Constitutional growth delay refers to children who are small for their age but are growing at a normal rate. Puberty is often late in these children.
These children continue to grow after most of their peers have stopped. Most of the time, they will reach an adult height similar to their parents' height. However, other causes of growth delay must be ruled out.
Genetics may also play a role. One or both parents may be short. Short but healthy parents may have a healthy child who is in the shortest 5% for his or her age. These children are short, but they should reach the height of one or both of their parents.
Delayed or slower-than-expected growth can be caused by many different things, including:
Many children with delayed growth also have delays in development.
Stool studies (to check for poor nutrient absorption)
X-rays to determine bone age and to look for fractures
Reiter EO, Rosenfeld RG. Normal and aberrant growth. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 23.
Bauchner H. Failure to thrive. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 37.
Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.