The past year has changed our family lives so much, especially the way our kids are going to school and how they’re learning. Quarantine and other protective measures have increased our children’s presence indoors and shifted a good chunk of schooling hours to the home. This has meant screen-time battles, kiddo’s wandering attention during online-classes,…Read More
Having your child being the shortest kid in class can be cause for concern for some parents. We spoke with Dr. Medhat Salem, a Specialist Paediatrician and Medical Director at Mediclinic Mirdif who helped shed some light on the matter.
“Doctor, my child is short, should I be concerned?”, is something Dr. Salem often hears from visiting parents. And this question is really important and interesting because of three reasons:
1) Short stature can cause lots of stress, especially psychologically, on the parents and on the child.
2) Short stature is not a disease, but it can be a symptom of a disease that should be treated and after the treatment, the child should grow normally.
3) The short child that is healthy can be treated with growth hormone and achieve an additional 7-12 cm at the final height.
How do we define short stature?
Short stature means the child is two standard deviations below of what they should be according to their age and gender. If your son/daughter is the shortest in the class that doesn’t mean he/she is short in stature. He/she has to go below two standard deviations and other children might be taller.
How do we measure the optimal height?
We add height of the father and mother, then for the boys we add 13 and divide by 2, and for the girls, minus 13 and divide by 2.
What are the causes of short stature?
80% of the causes are genetically determined. Genetic causes are familial short stature and constitutional short stature. Familial short stature is where the parents are short and the child is also short.
Constitutional short stature is when the child has delayed puberty, but when he/she reaches puberty the child gets to normal height. So he/she will be short initially and will achieve normal height when the child reaches puberty. This can be easily diagnosed, as one of the parents may have the same history, and this is the only condition where there is no treatment indicated.
Other causes will include the child being born small like IGR. Chronic diseases such as diabetes, chronic renal failure, malabsorption syndrome such as celiac disease or endocrine causes such as hypothyroidism can also cause short stature.
In addition, rare causes can be genetic syndromes, for example Down Syndrome, Turner Syndrome or disproportionate short stature where the trunk is normal but the limbs are short like in cases of achondroplasia.
What do we do? How do we work it out?
We usually do a complete history and complete examination and necessary lab investigations. We investigate mostly endocrine causes like thyroid deficiency, gross hormone deficiency, pituitary deficiency and we investigate for chronic diseases. After doing the full investigation and having the full picture of what is going on, if there is a disease, we treat the disease and the child’s short stature and general health can be rectified.
If the child is completely healthy and normal, he/she is not constitutionally delayed and everything is OK, we can also give him/her a growth hormone to improve his/her height by 7-12 cm if you choose.
Always remember that short stature is treatable and you need to see your child’s paediatrician.