Is your child's height making you anxious?

Some people say that spring is the golden season for children to grow taller. This is true. Compared with winter, the weather in spring is fine and children's outdoor activities increase significantly. Outdoor activities increase the secretion of human growth hormone, which in turn promotes height.

In China, height is the most common growth and development problem for children. Generally, parents pay attention to their children's height based on their height ranking in the school class, which results in some people being happy and some being worried.

"My child is the shortest in the class. Is there something wrong with his development?" "Don't worry about his height now. It's not time for him to grow taller yet." "If the parents are not tall, the children will not be tall either"... We often hear these statements, but the height issue is not a simple question and answer question. It is related to many factors.

Is there any reference value for being the shortest in the class?

The first thing you need to understand is, if you are the shortest in the class, does that necessarily mean there is something wrong with you?

Strictly speaking, this question is not up to doctors to decide, but requires professional data to judge. The professional data here refers to the growth curve. At present, each country has a normal growth data range for children of different ages and genders. These data are connected into a curve, which is a growth curve chart. The growth curve chart generally includes elements such as height, weight, head circumference, and body mass index (BMI). Among them, BMI = weight (kg) / height (m) squared.

As economic conditions and society develop, people's growth trends will change, and growth data will be updated every ten years or so. Based on the nationally recognized growth curve table, doctors will determine whether the child's height is normal at this stage. If the height is lower than the 3rd percentile or two standard deviations (-2SD, the standard line is called SD) of the normal height standard curve of children of the same age, gender, and race, it can be diagnosed as dwarfism.

The "3rd percentile" mentioned here is a statistical term. The origin of the percentile method is this: randomly select 100 children of the same age and let them line up from low to high. The height of the child ranked 50th is the normal height for this age. Those ranked before 3rd are short, and those ranked after 97th are tall. For example, the "Standard Table of Normal Height of Male and Female Children and Adolescents of Various Age Groups" has the notations P3, P50, and P97, which represent short, average, and super tall, respectively. Therefore, when paying attention to a child's height, you should not only focus on the height of his classmates, but also measure it in the growth curve table.

Generally speaking, children with dwarfism grow less than 5 cm per year. If you suspect that your child is short, you need to go to a professional hospital to find a specialist to find out the cause. Only after a detailed evaluation can you know whether your child has dwarfism.

How much height growth per year is considered growth retardation?

In addition to the growth curve, growth rate is another indicator to determine whether growth is slow. This requires knowing how many centimeters a normal child should grow each year at different ages.

In the first year after birth, a person's height increases by about 25 cm, and the fastest growth occurs in the first six months: from 0 to 3 months, the average growth is 3.5 cm per month; from 4 to 6 months, the average growth is 2 cm per month; from 7 to 9 months, the average growth is 1.5 cm per month; from 10 to 12 months, the average growth is 1 cm per month. In the second year after birth, the average height growth is 10-11 cm, and thereafter it increases by 5-7 cm per year. If the height growth does not meet the above standards, you need to consult a professional doctor.

From the age of two, people's growth rate will stabilize at a certain percentile due to the influence of their parents' genes. In other words, the distinction between tall and short people begins from then on according to genetic height growth. The correlation coefficient between the height at the age of three and the final adult height is as high as 0.8. There is also a saying among the people that "you can tell a person's future by looking at him when he is three years old."

If a person's annual growth rate from 3 years old to puberty is less than 4-5 cm, or during puberty the annual growth rate is less than 6 cm, it can be judged as growth retardation, and further investigation is needed. On the growth curve chart, we can see that the growth curve of such children is in a downward deviation state.

What factors affect growth and development

Through the analysis of clinical data, we found that there are four main factors that affect children's growth and development.

First, diseases always affect growth and development, which is relatively easy to understand. Diseases that affect growth and development are divided into two major types, namely endocrine diseases and non-endocrine diseases.

We will focus on non-endocrine diseases first. For example, digestive system diseases. Chronic diarrhea of ​​various reasons will lead to a large loss of nutrients, such as cow's milk protein allergy in infants and young children, inflammatory bowel disease, protein-losing gastroenteropathy, etc. Intestinal necrosis and intestinal obstruction caused by various reasons will inevitably require intestinal resection. The more intestines are cut off, the more the intestinal absorption function is affected, which ultimately affects growth and development. The same is true for respiratory system diseases, such as recurrent respiratory tract infections and congenital bronchopulmonary dysplasia. Therapeutic drugs can affect digestive function, causing children to have poor appetite, small food intake, and insufficient nutrient intake. In addition, blood system diseases, malignant tumors, chronic kidney disease, and nervous system diseases can all cause growth and development retardation.

Endocrine diseases include "small for gestational age" (referring to a birth weight that is lower than the 10th percentile of the average weight of children of the same gestational age and gender, also known as intrauterine growth retardation), "growth hormone deficiency", "hypothyroidism", "chromosomal disease", "precocious puberty", etc.

Second, malnutrition. The current narrow definition of malnutrition is: insufficient intake or absorption disorders of energy, protein and other nutrients, resulting in obvious abnormalities in body tissue, morphology and function. Malnutrition is an outcome with many causes. Any disease that causes less intake, more excretion and more consumption over a long period of time may cause malnutrition in children, resulting in delayed growth and development.

Third, genetics can account for 70% of the influence on height. During the rapid growth stage of adolescence, the timing and height of the sudden increase in height are also affected by genetics.

