Growth is a fundamental right of children. With India still following the secular trend for height, we expect the subsequent generations to be slightly taller than their parents. Many factors like genetic potential [height of the biological parents], birth weight and nutrition decide the final height of a child. Any kind of prolonged stress due to physical illness has a negative effect on the child's final height. Many hormonal deficiencies/excess can lead to growth failure.
How much a child should grow normally?
Growth rate varies with age. During infancy and toddler-hood, the height gain is very rapid, which slows down during mid-childhood. Once the puberty starts, the height gain also picks up, to fall again after the puberty is achieved [earlier in females]. The best way to know if the child is growing normally, is to keep a height record. There are many formulas to roughly calculate the average height for given age, but using a growth chart is simpler and ideal. Plotting the serial heights on a growth chart gives a fair idea about a child's growth.
Is my child short?
In the given population, not all persons are of same height. Generally speaking, there is a normal range for height. Being short, by definition, means having a height below the lower margin of normal range or 5th percentile for the reference population range. For those who are familiar with statistics, this 5th percentile roughly corresponds to - 2 standard deviations.On a growth chart, this height will fall below the lowest line.
A child will also be called short, if his predicted height is less as compared to his parents, this is particularly true for tall parents.
There are reference data available for Indian pediatric population.
Why is my child short?
There are many reasons for a sapling for not thriving. There can be problems in the sapling, the water or the soil. Similarly, there can be problems in the child, the nutrition and emotional environment. Various medical conditions slow down or halt the growth. Deficiency of Growth Hormone or Thyroid hormone may lead to severe degree of short stature. More commonly, there are children who are 'late bloomers'. These children start their pubertal growth spurt late and continue to grow beyond the normal periods, thus compensating for the earlier loss.
What are growth charts?
These are graphical representations of heights of healthy children with percentile lines drawn. The charts are different for boys and girls. Plotting the height of child on this chart gives a comparative idea as to on what percentile the child is lying. A normally growing child has all his plots within the normal area [usually depicted in white colour on the chart] [Click here for growth chart for Boys and Girls] and going parallel to the percentile lines. There are various growth charts available, it doesn't matter which one is being used for practical purposes, unless the child has condition like Down's/Turner's syndrome, where there are specific charts available.
How frequently do I need to check my child's Height?
It is recommended that the height should be recorded during each health visit. During first two years of life, the length is recorded instead of height. Frequent recordings are needed during this period as the child grows rapidly. After two years of age, at least 2 to 3 times a year. A period of at least 3 to 6 months is required to know the speed at which the child is growing, hence there is no point in measuring the height before 3 months interval.
Can You predict how much shall my child grow?
As there are many variables in a child's growth. exact height prediction is not possible. There are, however, methods to make rough predictions using parent's heights [Mid-parental height*]. There are ways to predict the final height based on the 'bone-age' of the child using a left hand x-ray. Girls beyond bone-age of 14 and boys beyond bone-age 16 generally do not grow much.
Shall I take off label medicines for optimizing my child's growth?
The market is flooded with useless and many a times harmful health supplements. Brands like 'Hightex', 'Step up', 'Speed Height', 'Body-plus' and 'Health-plus' falsely promise an exuberant height gain, these are nothing but hoax. None of these medicines is approved by Drug Controller General of India [DCGI]. Every medicine has side effects, and shouldn't be consumed unless required and prescribed by a qualified physician.
What is growth Hormone Therapy?
Growth hormone is a hormone produced by the master gland - pituitary. It is the major driving force for the growing bones and it acts well when all the other hormones like thyroid hormone are normal and the child is getting proper nutrition. In Growth hormone therapy, daily growth hormone injections are given to those patients, who have the deficiency of this hormone. It can also be given to short children with certain syndromes like Turner's, Prader-Willi or Russel-Silver syndrome, to improve the height. Growth hormone therapy is costly and has its own side effects, hence should not be given except when medically indicated.
What can I do to increase my child's height?
Ensuring proper nutritional intake that includes proteins, iron and calcium, is the minimum that parents can do to optimize their child's growth. Growing bones, especially during puberty, need calcium and vitamin D. Vitamin D needs to be supplemented if your children are not getting enough of sunlight. Milk is a rich source of calcium and at least half a liter milk is needed to meet the recommended daily intake of calcium during this growing period. Vegetarian diet has low quality protein, but the quality can be improved by combining different pulses and legumes [Mix Daal]. Eggs and meat have good-quality proteins. Green leafy vegetables are rich sources of iron. Health supplements are costly and are not required for normal growth. Regular exercise stimulates bone growth, but hanging on a bar [as shown in various misleading advertisements including Complan] doesn't help in increasing the height.
Consult your pediatrician / pediatric endocrinologist if you have any doubts or concerns about your child's growth or pubertal status.
*Mid-parental height/Target height is calculated using the formula:
For Boys: [Father's height+Mother's height + 13] / 2 in centimeters.
For Girls: [Father's height+Mother's height -13] / 2 in centimeters.
If father's height is 170cm and mother's height of 155cm, the target height for their boy will be 169cm [±5cm], and for their girl will be 156 [±5cm].
How much a child should grow normally?
