Short Stature

What causes poor growth or short stature?
Although slower than normal growth may be a sign of a significant health problem, most children who have short stature have no medical condition, are healthy, and grow at a normal rate. Causes of short stature not associated with recognized diseases include:• Familial short stature (one or both parents are short, but the child’s rate of growth is normal)
• Constitutional delay in growth and puberty (the child is short during most of the childhood but will have late puberty and end up in the normal height range as an adult).
• Idiopathic short stature (no identifiable cause, but the child is healthy)Short stature may occasionally be a sign that a child does have a serious health problem, but there are usually clear symptoms suggesting something is not right. Medical conditions affecting growth may include:• Chronic medical conditions affecting nearly any major organ, including heart disease, asthma, celiac disease, inflammatory bowel disease, kidney disease, anemia, and bone disorders
• Hormone deficiencies, including hypothyroidism, growth hormone deficiency, diabetes, and Cushing disease, in which the body makes too much hydrocortisone.
• Genetic conditions including Down syndrome, Turner syndrome, Russell-Silver syndrome, Noonan syndrome and rare bone problems, such as achondroplasia.
• Poor nutrition.
• Babies with a history of being born small (small for gestational age or with a history of intrauterine growth retardation).
• Medications, such as those used to treat attention-deficit/ hyperactivity disorder and inhaled steroids used for asthma. 

What tests might be used to assess my child?
The best “test” is to monitor the child’s growth over time using the growth chart. Six months is a typical time frame for older children, and if the rate of growth is clearly normal, no additional testing may be needed. In addition, your doctor may check your child’s bone age (x-ray of left hand/wrist), which may help a child older than 7 years predict how tall the child will be as an adult.
Blood tests are rarely helpful in a mildly short but healthy child who
is growing at a normal growth rate. However, if the child is below the 3rd percentile or is growing more slowly than normal, doctors will usually do some tests to look for signs of one or more of the medical conditions described above.