CONTENTS Introduction Part 1 Facts About Growth & Height Human Growth Periods 3 Growth Hormone 4 The Spinal Column 5 Height Decreasing Disorders 8 Height & Weight Chart 10 Part 2 Understanding Children’s Growth Possible Causes For Short Stature 12 Physical Examination 13 Standard Growth Chart 14 Part 3 Factors That Affect Growth Nutrition 17 Vitamins and Minerals 21 Sleep 24 Part 4 How To Look Taller Posture 27 Appearance 29 Part 5 Guidelines For Exercising Preparation Notes 31 Breathing 31 Self Back Massage 33 Part 6 Stretching Yoga & Pilates 35 Hip & Lower Back Stretches 46 Neck & Shoulder Stretches 47 Inversion 48 Ankle Weight Methods 49 Kicking 51 Hanging 51 Part 7 Mental Exercises Guided Imagery 53 Subconscious 54 Positive Thinking 54 Relaxation Techniques 55 Self-Hypnosis 55 Part 8 Other Exercises Aerobic Exercises 56 Anaerobic Exercises 60 Back Exercises 64 Part 9 Exercise Routines Exercise Routine 1 66 Exercise Routine 2 66 Exercise Routine 3 66 Exercise Routine 4 66 Exercise Routine 5 67 Exercise Routine 6 67 Exercise Routine 7 67 Exercise Routine 8 68 Part 10 Meal Plan 6-Meal Plan 69 Nutritional Supplements 70 Part 11 Tools Height Calculator 71 Personals Analysis 72 Part 12 Height Increasing Products Products That Help Increase Height 74 Companies That Promote Height Increasing Products 75 Part 13 Articles Cosmetic Leg Lengthening 78 6 Ways To Boost Growth Hormones 82 Successful Short Individuals 85 Height is a very subjective term. What one person considers as tall may be short to someone else. Nevertheless, there are many personal, professional, financial and gender advantages to being taller such as the following: · women are naturally more attracted to taller men · society associates attributes power, intelligence, leadership, confidence, and competence to taller individuals · better self-confidence and self-esteem · taller men are inexplicably selected 75% of the time for a job compared with shorter men with similar credentials and experience Like it or not, height does play a part in our daily lifestyles and chances of success. It may the deciding factor towards your professional and personal successes. Here’s another little known fact - 95% of all the tall people in this world have shorter parents and grew taller as a result of certain factors that will be discussed in this book. Information in this book will increase your height, maximise your individual growth potential as well as provided you with the following additional benefits. · longer, stronger, flexible, and more supple spine · thin and sculpted stomach and back · enhanced ability to perform skilled movements · increased mental and physical relaxation · enhanced development of body awareness · enhanced physical fitness You will grow taller, think clearer and be physically fit. By reducing the effects of aging, you will be able to live your life to the fullest! This book promotes total well being by presenting nutritional advise and numerous growth enhancing exercises, as well as interesting snippets on height-related information that can be enjoyed by everyone. No matter how old you may be, follow the recommendations in this book and you can increase your height and stand tall in due time. Good luck and happy reading! INTRODUCTION Part 1 FACTS ABOUT GROWTH & HEIGHT 3 Human Growth Periods There is a lot of misinformation regarding the ages that growth takes place, how tall you will likely be, and what the exact roles of heredity and environment have on your growth. Throughout your life you will constantly generate human growth hormone. Maintaining your bodies chemical balance and cell rejuvenation are two main reasons your body generates Human Growth Hormones (HGH). Whether you are looking forward to increasing your linear height, developing bone density, or regenerating your bone cells, human growth hormone can be manufactured in great amounts and is distributed most often during certain periods of your life. There are a number of factors that, if manipulated correctly, will substantially increase growth hormone levels in your body. It is quite common for boys and girls to grow suddenly as they enter puberty. This is called the growth spurt. The graph below shows this more clearly: Growth takes place from time of fertilisation to about age thirty and it is seldom smooth, regular, and predictable. Most girls will have their growth spurt between ages 10 and 14, during the early stages of puberty. During this growth spurt that lasts for a year or two, growth is rapid. They can grow as much as 3½ inches