The new semester is coming, and some parents look at the children who have lined up at the top of the class line and secretly worry and lament: Why do they always grow so slowly, always shorter than other children?
For children who are lagging behind, the variety of "heightening" products on the market has made parents excited. Some parents have spent unjustified money regardless of the actual situation, and some even buried hidden dangers for their children's future growth. Nie Yaling, the chief physician of the pediatric department of the Rocket Army Characteristic Medical Center, said that the child is short and the parents are anxious. This is understandable, but unnecessary and extraordinary measures should not be used. There are strict clinical indications as to whether a child needs altitude intervention, and "pulling out seedlings to promote growth" can only be counterproductive and even cause irreversible damage to the child's body. Today, let's talk about how to correctly treat a child's height and what conditions require medical intervention.
How to judge whether a child is short or not
In medicine, there are clear criteria for determining whether a child is short. Under the same living environment, height is lower than the third percentile of the height of normal healthy children of the same race, age, and gender, or less than 2 standard deviations, which is referred to as short stature. Simply understood, 100 children born in the same month of the same sex are ranked from short to high, with the first three children being short. Below are some examples of height standards for several age groups.
● 3 years old
The average height of boys is 96.8 cm, and their stature is 89.3 cm;
The average height of girls is 95.6 centimeters, while their stature is 88.2 centimeters.
● 7 years old
The average height of boys is 124 centimeters, and their stature is 114 centimeters;
The average height of girls is 122.5 centimeters, while their stature is 112.7 centimeters.
● 12 years old
The average height of boys is 151.9 centimeters, and their stature is 137.2 centimeters;
The average height of girls is 152.4 centimeters, while their stature is 139.5 centimeters.
● 15 years old
The average height of boys is 169.8 centimeters, and their stature is 156.7 centimeters;
The average height of girls is 159.8 centimeters, while their stature is 148.8 centimeters.
Overall, normal children have different growth rates at different times. The term "late growth" in some older populations does exist. This mainly refers to children with delayed puberty. By puberty, their peers' height increases sharply and they appear to be short due to delayed puberty. If the child's bone age lags behind the actual age by 2 years, and the growth hormone level is normal, it may be late puberty or constitutional delay in puberty; If the bone age matches the child's age, it indicates that the child does not belong to late growth, and the specific situation needs to be evaluated by taking X-ray films.
What causes height lag
As everyone knows, height is determined jointly by genetics and external environment, so who accounts for the larger proportion? Current research generally believes that genetic factors range from 70% to 80%, which means that a child's height mainly depends on the height of their parents.
Speaking of this, it is time for someone to raise a question: Experience around us tells us that some parents are tall, but their children are not tall, while some parents are not tall, and their children are not short. Why is this? Because although a child's height mainly depends on their parents, it is still affected by multiple genes. The height of family members has a certain impact on children, and the closer they are, the greater the impact. Therefore, the height of relatives such as siblings, uncles, uncles, and grandparents can all become a child's growth potential. Another possibility is that parents' short stature is caused by poor nutrition or other factors when they were young. If a child's grandfather or uncle is tall, it indicates that the child's genetic factors are still high, and the child is highly likely to be tall.
In addition to genetic factors, controllable factors include environment, nutrition, exercise, and disease control. Among them, nutrition is an important factor affecting height. If children suffer from long-term malnutrition, it is certain that their height will lag behind. After all, it is precisely because of the continuous improvement of living standards that the average height of modern people has significantly increased. Another important factor is sleep, where growth hormone secretion peaks during deep sleep at night. Prolonged late sleep or insufficient sleep must not be beneficial for a long child.
In fact, it's good for a child to grow and develop normally, not only late but also early. A child grows up one year from birth, which is the time age, but its physical age does not necessarily match it. Children whose annual growth rate is too high are called "tall children" among children of the same age, but they often have limited growth space due to early bone age, and eventually become "short adults" who are very tall in adulthood. In summary, bone age reflects a child's growth process and future growth and development trends within a certain range. Delayed bone age development can be caused by growth hormone deficiency, thyroid function deficiency, familial physical development delays, and other reasons. Early bone age development can be caused by ingestion of drugs and foods containing sexual hormones. When bone age is advanced, the initiation of sexual development will also be advanced. Girls begin to develop secondary sexual signs before the age of 8 and boys begin to develop secondary sexual signs before the age of 9, both of which fall within the scope of sexual precocity.
What situations require medical intervention
Scientific research has shown that growth hormone is a key factor in promoting growth, and nutrition, sleep, exercise, and mood can affect growth hormone secretion. Scientific height management through acquired nutrition, sleep, exercise, psychology, and disease prevention can help improve height. However, if it is due to diseases such as endocrine abnormalities that cause height backwardness, it is necessary to receive professional diagnosis and treatment.
