Short stature is a general term for people whose height is considerably below average compared to the height of their peers. While it can apply to adults, the term is more commonly used to refer to children.
A child can be significantly shorter than their friends and still be perfectly healthy. This is particularly true if both parents are also shorter than average. Genetics is a major determinant of height.
However, short stature can indicate an underlying medical problem. In these cases, many children can grow to a normal height with proper treatment. For others, short stature may be permanent.
Your child’s doctor will measure your child’s height and then refer to a growth chart. This chart shows the average height of other children of the same age and sex. Based on guidelines set by the American Association of Clinical Endocrinologists, doctors consider a child to be of short stature if their height falls within the lowest two percentiles of their peer group.
What Causes Short Stature?
The three major reasons for short stature are constitutional growth delay, genetics, and disease.
Constitutional Growth Delay
Some children simply develop later than others. These children are often referred to as "late bloomers." These kids are small for their age and often enter puberty later. However, they’ll continue to grow after their friends have stopped. They usually catch up by adulthood.
If one or both parents are short, there’s a strong possibility that their child will also be short. If there are no underlying medical reasons why either parent is short, their child’s short stature may be perfectly healthy.
A number of diseases may cause unusually short stature. These diseases fall into several categories.
- Endocrine diseases affect hormone production, and often height. These include growth hormone deficiency (GHD), hypothyroidism, or low thyroid hormone levels, and Cushing’s disease.
- Chronic diseases can also decrease height through their effects on overall health. Examples of chronic disease are heart disease, asthma, inflammatory bowel disease, diabetes, kidney problems, sickle cell anemia, and juvenile rheumatoid arthritis.
- Genetic conditions that affect height include Down syndrome, Turner syndrome, and Williams syndrome.
- Bone and skeletal diseases, such as rickets or achondroplasia, may change stature through their effects on bone growth.
Problems during pregnancy can affect the height of a child. Malnutrition can also lead to short stature. Growth problems caused by malnutrition are uncommon in the United States.
When Should I Seek Medical Attention?
Only a doctor can determine whether your child’s short stature has a medical cause. This process takes time. That’s why it’s very important to have regular checkups with a family doctor or pediatrician.
You can also monitor your child’s height and overall health at home. Some questions to ask yourself are:
- Is my child significantly shorter than classmates who are the same age and gender?
- Has my child’s growth started to decrease?
- Does last year’s clothing still fit my child comfortably?
- Is my child frequently tired?
Providing the answers to these questions will give your doctor a head start in diagnosing any issues.
How Is the Cause of Short Stature Diagnosed?
Your doctor will measure your child’s height, weight, and limb length. Your doctor will also ask about your family’s and child’s medical history. Questions you should be prepared to answer include:
- What is the average height of past and current relatives?
- Do you have any history of disease?
- When did puberty start for both parents?
- How was your child’s birth?
- Are there any patterns in your child’s growth?
- What is your child’s normal diet?
- Are there any other symptoms present?
Your doctor may order medical tests if they suspect a medical condition. These tests can include:
- an X-ray of the growth plates in the left hand to check that your child’s growth corresponds to their age
- a screening for GHD
- a complete blood count to check for any blood diseases
- a DNA analysis to check for Turner syndrome in girls and other genetic diseases
- blood tests to check for thyroid, liver, kidney, and other problems
- imaging scans can look for tumors
What Are the Treatment Options for Short Stature?
Treatment for short stature depends on the cause.
Thyroid hormone replacement can be used to treat hypothyroidism. Growth hormone injections can treat GHD and a number of other conditions, including Turner syndrome and chronic kidney failure.
Not all short stature needs treatment. For children who are naturally short, no treatment is necessary. However, it can be challenging if a child is dealing with teasing from other kids. Parents can provide reassurance and emphasis on acceptance and loving one’s body.
What Is the Long-Term Outlook?
People who have a naturally short stature that’s not due to a medical condition or disease can expect to lead normal and healthy lives.
Children with GHD and other hormone-related conditions generally reach average height or a height similar to their parents if they receive treatment before puberty. For those with genetic or skeletal diseases, short stature will likely be a lifelong issue.
Medically Reviewed by: George Krucik, MD, MBA
Published By: Healthline Networks, Inc.