Can children grow hormone?About 13 questions height, answer at a time

*For medical professionals for reading reference

If the child's bone line is closed, it is useless to use growth hormone anymore

Guide

After having a child, parents naturally began to compare, especially when a large group of children were playing together, parents must have to make their children the best, and the easiest to be compared with height.

Is your baby short, how to evaluate? Is it abnormal if you are short? Do I need to use growth hormone treatment? Will it delay the child when treatment is late? Let's talk briefly today.

Table of contents

1. How to evaluate whether the child's height is short?

2. Is the short body abnormal?

3. What is the essence of height?

4. How does a doctor evaluate whether there is a problem with short figure?

5. The short body caused by the shortness of parents

6. The body that looks late is short

7. The body is short caused by the deficiency of growth hormone

8. When is the right growth hormone? When do you use at the latest?

9. What are the reason why the pathological body is short?

10. Is the child's height gradually decreased abnormal?

11. Is there a lot of boys with short figures?

12. Under normal circumstances, how to estimate the child's height?

13. Why is he tall shorter than before the age of 2?

1

How to evaluate whether the child is short?

Medically, children are short as short. It means that the child's height is lower than the same gender, the average height of the same age of the same age (2SD) or above, that is, the height is less than 2.3 percentage. To put it simply, the child is sorted according to height. If your child's height is under the lowest 2.3 children, it is short.

How do we know if the child is under 2.3 percentage? Generally, we look at the height curve, but there is a problem. There is no 2.3 percentage level on the height curve. Therefore, it is usually 3 % (equivalent to the average height 1.88 standard deviation). As shown in the figure below, the height curve of the 0-2-year-old boy formulated by the World Health Organization. If your child, pay attention to the boy, the height is under the 3 % level (the bottom red line). Essence

Let me remind you here that it is not to clarify whether the child is short through the green line in the figure above. It is 50 %. If it is determined in that line, half of the children will be short.

If there is no growth curve, the domestic value is OK, and the blue background less than the figure below indicates that the figure is short. The chart data from: The growth and development standard of children under 7 years of age -2009 of the Ministry of Health and Community Health Department 2009.

Boy's height standard value

Girl height standard value

Swipe left to check the girl's height standard

2

Is the short body unusual?

After reading the table above, you must compare your children. If you are higher than this, you can rest assured; if you are low, you will definitely worry, what should my child do? In fact, don't worry first, because the small figure is not abnormal.

For example, the child's parents are short; for example, the child looks late, but when he is adult, he caught up. Both of them are normal, and their bodies within 2 years are short, mostly caused by the above two reasons. Therefore, the short body is not necessarily abnormal.

Of course, in addition to the above normal shorts, there are also short growth caused by various diseases, such as growth hormone or thyroid hormone deficiency, such as malnutrition caused by digestive system diseases, such as some short syndrome (Turner syndrome, etc.).

How do you know whether your body is short is normal? We have to look at the next one, what is the essence of height.

3

What is the essence of height?

Our height is actually the length of the bones, and the growth of the bone is the growth of the bone. For the human body, the height is the length of the leg bone, spine, and skull. Which of which is more important, big long legs.

How does bone grow? The most important thing is that the skeleton end of the skeleton is constantly split and proliferate, so that the bones will gradually become longer, and the cartilage at the end of the bone end will become the bone, which is not long.

Therefore, according to the degree of osteomanization of dryness, the age of the bone can be evaluated. If the ossification is fast, the cartilage becomes the bone quickly. Slow, there is still a lot of growth potential in the future, suggesting that bone age is backward.

This early and backwardness is compared to the actual age of the child. If the age of bone age is younger than the actual age, that is, the age of bone age is backward, prompting the child to last; if the bone age is older than the actual age, that is to say, the bone age is advanced. The space is small.

Factors affecting bone age include poor nutritional levels, abnormal hormone levels.

For example, if the child has diseases such as poor absorption, and without so many energy to differentiate bone growth, the bone age will be behind.