Fourth, mood. Here we need to mention a concept, namely, psychological short stature. It often occurs in families with chaotic structures, such as when the relationship between the child and the guardian cannot develop in a healthy way, or when the parents have mental or psychological illnesses. Influenced by the family, such children may have abnormal mental state, backward language and IQ development, backward height and weight, delayed puberty development, etc. Therefore, a warm family environment is very important for the development of children.

Can "growth hormone" cure short stature?

The only clinically recognized effective treatment for dwarfism is growth hormone. Some parents, hoping that their children will grow taller, ask whether growth hormone can be used on children of normal height. We must emphasize that the use of growth hormone is a very professional and serious issue, with strict indications. It must be used under the guidance of professional doctors, and not everyone who wants to grow taller can use the drug.

Natural growth hormone is originally secreted by the human pituitary gland. The secretion amount in childhood is higher than that in adulthood. Its main function is to promote growth. Although the secretion of growth hormone decreases in adulthood, it will continue to be secreted into old age. In addition to promoting height growth, growth hormone also promotes muscle growth, reduces fat content, improves sleep, enhances immunity, promotes wound healing, and prevents cardiovascular disease.

The growth hormone currently used in clinical practice is also called "recombinant human growth hormone", which is a special protein produced using modern genetic technology. Its amino acid content, spatial conformation and sequence are the same as those of the growth hormone naturally produced by the human body. In theory, it can be applied to the following height problems.

The first is growth hormone deficiency; the second is intrauterine growth retardation without catch-up, which is the "small for gestational age" mentioned above; the third is idiopathic short stature: the stature is unexplained and is 2.25SD lower than that of normal children of the same age and gender; the fourth is familial short stature, which can also be classified as idiopathic short stature; the fifth is Turner syndrome, Noonan syndrome, and Prade-Willi syndrome; the sixth is precocious puberty, hypothyroidism, chronic renal failure, etc., which are predicted to have a significant impact on adult height after treatment.

However, whether recombinant human growth hormone is completely suitable for the above patients and can clearly improve height requires more evidence and evaluation, and it should not be used routinely.

A more concerned issue is "drug side effects". If growth hormone can be used, it needs to be used every day, even for several years. Will there be side effects? At present, the international medical community believes that because the structure of recombinant human growth hormone is exactly the same as the growth hormone produced naturally by the human body, and decades of global application data have been accumulated, the overall conclusion is that it is safe and effective. However, during the application process, professional doctor guidance is first required, and regular review is required.

Doctors explain: These three statements are wrong

Myth 1: It’s high now, but it will be higher in the future

A child's height now does not mean that he will be tall when he grows up. The key to a child's growth space depends on his bone age. For example, a precocious child develops his physique earlier and his epiphyseal closure is also earlier. He may be shorter than ordinary children when he grows up. Of course, not all precocious children are short. In short, parents should always pay attention to their children's growth and development process.

Myth 2: I am short now because I will grow up later

Due to genetic factors, it is possible that some children grow "late". Through examination, it can be found that although the bone age of such children lags behind the actual age, the endocrine hormones such as growth hormone and thyroid hormone are normal. However, some children have delayed bone age because of malnutrition, going to bed too late, too much stress, and little exercise, which leads to insufficient secretion of growth hormone. They are not tall now and may not grow taller in the future. For such children, in addition to recording their height growth, parents can also consult a doctor and don't miss the best time for intervention. It is not uncommon for treatment to be delayed because of waiting for children to "grow late".

Myth 3: If parents are tall, their children will definitely be tall

The influence of parents' genetic factors on children's height development accounts for 70%, and the acquired environmental factors account for 30%. Although height is closely related to genetics, genetics only gives a range of height, with a deviation of 8 cm. If the child is closer to the lower limit of genetics, the child's height will be shorter. About 30% of children in my country do not reach their genetic height when they grow up. In this case, problems can be discovered in time by monitoring the child's growth curve.

In addition, modern medical research has shown that the influence of the acquired environment can cause a child's final height to vary by 10 cm. Infancy and adolescence are the two golden periods for growth, so it is important to seize these two golden periods.

Five things to pay attention to when growing taller

Suggestion 1: Go to bed before 22:00 at the latest

Many studies have shown that sleep can affect height. Generally, the peak period of growth hormone secretion is from 9 pm to 1 am, and the premise of growth hormone secretion is deep sleep. People can enter deep sleep half an hour or an hour after falling asleep, so we recommend that children go to bed at 8:30. If this requirement cannot be met, go to bed before 10 pm at the latest. Don't eat too much before going to bed, and keep the sleeping environment quiet and dark.

Recommendation 2: Proper diet is the key

Nutrients such as calcium and protein are the main "building materials" of the human body. During the growth and development period of children, it is necessary to ensure daily intake of high-quality protein and calcium. The ideal state is to have a balanced diet, not picky eaters, not partial eaters, and not overeating.

Tip 3: Exercise for half an hour every day

The survey found that people who exercise during the day secrete more growth hormone when they sleep at night than those who do not exercise. This is true for adults and more obvious for children. Exercise should be diverse and continuous, and outdoor exercise is better, as it can get sun, help the body synthesize vitamin D and promote height development.

Tip 4: Measure your height regularly

It is best to measure the height of children under two years old once a month; for children over two years old, measure their height every 3-6 months, preferably at the same time, and take off their shoes. If the growth rate is less than 4-5cm/year from 3 years old to pre-puberty and less than 6cm/year during puberty, parents should take their children to see a doctor to find out the reason. Parents can also monitor height through the growth curve chart of boys and girls aged 2-18.

Tip 5: Keep a good mood

We should always encourage children, take them out regularly to relax, get in touch with nature, and keep a good mood. In addition, we should maintain a healthy weight.