per year during this duration. Hence, it is common for 12 and 13 year old girls to be taller and heavier than boys. Most boys start puberty and begin their growth spurt between ages 13 and 15. Their growth spurt also lasts for a year or two and during this period they may gain as much as 4½ inches per year. By age 15, it is common for boys to become taller and heavier than girls. After the growth spurt, growth continues but slows down to a steadier rate. It is important to note that growth spurt can occur within a wide age range. Each individual may experience growth spurt earlier or later than the average age. Although it is widely accepted that an individual's maximum height is achieved by the late teens, it is however incorrect. Most girls reach their full height by 17 while most boys by 19, although lots of individuals continue to grow into the twenties. The vertebrae in the spinal column continue to grow in length and width until about age thirty. The growth you experience and the height that you ultimately acquire is the result or heredity and the environment. Therefore it will be incorrect to assume that the maximum height you obtain is solely the result of heredity. Environmental factors that affect your height include disease, stress, nutrition, exercise and sleep. They are just as important as heredity in determining growth. You may have little or no control over your genes, but you may manipulate the environment you are in. By understanding these factors, you can use them to your full advantage. Girls and Boys Growth Rates Inches Centimeters Age in Years Boys Girls Part 1 FACTS ABOUT GROWTH & HEIGHT 4 Growth Hormone Hormones are chemicals produced by special cells in glands and other organs of the body. Most hormones are produced by cells in the endocrine glands. These hormones are produced in very small amounts and are released into the bloodstream and travel to the organ or tissue where their effect takes place. Several hormones are involved in regulating growth. Some act directly on organs, while others act by triggering the production of other hormones, which activates specific organ functions that is necessary for growth. Growth hormone is a protein produced particularly by the pituitary gland. Proteins are made of building blocks known as amino acids. Located in the centre of our brain, the pituitary gland is often called the master gland because it controls the release of many of the body's hormones. Overview of some of the most important hormones There are two unnatural ways to increase growth hormone level – growth hormone-releasing products and injections. Growth hormone-releasing products such as glycine, glutamine, agrinine, ornithine, niacin, and 16 other amino acids can be obtained without prescription. These substances are usually used by bodybuilders. Some of them are good for boosting immunity, protecting the liver, fighting cancer, rebuilding body tissue after surgery or trauma, amongst many other applications. Some types of amino acids help produce growth hormone and with proper exercises may increase your growth. Performing this self-treatment without medical supervision, especially for children, is not recommended. These drugs have to be taken in proper dosage and some of them need to be combined with other drugs or nutrients. Improper usage may cause you grievous health problems. There are many side effects such as diarrhoea, low toxicity, headache, drowsiness, muscle spasms, dizziness high blood pressure, nervousness, depression, hair loss, gaining weight, and many more. Manmade growth hormone is administered by a series of injections that could cost anywhere from USD12,000 to USD18,000 a year. It is usually prescribed after careful evaluation of an individual's growth pattern and growth potential. These injections may help you grow, but inducing growth too quickly may inhibit growth at a later stage. Growth hormone may produce various other side effects such as high cholesterol, diabetes, liver abnormalities, increased tissue stiffness, carpal tunnel syndrome, musculoskeletal disease, neuropathy, allergic reactions, pancreatitis, hyperglycemia, visual deterioration, headaches, vomiting, increased liver enzyme levels, increased sweating, edema, pain in general and back pain specifically. If you receive these injections, your body will adapt to this drug, and will refuse to produce natural growth hormone after you stop receiving injections. If you think these procedures are not for you, read further. ACTH LH FSH GH TSH Adrenal Gland Testicles