For example, if the secretion of thyroid hormones and growth hormones is insufficient, the chondrum differentiation will become slow, and the growth of the bone will grow slowly, resulting in backward age.

However, the sex hormones are different. If the secretion of sex hormones will cause precocious puberty, it will first promote the growth of bone growth, the dryness of the skeletal dry end, and the child's early height grows quickly, but after the drying end is used, it will be osteoma quickly. After that, then it will be large. Not long, the overall height is low. In fact, this is also easy to understand that sex hormones are for reproductive services. If you want to obtain the right to reproduce, you must grow tall and magnificent. You must develop first. Therefore, through the normal, early or postponed, it can also analyze the small cause of the child's short figure.

4

How to evaluate doctors

Is there a problem with short figure?

After parents go to the hospital with a short child, the doctor should clarify the reason why they are short, and find out that it is a pathological short body (that is, the abnormal figure short) for treatment. How to evaluate whether it is normal or abnormal? Mainly the following ideas:

1. Determine whether the body is short and determined through the height curve or the standard value of the height.

2. After being clear, according to the child's height (through the height curve recorded by the previous record), the height growth rate (Height Velocity (HV), the parents height, and the age of the child (below the 3 %, it is recommended to check the bone age)) It is judged that the child is short or abnormal (pathological) with a short body.

The picture above is that as the child grows older, the child's left wrist ostelatics center is increasing. From here, you can evaluate the child's bone age. The above is a schematic diagram. Now it is not just a number of bone age. Listen to the doctor.

3. The normal figure is small, let parents go home to continue normally, ensure that nutrition and exercise are OK.

4. If the abnormal figure is short, the child is short, the child's nutritional conditions, whether there are special faces and skin abnormalities, and decide whether to perform hormones such as growth hormone in order to give supplementary growth hormone and other treatment.

In the following, you can look at the specific content of the normal figure and short body.

5

The short body caused by parents is short

The children who are not tall in their bodies are short and are called short -sized figures. This is normal. These babies are definitely low, under the 3 % level; but there is a characteristic that it will not be lower and lower, but it is maintained at a low value; Consistent age.

Specifically, everyone can see the growth curve: I can see that the child's height has always been below the 3 %, but it has always been like this, and there is no distance from the 3 %.

This is getting lower and lower than the 3 % percentage, which means that the child's growth rate (HV) is normal, but it is normal, but it is at the lowest value.

What is the lowest growth rate?

For children aged 2-4, their height increases at least 5.5cm each year;

For children aged 4-6, their height increases at least 5.0cm each year;

For 6-year-old-adolescent children, boys grow at least 4cm in height each year, and girls at least 4.5cm; girls at least 4.5cm;

These family -based children are short of the above number of height. If they are lower than this number, consider other pathological figures.

Because these children grow normally, they are only short and do not involve nutrition and hormone levels. Therefore, their bone age is normal and will not be advanced or lagging.

6

The body that looks late is short

This late -growing body is short, known as constitutional growth and adolescent delay (CDGP), which is due to their delayed growth and most adolescents are delayed. These children are because the bones grow slower than the actual age, resulting in a lower height. For example, the child is 5 years old and the age is only 3 years old. The height must be short.

Many times consulting children's parents, there are also late long heights, and only in adolescence to catch up.

These children have a characteristic that the parents are normal (more than 3 percentage level). When the child is born, he is normal, and then gradually decreases to below the 3 % level. Value, but after adolescence, height will grow suddenly, entering the normal range, that is, higher than the 3 % level, which is a small difference from a family body.

In addition, if these children are tested for bone age, they will find that bone age is smaller than the actual age, which is also the difference between short and small figures.

7

The body is short caused by the deficiency of growth hormones

This short body is pathological and needs to be treated, and parents are more worried. Such a short child, the parents are normal, the child may be normal, but it will soon show a slower growth, lower than the 3 % level, and then deviate from this line. The diagram of the curve indicates that the height growth rate is lower than the normal value. These children are also short and short. We so -called dwarfs are caused by the deficiency of growth hormones.

