“How can I help my son grow to his potential?”

Stature (height) is a very important parameter of growth and development. It has physical, psychological and emotional implications. Short children may experience emotional difficulties and may experience low self-esteem. Tall stature is perceived in society positively as it implies power, authority, fertility etc. Taller men are more desirable in relationships, sports and even politics due to our perception about them. If you follow American presidential history most of the time the taller guy wins.
It is logical to assume that children would have similar perception about height as adults. Therefore short children may experience emotional difficulties and problems with self-esteem.
Any child who is below the normal growth channel (curve) for his age or one who is falling of the growth chart or one who is below his biological background need to have proper evaluation. If there are no medical issues to explain his growth problems, the child needs to see endocrinologist for further evaluation. If there are no explainable medical causes helping him with growth hormone could be considered if indicated. Good nutrition may help a child grow. But that may not be enough in many cases.
So your child needs proper evaluation. He may be a late Bloomer, or has medical issues. See your primary care and discuss it with him/her. If the height is imotionaly affecting, age of 9 years seems a good age to get help.
Good luck

Take multivitamins and, if growth velocity is poor, have him evaluated by a pediatric endocrinologist.

Best,

LG

Growth hormone is mostly secreted during deep sleep. Make sure your son is getting 8-10 hours of sleep every night. Also make sure that he is eating a well-balanced diet. No, I do not recommend supplements.

Key in dealing with short stature is a good family history to know if the stature is a posible genetic, familial situation, or if his shortness is different from others in the family. Most important is to chat with your primary physician to have height and weight plotted on a graph and see if there is a pattern of growth that is normal or abnormal. Familial short stature usually follows the charts just on the lower side of the curves while other problems often show growth deceleration falling away from everyone else. A simple bone age hand X-ray also is very helpful to see if bone age is consistent or different from chronologic age as part of a screening test. Comparison of weight changes and height changes also can help decide if a consultation with a pediatric endocrinologist is needed to better evaluate the short stature more thoroughly. Some common early screening tests: IGF-1 levels in blood, celiac antibody testing, and thyroid hormone testing are also important to check specifically if there's nothing unusual on the physical examination or detailed family and individual health history. Kids who were small for gestational age may not catch up in about 20% of cases and respond to growth hormone. Kids with Noonan Syndrome (boys and girls) also are significantly short and respond to growth hormone (like girls with Turner Syndrome). Being aware of these associations allows medical folk to think about options, so key is evaluation of growth chart patterns, detailed family history, and system reveiw as well as
a physical exam. Hope this helps.

Stuart Brink, MD

To answer your question, there are several factors that need to be considered, such as parents' height to determine his potential adult height (mid-parental-target-height), his bone age, which help us also to predict his final adult height, his puberty status, etc. The most common situation is what we call constitutional delay of growth (late bloomers), which is a normal pattern of growth in some kids. However, if you are concerned about his growth, the best that you can do for your son is to have him evaluated by a pediatric endocrinologist.

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