Fairy tales are filled with stories of giants and little people.
The stories were written hundreds of years ago, and they sometimes
tried to explain why these people looked different from others
around them.
These old-fashioned fairy tales might have been different if the
writers had known what today's doctors have learned about
growth.
What's a Growth Disorder?
Everyone grows and matures differently. You may be taller than
your best friend in fourth grade. But then in sixth grade, your
best friend may be an inch taller than you. Usually, this is
totally normal.
A growth disorder, however, means that a kid has abnormal growth
- for example, growing a lot slower or a lot faster than other kids
the same age.
What's Normal Growth?
If growth isn't the same for all kids, how do doctors know
what's normal? By feet and inches (or meters and centimeters)!
Over the years, lots of height and weight measurements have been
taken for lots of children of different ages. These measurements
have been put together in what is called a standard growth chart,
which tells doctors about how most kids grow.
From the time you were a baby, your doctor has weighed and
measured you whenever you've had a checkup. Because kids grow
differently, your doctor checks your height against the standard
growth chart. If you are in the 50th percentile on the growth
chart, it means half of the kids your age are taller than you are
and half are shorter. If you fall in the 25th percentile that means
75% of the kids your age are taller and 25% are shorter, and so
on.
Most kids whose heights are between the 3rd percentile and the
97th percentile and who are growing at a steady rate are considered
to have normal growth. Kids who are higher or lower than this on
the growth chart are usually normal, too. But some children who are
under the 3rd percentile or over the 97th percentile, or who are
growing a lot slower or faster than most other kids, may have a
growth problem. In this situation, the doctor will usually want to
check things out.
One thing your doctor will want to know is how tall your mother
and father are and how they grew when they were children. You may
have inherited short or tall genes from them. You may also have
inherited the tendency to have your growth spurt earlier or later
than most other kids do.
Problems With Puberty
Glands
in your body produce chemical messengers called hormones. Normal
increases in the amounts of some of these hormones being produced
trigger the changes your body goes through during puberty.
Puberty is the stage of your life when sexual development
happens, like breast development and menstrual periods in girls and
growth of the penis and testicles in boys. One of the body changes
that happens during puberty is a big increase in your rate of
growth - a growth spurt. The higher levels of hormones in your body
tell your bones to grow, grow, grow!
When these changes happen before the age of 8 in girls or 9 in
boys, it's called precocious (say: pree-
ko
-shes), or early, puberty. At first, these kids may be taller than
their friends. Later, however, they may stop growing sooner than
most other kids do, and they may not become as tall when
they're adults as they might have been otherwise. Usually, kids
with precocious puberty can be treated with medications that help
correct this problem.
Delayed or late puberty occurs when the hormonal and body
changes that should happen with puberty take place later than
normal, or sometimes not at all. Girls who have not begun
puberty
by age 13 and boys who have not begun by age 15 have delayed
puberty and are sometimes called late bloomers. When puberty
finally occurs, either by itself or with treatment, these teens
have a growth spurt and tend to catch up to their peers. Sometimes
they even grow to be taller than their friends!
Hormones and Growth Disorders
One of the glands in your body is called the pituitary gland
(say: peh-
too
-eh-ter-ee). It's found at the bottom of your brain and is
shaped like a peanut. It may be small in size, but it's pretty
big in importance. One of the chemical messengers the pituitary
gland sends out to your body is called growth hormone, which (no
surprise) is essential for growth.
When the pituitary gland doesn't make enough growth hormone
- and sometimes other pituitary hormones as well - the condition is
called hypopituitarism (say:
hi
-po-peh-too-eh-ter-is-em). This can slow down a kid's growth.
There are special tests to find out if children don't produce
enough growth hormone. If they don't, daily shots of growth
hormone can often help these kids grow to be normal-sized
adults.
Another gland that produces hormones important for growth is
your thyroid (say:
thi
-royd). You may be able to feel it if you press gently with your
fingers across the front of your neck, just under your Adam's
apple. It is shaped like a butterfly and moves up and down when you
swallow.
Your thyroid makes a hormone called thyroxine (say: thi-
rocks
-in). If it makes too little, the condition is called
hypothyroidism (say
hi
-po-
thi
-royd-is-em). Having too little thyroxine makes a kid grow more
slowly. Doctors can do a simple blood test for hypothyroidism. If
it's needed, a kid can take the missing hormone as a pill.
What Are Some Other Reasons Why Kids Do Not Grow Normally?
Although hormones play a major role in growth, there are lots of
reasons why kids might not grow normally. Some others include:
-
Chronic diseases.
These include heart and kidney problems, cystic fibrosis,
juvenile rheumatoid arthritis, and sickle cell anemia,
which may slow growth in some cases.
-
Complications during pregnancy.
One of the reasons a pregnant woman is warned not to smoke or
drink is because it may slow down her baby's growth. A baby
may be too small when it's born and some remain small for
life. This condition is called intrauterine (say:
in
-trah-yu-ter-in) growth retardation, or IUGR. Some infections
during pregnancy, other pregnancy problems, and certain genetic
diseases can also cause this problem.
-
Failure to thrive.
Some babies don't grow and gain weight normally after
they're born. This is called failure to thrive (FTT). FTT may
happen when a child simply doesn't get enough to eat. Some
babies may have an illness that needs to be treated, but most
will grow normally after they start eating enough food.
-
Genetic conditions.
Some genetic conditions can also cause children to not grow as
they should. Some girls who are short may have Turner syndrome.
This means they have one X chromosome instead of two, or that one
of their X chromosomes is abnormal. Another genetic condition,
called
Marfan syndrome
, makes a person tall, with very long legs and arms. The person
may also have heart and eye problems.
Many of these growth disorders can be successfully treated
today. With help, kids who might once have ended up very short or
very tall can grow up more like other children. And that's a
happy ending to any fairy tale!
Reviewed by:
Steven Dowshen, MD
Date reviewed: April 2006
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation/KidsHealth. All rights reserved.