When a Child is Unusually Short or Tall

What kind of value does our society place on height? Consider the fact that once children reach school age, parents often worry if their otherwise healthy son looks considerably shorter than other boys his age, though they are generally less concerned if he is unusually tall. Girls who are short tend to elicit less attention. But in most cases, short children are simply following their genetic pattern.

The Growth Hormone

It’s rare that children fail to grow because they lack growth hormone, which is produced y the pituitary gland. But if a child seems significantly outside the norm, parents should raise their concerns with their pediatrician so that he can evaluate for—and most likely rule out—any medical disorders. If you have questions about growth hormone treatment, discuss it with a pediatric endocrinologist, a doctor who specializes in hormonal functions in children and who can best judge whether your child might benefit from growth hormone injections.

If you are undecided or feel you don’t have enough information, seek a second opinion. Growth hormone treatment has risks and side effects and costs thousands of dollars a year. Many health insurance plans do not pay for this treatment unless there is a true hormone deficiency. If your child has a proven deficiency and growth hormone is prescribed, therapy should begin as early as possible because treatment produces faster and greater growth when given to younger rather than older children.

The long-term risks of human growth hormone treatment are not yet known. However, while one purpose of giving growth hormone is to improve a child’s self-image and enable him to fit in with others his age, the need for injections over a period of years may only reinforce the negative self-image that many of these children already have.

Other Causes of Short Stature

Some children are born small because of poor growth in the uterus, and they never catch up. They are called small for gestational age. A baby may be abnormally small for many reasons, including a decreased blood supply to the placenta, exposure to infection while in the uterus, or extreme prematurity. For these children, their small size is determined prenatally. They should not be overfed. Though growth hormone is not recommended by many and perhaps most pediatricians in such cases, this can be discussed with your pediatrician in consultation with a pediatric endocrinologist if you feel otherwise.

When a Child is Abnormally Tall

On the other end of the spectrum, when a child is abnormally tall, a rare cause may be a tumor of the pituitary gland that releases excessive amounts of growth hormone. This stimulates growth, particularly of the jaw and the long bones in the arms and legs. Disproportionate height cannot be reversed, but the condition can be treated with surgery, medications, or irradiation.

Height Genes 

Height and weight tend to run in families. In fact, you can get a rough idea of how tall a child is likely to be by looking at the parents.

Here’s one way to predict a child’s probable height at maturity:

• Add together the heights of the mother and father in inches and divide by 2.
• For a boy: add 2½ inches
• For a girl: subtract 2½ inches

Although this is just a rough estimate, it provides a guideline. Quite simply, the taller the parents, the taller the child is likely to be; on the other hand, short parents tend to have short children.

A child may also have a genetic predisposition to thinness—with thin parents, siblings, and even grandparents—but if her diet includes large amounts of high-fat, high-calorie foods and she spends most of her time watching television or playing video games, her environment may overpower her genes and she’ll be at risk for becoming overweight.