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Short Stature: Understanding Your Child’s Height

By Jaime Tsay, MD | Pediatric Endocrinology

A child’s growth is one of the most important aspects of childhood that is regularly tracked. It is a reflection of overall health and nutritional status, and poor growth can be an indicator of an underlying medical problem. A child whose height percentiles have decreased over time or whose height percentiles are significantly lower than what would be expected for his or her genetic potential can be concerning and may warrant further evaluation. CareMount Medical uses computerized growth charts in every child’s electronic medical record to track height. Upon request, your Pediatrician can show you these charts when your child is being examined.

Growth hormone is a hormone made by the pituitary gland in the brain. It acts on bones to promote growth during a child’s growing years. While nutrition and growth hormone play an essential role in growth during early childhood, growth in the later years is also strongly influenced by the sex hormones of puberty (estrogen in girls and testosterone in boys).


  • Genetics • Delayed puberty • Bone disorders • Nutritional deficiencies • Hypothyroidism
  • Chronic illness • Growth hormone deficiency • Genetic syndromes • Having a low birth weight or birth length


An evaluation for a child with poor growth can include blood tests to investigate whether there is any underlying problem or hormone deficiency. In addition, a bone age, or x-ray of the hand and wrist, can be used to assess how mature a child’s bones are and how much more time there is left for growth. It can also be used to estimate how tall a child will be when his or her growth is completed. Further testing can be done in children who are suspected to have growth hormone deficiency.



  • Growth hormone – for children with growth hormone deficiency, low birth weight or length, those growing at less than the 1st percentile in height, and certain genetic syndromes.
  • Medications to stop the progression of puberty in order to prolong the time for growth (typically given to children who enter into puberty on the early side).
  • Medications to halt the progression of bone age advancement to allow for increased time to grow.