Growth - The Long Short Story

This has been written by a parent for parents who want to know AS MUCH AS POSSIBLE!

If your child is short should you be worried? Have you spoken to friends who have tried to re-assure you that you are being a little bit over anxious? 'Well, you're not very tall, are you?' ...'Well, what do you expect with all that he/she has been through?'.... 'I know someone who was very worried that their son was really small and then suddenly, whoosh, up he went and turned out to be taller than most of his friends!'

Boys are more likely to cause concern than girls, possibly because we don't worry about our daughters being short as much as we do our sons and perhaps because growth hormone deficiency does actually happen more often in boys than girls, it does sometimes come as part of the 22q11.2 deletion package of goodies!

The aim of this document is to outline the main elements of growth concerns in plain English. This is a very complicated issue as it's a matter of weighing up lots of factors. There is a glossary of terms at the end, so if something is new to you then have a look because once you get to grips with the 'technical terms' the fog often lifts by itself! Having said that you may need to read this all through several times... it has taken a long time to write!

This paper has been read and endorsed By Dr Jeremy Kirk, Consultant Endocrinologist at Birmingham Children's Hospital, which is one of the largest growth centres in the world (October 2004). It has also been read by Dr Tim Cheetham, Consultant Endocrinologist and Senior Lecturer in Endocrinology at University of Newcastle upon Tyne. We are very grateful to them for their time and valuable help.

Is your child actually short?

Get your red book and familiarise yourself with the growth charts (or give Max Appeal a tinkle if you can't find it/don't have one) and then follow the following steps:
1. Add Mum and Dad's height (in cms) and divide by 2 then, for boys add 7cm and for girls take away 7cm. This gives the 'Mid-Parental Height.' See where this is on the far right hand side of the chart.
2. Your child's final adult height could be 8.5cm above or below this, it's called the 'Target Centile Range'.
3. Measure your child. Sounds easy but make sure you have them standing up straight on a firm surface with heels against wall and feet flat on the floor (no tippy toes, no slumpy shoulders!), and that you measure from the top of the head at a 90 degree angle. The best way to do this is to use a cereal packet or book with the edge held vertically (not horizontally) against the wall. (If you are monitoring their growth then do it in the same spot at the same time of the day at the same time of the month with the same tape measure!)
4. Look on the left hand side of the chart for height and follow the bottom line across to your child's age and mark the spot where they meet.
5. Find the closest centile line to that and follow it up to the right of the chart.

Most (82%) children will fall between the 91st and 9th centile (this doesn't always mean that everything is okay but we'll come to that in a bit!). Also most of our children will have a target centile range that falls between the 91st and 9th centile.

If your child is in the shaded area at the bottom (below the 2nd centile) and you and your child's other biological parent are pretty average in height i.e. your child falls below their target centile range then there could be a problem.

Is being short just a cosmetic thing?

Having a little child can be cute and sweet. They can be babied and cuddled more. They get lots of attention for being so lovely. What happens when they are teenagers and adults?

Some might think that being short is no big deal. Being a bit short probably isn't... (being 5'3' myself) but being really short (perhaps more so for a man) such as to be 5 foot or under may not be a fun situation. Not everyone can be Frankie Dettori!

It is accepted th