A parent needs to be aware of certain things to be able to identify if their child is faltering in growth or is falling short. These are some of the questions that parents need to know about, so that they can get timely interventions if needed. A simple question that I often ask is if the child has outgrown his shoes and needs to buy new shoes at the beginning of new term at school ? if the answer is yes a lot of times it implies the child is growing well.
How Do you Decide If The Child is Not Growing well ?
This can be answered by a few simple questions
Q1) What is his current growth Centile ?
A1) A child’s growth centile is plotted on gender specific growth Charts in relation to his Mid Parental Height or Target height, since every boy or girl of the same age will not have the same height target. Each child is different and should be plotted accordingly. If the child is failing for his Target Height then he or she is considered as faltering.
Q2) What is the Childs Height Velocity ?
A2) Childs Height Velocity means the height the child achieves over a period of time. This is usually calculated over 6-12 months. Any children above 3 yrs of age and before start of puberty should grow a minimum of 5-6cm every year.
When a child grows less than this they are said to be faltering for height. When you plot the child regularly on a growth chart a child who has poor height velocity will fall down from the centile is growing on – meaning there will be a down slope on his growth curve.
This is a “Red Flag Sign” !
Q3) What is a Child Growth Potential ?
A3) this is the genetic potential of the child for height, that he inherits from his parents. It is calculated using both the parents height (adding 13 cm in boys, subtracting 13 cm in girls) and taking the average of it all. So if both the parents are tall an d the child is short then. It’s a strong indicator for testing !
“however I have found it useful to go back a generation and evaluate the parental height as well to see if any of the parents were short because of any reason in comparison to their potential”
Q4) How much time does the child have for growing / How long can the child continue to grow ?
A4) The child grows as long as the bones have not fused !
Fusion of the bones happens after completion of puberty in both boys and girls. In girl the last stage of puberty is getting periods. In boys is the development of beard, moustache, voice change and full development of secondary sexual characteristics.
Myth : Children continue to grow till 18years of Age.
Children will continue to grow only till bone space permits. If puberty happens early they will fuse early and children will stop growing early!
Treatment for short stature should ideally be completed before the START of puberty NOT after the end of puberty.