What is the growth rate lower than normal? It is also very simple, that is:

For children aged 2-4, their height grows less than 5.5cm each year.

For children aged 4-6, their height grows less than 5.0cm each year.

For 6-year-old-adolescent children, boys grow less than 4cm each year, and girls are less than 4.5cm. In addition, for children over 2 years of age, if at the age of June, the child's height curve decreases more than two main percentage curves, then it indicates that the growth rate is also lower than normal;

The main height curves are 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, 97th. For example, from more than 10 % to less than 5 %, it is prompted to grow slowly;

For children who are not very serious in growth hormone, they may grow slowly after the age of 1 and 2. This reference indicator can be used.

The growth rate is lower than that of normal stature, which is short, which is different from the short body.

These children's bone age is also smaller than the actual age, because the hormones are insufficient, and the bones are slow.

For children with short stature and low growth rate at the same time, growth hormone examinations will be performed. In addition, thyroid hormones, insulin-like growth factors -i, etc. will be performed to clarify whether there are related problems.

It is clear that after the problem of growth hormone, it will give supplementary growth hormone treatment. The effect is very good and allows children to grow to normal levels.

8

When is it appropriate to grow hormones?

When do you use at the latest?

If it is clear that the body is short is caused by the deficiency of growth hormones, it is recommended to use growth hormones, and there is no age limit. Growth hormones promote height growth by stimulating the growth of bone bone cartilage. Therefore, if the child's bone lines begin to close, then the use of growth hormones is useless.

Therefore, the use is not late as soon as possible. If the bone age is too large, the bone bone is basically closed and the height increases by less than 2cm each year.

In adolescence, height enters the period of rapid growth again. At the same time, after this period, the bone end is closed, and the effect of growth hormone alone is not good. Therefore, it is better to be treated before adolescence.

So what is a sign before adolescence? Girls' breasts are developing, and boys have increased testicles. At this time, they must start treatment. If it is later, as the child develops further, such as the body hair is significantly, the treatment effect is not good.

Therefore, if you find that your child is short, check it as soon as possible, when you need to use growth hormones, treat it as soon as possible to avoid regrets.

But everyone should also pay attention to it, go to a regular hospital for treatment, do not listen to recipes and other medicines, delay the treatment time in vain.

9

What other pathological body is short?

There are many other causes of children's short body. There are many pathological reasons:

For example, malnutrition, such children are not only short, but also have low weight and low muscle content.

For example, children have inflammatory bowel disease, which leads to poor nutrition absorption. In addition to short figures, these children also have low weight, diarrhea, blood blood stools, and weakness.

For example, chronic kidney disease, heart disease, cancer, etc. can also lead to short bodies. When these diseases, the original disease is more obvious, so there is no need to repeat it.

For example, some syndrome, such as Turner (Turner) syndrome, is an important reason why girls are short. These girls' X chromosomes have abnormalities, and they cannot develop normal ovaries. They cannot secrete estrogen normally, causing estrogen to lack physical functions;

For example, these girls do not have a second sexual characteristic (breast development, etc.), and the body is short, which may be combined with heart disease and skeletal disease. In the early child's performance, there were one or more types of neck, barrel, or shield -shaped thoracic, fourth, fourth, five -handed bone shortness, dysplasia, and lower limb edema.

Neck

A dysplasia

Lower limb edema

Slide left and right to view more Turner syndrome performance

10

Is the child's height decreased abnormally?

From the above, we can know that if the child's height gradually decreases, it means that the growth rate is slowing and it needs to be paid attention to, but it is not to say that as long as the height gradually decreases, it is abnormal. Above.

You can see the black dots and red dots from the figure above, indicating the height curve of the two children. Look at the red dots first. This child was on the green line (50 %) at the age of June, and then dropped to the green line. By the age of 1, he dropped to the orange line (15th percentage level. ), Then increased along this 15th percentage line.

