Causes and risk factors
Causes are either associated with failure to thrive, chronic illness, normal delayed growth, or hormonal defects. They are poor nutrition, lack of growth hormone, hormonal imbalances [such as low levels of thyroxin due to hypothyroidism], dwarfism, certain anemia such as sickle cell anemia, Turner syndrome, Down’s syndrome, pituitary gland tumor; kidney, heart, digestive, or lung diseases. Family history of growth delays, smaller birth and fetal weight can cause delayed growth. Severe stress, long-term use of certain drugs by pregnant mother can lead to growth delays in children.
Clinical presentation
The primary symptom that indicates a growth delay is when a child grows less than two inches a year after his/her second birthday. Other symptoms may include slow development of physical skills, such as rolling over, sitting up, standing and walking, delayed social and mental skills, delayed development of secondary sexual characteristics in adolescence. A few physical symptoms like constipation, excessive crying, excessive sleepiness [lethargy], irritability, etc. can also be found.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Routine blood tests are advised. Hormonal profile, genetic syndrome evaluation is necessary where there is family history. Stool studies to check for poor nutrient absorption are recommended. Urine test is done. Imaging studies such as x-rays to determine bone age may be useful for further evaluation.
Treatment
If an underlying medical condition is found, accordingly treatment given may result in improved growth. Growth failure due to hypothyroidism is treated with thyroid hormone replacement medicines. Growth hormone injections are given for children with growth hormone deficiency, Turner syndrome, and chronic kidney failure which help kids reach a more normal height. If slow weight gain is due to a lack of calories, feeding the child on demand along with increase in the amount of food can help. Offering nutritional, high-calorie foods is required.
Other Modes of treatment
The other modes of treatment can also be effective in treating delayed growth. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating delayed growth.