Ovaries Liver Thyroid Hydrocortisone Testosterone Estrogen Progesterone IGF T3&T4 Pituitary Hypothalamus Releasing Factors Brain Part 1 FACTS ABOUT GROWTH & HEIGHT 5 Exercise, stress and emotional excitement induce growth hormone release. On the other hand, obesity and fatty acids inhibits the release of growth hormone. It is growth hormone that grows the cells, bones, muscles, and organs of our bodies. The Spinal Column Fundamental knowledge of its structure and function can dramatically increase your height and growth potential. The spinal column is one of the most important body parts. Without it you could not support yourself upright and perform many complex functions. A healthy spine will optimise your body's transmission of energy and go through your daily tasks with ease and comfort. For adults, there are 33 vertebrae in your spinal column. The first important component of the spine is cartilaginous pads called intervertebra discs. These discs are located between each of these 33 vertebrae. They are pads of soft tissue that lie between the vertebrae. Its main function is to act as shock absorbers and provide separation between each vertebra. It is also responsible for the flexibility of the spine. On average, your total discs account for one-quarter the length of your vertebral column 4.50" to 6" (12 to 15 cm) for most people. The thicker those discs, the longer your spinal column is and the taller you become. The Spinal Column The vertebral column typically consists of 33 vertebrae - 7 cervical, 12 thoracic, 5 lumbar, 5 fused sacral and 4 coccygeal. The only way for the discs to return to a more youthful state is to stimulate the spine. This can be done by regular stretching and moving the spine through its full range of motion so that blood circulation and fluid content of the discs are increased. Otherwise, the discs may lose its elasticity and become rigid, and hence will lead to height loss. Regular stretching and inversion can help increase your height by expanding the discs and lengthening your spine. C1 C2 C3 C4 C5 C6 C7 T1 T2 T3 T4 T5 T6 T7 T8 T9 T10 T11 T12 L1 L2 L3 L4 L5 Part 1 FACTS ABOUT GROWTH & HEIGHT 6 Intervertebral discs . These discs acquire nourishment through fluid-attracting and fluid-absorbing qualities of its jelly-like nucleus. During non-weight bearing activities (like sleeping) the discs expand as they soak up fluid, increasing the length of the spine by as much as an inch overnight. However, the pull of gravity during the day results in compression fatigue that causes the average adult loses an inch in height each day primarily because fluid is squeezed out of the spinal discs (this reverses during sleep). Therefore, if you measure yourself in the morning right after you wake up, you are about an inch taller than if you were to measure yourself at night. The second important component of the spine is the supporting muscles i.e. adjoining muscles and ligaments. They help you move and support your spine. Muscles are used for three basic functions – support, movement and posture control. Your muscles help influence your posture and height by: 1. Creating and maintaining the curves of your spine 2. Resisting the force of gravity, and straightening by contracting and exerting compressive force on your spine 3. Supporting your spine Weak muscles will give you poor posture and hence, your height is not maximised. You can grow taller and increase your height by correcting your posture. Pilates is one exercise that will help strengthen your postural muscles. By emphasising posture, you will learn to stretch your spine. The third important structure of the spine is the spinal curves. A normal spine is shaped like the letter "S". Any excessive exaggeration of the spine's curves results in height loss and compression of the discs. There will also be stress and strain on the entire back. The most common posture problem is swayback, where your lower back's curve is exaggerated. This is caused by weak abdomen muscles, excessive stomach fat (tummy) or just plain old habits. Spinal curves are either kyphotic or lordotic. In a normal spine there are four types of spinal curvatures important to balance, flexibility, and stress absorption and distribution. Curve Description Concave anteriorly and convex posteriorly Convex anteriorly and concave posteriorly Normal Curvature 20 to 40 degrees 20 to 40 degrees 40 to 60 degrees Sacrum fused in a kyphotic curve Type of Spinal Curves Kyphosis or Kyphotic Curve Lordosis or Lordotic Curve Curvature Cervical Lordosis Thoracic