Growth Failure in Children Causes

Normal growth is the result of several factors, such as nutrition, genetics, and hormones. The following are possible causes of growth failure.

• Familial short stature: Children with this condition have parents with short stature. They have a normal growth velocity, and bone age is not delayed. They enter puberty at a normal time and often complete growth with a short adult height.



• Constitutional growth delay: Also called delayed puberty, children with constitutional growth delay have a normal birth weight, and their growth slows usually during the first year of life. From about age 3 to puberty, these children have an adequate growth velocity. Bone age is usually delayed, and puberty is late. Late puberty allows for more prepubertal growth, usually resulting in a normal adult height. Usually, children with constitutional growth delay do not show growth failure but a period of slow growth velocity occurs during the first year of life and just before puberty.



• Malnutrition: Worldwide, malnutrition is probably the most common cause of growth failure and is usually poverty-related. Nutritional deficiencies in developed countries are more often the result of self-restricted diets. Poor weight gain is often more noticeable than short stature.



• Diseases and disorders: Chronic diseases and systemic disorders that involve the nervous, circulatory, or gastrointestinal systems may be a cause of growth failure. Diseases or disorders involving the liver, kidneys, lungs, or connective tissue may also be a cause.



• Psychosocial dwarfism: This is a disorder of short stature or growth failure and/or delayed puberty. This often occurs in association with emotional deprivation and/or child abuse and neglect.



• Syndromes: Growth failure can be a feature of genetic syndromes, such as Turner syndrome and Down syndrome. It can also be a part of other syndromes, such as Noonan syndrome, Russell-Silver syndrome, and Prader-Willi syndrome.



• Endocrine (hormonal): Endocrine causes include thyroid hormone deficiency (hypothyroidism), growth hormone deficiency, or other hormone disorders. Thyroid hormone is necessary for normal growth; in children with hypothyroidism, growth is extremely slow. Children with growth hormone deficiency have normal body proportions, but they may appear younger than their actual age.



• Other: Growth failure may be related to intrauterine growth retardation (a condition in which children weigh less than 5 pounds at full term or who are small for gestational age if born preterm). Bone and cartilage disorders (called chondrodystrophies) may also be a cause of growth failure. Achondroplasia (one of the most common conditions that cause growth failure and short stature) is a genetic disorder of bone and cartilage. People with achondroplasia have a normal-sized trunk, short arms and short legs, and a slightly enlarged head with a prominent forehead. Adults with this condition are typically about 4 feet tall. There are other chondrodystrophies, such as hypochondroplasia, which are similar to achondroplasia but not as severe.