The above letters reflect many of our children’s feelings when they are first seen by Dr. Kletter. They and their families arrive to the Pediatric Endocrinology clinic with hope that something can be done.
Children are usually followed by their pediatrician or primary care provider. The following questions are guidelines for parents who are worried about their child’s growth. While any “yes” to the questions may not indicate a problem, it warrants a discussion with your child’s healthcare provider.
- Is my child the shortest or tallest in the class?
- Is my child unable to keep up with children of the same age in play?
- Is my child growing less than 2 inches or more than 3 inches a year?
- Is my child showing signs of early sexual development (before age 7 in girls and before age 9 in boys)?
- Has my 13 year old girl or 15 year old boy failed to show signs of sexual development?
An experienced pediatric endocrinologist will evaluate the following possible causes of short stature and growth failure:
- Familial Short Stature – “Heredity” (short parents are more likely to have short children)
- Constitutional Delay – delayed puberty, delayed growth spurt, normal adult height. “Late bloomers”
Illnesses and diseases that affect the whole body. (systemic diseases)
- Nutritional diseases – undernutrition or malnutrition
- Digestive Tract Disease – bowel disease
- Kidney Disease
- Heart Disease
- Lung Disease
- Diabetes Mellitus
- Severe stress or deprived environment
Endocrine (hormone) diseases
- Lack of thyroid hormone – hypothyroidism
- Too much cortisol (stress hormone) – Cushing’s syndrome
- Lack of growth hormone (GH) – GH deficiency
Problems in the tissues where growth occurs (congenital conditions)
- Intrauterine growth retardation – slow growth before birth caused by infections, smoking, alcohol use during pregnancy, or unknown factors
- Chromosome abnormalities – Turner syndrome, other genetic syndromes
- Skeletal abnormalities (bone diseases) – defects in size, shape, growth of bones.
- Idiopathic – no cause can be found.
As you can see, it takes a very experienced specialist and staff to evaluate and treat children with growth disorders. The process can be long, but the thoroughness of the clinician is important in the proper diagnoses. We at Swedish Pediatric Specialty Care attempt to give that individual care to our children and explain each and every step to our families.
If you're wondering about the patients who wrote the above letters: these twin girls were able to get treatment due to the diligence of the family and staff at Swedish. They are now 15 years old and thriving!