March 26, 2010

This article was written by our pediatric endocrinologist, Dr. Deborah Rotenstein for the Pittsburgh Post Gazette.  Links to Dr. Rotenstein's webpage and links to the Pittsburgh Post Gazette can be found at the bottom of this page.

Question: How do I know that my child is growing normally?

Answer: Children can be tall or small, but what is fundamental is that they grow at an appropriate rate each year. This rate changes by age, as children grow the fastest in the womb and slow down during childhood. During the first year of life children grow on average about 10 inches. From years one to two they grow about five inches and from years two to three about 3 1/2 inches. After age 3 children grow on average two inches per year. Pediatricians plot growth rate, head circumference and weight. Normal growth is one of the best barometers of good child health.

Height has a very strong genetic component, with the greatest influence being the height of the child's parents. The age of the onset of puberty and the duration of puberty also has a lot to do with the height the child will achieve. If puberty is late, they may grow for a longer amount of time, but if it is early they may not have as much time to grow. The size of the child just before the start of puberty represents 85 percent of their adult size. If the child does not grow normally before puberty, they are not likely to make up all the difference with a pubertal growth spurt. In addition, not every child will have a pubertal growth spurt.

Worldwide the most common reason children are too small is malnutrition, which happens in every country and in every economy. Growth hormone is secreted during sleep and play. Illnesses of nearly every system can influence growth. Even emotional issues can have a role to play. A variety of medications can also influence growing in a negative way, but the medicines may be essential for other aspects of their health.

If you have questions about your child's growth, talk to your child's pediatrician. The specialty physician that works with growth issues is a pediatric endocrinologist. It is best to evaluate growth issues after the age of three years and prior to puberty. This gives the physician the most amount of time to evaluate growth and help make an intervention if one is needed.

Dr. Rotenstein is a Board Certified Pediatric Endocrinologist at the Endocrinology Division
Click here to visit the Endocrinology Division Page

Read more: http://www.post-gazette.com/pg/10041/1034641-114.stm#ixzz0fEvrOnMA

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