Short stature is a height that is less than or equal to the third percentile for a person's age, sex, and race.
Short stature is generally broken down into 3 subgroups:
- Familial short stature—parents are short
- Constitutional delay and development—child is small for age but growing at normal rate, will reach an adult height similar to parents
- Caused by chronic disease—such as malnutrition, genetic disorders, heart problems, and growth hormone deficiency
Expected Growth (Shadow) and Short Stature
Familial and constitutional delays are due to the child's genetic make-up. If both parents are shorter than average, the child will most likely have short stature. The child may also have delayed puberty. This may cause temporary short stature, but normal height will eventually be reached.
Medical conditions that may contribute to short stature include:
- Malnourishment—most common cause of growth failure and is generally associated with poverty
- Genetic disorders such as skeletal dysplasias, Turner syndrome, Down syndrome, and Silver Russell syndrome
- Endocrine disorders such as hypothyroidism or growth hormone deficiency
- Congenital heart diseases
- Kidney diseases
- Liver failure
- Sickle cell anemia
- Intrauterine growth retardation or small for gestational age
- Disorders of the stomach or intestines such as inflammatory bowel disease
- Lung conditions such as severe asthma and chronic obstructive pulmonary disease
- Malabsorption due to cystic fibrosis or celiac disease
- Use of selective serotonin reuptake inhibitor (SSRI) medications—may be used to treat attention deficit disorder or obsessive compulsive disorder
- Radiation therapy for cancer
- Chronic use of steroids
Factors that may increase your child's chance of short stature include:
- Having family members with short stature
- Poor diet
- Certain diseases in a pregnant woman will increase risk to the newborn child
- Certain drugs taken by a pregnant woman will increase risk to the newborn child
Symptoms vary. Children with familial short stature do not have any disease-related symptoms. They will often reach a height similar to that of their parents.
Children who have delayed puberty will often have a close relative with the same delay. These children will also eventually catch up to their peers in height.
Symptoms that may indicate a medical condition include:
- Stopped or dramatically slowed growth—below the third percentile as determined by your doctor
- Weight loss or gain—more than 5 pounds in a month
- Poor nutrition
- Loss of appetite
- Chronic abdominal pain and diarrhea
- Persistent fever
- Chronic headaches and/or vomiting
- Delayed puberty—no spotting by age 15 years for a girl or no enlargement of the testes by age 14-15 years for a boy
You will be asked about your child's symptoms and medical history. A physical exam will be done. Your child's height, weight, and body proportion will be measured. The skull and facial features will also be examined.
Your child's bodily fluids may be tested. This can be done with:
- Blood tests
- Urine tests
Images may be taken of your child's bodily structures. This can be done with x-rays.
Your child may be tested for chromosomal abnormalities. This can be done with a genetic exam.
Children with familial short stature do not require treatment. For others, treatment will focus on the cause of short stature. Treatments can vary greatly, but may include medication or nutritional changes.
Medications that may be used to treat associated conditions include:
- Thyroid hormone replacement therapy—may be used in children with hypothyroidism
- Growth hormone replacement—may be used in some children such as those with growth hormone deficiency, Prader-Willi syndrome, Turner syndrome, chronic kidney disease, or idiopathic short stature
If a medication is associated with short stature, you may be advised to stop taking the medication. Make sure to talk to your doctor before stopping any medication.
Short stature cannot be prevented in children who have a familial short stature or short stature from genetic conditions. However, short stature from chronic disease can be prevented by treating the condition. In some cases, you can minimize your child’s risk of developing short stature by encouraging a nutritious diet.
Pregnant women can minimize the risk of short stature in their children by:
- Eating a nutritious diet during pregnancy
- Avoiding smoking
- Avoiding illegal drugs
Human Growth Foundation
The MAGIC Foundation
Little People of British Columbia: Society for Short Stature Awareness
Disorders of short stature. Human Growth Foundation website. Available at: http://hgfound.org/resources/disorders-of-short-stature/. Accessed June 6, 2016.
When a child is unusually short. American Academy of Pediatrics' Healthy Children website. Available at: https://www.healthychildren.org/English/health-issues/conditions/Glands-Growth-Disorders/Pages/When-a-Child-is-Unusually-Short.aspx. Updated January 27, 2016. Accessed June 6, 2016.
Last reviewed June 2016 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.