All children should have their growth and development monitored on a regular basis.

If your child appears to be much shorter than most children his or her age (or if the growth rate has decreased or stopped), call your health care provider.

The health care provider will perform a physical examination. The child's height, weight, and arm and leg lengths will be measured. If the short stature appears to be a sign of some medical condition, further tests, including laboratory studies and x-rays, may be needed.

To learn more about possible causes, the health care provider will ask questions, such as:

• Family history
  • How tall are the parents and grandparents?
  • How tall are the brothers or sisters?
  • Are other relatives less-than-average height?
  • Have any family members been diagnosed with a disorder that can cause short stature?
  • At what age did the parents start puberty?
• Child's history
  • What was the child's birth like?
  • How is the child's diet?
  • Has the child begun to show signs of puberty?
  • At what age did puberty signs begin?
  • Has the child always been on the small side of the growth charts?
  • Was the child growing normally and then the rate of growth began to slow?
  • What other symptoms are present?
  • Is the child's short stature affecting self-image or causing any problems at school or with friends?

A bone age x-ray is often done. X-rays are usually made of the left wrist or hand. Normally, the size and shape of bones change as a person matures. These changes can be seen on an x-ray and usually follow a pattern as a child grows older. Certain causes of short stature may be present if the bones have not changed or matured as expected for the child's age.

Girls with short stature may have a karyotype done to check for certain genetic diseases, such as Turner syndrome.

Other tests may include:

• Complete blood count
• Other blood tests to look for liver, kidney, thyroid, and other medical problems
• Insulin growth factor-1 (IGF-1) levels may be done for some children
• Growth hormone stimulation test may be done for some children

Although your health care provider keeps records of height and weight from routine examinations, you may find it helpful to keep your own records. You may want to bring these records to your health care provider's attention if the growth seems slow or the child seems small.

TREATMENT

Children of short stature who are found to have a lack of growth hormone in their body will usually be treated with growth hormone injections.

Growth hormone injections are also used to treat children with Turner syndrome, Prader-Willi syndrome, chronic kidney failure, or idiopathic short stature (ISS).

Many children with short stature of unknown cause do not need growth hormone injections. Children who are more likely to receive growth hormone injections are:

• Those who are greater than 2.25 - 2.5 SD below the average for their age and gender, or in the shortest 1.2% of children
• Those who were born small for gestational age

Some boys with short stature who also have delayed puberty may receive certain medicines containing the male hormone, testosterone.