Growth Retardation in Children: Symptoms and Treatment

Growth retardation in children means that a child's growth rate fails to reach normal weight and height limits according to age, gender, and genetic potential. Since the growth and development rate is high in the first years of life, this condition is particularly noticeable in infants. Growth retardation in infants is a condition that needs to be noticed and intervened early. An infant with growth retardation may not be at the expected weight and height for their month, and furthermore, some motor skills may also be delayed. Such symptoms may stem from an underlying health problem. Factors such as hormonal imbalances, developmental disorders, genetic diseases, and nutritional deficiencies cause growth retardation or growth disorders. If growth retardation is not noticed and progresses, its negative effects in later ages may be irreversible. To minimize these negative effects, parents need to regularly monitor their children's growth and development processes.

What Are Growth Retardation and Growth Disorders in Children?

There is a value that children should have for each age starting from birth. These values form a standard chart, and this chart shows the height and weight values that the child should have according to age and gender. A detailed family history is generally questioned for children who fall below these values. If there are features in the family such as genetically short stature or a fast metabolism, and the child continues to develop, there may not be a growth disorder. The growth rate is monitored, and regular measurements are taken. If the child does not have a genetic condition in their family history and still falls behind in regular measurements, hormone deficiency, hypothyroidism, and genetic diseases are investigated. Genetic diseases such as Marfan syndrome are also among growth disorders characterized by excessive growth of the child according to age and gender.

How Do Growth Retardation and Growth Disorders Occur in Children?

Factors causing growth retardation in children can be nutritional deficiencies, chronic diseases, hormonal disorders, or genetic factors. While the cause of nutritional deficiency in children may be the inability to get the necessary vitamins and nutrients, it can also stem from a malabsorption in the child despite taking these nutrients. Malabsorption disorders such as Celiac and Crohn's diseases can cause growth retardation in children.

Celiac disease: Celiac disease stems from an abnormal reaction of the immune system in the absorption of gluten protein found in foods such as wheat, barley, and rye. Celiac disease can affect people of all ages. It can cause growth retardation in children.

Crohn's disease: Crohn's disease, which reduces the nutrient absorption capacity in the small intestine, is an inflammatory disease affecting any part of the digestive system.

Nutritional disorder: Malnutrition is one of the frequent causes of growth retardation. In children with nutritional disorders, growth retardation manifests itself with short stature or delayed puberty onset.

Growth and development disorders in children may also depend on genetic causes such as Down syndrome and Turner syndrome. Apart from these two common syndromes, genetic causes such as Prader-Willi, achondroplasia, and Williams syndrome can also be seen.

Turner syndrome: Seen only in girls, Turner syndrome stems from the absence of the X chromosome. It can manifest itself with symptoms such as short stature and delayed onset of puberty in children.

Down syndrome: It stems from the presence of an extra copy of the 21st chromosome. It manifests itself with symptoms such as mental retardation, heart anomalies, and growth retardation.

Achondroplasia: This genetic disease, which is one of the most common causes of dwarfism, causes arms and legs to remain short. Intelligence is normal and other organs are not affected much, but growth retardation is noticeably prominent in the limbs.

Prader-Willi syndrome: As a result of an anomaly in the 15th chromosome, weak muscle contraction and feeding difficulties can be seen in infants. Growth hormone deficiency may occur, and therefore growth retardation can be experienced.

Williams syndrome: Resulting from an anomaly in the 7th chromosome, there are learning difficulties, growth retardation, and characteristic facial appearances. Growth curves can generally remain low according to the chart.

Developmental disorders in children can also stem from chronic diseases.

Chronic anemia: Anemia and growth and development retardation in children are associated in all stages between 0-18 years of age. Chronic anemia has a direct negative effect on growth. Delays in cognitive, motor, and emotional development can be seen in infants experiencing chronic iron deficiency anemia. Chronic iron deficiency anemia also causes the IGF-1 hormone, which plays a role in the growth mechanism, to be defective.

Hypothyroidism: Primary hypothyroidism can stem from causes such as Hashimoto's disease or subacute thyroiditis. It refers to low thyroid hormones alongside low thyroid-stimulating hormone which causes the release of thyroid hormones. Hypothyroidism slows down the body's metabolism and also has an effect on growth hormones. Children with hypothyroidism generally apply to the doctor for reasons such as short stature.

Cushing's syndrome: Symptoms arising due to excessive cortisol hormone production in the body are called Cushing's syndrome. Cushing's syndrome has a suppressing effect on the response that will promote growth in organs where the growth hormone exerts its effect. Therefore, growth and development disorders can be seen in children with this syndrome.

Another growth disorder is growth hormone deficiency. It stems from the deficiency of a hormone secreted from the hypothalamus, called growth retardation (growth hormone), or from disorders in the cells where this hormone will act. If growth and development retardation in children cannot be attributed to a cause, it can be defined as "idiopathic".

What Are the Symptoms of Growth Retardation and Growth Disorders in Children?

Developmental disorders in children can manifest themselves with different symptoms in every period.

