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Stature

It’s commonly accepted that people from different parts of the world tend to have different physical characteristics, including height. When an internationally adopted child comes home and goes for their first physical, he/she will often be very low in percentiles of height and weight, as compared to the average child. This is especially true if the growth charts are not the most applicable ones. Adoptmed, a medical clinic that specializes in working with adoptive families, lists growth charts from different countries (the information may be outdated and is just for reference). Please check with the child’s pediatrician to use country appropriate growth charts to track these developmental parameters.

Children from orphanages often catch up in weight. If height is a concern and the child is not catching up, then further evaluations could be needed. A 2015 scholarly article published in the American Family Physician journal provides detailed definitions of short and tall stature, probable causes and appropriate testing. They define the parameters that are cause for concern. “Short stature is defined as a height more than two standard deviations below the mean for age (less than the 3rd percentile). Tall stature is defined as a height more than two standard deviations above the mean for age (greater than the 97th percentile). “

There are many reasons for short or abnormally tall stature in children, including genetic traits or hormone issues. A pediatric endocrinologist or a growth specialist should evaluate the child.

Some of the reasons why growth could be an issue include:

  1. Hereditary: The child’s biological parents exhibited the same stature. Unfortunately, it may be impossible to know the genetic height patterns of the birth family in order to eliminate this factor.
  2. Hormonal (Endocrine causes) reasons:
    • Hypothyroidism, lack or excess of Human Growth Hormone
    • Pubertal development:  At puberty, children attain close to their adult height. If a child has short stature and shows precocious puberty, this would affect the child’s height. In a case of delayed puberty, the child may exhibit short stature since the maturation of bones will happen at the end of puberty. Endocrinologists can take X-rays to figure out the bone age of children to find out the maturation of the bones.
  3. Growth failure, due to non-Endocrine causes – mostly related to short stature:
    • Poor nutrition
    • Gut issues – It’s possible the gut is not absorbing nutrition appropriately and bowel movements may be an indication of these kinds of gut issues.
    • Celiac disease could be causing issues with wheat consumption and a leaky gut
    • Other kidney, lung or heart conditions
  4. Genetic conditions (non-endocrine causes) :

Treatment options

Treatment depends on the cause of the growth issue. If it’s a growth hormone deficiency, then the child is treated with growth hormone injections. However this treatment option is complicated and requires discussion with professionals. If it’s a gut issue, then improving gut health is necessary.

Resources

  1. “Disorders of short stature” (hgfound.org)
  2. “Short stature child” (yalemedicine.org)
  3. “Bone Age” (childrenscolorado.org)

See also

  1. Precocious and Delayed Puberty
  2. Gut, Diet and Health Interventions

 

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