by Ann Marie Dwyer

Created on: January 07, 2009   Last Updated: April 22, 2011

Upon the birth of a child, we have certain expectations and beliefs.

The first belief is our child is the most beautiful baby in the world. Of course, we are correct! Next, we believe our child is above average.

For some of us, however, we are startled at some point in their development. Whether it is the first day of day care or kindergarten, we notice they are smaller than other children the same age. Or they do not speak or walk as soon as other babies. Our parental instincts kick in, and we begin to worry.

Trips to the pediatrician yield a "Don't worry. He will catch up." response to our concerns. Nonetheless, we continue to worry and compare our child to his classmates.

In fairness to the physicians, every parent expresses these same concerns. It is not until symptoms become so dramatic they cannot be wished away before further testing or referrals to specialists are considered.

The differences between our children and others become more noticeable. Finally, the alarm bells go off, and we go into high anxiety. We push for testing or referrals, if the physician does not do it for us.

What can cause a lapse in a child's normal growth? Is it really important?

There are many things ranging from simple nutritional imbalances, poor eating habits or the inability to absorb nutrients to kidney disease, tumors, hormone imbalances and genetic syndromes which can a child to grow less than he should.

Often, there is a family member who was small, and parents attribute the shortness to a genetic trait. What would you think if you knew great-grandma was small because she had a syndrome which was not identified during her generation?

If the cause is not identified, the problems may be much greater for your child than it was for great-grandma. So, knowing both what is going on and why is important.

The more rare issues, tumors and diseases, frustrate a child's growth pattern in the name of self-preservation. The child's body reserves the energy it would normally use to grow, saving it to fight off the more serious problem. Each year, the child slips a little further behind in growth.

If a child has a developing kidney disease or tumor, the earlier it is identified the sooner intervention and treatment can begin. Combined, they give a child the best chance of overcoming these serious conditions.

What about those children without a tumor or disease, but who are still not keeping up with their peers?

Many times, these children slip through the cracks and are not identified

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