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 before age nine because they often excel in school and other things. However, they do not grow the "normal" and "healthy" minimum accepted by the Lawson Wilkins Society of pediatric endocrinologists: Two inches each year, after age two and before puberty.
These are the children whose parents are often told, "Don't worry he will catch up." Without simple medical tests to verify that assumption, this is not the best advice.
Why do doctors say, "Wait and see."?
The media has given a lot of attention to the athletes who have abused growth hormones and other medicines in the hopes of taking shortcuts to physical fitness. This has prompted a misguided assumption by the public, some physicians and insurance companies: Parents of "short children" are simply concerned with the heights of their children.
While this may apply to a few of the parents, the majority of parents are alarmed. Parental instinct tells them to be alarmed. But they do not have all of the facts...just instinct, even if they do not understand what set off the alarm.
Take one specific condition as an example, growth hormone deficiency (GHD. A child with GHD will not grow as much as his peers of the same sex and age. Most will grow some each year, just not the "normal" amount.
Parents can "see" the problem and get concerned. Growth hormone deficiency (or any other condition) is also affecting things which parents cannot see. The child's heart strength, lung capacity, bone mineralization and many other factors are also compromised.
Deviations from normal growth are a visible gauge for medical conditions which affect the child in ways which are otherwise invisible. If the same problems were to suddenly affect an adult, it would be much more difficult to diagnose. Adults are finished growing and no longer have a "visible" alarm system.
Therefore, the damage continues occurring throughout the body for a long time until such time it is very obvious a problem does indeed exist.
The bottom line: It is important.
Diagnosing the cause of a child's failure to grow within the normal parameters is crucial to minimize potentially permanent damage to their body, allow normal maturation and development. Early diagnosis and treatment will allow them to be happy, healthy children with the same issues as their friends.