Short Stature
En Español (Spanish Version)

Definition
Short stature is a height that is less than or equal to the third percentile for a person's age, sex, and race.

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, and growth hormone deficiency
Expected Growth (Shadow) and Short Stature

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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:

  • Malnourishment—most common cause of growth failure and is generally associated with poverty
  • Genetic disorders such as skeletal dysplasias, Turner syndrome , Down syndrome , and Silver Russell syndrome
  • Endocrine disorders such as hypothyroidism or growth hormone deficiency
  • Congenital heart disease
  • Kidney diseases
  • Liver failure
  • Sickle cell anemia —a blood disorder
  • Intrauterine growth retardation or small for gestational age
  • Disorders of the stomach or intestines such as inflammatory bowel disease
  • Lung conditions such as severe asthma and chronic obstructive pulmonary disease
  • Malabsorption due to cystic fibrosis or celiac disease
  • Use of SSRI medications—may be used to treat attention deficit disorder or obsessive compulsive disorder
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. 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 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
Diagnosis
You will be asked about your child's 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.

Your child's bodily fluids may be tested. This can be done with:

  • Blood tests
  • Urine tests
Images may be taken of your child's bodily structures. This can be done with x-ray.

Your child may be tested for chromosomal abnormalities. This can be done with a genetic exam.

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
Medications 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 some children such as those with growth hormone deficiency, Prader Willi syndrome , Turner syndrome, chronic kidney disease, or idiopathic short stature
If a medication is associated with short stature, you may be advised to stop taking 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 short stature from genetic conditions. However, short stature from chronic disease can be prevented by treating the condition. In some cases, you can minimize your child’s risk of developing short stature by encouraging a nutritious diet.

Pregnant women can minimize the risk of short stature in their children by:

  • Eating a nutritious diet during pregnancy
  • Avoiding smoking
  • Avoiding illegal drugs



RESOURCES:
Human Growth Foundation

The MAGIC Foundation

CANADIAN RESOURCES:

Little People of British Columbia: Society for Short Stature Awareness

References:
Is your child growing normally? The Magic Foundation website. Available at: http://www.magicfoundation.org. Accessed June 3, 2014.

Short stature. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 7, 2014. Accessed June 3, 2014.

Short stature. Pediatric Orthopedic Society of North America website. Available at: http://www.posna.org/education/StudyGuide/shortStature.asp. Accessed June 3, 2014.

When a child is unusually short or tall. American Academy of Pediatrics' HealthyChildren.org website. Available at: http://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/When-a-Child-is-Unusually-Short-or-Tall.aspx. Updated May 28, 2014. Accessed June 3, 2014.

Last Reviewed June 2014



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