Applications to the doctor are frequently made with short stature. A detailed anamnesis and physical examination are taken from children whose growth curves are below the average for their age, and further examination is requested if deemed necessary.

Another symptom that can be frequently seen especially in nutritional disorders is the slowing down of weight gain. The underlying reason why the child cannot show the expected weight increase must be investigated. Along with this, loss of appetite can also be seen.

Delays in the timing of entering puberty are frequently seen in children. The failure of the menstrual cycle to start yet at expected ages in girls, and testicular development disorder in boys may indicate growth retardation. These situations may stem from reasons other than growth retardation. The reason underlying this symptom must be investigated in detail.

There may be abnormalities in body proportions, such as legs remaining short compared to the torso.

Apart from physical features, delays can also be experienced in motor skills. Skills such as walking and talking can stem from growth retardation.

Symptoms of growth and development disorders in infants can be more pronounced. The reason for this is that the growth rate is high during this period.

It is expected that the infant's weight gain is rapid in the first months after birth. If the infant cannot gain weight regularly and experiences weight loss, it may be a symptom of growth retardation. Apart from this, there may be another underlying cause.

Inadequate growth in head circumference is an important symptom for infants because head circumference also reflects brain development. Neurological development problems must be examined.

Difficulty in the sucking reflex in infants, inability to take milk, or deterioration in feeding patterns correlated with weight loss may indicate growth retardation.

Changes in stool pattern can also be seen in infants experiencing growth retardation.

Behavioral symptoms such as constant restlessness and excessive sleeping can also be observed.

Just like in children, delays experienced in expected developmental steps according to age in infants can be a symptom of growth retardation.

How Is the Diagnosis of Growth Retardation and Growth Disorders Made in Children?

A child patient who has symptoms that may indicate growth retardation as a result of monitoring by parents is examined by a pediatrician. If the child has short stature or an inability to gain weight, it is monitored whether these continue. If growth retardation symptoms are detected in the child as a result of the anamnesis taken, family history, and physical examination performed, diagnostic tests are requested.

The child's growth and development disorder may depend on a hormonal disease, malabsorption, or a genetic disease. Blood and hormone tests are requested for differential diagnosis. Radiological imaging is requested to look at the pituitary gland and hypothalamus where hormones are secreted/stored. A hand X-ray is also requested to see whether bone development is progressing appropriately for age. Bone age is generally behind, especially in children presenting with a delayed puberty problem or who have a hormone deficiency.

Diagnosis is made by combining the results and symptoms emerging according to these tests. Factors causing growth retardation in children are determined. Early diagnosis in growth retardation is important to ensure that the child's development progresses properly.

How Is the Treatment of Growth Retardation and Growth Disorders Done in Children?

The treatment of the child's growth retardation is shaped according to the diagnosis. The treatment is decided based on how severe the diagnosed disease is, whether the child has another disease, and the attitude of the family. Growth and development retardation is a condition that the child psychiatry department must also participate in the treatment of. How the growth retardation experienced by the child psychologically affects the child among peers and within the family must be addressed by child psychiatry.

If there is a growth retardation dependent on hormone deficiency, hormone treatment can be started. Treatment aimed at improving symptoms is given in genetic diseases. Treatment is given according to the type of malabsorption in nutritional disorders. If the child has iron deficiency anemia, iron supplementation can be given. If celiac disease is in question, its treatment involves applying a gluten-free diet.

Frequently Asked Questions About Growth Retardation and Growth Disorders in Children

Growth hormone diagnosis is made with the hormone test performed on the patient suspected of growth hormone deficiency. The pediatric endocrinology department deals with developmental disorders. A patient suspected of nutritional deficiency can go to the pediatric gastroenterology department. Diseases such as chronic anemia, celiac disease, Turner syndrome, Down syndrome, achondroplasia, and growth hormone deficiency can cause growth retardation. Children experiencing developmental retardation dependent on nutritional disorder or hormone deficiency can have their growth periods restored to normal by receiving treatment. This can be achieved with the right diet and supplementation or with hormone replacement therapies. In genetic syndromes, attempts are also made to slow down growth retardation. Pediatric endocrinology deals with the diagnosis and treatment of symptoms such as falling behind in bone age and delay in puberty. Along with this, if an infant shows growth retardation, the neonatologist can also detect this, examine them, and request the necessary tests. Growth retardation in infants can manifest itself with symptoms such as being excessively thin, irregularity in defecation, loss of appetite, weakness in the sucking reflex, and failure to see the expected growth in head circumference. Growth and development disorders in infants can be understood by falling behind in the height, weight, and motor skills levels that the infant should be at in the growth process. Symptoms of growth retardation in infants can cause suspicion in this regard, and if noticed, it is recommended to take an expert opinion.

Parents should closely monitor their children's growth and development. If you notice a persistent delay in development, an expert physician evaluation is definitely necessary. Our Hisar Hospital PEDIATRIC GASTROENTEROLOGY experts are by your side to determine the causes of growth retardation and initiate the appropriate treatment process.