Short Stature

Definition

Short stature is a height that is smaller than the average height for a person's age, sex, and racial group. It is specifically height that is in the third percentile.
Short stature is generally broken down into three subgroups:.
  • Familial short stature—parents are short
  • Constitutional delay and development—child is small for age but growing at normal rate, will reach an adult height similar to parents
  • Caused by chronic disease—such as malnutrition, genetic disorders, heart problems, or growth hormone deficiency are just a few that can affect growth treatment will be needed to reach full height potential
Expected Growth (Shadow) and Short Stature
Stunted Growth Child
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Contact a doctor if you notice a significant decrease in your child's growth rate or if your child has stopped growing.

Causes

Familial and constitutional delay are due to the child's genetic make-up. If both parents are shorter than average, the child will most likely have short stature. The child may also have delayed puberty. This may cause temporary short stature, but normal height will eventually be reached.
Medical conditions that may contribute to short stature, include:

Risk Factors

Factors that may increase the risk of short stature include:
  • Having family members with short stature
  • Poor diet
  • Certain diseases and drugs taken by a pregnant woman will increase risk to the newborn child

Symptoms

Symptoms vary depending on the type of condition. Children with familial short stature do not have any disease-related symptoms. They will often reach a height similar to that of their parents.
Children who have delayed puberty, late bloomers, will often have a close relative with the same delay. These children will also eventually catch up to their peers in height.
Symptoms that may indicate a medical condition include:
  • Stopped or dramatically slowed growth (below the third percentile as determined by your doctor)
  • Weight loss or gain (more than five pounds in a month)
  • Poor nutrition
  • Loss of appetite
  • Chronic abdominal pain and diarrhea
  • Persistent fever
  • Chronic headaches and/or vomiting
  • Delayed puberty (no spotting by age 15 for a girl or no enlargement of the testes by age 14-15 for a boy)
  • Obstructed sleep apnea

Diagnosis

Your child’s doctor will ask about symptoms and medical history. A physical exam will be done. Your child's height, weight, and body proportion will be measured. The skull and facial features will also be examined.
Some tests may be done to diagnose or exclude contributing conditions. These tests may include:
  • Bone age: an x-ray to determine the chronological age of your child’s bones
  • Blood tests:
    • To check for hypothyroidism–low levels of thyroid hormone
    • To check growth hormone levels–an important factor in growth
    • To check for signs of conditions that may cause short stature like respiratory problems, malnutrition, and liver disease
  • A complete blood count to check for blood diseases
  • A genetic exam to detect chromosomal abnormalities and to exclude Turner syndrome (a common cause of short stature in girls)
  • Urinalysis—examination of urine to look for conditions like kidney disease

Treatment

Children with familial short stature do not require treatment. For others, treatment will focus on the cause of short stature. Treatments can vary greatly but may include medication or nutritional changes.

Medications

Medication that may be used to treat associated conditions include:
  • Thyroid hormone replacement therapy—may be used in children with hypothyroidism
  • Growth hormone replacement—may be used in children with growth hormone deficiency, Prader Willi syndrome , or Turner syndrome
If a medication is associated with short stature your doctor may stop the medication. Make sure to talk to your doctor before stopping any medication.

Improved Nutrition

Malnutrition can contribute to short stature. It may be due to a lack of proper food or other conditions like gastrointestinal problems. In either case, a change in diet may help. Talk to your doctor or dietitian to help make effective changes to your child's diet.

Prevention

Short stature cannot be prevented in children who have a familial short stature or those who have a chronic disease. In some cases, you can minimize your child’s risk of developing short stature by making sure the child eats a nutritious diet.
Parents can minimize the risk of short stature in their children by eating a nutritious diet during pregnancy.

RESOURCES

Little People of America (LPA), Inc. http://www.lpaonline.org

Human Growth Foundation http://www.hgfound.org

International Skeletal Dysplasia Registry Cedars-Sinai Medical Center http://www.cmsc.edu

The Magic Foundation http://www.magicfoundation.org

CANADIAN RESOURCES

BC Health Guide, British Columbia Ministry of Health http://www.bchealthguide.org

Little People of British Columbia: Society for Short Stature Awareness http://www.littlepeopleofbc.org/

References

Short stature. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated August 2011. Accessed August 8, 2012.

Short stature. Pediatric Orthopedic Society of North America website. Available at: http://www.posna.org/education/StudyGuide/shortStature.asp . Accessed August 8, 2012.

Little People of America (LPA), Inc. website. Available at: http://www.lpaonline.org . Accessed September 2005.

Is your child growing normally? The Magic Foundation website. Available at: http://www.magicfoundation.org . Accessed August 8, 2012.

When a child is unusually short or tall. American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/When-a-Child-is-Unusually-Short-or-Tall.aspx . Accessed August 8, 2012.

Revision Information

  • Reviewer: Michael Woods
  • Review Date: 09/2012
  • Update Date: 00/91/2012