What are growth disturbance?

If the growth of your child appears to be stagnant then you should see a doctor.

A growth disturbance is defined as a departure from the normal growth pattern for children. It is important to remember that because no two children are exactly alike, the notion of what 'normal' growth is has very broad limits.

Before birth, the growth of the embryo is monitored by midwives and doctors. After birth, infants should gain between 150 and 200g per week from their second week to the age of three months. By the age of five months, their birth weight should have doubled.

Since children differ in size genetically, normal growth cannot be based on just one examination. For this reason, it is important to follow the child's development over a period of time using special measurement systems. This way, it is not size as such that is monitored, instead it is the growth and weight gain of the child.

How is a growth disturbance discovered?

It doesn't matter if the child is slighter, taller, or shorter than the established measurements as long as the general pattern is normal. The problem arises if the child suddenly deviates sharply from the growth pattern they have been following. If this happens, you should consult your doctor.

The weight of healthy children can vary substantially. Many infants gain a lot of weight during their first six months, then less between 10 and 18 months.

Children with short parents will often grow at the same rate as those with tall parents until around one year old. Then they simply follow a slower growth curve.

After an illness, it is normal for children to rapidly regain any lost weight and then revert to their original rate of growth. Babies who have grown too slowly in the womb grow proportionally more than other children after birth. Then they start to follow the correct growth curve.

Babies born prematurely are often measured against a different growth chart. This is calculated by subtracting the number of weeks premature the baby was from their current age. This correction can be applied until the child reaches two years of age.

A child's rate of growth and onset of puberty is partly dependent on hereditary factors. For instance, sometimes a father and his son are both short in early puberty, but taller in late puberty. Likewise, a mother and her daughter might both be tall at the age of 12 and get their first period before other girls in their class.

Why do some children have a growth disturbance?

A child's growth is mainly determined by a combination of genetics and environmental factors, especially diet and exercise. However, a number of diseases may also affect growth including:

• deficiency of growth hormone
• deficiency of thyroid hormone
• nutritional problems.

What can I do myself?

Everybody can measure and weigh their children. However, a professional growth examination should be carried out regularly by health visitors and doctors. These often take place at school, or during routine medical check-ups.

How does the doctor diagnose a growth disturbance?

The doctor measures and weighs the child and draws growth curves. The parents' height and weight as adults, at puberty and as infants will be taken into consideration.

The doctor will ask questions about the child's diet, appetite, exercise habits, pattern of defecation and any social problems.

The patient is then examined for signs of disease and, possibly, puberty and/or tooth development. In addition, an X-ray of the left hand and wrist is sometimes taken so that the development of the bones may be examined. The so-called 'bone age' may be ahead or behind in relation to the child's age.

If there seems to be a problem, the doctor will probably recommend a consultation at a paediatric unit in order to determine its cause and the best medical treatment.

What is the probable outcome and how is the growth disturbance treated?

This depends entirely upon the type of growth disturbance and the cause of the growth abnormality.