If you only look at the data before the age of 1, you must feel that the child has a problem with the growth, but fortunately it is above the 3 %, but it is worrying to see the black dot. Because at the age of 1 in January, he fell 3 %, but fortunately, he was growing up along the 3 % level and did not decrease.

The above performance is normal. In the age of 2, most infants and young children will grow slowly. About 1/3 of the baby growth curve will fall (or rise) 1 major percentage line line, 1/4 infants and young children will fall (or rise), 1/10 infants will fall (or rise to rise (or rise to rise (rising rising ) 3.

But as long as the child's height continues to grow along a growth curve, it is okay.

This transition is mostly after June, because the growth of the first 6 months was mainly affected by the environmental environment, and the height began to be related to genetic factors and nutritional factors.

Due to the limited nutrition in the palace, the length of the body was short, and the curve began to increase; due to excess nutrition in the palace, the tall body was born, and the curve would be reduced. 11

Is there a lot of boys with short figures?

In the clinical consultation data, there are more boys with short figures than girls, and there are more boys for treatment. This is not a boy who is naturally short, but people pay attention to the boy's body. When the girl looks short, she thinks she should grow short, and the illusion of treatment is less.

12

Under normal conditions,

How to estimate the height of the child?

In fact, the easiest way is to use the child to be 2 years old and 2.5 years old, which is basically the height of adulthood. At this time, the factors in the palace are basically eliminated, and the children have grown for about 2 years. It is more adaptable to the outside world's environment and influence. Basically, the height is the control of its own factor.

At the age of 2, the child's length and adult height correlation coefficient is 0.80, which can be used to estimate.

We do not recommend using the height of their children's adults at the time of birth, because the height at this time depends on the mother's nutritional state and uterine conditions. It is not the child's own height, and the coefficient of the height of adulthood is only 0.25.

Therefore, when the child is 54cm (normal 50cm) at birth, it can only indicate that the mother is healthy.

Of course, everyone pays attention, we are talking about the estimation under normal circumstances. If there is a short or too high, we cannot use this estimate.

Sometimes everyone still uses the height of their parents to estimate the height of the child, such as:

Boy is expected to be adult height = [Father's height+mother height+13cm] ÷ 2

Girl's expected adult height = [Father's height+mother height -13cm] ÷ 2

The above result is the middle value of the expected height, subtracting or adding 8.5cm to indicate the 3rd to 97th percentage of an adult height. The child's height is expected to be within this range, not just the calculated one Value.

13

Why is he tall after the age of 2

Is it shorter than before the age of 2?

Because the height of the age of 2 is measured, and the amount of lying down before the age of 2 (lying down before the age of 3). When standing against the gravity, it will be compared to the height of the height when lying down.

Everyone should also have an impression that the height in the morning will be a little higher than the evening, and it is also caused by the time when standing for a long time, the spine is shortened.

Therefore, the height of measuring after the age of 2 may be a little lower than before the age of 2, but at the age of 2, it will definitely get higher in a few months.

Everyone may see from the height curve shown in the figure below that at the age of 2, there is a broken file at the age of 2, not continuous.

references:

[1] .diagnostic approach to children and adolescents with short stature.uptodate.2018.

[2] .capes of short stature.uptodate.2018.

[3]. Normal Growth Patterns in Infants and Prepubertal Children.uptodate.2018.

[4] .measurement of Growth in Children.uptodate.2018.

[5] .Growth Hormone Treatment for Idiopathic Short Stature.uptodate.2018.

[6]. THE PEDIATRIC PHYSICAL Examination: General Principles and Standard Measurements.uptodate.2018.

[7] .individual grewth charts.https: //www.cdc.gov/growthcharts/charts.htm

Source of this article: pediatrician Kong Lingkai

Author of this article: Happy Dad Kong Lingkai

Editor in charge: Xiang Yu

- END -