Kyphosis Lumbar Lordosis Sacral Kyphosis Part 1 FACTS ABOUT GROWTH & HEIGHT 7 The second most common is that of a rounded upper back or hunchback. This is due to weak shoulder muscles or poor standing posture. The final one is what we call a poke neck. This is where the head thrust forward at the neck. This is mainly due to habitual behaviour. By consciously trying to stand straight and walk tall at all times, you can start to improve your posture and strengthen the relevant muscles to relieve unnecessary stress and compression on your discs. As a result, your height is maximised. Follow the recommended exercises to correct any excessive spinal curve exaggeration. Cervical (Lordosis) Thoracic (Kyphosis) Lumbar (Lordosis) Sacral (Kyphosis) Coccyx (Tailbone) As you can see, proper posture can greatly decrease the forces that are applied to your lower back. Here are a few things you can do to protect your back: • Lift objects by bending at the knees, not at the waist. • If you are carrying an object, hold it close to your body, not with your arms extended. • Never cough while bending forward as this really puts you in a position to hurt your back. Position Standing at ease Lying on your back Sitting, no back support Sitting with lumbar support Coughing Forward Bend, 20° Forward Bend, 40° Forward Bend, 20° with 20 kg Forward Bend, 20° rotated 20°, 10 kg Sit-ups Holding 5 kg, arms extended Force 500 N 250 N 700 N 400 N 600 N 600 N 1000 N 1200 N 2100 N 1200 N 1900 N Different positions can place different stresses on the spine. The following chart outlines how posture can affect the low back. Approximate load on L3 disc in a person weighing 70kg Lateral (side) Spinal Column Part 1 FACTS ABOUT GROWTH & HEIGHT 8 Height Decreasing Disorders Many conditions or disorders can cause a loss of height or a hindrance of growth. Some are easy to detect and correct, and some are not. The stresses and pressures caused by the environment have lead many people, particularly women, into establishing unhealthy eating habits and disorders. There are a couple of genetically induced diseases that contribute to growth abnormalities as well as height decreasing conditions. We will briefly highlight a few common problems that can cause height loss. Scoliosis Scoliosis is a condition where there is a sideways or lateral curvature of the spine. If scoliosis is severe, it can be observed by looking at an individual's back. If the scoliosis is present in a lesser degree, it can be detected through an X-ray. This condition reduces your height, adds stress and strain on the muscles, ligaments, and discs at the back. If the condition is not corrected, it may cause further problems. When scoliosis is severe, surgery is required to correct it. Upon which, patients usually gain at least an inch and more in height. If anyone suffers from scoliosis, the best thing is to consult a professional before starting any type of stretching or exercise programme. However, if scoliosis is present to a lesser degree, stretching and strengthening exercises can be extremely beneficial in correcting it. Stretching and strengthening underdeveloped back muscles can correct postural imbalances and promote proper alignment of the back. Hence, there will be a decrease of the curvature and an increase in height. Scoliosis Knock-knees One condition that may cause a decrease in height is knock-knees, also known as valgus knees. Knock-knees usually occur after an injury when proper healing does not happen. They can also result from poor arches or weak muscles and ligaments. If you suffer from knock-knee that causes any pain or discomfort, it is best to consult a physician. Exercise cannot help severe cases of knock-knees. In severe cases, surgery may be required. Bowlegs Bowlegs, also known as varus knees, can occur after an injury but it is most often caused by weak ligaments and muscles of the knees. This condition usually begins from childhood. If it is diagnosed early, when the child is still growing, it can be corrected by wearing special kinds of shoes. Part 1 FACTS ABOUT GROWTH & HEIGHT 9 Another cause is malnutrition, especially a lack of Vitamin D or insufficient calcium intake where the bones failed to ossify. This results in soft bones resulting in bowlegs. Same as knock-knees, it is best to consult your physician if your bowlegs cause pain or discomfort. Exercises can help and retard mild case of bowlegs by strengthening the muscles, tendons, ligaments, and bones of the legs. Severe cases such as injury or subnormal absorption by