Growth spurt

Definition

A growth spurt is a significant increase in the speed of growth, usually related to the increase in height per unit of time. However, body weight and head circumference are also important for assessing growth in children. In humans, growth spurts usually occur preferentially at certain stages of life.

Thus babies grow fastest immediately after birth and adolescents between 12 and 15 years of age grow particularly fast in a relatively short time. In girls, the growth spurt usually begins about two years before the boys, but is usually less pronounced. The growth of children and adolescents is documented and compared by the doctor using so-called percentiles after determining their height. The average height or body weight of a cohort of the same age is plotted on these percentiles, thus simplifying the assessment in each individual case. If the height deviates significantly from the norm, a growth disorder could be present.

Causes

In human growth, growth hormones such as somatotropin are of crucial importance. A deficiency of these hormones leads to short growth, whereas an excess leads to gigantic growth. Somatotropin is produced in the pituitary gland and can be released by various stimuli, both increased and decreased.

An increased release of somatotropin from the gland can be caused by a lack of energy substrates, sports or fasting, protein-rich diet, psychological stress or fever. In contrast, somatostatin, an inhibitory hormone, reduces the release of somatotropin. Physiologically, most somatotropin is produced in the pituitary gland during sleep. The age with the highest production of this hormone is puberty, as the sex hormones produced there, such as estrogens and androgens, stimulate the release of growth hormones.

Symptoms

Overall, the major growth spurts can be divided into three phases: those in babies, toddlers and puberty. In the first two years of life, babies go through about eight growth spurts. This is also known as the first phase of growth spurts and it is during this time that children grow fastest in their entire lives.

On average, they grow about 43 centimeters per year, then slightly less from year to year. The growth spurts during this time usually last about a week and occur at intervals of one to two months. This is usually followed by a physical as well as a mental development surge.

Nerve growth also plays an important role, which is often perceived by children as confusing and disturbing. This is also reflected in their behavior. In this phase, the children are usually cranky and more strenuous than usual.

They cannot sleep as well as usual and increasingly seek constant contact with their caregivers. They are more affectionate and the mood is very changeable. Babies often get hungry during a growth spurt and have to be breastfed more often than usual.

The second major growth phase begins at the age of three and lasts until puberty. During this time, children continue to grow steadily, but strong growth spurts are rather unusual. On average, the body length gain in this phase is about five to six centimeters per year.

The third and final growth phase is during puberty and begins slightly earlier in girls than in boys, usually about two years before. This growth spurt is also called “pubertal growth spurt”. In girls it usually occurs at the age of 13 and from this time on they grow an average of 15 to 20 centimeters.

Boys usually grow about 20 to 25 centimeters from the age of 14. So on average they grow about seven to nine centimeters per year. With the end of puberty the final height is usually reached.

For girls this is around the 15th, for boys around the 17th year of life. In addition to the externally visible change in body size, bone or joint pain in the form of growth pain can also occur during a growth spurt. Increased appetite and tiredness are also possible.

When a baby is in a growth spurt, it usually shows typical behavioral patterns by which an increase in growth can be recognized. It is possible that the baby sleeps less or at shorter intervals than is usually the case. Particularly noticeable and associated with the shorter sleep phases is the increase in appetite.

Infants and toddlers are often more affectionate in growth phases and have to cry more. In puberty, a growth spurt can be manifested by increased sleep and growth pains in legs or arms.Fever during growth spurts is rather unusual and in most cases has a different cause. In children, fever can occur for many sometimes unrecognizable reasons.

From 37.5°C on, one speaks of increased temperature and from 38°C on of fever. It shows the body’s natural defensive reaction to germs and is an important part of the formation of the immune system, especially during development. In principle, fever does not have to be clarified or treated immediately by a doctor.

However, it is advisable to consult a pediatrician if you are not responding to fever reduction, high fever above 39°C, febrile convulsions or a strong feeling of illness. Paracetamol is recommended as a fever reducer, which can be given in consultation with the doctor and adapted to the child’s weight. During a growth spurt, circulation problems can occur, especially in connection with puberty.

Syncope (short-term unconsciousness) occurs when there is a sudden reduction in blood flow to the brain. The reason for this is the adaptation of blood volume and blood pressure to longitudinal growth that is still taking place, with additional trigger factors such as menstruation, prolonged standing, insufficient drinking or hypoglycaemia. Although in most cases no worrying reasons for syncope can be found, diseases such as heart problems should be excluded.

Growth pains often occur during strong growth phases in the development of a child. It is characterized by nocturnal occurrence and localization in the legs, which is often compared to the feeling of a nocturnal calf cramp. After a few minutes, however, the pain disappears quickly.

Many children find massage, warmth and affection relieving in acute pain. If these pains occur frequently, one should seek the advice of a pediatrician, as other illnesses can also trigger such pain and should or can possibly be treated. A cause for the development of growth pain has not yet been found, as normal growth does not actually cause pain.

Some children may experience growth pain during a growth spurt. This pain typically occurs between late afternoon and evening, and occasionally children wake up from the pain at night. In fact, this form of pain is one of the most common in children.

Typically, the muscles of the calves and thighs hurt, not the joints. If there are accompanying symptoms such as high fever, skin rashes or severe pain during the day, there is probably another cause and it is advisable to consult a pediatrician. Even if the pain persists over a longer period of time and the child is unusually flabby, further diagnosis must be made.

Newborns experience many growth spurts, especially in the first year of life. These are usually divided into eight different growth phases. The duration of a growth spurt can vary greatly, from 3 days to 4 weeks.

