Growth disorders in children refer to conspicuous growth behavior during adolescence. As an orientation for the classification of a growth disorder, the so-called growth curve is used.
What are growth disorders?
A growth disorder in children is considered to be growth that deviates significantly from the normal growth pattern for the age. To determine this, the growth curve is used. This describes an age-typical ideal growth pattern, but also includes the low and high values that are considered normal. If a child’s growth pattern lies outside this range, the child is considered to have a growth disorder. The children are then classified as short stature or tall stature. Only 0.05 percent of all children are affected by such developmental disorders, the causes of which can vary in nature. A rough distinction is made between hormonally induced, genetically based and disease-related growth disorders. If these causes can be identified as triggers for the developmental disorder and if, in addition, several examinations prove the deviations from the growth curve, one speaks of a growth or developmental disorder in children.
Causes
The causes of a growth disorder in children are varied. For example, genetic predisposition and the growth of parents influence the growth curve of their children. A special case in this regard is constitutional short stature. The growth values of the children affected by this are in the lower normal range of the growth curve and the curve of the parents is also still normal. Nevertheless, skeletal development is delayed in these children. Although their puberty is also often delayed, the affected individuals regain a normal height in adulthood. Pituitary dwarfism is considered a hormonally induced growth disorder and is caused by the pituitary gland not producing enough growth hormones. Finally, chronic heart and lung diseases can also cause growth disorders in children, such as so-called secondary short stature.
Symptoms, complaints, and signs
In addition to a body size that is too small or too large outside the normal range for age, various abnormalities may indicate a growth disorder in children. These include an unnatural head circumference that does not correspond to age and hands and feet that are too small or too large. In many cases, slowed tooth development is also an indication of growth retardation. Therefore, the change of teeth also develops later than in children of comparable age. There is also increased adipose tissue and a doll-like face. In boys, the genital development is conspicuously small. Over a long period of time, the voice remains high and squeaky sounding. Muscle mass is less developed, causing less strength. Peers have more energy. Growth disorders in children often lead to mocking comments from other children, which can lead to signs of depressive moods. Inferiority complexes and a lack of self-esteem can present as complaints as well. A symptom of a growth disorder in babies may be a significantly low blood sugar level. A growth disorder due to a growth hormone deficiency usually affects all parts of the body (proportionate short stature). If hypothyroidism is responsible for the short stature, children may suffer from fatigue, dry skin as well as constipation. A growth hormone deficiency can cause children to frequently not want to eat or drink enough. Excessive growth spurts can cause pain in the limbs, especially during rest periods.
Diagnosis and course
Multiple growth progression examinations help match their growth pattern with the general age-typical growth curve and identify growth disorders in children. Preconception examinations can help identify developmental abnormalities in children before birth. Further regular growth and weight measurements then reveal the child’s individual growth curve. Separate rules should be applied to premature infants. If a deviation from the normal age-related growth curve is detected that can be classified as significant, a growth disorder in children can be assumed.Then, follow-up examinations, as well as identification of other factors such as diet and digestion, physical activity, and symptoms for other conditions, help determine any hormonal and disease-related causes of growth disturbance in children.
Complications
Growth disorders in children can manifest themselves in very different ways and, as a rule, always lead to significantly delayed development. This has a very negative effect on the further life and adulthood of the affected child. Many children also suffer from bullying or depression with these disorders and sometimes develop psychological upsets or even depression as a result. Significantly reduced self-esteem or inferiority complexes can also occur in this case and make the child’s everyday life more difficult. Frequently, growth disorders in children are also associated with other diseases, so that the children suffer from very brittle bones or various tumors. As a result, the patient’s life expectancy may possibly also be limited. The parents and the relatives also very often suffer from depression or psychological complaints. The treatment of growth disorders in children is carried out with the help of medication. In the case of tumors, these must be removed. A completely positive course of the disease does not appear in most cases. With the help of supplements, growth can be accelerated in some cases. Early diagnosis of these disorders always has a positive effect on the course of the disease.
When should you go to the doctor?
