Doctor's Notes on Growth Failure in Children
Growth failure in children describes a growth rate is below the appropriate rate or speed for the child's age. Signs and symptoms include a height below the about the 3rd to 5th percentile on a human growth chart. Symptoms and signs of growth failure in children may include one or more the following: the child's height, weight, and head circumference do not progress normally according to standard growth charts, physical skills of babies are slow to develop (for example, rolling over, setting up, standing and/or walking), delayed social and mental skills, and delay in the development of secondary sexual characteristics (for example, breast development in females and development of men's facial hair).
Causes of growth failure in children are often the result of a combination of two or more factors, such as genetics, hormone production, emotional problems, and even nutrition. The following possible causes of growth failure in children may include familial short stature, delayed puberty, malnutrition, chronic diseases and/or systemic disorders (for example, lungs, liver, kidney or connective tissue disorders), child abuse and/or emotional deprivation and neglect (also termed psychosocial dwarfism), endocrine (hormonal) deficiencies, genetic syndromes like Down syndrome, Prader-Willi syndrome, or genetic disorders of bone and cartilage or intrauterine growth retardation.
What Are the Treatments of Growth Failure in Children?
Treatments of growth failure in children are directed at the underlying cause. Consequently, having the diagnosis of the underlying cause(s) determines the treatment. For example, the following underlying causes need treatment to eventually address growth failure:
- Growth hormone deficiency
- Delayed puberty
- Chronic diseases like connective tissue disorders
- Genetic syndromes and disorders
- Child abuse
The above are examples of underlying problems that, untreated, may lead to growth failure; there are others. However, your doctors may help determine if treatments will likely reduce or stop growth failure in children.
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Child AbuseChild abuse is defined as a variety of abnormal behaviors directed against children. It can take many forms. Child abuse may be in the form of: sexual abuse, pedophilia, physical abuse, child neglect, emotional neglect and abuse, failure to thrive, and Munchausen syndrome by proxy.
Down SyndromeDown syndrome is a genetic disorder that is caused by an extra chromosome 21. Down syndrome is also referred to as Trisomy 21. Other variations of Down syndrome include Robertsonian translocation and partial/segmental trisomy, and mosaic Down syndrome. There is no treatment for Down syndrome.
Growth Hormone DeficiencyGrowth hormone (GH) deficiency is a disorder that involves the pituitary gland, which produces growth hormone and other hormones. People affected by growth hormone deficiency may have short stature and a variety of health problems. Treatments include hormone replacement therapy and other measures, depending on the root cause of the deficiency.
Growth Hormone Deficiency FAQsWhen the pituitary gland at the base of the brain fails to produce enough human growth hormone, it causes all sorts of symptoms in children with the deficiency. They include: Short height for child's age, Increased fat around the waist and in the face, Feeling upset about his or her height, The child may look younger than other children his or her age, Delayed onset of puberty, and Delayed tooth development. Treatments include hormone replacement therapy.
Growth Hormone Deficiency in ChildrenGrowth hormone deficiency is a disorder of the pituitary gland in the brain which produces growth hormone. A lack of growth hormone in children causes abnormally slow growth; and the deficiency may be caused by a birth defect or any number of acquired conditions like brain cancer or infection. Depending on the cause of the deficiency, children may have to receive growth hormone injections or other therapy as the underlying condition warrants.
HypothyroidismHypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormone. Causes of hypothyroidism include: Hashimotot's thyroiditis, subacute thyroiditis, previous thyroid therapy, drug-induced, Pituitary or hypothalamic disease, and iron deficiency. Some common symptoms of hypothyroidism are: fatigue, constipation, weight gain, poor appetite, dry and rough skin, coarse hair, hair loss, edema, depression, and elevated cholesterol levels. Treatment of hypothyroidism is generally with medication.
Magnetic Resonance Imaging (MRI)Magnetic resonance imaging (MRI) is a scanner that takes cross-sectional images of the body. It is used to evaluate tissues of the head, neck, chest, limbs, abdomen, and pelvis. MRI is a very safe procedure; sedation may be used for infants, small children, or adults who are claustrophobic.
X-RaysX-Rays are a form of radiation used to image solid forms inside the body. X-rays are administered by radiologists for many different routine tests, such as mammograms, checking for broken bones, upper GI series, and dental exams, among others. Radiologists carefully monitor the X-ray equipment to make sure the patient receives the smallest dose of radiation possible.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.