the small intestine would require medical attention. Hyperextended Knees Hyperextended knees refer to condition where the knees are thrown back in a locked position. This causes problems to your knees and also contributes towards the development of lordosis. Bowlegs Knock-Knees Normal If the knees are not extensively hyperextended, they can be corrected. The best treatment is to strengthen the leg muscles, especially the thigh muscles. Some of the helpful thighs strengthening exercises include squats, lunges, and leg presses. Consciously reminding yourself to keep your knees loose when you feel them locked back also helps correct the problem. Growth Hormone Growth hormone, also known as somatotropin, is most readily released during deep sleep and exercise. Growth hormone accelerates growth by increasing the size of organs and promoting the growth of bones. If there is an overproduction of growth hormone is an adult, the bones increase in thickness instead of length. That leads to acromegaly - the enlargement of the bones of the head, feet, hands, and sometimes other structures. Knee Flexure Knee flexure is when the knees are in a constant state of being bent. A flat back and poor posture usually accompanies this condition. Knee flexure is not a serious problem and can be easily corrected. Stretching and increasing the flexibility of the hamstring and calf muscles can correct mist knee flexure problems. Knee Flexure Dysfunction that causes underproduction of growth hormone during childhood may result in dwarfism. As described in an earlier chapter, most physicians hesitate to administer artificial growth hormone to normal children for the sole purpose of making them taller. Part 1 FACTS ABOUT GROWTH & HEIGHT 10 Other Growth Disorders Other growth disorders include the inability to properly absorb food. This is usually caused by a problem in the intestine. When an individual cannot properly absorb and digest essential nutrients, they suffer from a lot of symptoms, including stunted growth. A growth disorder can also be the result of certain lung and kidney disorders. Psychological stress can also cause short statue and stunted growth. Some children fail to grow if they suffer from severe physical or emotional abuse. However, if removed from an abusive environment, the secretion of human growth will tend to resume. If you have concerns regarding your growth, it is best to visit your doctor or medical professional that specialises in growth disorders. Height & Weight Chart Ideal Height and Weight Table for Men (indoor clothing weighing 5 lbs. & shoes with 1" heels) Height Small Medium Large Frame Frame Frame 157.5 cm 58.2 - 60.9 kgs 59.5 - 64.1 kgs 62.7 - 68.2 kgs 5 feet 2 inches 128 -134 lbs 131-141 lbs 138-150 lbs 160.0 cm 59.1 - 61.8 kgs 60.5 - 65 kgs 63.6 - 69.5 kgs 5 feet 3 inches 130-136 lbs 133-143 lbs 140-153 lbs 162.5 cm 60.0 - 62.7 kgs 61.4 - 65.9 kgs 64.5 - 70.9 kgs 5' feet 4 inches 132-138 lbs 135-145 lbs 142-156 lbs 165.1 cm 60.9 - 63.6 kgs 62.3 - 67.3 kgs 65.5 - 72.7 kgs 5 feet 5 inches 134-140 lbs 137-148 lbs 144-160 lbs 167.6 cm 61.8 - 64.5 kgs 63.2 - 68.6 kgs 66.4 - 74.5 kgs 5 feet 6 inches 136-142 lbs 139-151 lbs 146-164 lbs 170.2 cm 62.7 - 65.9 kgs 64.5 - 70 kgs 67.7 - 76.4 kgs 5 feet 7 inches 138-145 lbs 142-154 lbs 149-168 lbs 172.7 cm 63.6 - 67.3 kgs 65.9 - 71.4 kgs 69.1 - 78.2 kgs 5 feet 8 inches 140-148 lbs 145-157 lbs 152-172 lbs 175.3 cm 64.5 - 68.6 kgs 67.3 - 72.7 kgs 70.5 - 80.0 kgs 5 feet 9 inches 142-151 lbs 148-160 lbs 155-176 lbs 177.8 cm 65.5 - 70.0 kgs 68.6 - 74.1 kgs 71.8 - 81.8 kgs 5 feet 10 inches 144-154 lbs 151-163 lbs 158-180 lbs 180.3 cm 66.4 - 71.4 kgs 70.0 - 75.5 kgs 73.2 - 83.6 kgs 5 feet 11 inches 146-157 lbs 154-166 lbs 161-184 lbs 182.9 cm 67.7 - 72.7 kgs 71.4 - 77.3 kgs 74.5 - 85.5 kgs 6 feet 0 inches 149-160 lbs 157-170 lbs 164-188 lbs 185.4 cm 69.1 - 74.5 kgs 72.7 - 79.1 kgs 76.4 - 87.3 kgs 6 feet 1 inches 152-164 lbs 160-174 lbs 168-192 lbs 188.0 cm 70.5 - 76.4 kgs 74.5 - 80.9 kgs 78.2 - 89.5 k 6 feet 2 inches 155-168 lbs 164-178 lbs 172-197 lbs 190.5 cm 71.8 - 78.2 kgs 75.9 - 82.7 kgs 80.0 - 91.8 kgs 6 feet 3 inches 158-172 lbs 167-182 lbs 176-202 lbs 193.0 cm 73.6 - 80 kgs 77.7 - 85.0 kgs 82.3 - 94.1 kgs 6 feet 4 inches 162-176 lbs 171-187 lbs 181-207 lbs Part 1 FACTS ABOUT GROWTH & HEIGHT 11 Ideal Height and Weight Table for Women (indoor clothing weighing 3 lbs. & shoes with 1" heels) Height Small Medium Large Frame Frame Frame 147.3 cm 46.4 - 50.5 kgs 49.5 - 55.0 kgs 53.6 - 59.5 kgs 4 feet 10 inches 102-111 lbs 109-121 lbs 