There are many factors that ensure that a child grows well and abnormalities in any of these can lead to poor growth and short stature. Pediatric endocrinologists will evaluate a child’s stature and growth rate by comparing these measurements to those of other children of the same age. They can also evaluate a child’s height in relation to the genetic potential of the family based upon the parents’ heights. A decreased growth rate can be the result of chronic disorders of almost every system in the body such as the heart, lungs and gastrointestinal tract. In addition, hypothyroidism can lead to poor growth if not treated. If a child lacks or is deficient in growth hormone, they will grow very poorly; when it is replaced the child can catch up to a normal growth rate and reach an adult height based upon the family’s genetic potential.
Children grow quite a bit during the period of the adolescent growth spurt but if puberty is delayed the child may appear short for age. If puberty is only slightly delayed because of familial tendencies, a condition known as constitutional delay in growth and development, the child will progress through puberty on their own, but later than their peers. However, a more significant delay in the onset of puberty may be due to serious problems with the gonads (ovaries and testicles) or of the central nervous system. It’s important to have a girl who has had no pubertal development by 13 years of age or a boy who has had no such development by 14 years of age evaluated by a Pediatric Endocrinologist.