Why my child does not grow? More frequent concerns.

One of the concerns that every parent has is to know if their child is growing properly. Longitudinal growth is an indicator of health, and the fact that a child does not grow properly is an indicator that something is not right. But throughout this process, many myths and realities are also presented, as well as factors that are modifiable and others that are not.

This is a very important indicator since each individual must be compared with another of the same age and sex. However, when reviewing the different standard growth curves we realize that at a certain age there may be a variability of normal height that averages 20 centimeters, for example, a 9-year-old boy can measure normally between 120 and 140cm, on average 130cm. A much more important indicator is when the same child in the same group progressively becomes to be the first in the row in order of size since it could mean that it goes at a slower velocity than the others.

This observation is definitely suggestive of evaluation, since we are even in the presence of two individuals with the same genetic potential (children of the same parents), however it is not unequivocal determinant of pathology, since between siblings of the same sex there could be a difference in final size of up to 16 centimeters, so at a certain moment two brothers with a difference of 1 to 2 years of age could have similar statures. Another aspect that influences, especially in males, is the so-called "Tempo to grow", this concept is related to the rhythm of maturation of each individual and the moment that begins his puberty. A boy, early maturing, can be one of the highest in relation to their age, begins puberty at age 9 and ends up growing at 15; another, late maturing, is the smallest, begins his puberty at age 13 and ends up growing at age 20, both end up with the same final height, only they had different "Tempo to grow".

The main determinant of the size is genetic, so it is in relation to the stature of the parents, this aspect is unchangeable. However, this does not mean that all the children of small parents are small, there is a variability of up to 10 cm in relation to genetic potential. For example, a male child of a mother of 156cms and a father of 176cms, it is estimated that his adult height could be between 162 and 182cms.

This concern is becoming more frequent, and if it were that simple there would be no small athletes. Some of them receive growth hormone without formal indication, and when they finish growing, (take the previous example) if they measure 182cms they say it was for the growth hormone, if they measure 162cms they say they did not respond to the hormone. The reality is that it will be his definitive height regardless of the growth hormone.

In conclusion, when we evaluate the growth of a child, it must be individualized, in order to determine whether or not it has criteria of pathology. The control of the pediatrician is very important even if the child is healthy, it is the only one that could determine if a child is growing properly and determine when to refer him to a specialist.