increase in height by an average of 25 centimeters in the first year. This is the first growth spurt in life and has a great impact on the whole life. During this year, parents usually take their children to children’s health care institutions for regular physical examinations, if the assessment result is at the lower or lower middle level, which should be taken seriously. 1~3 years old, normal children can grow 7~8 centimeters per year, and 3 years old to the pre-pubertal development is usually above 5 centimeters per year.
After the start of puberty, children will usher in a second growth spurt, growing at least 6 centimeters per year, and some will even grow more than 10 centimeters. If the child’s growth rate in these stages is lower than the above low limit, it is growth retardation, should promptly go to the hospital growth and development specialist or pediatric endocrinology specialist examination.
2.If you want your child to grow taller, it is important to check the bone age
After going to the hospital growth and development specialist or pediatric endocrinology specialist, the doctor will ask the child to take a bone age film (left hand orthopantomograph) after understanding the medical history and physical examination. This is very important. This is because the child grows taller mainly by the continuous ossification of cartilage in the long epiphysis. When all the cartilage in the epiphysis ossifies and fuses with the bone stem, the person will not grow taller. As the cartilage ossifies, different centers of ossification appear at different ages, and these centers of ossification can be examined in X-rays. This is commonly referred to as bone age.
Bone age should be consistent with age, and being too old or too young is not conducive to growing taller. Too small is often due to congenital deficiencies, malnutrition, rickets or lack of thyroxine or growth hormone, which can cause growth to lag. And if the bone age is too old, it is often due to excessive ossification due to overdevelopment of sex or some other endocrine problem.
This kind of children will grow faster than other children at first, but due to the high level of sex hormones in the body, the epiphysis will close early and make the growth terminate early, and eventually they will be shorter than other children instead. This is the reason why children with precocious puberty end up being short in height.
Therefore, whether a child grows too slowly or too fast, it is best to go to the hospital to check the bone age. If there is nothing abnormal, parents can take their children to the hospital to have a bone age taken at 4 weeks, 8 weeks and 12 weeks of age respectively. It is important to determine if the child is behind or ahead of the bone age because this is the transition period between early childhood, school age and adolescence. Of course, if it is clear that the child is short or precocious, it is more important to check early and review for a short period of time.
3. Don’t wait for the girl to get her period before you regret it
When it comes to precocious puberty, I’d like to cite another case that came to the clinic the other day. This girl is called Xiao Li, 12 years old. The company’s main business is to provide a wide range of products and services to the market. At that time, the bone age was already 10 years old, and the doctor had suggested that she do a sex hormone stimulation test, but Xiao Li and her mother were a little scared, so they did not check.
As a result, last month Xiao Li suddenly found coffee-colored blood below. Mom brought her to Yiwu Oriental Hospital to see me, a check of the bone age has been 13 and a half years old! According to Xiao Li’s current height of 1 meter 43 to project, her final height may not necessarily reach 1 meter 50.
Adolescent development is a gradual process. The normal girl at the age of 9-11 years old first appear breast hard, enlarged, followed by the development of vulva, and finally menstruation. Boys generally appear testicular enlargement at the age of 11-13, and then appear penis thickening, voice change, beard, throat knot and other sexual signs. If breast development occurs before the age of 8 for girls and testicular enlargement for boys before the age of 9, it should be considered precocious. This is the time to take intervention measures, whether to delay sexual development, or to promote the growth of height can be done. But like Xiao Li, wait for the arrival of menstruation and then intervene will be too late.
4. Don’t wait for your child to go on vacation before you take them to the hospital
The children around the time of puberty development are in the critical period of primary school, middle school and high school exams, and students nowadays are heavy in their studies. Many parents have the desire to take their children to the hospital for a checkup, but the children are not available. When the child is free, the parents themselves are too busy with business and work to take the child for a checkup. Therefore, many parents want to wait until their children are on summer or winter vacation before going to the hospital for a checkup. Unbeknownst to them, children who are in the budding or progressing stage of puberty can grow 1-2 years older in six months or a year! In order to allow school-age and adolescent children to be seen and treated in a timely manner, and to avoid conflicts between growth and development examinations and school study time, many hospitals have opened weekend or evening clinics for growth and development specialists.
Children are our future, and their growth requires the joint efforts of family members, school teachers and medical staff. We should all try to reduce the burden of our children, increase their free time and pay attention to their growth and development as early as possible, which is what we should and can do for their growth.