If abnormalities occur in children during their natural growth and development process, the observations should be discussed with a doctor. Malposition, limitations in range of motion, pain or other abnormalities indicate a health disorder. A doctor should be consulted so that an investigation into the cause can be initiated. If the child shows greatly reduced or increased growth in direct comparison to playmates of the same age, a visit to the doctor is advisable. In case of gait disturbances, visual conspicuities of locomotion as well as unequal lengths of the limbs, medical help should be sought. If problems occur in everyday life or during sports activities, the child needs support. Modification measures are necessary so that the quality of life is not impaired. In the case of growth disorders, a reaction should always be taken as early as possible. This is essential for the best possible treatment strategy. The more advanced the disorders are, the more complex necessary measures become. In some cases, there are lifelong impairments. If, in addition to the physical abnormalities, there are also emotional stresses, the child also needs adequate support. In the case of mood swings, behavioral problems and withdrawal from social life, clarification of the triggers and reasons is advisable. In the case of depressive states, tantrums, disturbances in eating behavior or irregularities in sleep, consultation with a physician is recommended.
Treatment and therapy
Genetically determined growth disorders can be detected in children by preliminary fetal examinations and by looking at the growth patterns of the parents. For example, both hypochondroplasia and brittle bone disease are growth disorders in children that are both due to alterations in the same gene. However, these changes manifest themselves in very different disorders of bone and cartilage structure, of which there are over 200 different variants. Hormonally induced growth disorders can be treated by the targeted supply of hormones. If a tumor is responsible for the corresponding gland producing an excess or too little growth hormone, surgical removal of the tumor can have a positive effect on the growth disorder. In any case, precise preliminary examinations are required in this case. If growth disorders occur in children due to chronic diseases, their therapy can also compensate for the developmental disorder. For example, the consequences of chronic malnutrition can be counteracted by a targeted change in diet or nutritional supplementation.Due to the multitude of possible causes as well as the different manifestations of growth disorders and not least due to the always individual growth pattern of each child, the treatment of a growth disorder in children should also be planned individually.
Prevention
Growth disorders in children due to a deficiency or malnutrition can already be prevented by a healthy diet during pregnancy. The child’s diet is also crucial in this regard. However, hormonal and genetic growth disorders in children can hardly be prevented, as these factors are not subject to external influence. Nevertheless, regular examinations by the pediatrician and the determination of the individual growth curve can help to detect a growth disorder in children in time.
Follow-up
Whether follow-up treatment is necessary for growth disorders in children depends on the causes and consequences of the growth disorder and its intensity. If there was only a mild growth disorder that did not result in any sequelae, no follow-up treatment is necessary. If, on the other hand, insufficient endogenous production of growth hormones is the cause of the growth disorder, regular checks of the growth hormone levels in the blood must also be carried out in adulthood, since adults also still produce growth hormones and the body needs them. If a patient does not produce sufficient growth hormones even in adulthood, these must be supplied artificially by means of medication. In addition, regular checks of bone density and musculature should be carried out, as growth disorders in children increase the later risk of osteoporosis, malformations of the bones and bone diseases of all kinds, as well as muscle diseases. If bone disease is detected, it must be treated separately. To prevent bone diseases and other consequences of growth disorders, the constant intake of calcium and magnesium as dietary supplements in addition to the daily diet can be helpful. This is particularly true if a small for gestational age, i.e. short stature, was already present at birth or if a calcium or magnesium deficiency was diagnosed in combination with the growth disorder. In addition, if supplemental nutrient preparations are taken permanently in addition to the diet, the nutrient levels in the blood should be checked regularly.
What you can do yourself
In the case of growth disorders in children, the focus is on therapy by a doctor. Nevertheless, parents can act supportively and take steps to help themselves. As a rule, the situation is very stressful for the affected children and their entire family. Often they even develop inferiority complexes or other psychological problems. Parents should be open and honest about the disease and answer all the child’s questions. The child should be given access to all information. Depending on the specific cause of the growth disorder, both the affected children and their families can get help from self-help groups or on Internet forums. Due to the small body size, certain problems arise in the children’s everyday life, for example, when choosing clothes or opening doors. It is important to support the children as much as possible and to make everyday life easier for them. Nevertheless, they should not be patronized under any circumstances. Parents should assign them certain household tasks that they can perform despite their limitations. In general, the condition should be taken seriously, but should not dominate the family’s everyday life. Regardless of the cause of the growth disorder, it is important to provide the affected children with a healthy and balanced diet.