Pediatric Growth Problems

What causes growth problems?

The cause of a growth problem depends on the type of growth disorder in question. Some growth problems are genetic, while others may be caused by hormonal disorders or poor absorption of food. Causes for growth problems usually fall into the following categories:

• Familial short stature. Familial short stature is a tendency to follow the family's inherited short stature (shortness).
• Constitutional growth delay with delayed adolescence or delayed maturation. A child who tends to be shorter than average and who enters puberty later than average, but is growing at a normal rate may have a growth delay.
• Illnesses that affect the whole body (also called systemic diseases). Constant malnutrition, digestive tract diseases, kidney disease, heart disease, lung disease, diabetes and severe stress can cause growth problems.
• Endocrine (hormone) diseases. Adequate production of the thyroid hormone is necessary for normal bone growth. Cushing's syndrome, a rare condition, can be caused by a myriad of abnormalities that result in hypersecretion of corticosteroids by the adrenal gland. Growth hormone deficiency involves a problem with the pituitary gland (small gland at the base of the brain). The pituitary gland secretes several hormones, including growth hormone.
• Congenital (present at birth) problems in the tissues where growth occurs. With a condition called intrauterine growth restriction (IUGR), slow growth within the uterus occurs during a pregnancy. This can be caused by many factors, including smoking during pregnancy. The baby is born smaller in weight and length than normal, although proportionate to his/her short stature.

Having too many or too few chromosomes can result in health problems, including problems with growth. A common chromosome abnormality that results from too few chromosomes is the following:

Turner syndrome is a genetic disorder seen in girls that causes them to be shorter than others and fail to develop during puberty. The severity of these problems varies among affected individuals. Other health problems may also be present involving the heart or renal system (kidneys, etc.). Many conditions can be managed or corrected by medical treatment. Turner syndrome occurs in one in 2,500 females born. The features of Turner syndrome result from having a missing X chromosome in each of the body's cells.

There are different bone diseases that affect height and growth, many of which are genetic. The most common is achondroplasia, a type of dwarfism in which the child's arms and legs are short in proportion to his or her body length.

Further, the head is often large and the trunk is normal size. Some girls may have an abnormally tall stature for their age if their parents are tall. In addition, a growth disorder called precocious puberty is characterized by an early onset of adolescence in which a child is tall for his or her age initially, but, due to rapid bone maturity, growth stops at an early age and they may be short as adults. There are a few genetic conditions that result in tall stature with other health problems also present. There are several growth disorders that are idiopathic with no known cause for the growth problem.