Child Growth and Development

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Child Growth and Development

Do you have growth retardation?
The amount of growth in a child in a certain period of time, for example 6 months or 1 year, is called the growth rate. While the average growth rate in the first year of life is 25 cm, it is 12 cm in the second year, 8 cm in the third year, and 5-6 cm annually from the age of six to adolescence. Growth retardation, on the other hand, is a slow growth rate compared to peers in a period of time. For example, a child between the ages of six and adolescence has growth retardation if their annual growth is less than 4.5 cm. Growth curves are used to evaluate the growth rate. Physiological deviations up or down the growth curve can be observed in the first two years of life. A child older than two years of age has growth retardation if a downward shift is observed in the growth curve. Even if the child’s height is normal, if there is growth retardation, it is necessary to investigate the disease.

How do we know that growth is complete in children?

If the growth rate has decreased below 1 cm per year, the growth is about to be completed. At the end of adolescence, 99 percent of adult height is completed. After the growth plates of the long bones are closed, the final height is reached by increasing the length of the vertebrae and extending the body a little more. Girls reach adult height at approximately 16 years of age and boys at 18 years of age. In fact, these ages are bone ages and the calendar and bone ages of the people are mostly compatible with each other. However, early or late puberty affects bone age, and the chronological age at which growth is complete can vary. In those who enter puberty early, the growth plates close earlier and growth is completed earlier. In order to understand this, radiological evaluation of children’s hand-wrist bones, that is, bone age should be determined. If all the growth plates are closed, the child’s growth is complete.

How Tall Does He Grow During Adolescence?

The growth of boys and girls differs during puberty. This difference causes the average adult height to be different. Girls’ pubertal growth begins and ends 2 years earlier than boys. It makes a difference by 8-10 cm for girls to grow two years less. At puberty, boys grow 25-30 cm in total, while girls grow 20-25 cm. This causes a difference of around 3-5 cm. Thus, the average adult height of boys (176 cm) is approximately 13 cm longer than that of girls (163 cm).

How does precocious puberty affect growth?

The growth of the child, who grows 5-6 cm per year before puberty, accelerates again with puberty. The increase in sex hormones, especially estrogen, during puberty accelerates the maturation of bones and thus the closure of growth plates. Adolescence is a period when growth is accelerated on the one hand and completed on the other. Because early puberty causes the child to grow faster than their peers, it initially causes taller stature. However, the final height remains short because the growth plates close earlier and growth ends early. This is especially true for early adolescence, which starts at a young age and progresses rapidly. Early puberty does not always negatively affect growth. Every child with suspected precocious puberty needs to be specifically evaluated by endocrinologists.

Does puberty delay also cause problems?

Since the growth spurt does not start in children with puberty delay, there may be a height difference with their peers. In addition, chronic diseases that can cause delay in puberty can negatively affect the growth of the child. Puberty delay in children is most commonly seen as part of structural growth delay. Such children are usually brought with the complaint of short stature around the age of 10-14. Bone age is delayed by 2-3 years in children with structural delay. Therefore, they enter puberty late; they grow up later than their peers and it may take 20-21 years to complete growth. In other words, there is a reverse situation with early puberty: While the stature is shorter than the peers at the beginning, the height reaches the normal limits with the late closure of the growth plates.

May have disproportionate body proportions

Some children with delayed puberty have persistent problems; puberty either never begins or is not completed even if it does. Since these children are deficient in sex hormones, the closure of the growth plates is delayed, and therefore their height continues to grow. During this period, the proportion of the body deteriorates as more arms and legs lengthen. Leg length becomes disproportionately long compared to the trunk; again, the stroke distance becomes longer than the height. Children with delayed puberty may have a disproportionate body structure with long arms and legs.

Is the height normal?

The child’s height is evaluated on growth charts and curves developed for the community. If the height is less than 3 percent of the age group, there is short stature. Height is within normal limits when it is between 3-97 percent.

What if the child does not grow in height?

A child who does not grow tall enough can have many problems. After excluding other causes, growth hormone deficiency can be evaluated. The most common cause of growth retardation is nutritional deficiency. While malnutrition is mostly due to insufficient food intake in underdeveloped countries, it develops due to chronic diseases in developed countries. Growth retardation may be the first and only manifestation of chronic diseases. Bone diseases and genetic diseases can also cause short stature. For this reason, research on nutritional deficiency, chronic diseases and skeletal and genetic diseases should be done first. If no reason can be found to explain the growth arrest, tests are also applied for growth hormone deficiency. For this, warning tests are performed by giving medication.

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