Short Stature, Pediatric

Short stature is when a person is below average height when compared with other people. Short stature may happen because of genetic makeup (heredity), growth hormone deficiency, genetic disorder, or another medical condition. Factors that may influence normal growth and stature include:

The height of a child's parents.
Rate of growth and development.
Lack of access to nutrient-dense (nutritious) foods.
Being unable to eat enough food to support growth.
A long-term (chronic) health condition.

Your child's health care provider will review your child's growth pattern to uncover any causes that may be treated.

What are the causes?

Your child's short stature may not have a cause (may be idiopathic). Other times, there may be many potential causes. It may be related to:

A growth pattern called constitutional growth delay. Children with constitutional growth delay may:
- Grow to a normal height but may be shorter than their peers during childhood and adolescence.
- Reach puberty later than their peers.
- Be small for their age but have a normal growth rate.
- Reach an adult height similar to that of their parents.
Genetic makeup (heredity). Short stature in one or both parents may affect the adult height of their children.

Other causes may include:

Chronic diseases. These may include:
- Bone growth disorders or growth hormone deficiency.
- Endocrine disorders, such as hypothyroidism.
- Inflammatory bowel disease, such as Crohn's disease.
- Celiac disease.
- Genetic syndromes.
Poor nutrition.
Infections.

What increases the risk?

Your child is more likely to develop this condition if:

There is a family history of short parental height.
There is a lack of access to healthy food (food insecurity).
Your child is unable to consume an adequate amount of food.

What are the signs or symptoms?

Symptoms of this condition include:

Slow growth rate, with a height that is below the average height of others the same age.
Delayed puberty. This means that puberty happens later than normal. For males, normal puberty most often occurs around age 14, and for females, around age 13.

Other symptoms may be related to underlying medical conditions. These symptoms include:

A fever that will not go away.
Chronic headaches or vomiting, or both.
Pain in the abdomen and diarrhea.
Poor appetite.

How is this diagnosed?

This condition may be diagnosed with your child's medical history and a physical exam. The health care provider may look for hormonal or genetic causes for delayed growth or puberty. He or she will look at your child's growth over time. Your child may also have tests, such as:

Blood tests.
Urine tests.
Bone age X-ray.
Other X-rays.
Genetic tests.

Your child may also be referred to specialists, such as an endocrinologist. This is a health care provider who diagnoses and treats problems with the endocrine system.

How is this treated?

If the condition is thought to be hereditary, no treatment is needed. If your child's short stature is caused by a medical condition, your child's treatment will depend on the cause. Treatment may include:

Improved nutrition.
Medicines to correct hormonal imbalance, such as:
- Growth hormone replacement.
- Thyroid hormone replacement.
Regular health care visits. During these visits, your child's health care provider will check your child's height, weight, and stage of sexual development.

Follow these instructions at home:

Give over-the-counter and prescription medicines only as told by your child's health care provider.
Feed your child a healthy diet that provides enough calories and protein. Be sure to include fresh fruits and vegetables, whole grains, dried beans and peas, nuts, lean protein, and low-fat dairy products.
Do not allow your child to smoke or use any products that contain nicotine or tobacco.
Do not smoke around your child. If you or your child needs help quitting, ask your doctor.
People with this condition should avoid alcohol. Talk to your child about why it is dangerous to drink alcohol if he or she has this condition.
Keep all follow-up visits. This is important. During these visits, a health care provider will check your child's height, weight, and stage of sexual development.

Where to find more information

Endocrine Society: endocrine.org
Hormone Health Network: hormone.org

Contact a health care provider if:

Your child has unexplained hip or knee pain.
Your child is very tired (fatigued).
Your child has a headache.
Your child has vision changes.

Get help right away if your child has:

A bad headache that will not go away.
Double vision.

Summary

Short stature is a condition of being well below average height when compared with other people. Short stature may be a sign of a related medical condition or genetic disorder.
If your child's short stature is caused by a medical condition, your child's treatment will depend on the cause.
Treatment may include improved nutrition and medicines to correct hormonal imbalance.
Give over-the-counter and prescription medicines only as told by your child's health care provider.
Keep all follow-up visits. This is important.