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Nowadays, more and more parents encounter anxiety about their children's height in pediatric outpatient clinics. As a pediatrician, in daily work, timely detection of children with growth and development deviations can avoid missing the opportunity for treatment and help children and parents obtain the expected adult height.
So, how should your child's height be assessed clinically and abnormal growth and development should be detected? Let's find out.
Normal children's height development patterns
Children have two rapid growth periods, including infancy and adolescence. Children of different ages have different rates of growth and development.
There are individualized differences in growth rates. The average growth rate is 25 cm increase in height in the first year of life, 12 cm in the second year, and 5 to 7.5 cm per year thereafter until puberty. Puberty is the final period of height gain. By the end of puberty, height is close to adult level.
If the child has an abnormal growth rate, early detection intervention can give the child more time to catch up. If abnormalities are discovered close to puberty, the treatment window becomes narrow, which may affect the effectiveness of treatment in children (figure 1).
Figure 1 Child growth rate
How to assess the rate of growth and development
Height and weight values are measured regularly and evaluated against reference values for healthy children. Growth can be judged by the standard deviation method, the percentile method (Tables 1 to 2), and the growth curve (Figure 2).
Table 1 Standard Deviation (SD) Method
Table 2 Percentile (%) method
Figure 2 Growth Curve (Swipe left and right)
Key points to reduce height measurement errors
Measurement method: under 3 years old, supine position measurement, 3 years old and older, standing position measurement.
Ensure the same measurement time, the same measuring ruler, the same measuring person.
Measure 3 times, each time with an error of less than 0.3 cm, taking the average.
Predict height potential through bone age
Bone age represents the state of bone development, and the actual age is not necessarily parallel, if the bone age is advanced, it means that the child has precocious puberty. In addition, measuring bone age can also determine the child's height development potential. When the bone age reaches 14 years, the height of the body at this time is 92.7% of the adult height of boys and 98% of the adult height of girls. The specific calculation method is shown in Table 3.
Table 3 Calculation of growth potential predicted by bone age
In fact, growth and development deviation is a relatively common clinical phenomenon, and early recognition and evaluation can help children get timely treatment. Increases the therapeutic effect and reduces the damage to the height of the final adult.