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Why is my child the shortest in the class? Will they always be so short? Will short children develop low self-esteem? We speak to a medical expert about these common concerns parents have.

A slowing of growth can be noticed from around age two. It’s usually diagnosed when children start school and their height is compared to others their age, or at puberty when short children can become self-conscious, or subjected to teasing.

A growth problem can occur at any age and have any number of causes, from genetic to malnutrition, certain syndromes (Prader-Willi and Turner), skeletal disorders, head injuries, chronic medical conditions (kidney, heart, lung and intestinal diseases), serious illnesses (meningitis, encephalitis and brain tumours) and an underactive thyroid.

“Most children don’t have a serious problem with growth and will eventually reach a height that’s similar to that of their parents,” says Dr Yasmeen Ganie, a paediatric endocrinologist at Inkosi Albert Luthuli Hospital in Durban. But some have Growth Hormone Deficiency (GHD) and need treatment.

Injecting hope

The treatment for GHD is daily injections until the growth areas of the bones close. “In severe deficiency, treatment may continue into adulthood at a lower dose,” says Ganie. Initially, parents give then shots, but once they’re older, the children inject themselves. A child can grow to their normal or near-normal adult height potential if a diagnosis is made early and the child responds well. However, it’s important for both child and parent to have realistic expectations. Growth hormones can’t override genetic potential – if both parents are short, the child will probably be short too. (To estimate their adult height, average your height and your partner’s, then add 7cm for a boy or subtract 7cm for a girl.)

When to act

Measure your children twice a year and plot their growth on growth charts. Ask your GP about seeing a paediatrician or paediatric endocrinologist when your child:

  • is shorter than most others of the same age and the same gender
  • has a face that looks younger than his peers, a chubby build and prominent forehead with small hands and feet
  • has delayed puberty (lack of breast development by 13 years in girls, lack of testicular enlargement by 14 in boys).

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