In babies, these growth phases are usually associated not only with growth in size, but also with motor and mental achievements and certain behavioral patterns. As in the first growth spurt there is a strong desire for closeness to the mother and the child begins to recognize the mother by smell, a pronounced ”strangeness” is characteristic of the second phase. The third phase is characterized by a greater appetite for milk or the slow cessation of rituals such as naps.

Between the third and fourth month of life, the fourth growth phase usually begins, during which the baby often grows very quickly and restless nights are the order of the day. The next phase is mainly characterized by the acquisition of motor skills, such as independent turning and first crawling exercises. In addition, the first efforts to speak take place, even if they are initially rather single syllables.

At the end of the sixth phase (about 9 months), most babies can now crawl. But also a certain understanding for the reaction of the parents now appears in the newborn. Clear signals like ”yes” or ”no” are now slowly understood.

Babies can often speak their first word after the seventh growth spurt. However, this phase is often accompanied by tantrums. At the end of the eighth phase, many babies can now walk slowly, but there is often a renewed sense of strangeness.

andThe growth phases of babies again at a glance:

  • Phase 1: From week 5 onwards, babies smile and are more attentive. Above all, they often need breast milk and physical closeness.
  • Phase 2: From the 8th week onwards, babies become alienated and develop the ability to see colors. The children can now be calmed with toys.
  • Phase 3: From the 3rd month onwards, babies become hungry faster and cry more often.

    They should slowly become accustomed to rituals.

  • Phase 4: Between the 3rd and 4th month the children’s nights become more restless, patience and physical closeness can help here.
  • Phase 5: Between the 6th and 7th months, children start crawling and spinning and start their first attempts at speaking. In this phase, the encouragement of the children is especially important.
  • Phase 6: From the 9th month onwards, the children speak their first sentences and move more and more independently. Clear rules should already be introduced now.
  • Phase 7: From the 11th month onwards, babies improve their motor skills even further, lots of toys are a good occupation and tasks can already be assigned.
  • Phase 8: Between the 13th and 14th month, the children become increasingly moody, the defiance phase begins.

    Patience and, above all, clear boundaries are also helpful here.

Growth spurts are usually biologically pre-programmed and necessary for a healthy physical and mental development of children and adolescents. In some cases, however, they may not be regular, may be too strong or too weak and may be accompanied by further complications. These may require targeted therapy.

During the pubertal growth spurt, the lateral curvature of the spine (scoliosis) increases most strongly. If this phase proceeds unevenly or particularly quickly, an imbalance can occur, causing back pain. If the scoliosis is very pronounced and growth is not yet complete, physiotherapy and wearing a corset may be necessary, for example.

In very extreme cases, the spine may even have to be surgically straightened. X- and O- legs also occur relatively frequently in small children. Shortly after the start of the run, an X-leg position is even the normal finding.

This usually corrects itself by itself until the age of six and does not require any further therapy. However, if no spontaneous correction is seen or if the misalignment even increases, regular check-ups should be performed. If the leg malposition is corrected during prepubertal growth, it can be straightened relatively easily in a minor surgical procedure.

If the growth is complete, however, several extensive operations are usually required. Pathological short (short stature) or long (tall stature) stature is also conceivable in children and adolescents. One speaks of this when the child is one of the three percent smallest or largest among its peers.

The reason for this can be a lack or excess of growth hormones, which can be treated with medication. On the one hand, there are artificially produced growth hormone preparations that can help to achieve relatively normal size growth despite reduced production by the body. This can be the case, for example, in the context of hypothyroidism, delayed puberty or other chronic diseases.

On the other hand, extremely rapid growth can be slowed down by medication. This is sometimes necessary when a very large body size is expected and the growth spurts are so rapid that they cause additional complaints. For example, this can prevent the development of scoliosis or reduce its severity, which otherwise often causes lifelong back problems for those affected.

An excess of growth hormones is also conceivable in the case of a tumor of the pituitary gland. However, both short and tall growth can also be hereditary and must therefore be clarified in each individual case. Drug therapy is an intervention in the hormone balance and should therefore only be carried out on the doctor’s orders and under strict supervision.

During the pubertal growth spurt, the lateral curvature of the spine (scoliosis) increases most strongly. If this phase is uneven or particularly fast, an imbalance can occur and cause back pain. If the scoliosis is very pronounced and growth is not yet complete, physiotherapy and wearing a corset may be necessary, for example.

In very extreme cases, the spine may even have to be surgically straightened. X- and O- legs also occur relatively frequently in small children. Shortly after the start of the run, an X-leg position is even the normal finding.

This usually corrects itself by itself until the age of six and does not require any further therapy. However, if no spontaneous correction is seen or if the misalignment even increases, regular check-ups should be performed. If the leg malposition is corrected during prepubertal growth, it can be straightened relatively easily in a minor surgical procedure.

If the growth is complete, however, several extensive operations are usually required. Pathological short (short stature) or long (tall stature) stature is also conceivable in children and adolescents. One speaks of this when the child is one of the three percent smallest or largest among its peers.

The reason for this can be a lack or excess of growth hormones, which can be treated with medication. On the one hand, there are artificially produced growth hormone preparations that can help to achieve relatively normal size growth despite reduced production by the body. This can be the case, for example, in the context of hypothyroidism, delayed puberty or other chronic diseases.On the other hand, extremely rapid growth can be slowed down by medication.

This is sometimes necessary when a very large body size is expected and the growth spurts are so rapid that they cause additional discomfort. For example, this can prevent the development of scoliosis or reduce its severity, which otherwise often causes lifelong back problems for those affected. An excess of growth hormones is also conceivable in the case of a tumor of the pituitary gland. However, both short and tall growth can also be hereditary and must therefore be clarified in each individual case. Drug therapy is an intervention in the hormone balance and should therefore only be carried out on the doctor’s orders and under strict supervision.