The common growth hormone deficiency is a growth and development disorder caused by a partial or complete deficiency in the synthesis and secretion of growth hormone by the pituitary gland, or by abnormalities in the molecular structure of growth hormone. There is also a type of symmetrical short stature known as idiopathic short stature, which has no known cause. After evaluation by a professional doctor, if the patient's height meets the standard for short stature, treatment with growth hormone is usually effective.
"Short stature" is a type of disease characterized by growth and development disorders caused by abnormalities in the growth hormone axis or other causes, resulting in significantly shorter stature than peers or adults. In addition, there are data showing that 90% of short children have psychological disorders such as inferiority complex and depression.
Therefore, in clinical practice, emphasis is placed on "early detection, early diagnosis, and early treatment" for short stature. The optimal treatment age is from 2 to 13 years old. Generally, when the bone age of boys reaches 15 years old, and when the bone age of girls reaches 14 years old, the increase in height is not significant. The younger a child is, the more active the proliferation and differentiation of the cartilage layer in the epiphysis is, the greater the space and potential for growth of the child, and the more sensitive the response to treatment is. "Once puberty has passed, growth hormone secretion gradually decreases, and the epiphysis closes, and height growth begins to slow to a halt.".
Is Growth Hormone Therapy Safe
Xiaoming, who lives in Chaoyang District, Beijing, is 11 years old and about 10 centimeters shorter than his peers. His mother has always been haunted by this. Some time ago, Xiaoming's mother saw a kind of heightening spray on the Internet, and claimed that as long as she sprayed it under the tongue, it could grow several centimeters after several courses of treatment. So she spent thousands of yuan to buy it, but after several months, she did not see any obvious effect. However, she was still unwilling and bought several other "heightening" products in succession, still with little effect.
The market is flooded with many "high rise" products, making it difficult to distinguish the true from the false. "Some products have illegally added hormones or other unknown ingredients, which can promote height in the short term, but may also accelerate bone age aging and increase the space for height growth after overdraft. The gains outweigh the losses.".
In the Children's Shortness Clinic or Height Clinic of a regular hospital, doctors will conduct a series of evaluations on the visiting child. If the height is within a reasonable range, it is recommended that parents monitor the growth of the child's height every year - less than 7 centimeters per year before the age of 3, 4 centimeters to 5 centimeters per year from the age of 3 to pre puberty, around 11, and 5.5 centimeters to 6.5 centimeters per year during puberty, which is normal. For children with abnormal height, doctors will first check the bone age of the child, and need to conduct growth hormone stimulation experiments, sex hormone tests, thyroid function, pituitary magnetic resonance imaging, etc. to identify the cause and implement symptomatic treatment (mainly drug intervention treatment).
According to some data, through statistical analysis of the data of children seeking medical treatment nationwide, 46.4% of them suffer from growth hormone deficiency, and 27.0% suffer from idiopathic dwarfism. From a medical intervention perspective, these children can be treated with drugs such as recombinant human growth hormone.
Recombinant human growth hormone is produced by recombinant Escherichia coli secretory expression technology, and is completely consistent with human pituitary growth hormone in terms of amino acid content, sequence, and protein structure. Its clinical application has been nearly 40 years now, and it is currently internationally recognized as a clinically effective drug that can promote height growth. From the available data, the safety of recombinant human growth hormone is generally good, with a low incidence of adverse reactions.
In fact, the growth process of a person's height is inherently regulated and controlled by various hormones in the body. From infancy to pre puberty, it depends on growth hormone and thyroid hormone. Adolescence is influenced by both growth hormone and sex hormone, and the growth rate will accelerate again. Although the recombinant human growth hormone used for medical intervention is also known as "hormone", it is completely different from glucocorticoids and sex hormones in terms of source, chemical structure, physiological and pharmacological effects, and does not produce glucocorticoid or sex hormone-like side effects.
Parents should note that during the treatment period with recombinant human growth hormone, their children should ensure at least 500 milliliters of milk intake every day, supplement calcium tablets per doctor's instructions, adhere to an hour and a half of exercise every day, and enter a deep sleep state around 10:30 pm. Three months is a course of treatment before evaluating the growth effect. Generally, after 3 months of treatment, as long as the growth rate is above 1.5 centimeters, it indicates that the treatment is effective. Continued adherence will achieve better results. However, due to individual differences, not every child can achieve satisfactory results through treatment.
In summary, if the child's growth rate is lower than the normal standard, it is recommended to take the child to a regular hospital for bone age examination every six months. If the diagnosis is short stature, the specialist will take different treatment methods for different causes. Only by identifying the cause can symptomatic treatment be achieved. Parents should avoid credulity in advertising and random use of heightening products.
