How Tall is Tall Enough?

Little child, boy, measuring height against wall in room

When parents bring babies and toddlers in for checkups here at Alzein Pediatrics, some of the findings they’re most interested in are height and weight, and where those measurements fall “in the percentiles.” Knowing where your child lands on the scale of 1 to 100, in comparison to other children throughout the U.S. and also as your child’s own ratios, can help us determine if your child is thriving, growing and developing normally. For example, if your child is in the 95th percentile for height, but only 50th for weight, we may ask questions about eating habits and look a little closer at your child’s overall health.

For many people, height percentiles and measurements can be a concern. They ask if their child’s eventual height can be predicted by these early measurements and if their child will be tall. We understand that there are very real impacts of height, both “too tall” and “too short”, for children of all genders, but knowing the reason children top out where they do can ease parents’ concern.

Using family history and growth charts, over time your Alzein provider can determine if your child’s size is a natural variation or a medical concern.

Short stature, the medical term for significant growth delay, has various causes. For many children, short stature is idiopathic, with no known cause, or genetic. Sometimes called “familial short stature,” children whose parents, grandparents and other ancestors have been short typically have no underlying medical cause or additional symptoms. Genes have determined that this child will be shorter than most.

Short stature is diagnosed when a boy is shorter than 5’4” and a girl is shorter than 4’11”.

In some cases, “constitutional short stature” occurs because the growth process has been delayed or slowed, either by malnutrition, environmental factors, or a slower-than-normal growth process. While familial short stature tends to lead to shorter-than-average adults, children with constitutional short stature tend to catch up to their peers by adulthood. Your Alzein Pediatrics provider can help determine if better nutrition or other therapies are needed – or your child just needs to wait for a “growth spurt.”

Short stature can also be a symptom of other, more serious conditions. When we see concerning growth patterns over time, we may order bloodwork or bone scans to determine if the growth delay has an underlying hormonal or medical cause. Precocious or early puberty can delay development, as can endocrine disorders that impair the production of growth hormone. By identifying and treating the underlying cause, a child’s growth process can recover.

Talking about your child’s height can be difficult as they grow, as they should never feel ashamed, embarrassed or worried about their physical appearance. While some cases of short stature can be identified as early as age 5, most incidences of short stature become noticeable as the child enters puberty, exactly when they are most anxious and aware of their body in comparison to their peers.

If there is concern that a child seems to be much shorter – or much taller – than family members, we recommend you trust your instincts and send us message through your patient portal before your child’s next visit. We will examine your child with these concerns in mind, without drawing significant attention to these measurements as we do want to ensure that slow growth isn’t a sign of any disorder. If a nutritional, environmental, or hormonal cause is identified, early intervention gives your child the best chance to change their growth chart trajectory.

It’s also important to keep some numbers in mind, to keep everything in perspective. The average height for a post-pubertal boy in the U.S. is 5’9. For adult U.S. women, the average height is 5’4”. If everyone in your family is well over 6’, those measurements might be cause for concern. But if Dad is 5’11” and Mom is 5’6”, Son is probably perfectly healthy at 5’9”.

If you have a question about your child’s growth and development, send us a message through your patient portal or request an appointment. We are always happy to help!

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