Most short children are healthy
Many short children simply have short parents, or are late developers who will catch up and reach a normal adult height. Both grow at a normal rate.
Growth rate matters most
Between about age 4 and puberty, children usually grow about 5 to 7 cm a year. Growth well below this, or a child dropping across the lines of a growth chart, needs attention.
Warning signs
- Height well below that of other children the same age
- Growing less than about 4 cm a year
- Much shorter than expected from the parents’ heights
- Poor weight gain, tummy problems or frequent illness
- Puberty that is very early or has not started by the expected age
- Headaches or vision problems
Possible causes
Hormone causes include an underactive thyroid, growth hormone deficiency and, in girls, Turner syndrome. Other causes include coeliac disease, poor nutrition, long-term illness and being born small for dates.
What assessment involves
- Accurate measurements plotted on a growth chart
- Both parents’ heights
- A hand X-ray for bone age
- Blood tests such as thyroid, IGF-1, coeliac screen and blood count, with further tests only if needed
Treatment
Treatment depends on the cause. Growth hormone injections help children with proven deficiency and some other conditions, under specialist follow-up. Height supplements and tonics do not increase height.
Bring any previous height records and both parents’ heights to the appointment.
How is a child's growth assessed?
One height measurement is not enough. The clinician plots height and weight on an age- and sex-appropriate growth chart, checks previous measurements, calculates growth velocity and compares the pattern with family heights and pubertal stage. Accurate measurements taken over time are often more informative than a single laboratory test.
Some children are shorter because their parents are short or because they have a constitutional delay in growth and puberty. Others may have inadequate nutrition, coeliac disease, thyroid disorders, chronic illness or a hormone-related condition. Testing is guided by the growth pattern and examination rather than ordering every test for every child.
When should parents seek an assessment?
Arrange a review if height is falling across growth-chart centiles, growth is slower than expected, puberty is unusually early or delayed, or the child is much shorter than expected from family heights. Earlier assessment is useful because some causes are easier to identify and manage while growth is ongoing.
This guide is for general educational purposes and does not replace individual medical advice, diagnosis or treatment. Consult your doctor for advice specific to your health.
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