Growth rate varies with age. During infancy and toddler-hood, the height gain is very rapid, which slows down during mid-childhood. Once the puberty starts, the height gain also picks up, to fall again after the puberty is achieved [earlier in females]. The best way to know if the child is growing normally, is to keep a height record. There are many formulas to roughly calculate the average height for given age, but using a growth chart is simpler and ideal. Plotting the serial heights on a growth chart gives a fair idea about a child's growth.
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| Image courtesy: www.cdc.gov.in |
In the given population, not all persons are of same height. Generally speaking, there is a normal range for height. Being short, by definition, means having a height below the lower margin of normal range or 5th percentile for the reference population range. For those who are familiar with statistics, this 5th percentile roughly corresponds to - 2 standard deviations.On a growth chart, this height will fall below the lowest line.
A child will also be called short, if his predicted height is less as compared to his parents, this is particularly true for tall parents.
There are reference data available for Indian pediatric population.
Why is my child short?
There are many reasons for a sapling for not thriving. There can be problems in the sapling, the water or the soil. Similarly, there can be problems in the child, the nutrition and emotional environment. Various medical conditions slow down or halt the growth. Deficiency of Growth Hormone or Thyroid hormone may lead to severe degree of short stature. More commonly, there are children who are 'late bloomers'. These children start their pubertal growth spurt late and continue to grow beyond the normal periods, thus compensating for the earlier loss.
 |
| Indian Growth Chart |
How frequently do I need to check my child's Height?
It is recommended that the height should be recorded during each health visit. During first two years of life, the length is recorded instead of height. Frequent recordings are needed during this period as the child grows rapidly. After two years of age, at least 2 to 3 times a year. A period of at least 3 to 6 months is required to know the speed at which the child is growing, hence there is no point in measuring the height before 3 months interval.
Can You predict how much shall my child grow?
As there are many variables in a child's growth. exact height prediction is not possible. There are, however, methods to make rough predictions using parent's heights [Mid-parental height*]. There are ways to predict the final height based on the 'bone-age' of the child using a left hand x-ray. Girls beyond bone-age of 14 and boys beyond bone-age 16 generally do not grow much.
Shall I take off label medicines for optimizing my child's growth?
The market is flooded with useless and many a times harmful health supplements. Brands like 'Hightex', 'Step up', 'Speed Height', 'Body-plus' and 'Health-plus' falsely promise an exuberant height gain, these are nothing but hoax. None of these medicines is approved by Drug Controller General of India [DCGI]. Every medicine has side effects, and shouldn't be consumed unless required and prescribed by a qualified physician.
What is growth Hormone Therapy?
Growth hormone is a hormone produced by the master gland - pituitary. It is the major driving force for the growing bones and it acts well when all the other hormones like thyroid hormone are normal and the child is getting proper nutrition. In Growth hormone therapy, daily growth hormone injections are given to those patients, who have the deficiency of this hormone. It can also be given to short children with certain syndromes like Turner's, Prader-Willi or Russel-Silver syndrome, to improve the height. Growth hormone therapy is costly and has its own side effects, hence should not be given except when medically indicated.
What can I do to increase my child's height?
Ensuring proper nutritional intake that includes proteins, iron and calcium, is the minimum that parents can do to optimize their child's growth. Growing bones, especially during puberty, need calcium and vitamin D. Vitamin D needs to be supplemented if your children are not getting enough of sunlight. Milk is a rich source of calcium and at least half a liter milk is needed to meet the recommended daily intake of calcium during this growing period. Vegetarian diet has low quality protein, but the quality can be improved by combining different pulses and legumes [Mix Daal]. Eggs and meat have good-quality proteins. Green leafy vegetables are rich sources of iron. Health supplements are costly and are not required for normal growth. Regular exercise stimulates bone growth, but hanging on a bar [as shown in various misleading advertisements including Complan] doesn't help in increasing the height.Consult your pediatrician / pediatric endocrinologist if you have any doubts or concerns about your child's growth or pubertal status.
*Mid-parental height/Target height is calculated using the formula:
For Boys: [Father's height+Mother's height + 13] / 2 in centimeters.
For Girls: [Father's height+Mother's height -13] / 2 in centimeters.
If father's height is 170cm and mother's height of 155cm, the target height for their boy will be 169cm [±5cm], and for their girl will be 156 [±5cm].
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ReplyDeleteThe reason that growth hormones may be given to children is because a child might be growth hormone deficient. As previously mentioned, it is the human system that naturally creates growth hormones which are used by the body for scores of various different metabolic functions.
ReplyDeleteIf the human body is not producing the right amount of growth hormones during childhood then the young one suffering from the problem could be considered growth hormone deficient., This is not a good thing since there are all manner of serious problems which can arise from the deficiency. complete ageexperts site
I agree with Dr.Alma that one needs to give growth hormone treatment who are deficient in growth hormone. There is, however, enough of scientific evidence to support the use of GH in non-growth-horome-deficient conditions like Turner's syndrome, Pradeer willi, Idiopathic Short stature, Small for gestational age with failed catch up, All of these are FDA approved indications for GH therapy.
DeleteWell written! However, I find Parley’s multiplier method far easier and probably more accurate, based on what I’ve read. It requires little information, but is very accurate and universal when it comes to ethnicity.
ReplyDelete