Lack of Growth
Growth failure occurs when a child or adolescent's growth rate falls significantly below expected patterns for their age, sex, and genetic potential. While children grow at different rates, consistent poor growth can signal underlying medical conditions, nutritional deficiencies, or hormonal imbalances. Early identification is crucial, as many causes of growth failure are treatable, especially when addressed during critical growth periods. Understanding normal growth patterns, recognizing warning signs, and knowing when to seek evaluation helps ensure children reach their full growth potential and identifies any serious underlying conditions requiring treatment.
⚠️ Seek Medical Evaluation For:
- Height below 3rd percentile for age
- Crossing down growth percentiles
- Growth rate less than 2 inches per year (ages 3-puberty)
- Delayed puberty with poor growth
- Weight loss or poor weight gain
- Chronic illness symptoms
- Developmental delays
- Extreme short stature in family
- Disproportionate body segments
- Signs of malnutrition
Understanding Normal Growth
Growth Patterns by Age
- Birth to 2 years: Rapid growth, 10 inches first year
- Ages 2-3: About 3-4 inches per year
- Ages 3 to puberty: Steady 2-2.5 inches per year
- Puberty: Growth spurt 3-5 inches per year
- Post-puberty: Growth slows and stops
Factors Affecting Growth
- Genetics (parental heights)
- Nutrition
- Overall health
- Hormones
- Sleep quality
- Physical activity
- Emotional well-being
Common Causes
Hormonal Causes
- Growth hormone deficiency
- Thyroid disorders
- Cushing syndrome
- Delayed puberty
- Precocious puberty
- Diabetes (poorly controlled)
Genetic/Chromosomal
- Turner syndrome
- Down syndrome
- Noonan syndrome
- Prader-Willi syndrome
- Achondroplasia
- Familial short stature
Chronic Conditions
- Kidney disease
- Heart disease
- Inflammatory bowel disease
- Celiac disease
- Cystic fibrosis
- Severe asthma
Other Causes
- Malnutrition
- Eating disorders
- Chronic infections
- Medications (steroids)
- Psychosocial stress
- Constitutional delay
Types of Growth Problems
Proportionate Short Stature
- Body parts in normal proportion
- Overall small size
- Common with hormonal causes
- Familial short stature
- Constitutional growth delay
Disproportionate Short Stature
- Body parts out of proportion
- Often skeletal dysplasias
- Short limbs or trunk
- Achondroplasia most common
- May have other features
Failure to Thrive
- Poor weight gain primarily
- May affect length/height
- Common in infants
- Multiple possible causes
- Requires urgent evaluation
Medical Evaluation
Growth Assessment
- Accurate height and weight measurements
- Growth chart plotting
- Growth velocity calculation
- Body proportions
- Parental heights (mid-parental height)
- Pubertal staging
Diagnostic Tests
- Bone age X-ray: Skeletal maturity
- Blood tests: Hormones, nutrition markers
- Growth hormone testing: Stimulation tests
- Thyroid function: TSH, T4
- Genetic testing: Chromosomal analysis
- IGF-1 levels: Growth factor
- MRI brain: Pituitary evaluation
Treatment Options
Hormonal Therapy
- Growth hormone injections
- Thyroid hormone replacement
- Sex hormone therapy
- IGF-1 therapy
- Cortisol management
- Diabetes treatment
Nutritional Support
- Dietary counseling
- Calorie supplementation
- Vitamin/mineral supplements
- Feeding therapy
- Tube feeding if needed
- Treatment of malabsorption
Medical Management
- Treat underlying diseases
- Manage chronic conditions
- Medication adjustments
- Regular monitoring
- Specialist referrals
- Psychological support
Supportive Care
- Regular growth monitoring
- Family education
- School accommodations
- Peer support groups
- Physical therapy
- Transition planning
Timing of Treatment
- Early intervention: Better outcomes
- Before puberty: Maximum growth potential
- Growth plates open: Treatment window
- Diagnosis dependent: Some need immediate treatment
- Regular monitoring: Track response
- Adjust as needed: Dose optimization
- Transition planning: Adult care
- Long-term follow-up: Monitor effects
Living with Growth Issues
Psychological Support
- Address self-esteem concerns
- Peer relationship support
- Family counseling
- School integration
- Coping strategies
- Realistic expectations
Practical Considerations
- Age-appropriate activities
- Sports participation
- Clothing and equipment
- Car seat requirements
- Future planning
- Independence skills