Growth Delay or Disorder

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KEY POINTS

• A growth disorder means that your child is not growing normally. A growth delay means that your child is growing more slowly than normal.
• Treatment for growth delay depends on the cause. Malnourished children may need high-calorie supplements. Hormone shots or pills may help if the cause is a lack of hormones.
• You can help your child to understand the condition and know what to expect from treatment. Take care of your child’s physical health and be cautious about alternative treatment.

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What is a growth delay or disorder?

A growth disorder means that your child is not growing normally. A growth delay means that your child is growing more slowly than normal.

Growth patterns are different from child to child. For example, baby boys grow faster than girls grow until about 7 months of age. After that, girls grow faster until about age 4. After that, boys and girls grow at the same rate until puberty. The average growth rate is 2 to 3 inches (5 to 6 centimeters) a year.

Your child's height depends a great deal on your family history. Tall parents usually have tall children. Small parents usually have small children. A short child who has short parents may not have a growth problem.

What is the cause?

Nutrition, genetics, hormones, and chronic (long-term) diseases can all affect growth. If your child's growth seems to be slow, the cause may be a natural growth delay or a growth disorder.

There are several possible causes for growth problems.

• Normal delayed growth: Some children are small for their age because their bones are growing more slowly than normal. Puberty may be delayed until bone growth catches up. Often this “late-bloomer” growth pattern runs in the family.
• Failure to thrive: When children younger than age 3 do not gain weight or do not grow as expected, they may have a problem called failure to thrive. This is usually caused by a feeding problem or poor diet. Malnutrition is the most common cause of growth failure around the world. Failure to thrive may also be a result of child neglect or abuse.
• Hormone problem: A condition that causes too much or too little of one or more hormones can cause growth problems during childhood and teen years. For example, if the thyroid gland does not make enough thyroid hormone, it can prevent normal bone growth. If the pituitary gland does not work properly, it may not be able to make enough hormones for normal growth.
• Long-term illness: This is another common cause of delayed or slower growth. Growth can be slowed by diseases such as asthma, heart disorders, kidney failure, or diabetes because the body may not be able to use nutrients well for growth. Children with nerve or muscle diseases or some mental disorders may not get enough to eat.
• Genetic disorders: A problem with your child’s genes may cause slow growth. Inside each cell of your child’s body are genes. Genes contain the information that tells the body how to develop and work. Changes in the genes can be passed from parents to children. Down syndrome is an example of a genetic disorder that may cause slow growth.
• Other causes: Growth delays may be caused by infections during pregnancy or use of certain medicines, alcohol, or cigarettes during pregnancy.

What are the symptoms?

Signs of a growth delay or disorder may include:

• Your child is shorter or weighs less than most children of the same age.
• Your teen seems slow to reach puberty. For example, your daughter may not develop breasts or your son may not start having facial hair at the same age as other children.

How is it diagnosed?

Regular tracking of your child's height and weight is used to check growth rate. Your healthcare provider will ask about your child’s symptoms, medical history, and family history, and examine your child. Tests may include:

• Blood and urine tests
• X-rays of the bones of the wrist

Your healthcare provider will watch your child's behavior to see if your child is reaching milestones expected for age.

How is it treated?

Treatment for growth delay depends on the cause. For example, malnourished children may need high-calorie supplements. Hormone shots or pills may help a lack of hormones.

How can I take care of my child?

Children often compare themselves to their friends. This can cause stress and affect your child’s self-esteem.

• Build your child's self-esteem. Children who are not growing as quickly as their friends may not feel good about themselves. If they feel they cannot keep up, they may withdraw from their friends and social activities. You can build up your child's self-esteem if you remind your child of his or her strengths. Your child may need counseling to help change your child’s own views and expectations.
• Help your child understand the problem. Talk about the problem. Let your child know what to expect from treatment or that the growth delay is normal in your family. Sometimes talking with other children who have the same condition can help. Children may feel better if they know that they are not alone.
• Take care of your child’s physical health. A healthy diet, enough rest, play activities, and family outings will strengthen your child's body and mind.
• Be cautious of alternative treatments. Be sure to check with your healthcare provider before giving supplements, changing to a special diet, or using other kinds of alternative treatments.