Short Stature
Short stature is defined as being shorter than would be expected in comparison with one’s peer group - and in numerical terms is considered to be present when the height of the child is below the third centile for its age when plotted on a centile chart. A centile chart contains predicted growth curves for children between certain ages - covering infancy, childhood or adolescence - (and besides height include weight and head circumference). The curve in the middle - the mean - is called the 50th centile: 50% of children will be taller, and 50% shorter. The 3rd centile - at the bottom - means that 97% of children will be taller. Centile charts are an invaluable means of monitoring a child’s development. Normal growth requires adequate nutrition and is affected by different hormones at different times: insulin (from the pancreas) and thyroxine (from the thyroid) during infancy, growth hormone (from the pituitary) during childhood and sex hormones (from the testicles or ovaries and the adrenal glands) during the pubertal growth spurt. Many disorders - besides deficiency in any of these hormones - affect growth: any chronic disease of childhood (cardiac disease causing cyanosis, kidney disease causing renal failure, bowel disease causing malabsorption, lung disease causing reduction in oxygenation - such as cystic fibrosis); malnutrition, genetic disorders and emotional and psychological abuse can all interfere with growth. So to grow properly requires the correct diet, all the right hormones and a safe and secure environment. Children who fail to grow as expected should be investigated, because many causes are treatable. We have to remember that height is genetically determined - if both parents are on the short side, the offspring are unlikely to tower over their friends.
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