118-131 lbs 149.9 cm 46.8 - 51.4 kgs 50.5 - 55.9 kgs 54.5 - 60.9 kgs 4 feet 11 inches 103-113 lbs 111-123 lbs 120-134 lbs 152.4 cm 47.3 - 52.3 kgs 51.4 - 57.3 kgs 55.5 - 62.3 kgs 5 feet 0 inches 104-115 lbs 113-126 lbs 122-137 lbs 154.9 cm 48.2 - 53.6 kgs 52.3 - 58.6 kgs 56.8 - 63.6 kgs 5 feet 1 inches 106-118 lbs 115-129 lbs 125-140 lbs 157.5 cm 49.1 - 55.0 kgs 53.6 - 60.0 kgs 58.2 - 65.0 kgs 5 feet 2 inches 108-121 lbs 118-132 lbs 128-143 lbs 160.0 cm 50.5 - 56.4 kgs 55.0 - 61.4 kgs 59.5 - 66.8 kgs 5 feet 3 inches 111-124 lbs 121-135 lbs 131-147 lbs 162.5 cm 51.8 - 57.7 kgs 56.4 - 62.7 kgs 60.9 - 68.6 kgs 5' feet 4 inches 114-127 lbs 124-138 lbs 134-151 lbs 165.1 cm 53.2 - 59.1 kgs 57.7 - 64.1 kgs 62.3 - 70.5 kgs 5 feet 5 inches 117-130 lbs 127-141 lbs 137-155 lbs 167.6 cm 54.5 - 60.5 kgs 59.1 - 65.5 kgs 63.6 - 72.3 kgs 5 feet 6 inches 120-133 lbs 130-144 lbs 140-159 lbs 170.2 cm 55.9 - 61.8 kgs 60.5 - 66.8 kgs 65.0 - 74.1 kgs 5 feet 7 inches 123-136 lbs 133-147 lbs 143-163 lbs 172.7 cm 57.3 - 63.2 kgs 61.8 - 68.2 kgs 66.4 - 75.9 kgs 5 feet 8 inches 126-139 lbs 136-150 lbs 146-167 lbs 175.3 cm 58.6 - 64.5 kgs 63.2 - 69.5 kgs 67.7 - 77.3 kgs 5 feet 9 inches 129-142 lbs 139-153 lbs 149-170 lbs 177.8 cm 60.0 - 65.9 kgs 64.5 - 70.9 kgs 69.1 - 78.6 kgs 5 feet 10 inches 132-145 lbs 142-156 lbs 152-173 lbs 180.3 cm 61.4 - 67.3 kgs 65.9 - 72.3 kgs 70.5 - 80.0 kgs 5 feet 11 inches 135-148 lbs 145-159 lbs 55-176 lbs 182.9 cm 62.7 - 68.6 kgs 67.3 - 73.6 kgs 71.8 - 81.4 kgs 6 feet 0 inches 138-151 lbs 148-162 lbs 158-179 lbs Part 2 UNDERSTANDING CHILDREN'S GROWTH 12 Our society places a high value on a person's height, almost more than any other characteristic. Children who are shorter than their peers face significant challenges. They are often teased, and are on the receiving end of name-calling and prejudice. They may deal with their frustration by becoming depressed, angry, or aggressive. If they do not experience a growth spurt, they will face other challenges as adults. Parents need to be aware of these challenges so they can help their children become happy and productive. Administering Human Growth Hormone is one treatment, in certain cases, but we also explore other ways that parents can help their children. Genetics play the most important role in determining a child's final height but there are some common sense steps parents can take to maximise their children's growth. Growing children should: 1. Eat healthy food. 2. Get a good night's sleep. 3. Get plenty of exercise. Without exercise, nutrition goes into building fat instead of height. 4. Don't smoke! Second-hand smoke has also been linked to reduced growth. If you are concerned about a child's growth, the first thing you should do is contact the paediatrician. Depending on a child's age and height, the paediatrician may decide to begin diagnostics or refer you to a paediatric endocrinologist. A paediatric endocrinologist specialises in the hormone system of children. The hormone system regulates growth in children, as well as many other biological functions. It will be helpful to the physician if you provide information about your child's growth patterns. This could be as easy as providing a representation of the wall or door you use to measure a child's height, since he or she began to stand. Your The information presented here is meant to help parents discuss their child's growth with their paediatrician. It is not a substitute for those discussions. The physician should first discuss with you the possible causes of short stature. It is important to not jump to conclusions. Allow enough time for the physician to conduct the right tests. Testing may require six months to a year and may include detailed recording of height changes over time. Possible Causes For Short Stature There are many possible causes for short stature. Each cause may or may not be treatable. Familial The most likely reason for a child to be short is because his or her parents are short. Children generally inherit all of their physical characteristics from their parents. Besides height, some of the most obvious are eye colour, hair colour, facial features and perhaps intelligence. Children from short parents can be expected to reach an adult height about the same as their parents. However, children often grow taller than their parents because today's improved knowledge of nutrition and medical practices. Treatment with Human Growth Hormones is not indicated in these cases because the child's growth hormone production is normal according to their