The Tall and Short of It All

Should you worry if Junior is too tall or small for his age?



There is a wide range in what is considered normal growth, and children pass through various growth phases during adolescence before finally reaching adult height. Obviously some kids grow more and some less. This differs for all children, according to when they enter puberty. This isn’t necessarily a rule of thumb for every child – there are some children who have their growth spurts very soon after puberty and others towards the end.


The Difference Diet Makes

To a certain extent diet does contribute to stature: in order for a child to reach his full adult height potential, adequate nutrition is required, advises Dr Sarah Packer, consultant family physician, Raffles Executive Medical Centre (REMC). Of course, growth can be stunted by malnutrition, particularly when children miss out on growth spurts because of a lack of key nutrients. Thankfully though, this is rare in developed countries.


Much of a person’s adult height potential is determined by genetic factors and provided the diet and environmental conditions are adequate, they will generally attain close to this height. A popular way to predict adult height is to add the mother’s and father’s height in centimetres, add 13cm for a boy or subtract 13cm for a girl, then divide by two. Most children will grow up to be within 10cm of this estimate, explains Dr Packer. 


The Role of Mum and Dad

Children can feel like the odd one out when they are a lot taller or shorter than their friends. It is important for parents to emphasise that height should not prevent them from doing or achieving anything in their lives, emphasises Dr Packer. As with any other physical challenges, if they are markedly different from their peers (usually being shorter causes more challenges than being too tall), adaptations may be necessary to let them do certain things, such as stepping stools to reach counter tops or sitting at the front in class.


To ensure a child reaches his height potential, parents should provide a nutritionally balanced diet and a nurturing environment.


Focusing too much on the physical aspect of whether the child is taller or shorter than his peers can stress the child up as well as decrease the child’s self-esteem, advises Daniel Koh, a psychologist from Insights Mind Centre. Some children who are short may be teased by their friends in school.  If the child brings it up, talk to the child about it and get the child to focus on other qualities that he has. Avoid talking about it or showing your own anxiety, even if you are bothered by it. Children at this age are very sensitive and vulnerable.


Avoid making a big deal if junior is a little too tall or short in comparison to his peers. Making a big deal means that something is wrong with the child, explains Koh. Therefore, it is better to focus on the child rather than how the child looks. Parents need to address their own concerns and not transfer it to the child, advises Koh. It would be good for parents to address this by encouraging junior and to work with the school teachers to reassure junior that he is otherwise a healthy and normal child.


Parents should not be overly concerned based on the absolute height alone, but to they should also consider other factors like general health, rate of growth and if junior has other illnesses, explains  Associate Professor Loke Kah Yin, head and senior consultant, Division of Paediatric Endocrinology, National University Hospital. It is important for parents to know that being short or tall does not always mean that junior is unhealthy. Most times, children fall within the normal height range and they are healthy and well. There is a wide range of normal heights for each sex and age group of children, so minor deviations from the standard average values are usually nothing to worry about, advises Assoc Prof Loke.


Addressing Concerns

If parents are concerned, they should see their GP as the first point of contact. He or she can perform a general developmental assessment looking at all aspects of development as well as growth, examine your child to see whether they are growing normally and plot their growth on standardized growth charts to help decide whether there is cause to investigate further. In many cases, they will be able to reassure you that all is well.   


When the child’s height is radically different from his peers, or there are concerns that he is not growing properly because of an illness or a genetic condition, it might be good to seek help as well. Parents should seek medical advice from a specialist if the child is persistently growing below the third percentile for his height and weight despite adequate nutritional intake. A paediatrician can make a full medical assessment and determine if further tests are needed, explains Dr Mark Loh, paediatrician and neonatologist from Mount Elizabeth Novena Hospital. A child with persistent short stature inconsistent with average height in the family or an excessively tall child with signs of early puberty should be evaluated by a paediatric endocrinologist.


Children can feel like the odd one out when they are a lot taller or shorter than their friends. It is important for parents to emphasise that height should not prevent them from doing or achieving anything in their lives.



Thanks for sharing!