Is your child significantly shorter than their classmates? Watching your child struggle with growth concerns can be heartbreaking, especially when they notice the difference themselves. Without proper evaluation and treatment, underlying hormonal issues could affect not just your child’s height, but their overall health, confidence, and quality of life. The good news is that pediatric endocrinologists specialize in diagnosing and treating growth disorders, offering solutions that can help your child reach their full potential.
Understanding Normal Growth Patterns
Infants and toddlers grow the fastest; the rate of growth slows down in the early school-age years and then increases again during puberty in the teenage years. Every child grows at their own pace, but tracking growth patterns helps identify when something might need attention.
Short stature, or shorter height, is a common reason for a visit to a pediatric endocrinologist, a specialist in growth and hormones. Short stature is roughly a height below the 3rd percentile on a standardized growth chart. However, being shorter than average does not always indicate a health problem.
Key Signs It’s Time to See an Endocrinologist
Parents should consider consulting a pediatric endocrinologist if they notice any of the following:
- No growth for at least 10 months during the expected growth period.
- Height consistently below the 3rd percentile on growth charts.
- Sudden changes in growth rate.
- Significant deviations from family height patterns.
- Early (precocious) puberty: This condition occurs when the physical signs of puberty develop much earlier than normal.
- Delayed puberty: This condition occurs when the physical signs of puberty develop much later than usual.
Other Concerning Symptoms
In addition to height concerns, other indicators that may require an evaluation by an endocrinologist include:
- Rapid weight gain or loss.
- Hypothyroidism: A disorder in which the thyroid gland does not produce enough thyroid hormone.
- Signs of diabetes, such as excessive thirst, frequent urination, and unexplained weight loss.
- Unusual breast development in boys.
- Hypopituitarism: A condition in which the pituitary gland produces lower-than-normal hormone levels, potentially affecting growth, thyroid function, adrenal function, puberty, and thirst.
What do Endocrinologists Evaluate
Pediatric endocrinologists consider several factors when evaluating short stature, including birth history. Being born prematurely or small for gestational age can impact a child’s height during the early years of puberty. Most growth occurs in the middle of puberty, particularly before girls experience their first menstruation. Height growth typically stops once puberty is complete.
The heights of the parents also play a significant role. The mid-parental height estimate, which is an adjusted average of the mother’s and father’s heights, provides a rough prediction of how tall a child may grow. However, there is a wide range of possible heights on either side of this estimate.
Diagnostic Testing
When evaluation is needed, testing may include:
- A bone age x-ray:- This is a x-ray of the left hand and wrist that shows the growth plates. It can give an estimate of how old the bones “think” they are and how much longer a child may have to continue growing.
- Blood tests for hormone problems:- These may include looking at thyroid function or markers of growth hormone function. This also involves testing for deficiencies or excesses of growth hormones produced by the pituitary gland
Treatment Options
Treatment depends on the underlying cause and may include:
- Growth hormone injections, testosterone injections, or increased caloric intake
- Thyroid hormone replacement for hypothyroidism
- Nutritional counseling and dietary modifications
- Management of underlying medical conditions
During growth hormone therapy (GH), a child needs to receive daily injections of GH, administered at home. The child will meet with a pediatric endocrinologist every three months to monitor growth velocity, have a physical exam, and complete laboratory tests to make sure the therapy is working. The duration of therapy depends on the child’s age at the beginning of treatment and continues until the child has the potential to grow and is responding to treatment.
When to Act Promptly
It’s most important to see how the child is growing and check the growth velocity. If the child has had regular checkups, the rate of growth can be easily evaluated; if there’s an unusual pattern of growth, a consultation with an endocrinologist should be considered.
Early intervention often leads to better outcomes. If your child is upset by their height or is experiencing bullying at school, it is important to talk to their pediatrician or primary care provider. A referral to a pediatric endocrinologist may be necessary to make sure there is not an underlying problem.
Take Action for Your Child’s Growth
If you have concerns about your child’s growth or development, don’t wait to seek expert guidance. Contact Dr. Kehinde Folawewo at Hilltop Internal Medicine and Endocrinology for a comprehensive evaluation. Dr. Folawewo is a double board-certified endocrinologist providing expert care for hormonal and metabolic disorders in Oxon Hill, Maryland.
Schedule your consultation today at Hilltop Internal Medicine and Endocrinology and take the first step toward understanding and supporting your child’s growth journey. Visit us or call (301) 567-9570 to book your appointment with Dr. Kehinde Folawewo.
Frequently asked questions
Is short stature always abnormal?
No. Many children are healthy but shorter because of family genetics or a later growth spurt. A specialist helps separate normal patterns from treatable causes.
What is bone age, and why does it matter?
Bone age estimates skeletal maturity. A delayed bone age often means more growth remaining, while an advanced bone age can explain rapid early growth or early puberty.
When should early puberty be checked?
Breast development before 8 in girls or testicular enlargement before 9 in boys should be evaluated. Early referral allows timely testing and treatment if needed.
What if growth is slow but labs are normal?
Growth tracking continues. Many children with constitutional delay catch up in late adolescence. Your endocrinologist will set a follow-up plan and repeat measurements to confirm progress.
Can nutrition or chronic illness affect height?
Yes. Under-nutrition and chronic disease commonly slow growth. Endocrinology can coordinate with primary care, nutrition, and other specialists to address the whole picture.
Additional Reads:
Should I See a Gynecologist or Endocrinologist for PCOS?
Should I See an Endocrinologist or a Rheumatologist for Osteoporosis?
Can an Endocrinologist Prescribe Ozempic? What You Need to Know
Should I see an ENT or endocrinologist for thyroid