physiology. Constitutional Growth Delay In Constitutional Growth Delay, children grow slowly at first. Then during puberty they grow quickly, reaching a normal height approximately the same as their parents. Boys are more likely to have Constitutional Growth Delay than girls. Children with Constitutional Growth Delay may experience growth spurts before they start school but do not catch up to their peers until puberty. Constitutional Growth Delay may run in families. Part 2 UNDERSTANDING CHILDREN’S GROWTH 13 Growth Failure These conditions indicate a problem with the child's physiology and are grouped into three categories - Systemic, Endocrine and Congenital. Treatment may or may not be possible, depending on the specific condition. Idiopathic Short Stature When children do not demonstrate any symptoms, and test results do not indicate a problem, they are said to have idiopathic short stature. These children are physically and mentally normal, but they are short. Idiopathic short stature is uncommon. The effect of growth hormone treatment on children with Idiopathic Short Stature has been inconclusive. There is no evidence that treatment may increase their adult height and is not recommended by the medical community. Physical Examination After the first consultation, the physician or paediatric endocrinologist will conduct a series of tests to determine if there is a problem, and if there is a possible course of action. Height Measurements The first thing the doctor will do is measure the child and ask for information about the child's previous growth patterns and the heights of his or her parents and other relatives. With this information and a Standard Growth Chart, the doctor can determine if the child is on the right growth path according to his or her genetics, or if there might be a more serious problem. Blood Tests Blood tests will be performed to determine if there are any physiological problems. Some conditions are easily determined while others are more difficult. The lack of adequate production of Growth Hormone is difficult to determine because it is produced in spurts and does not remain in the blood stream very long. Many blood samples may be needed over the course of a few months to obtain an accurate reading. Alternatively, the doctor may advise that the child be placed in a hospital for a few days so the blood can be checked every few hours. X-rays X-rays of the child's hand can indicate his or her growth potential. Each long bone in the body has a growth plate on one or both ends where growth occurs. The doctor can view the structure of the growth plates and the distance between the bones to determine how much future growth is possible. The hand is a good part of the body to use because there are so many bones in it. As children reach puberty, the growth plates close and no further growth occurs. If the X-rays indicate that more growth is possible and that the child is low in growth hormones, then growth hormone treatment is indicated. However, if the growth plates are nearly closed, Growth Hormone treatment is not likely to produce positive results. Human Growth Hormone Treatment is an expensive proposition. It can cost up to USD1,000 a week, depending on how much growth hormone the child needs. While under treatment, the child receives injections three to seven times per week. For treatment to be effective, he or she must continue to receive injections until the end of puberty. It is important for parents to understand that Human Growth Hormone treatment should only be applied when it is determined that the child is not producing enough Growth Hormone. Part 2 UNDERSTANDING CHILDREN’S GROWTH 14 Too much Growth Hormone could trigger an early onset of puberty, closing the growth plates and reducing the child's final height. Whatever your physician advises, you may want to consider a second opinion, especially from a paediatric endocrinologist. Here are some websites for further information. • Human Growth Foundation - http://www.hgfound.org • Lilly: Humantrope - http://www.humantrope.com • Endocrine Society - http://www.endo-society.org • Physicians Committee for Responsible Medicine - http://www.pcrm.org/issues/Ethics_in_Human_Research/ ethics_human_growthhormone.html • Child Abuse & Neglect: Psychosocial Dwarfism - http://www.emedicine.com/PED/topic566.htm Standard Growth Chart One tool that physicians use to determine if there may be a growth problem is the Standard Growth Chart. There is a separate chart for boys and girls. Part 2 UNDERSTANDING CHILDREN’S GROWTH 15