Friday, January 18, 2019

Navigating Growth Spurts in Teens

By Alexandra Bicki, MD, MPH
Pediatric Resident at the University of Texas at Austin Dell Medical School
Member, Texas Medical Association


We can all remember a certain grade school classmate — maybe even ourselves — who was a “late bloomer.” Whether it was the boy who didn’t make the basketball team, or the girl who was last to buy her first bra, this can be a stressful time for both child and parent.
 
Many families bring their children in for annual check-ups, or well-child checks, wondering how their child’s height stacks up to their peers. The most important thing that determines how tall a child will be is how tall the biological parents are, and how each parent went through puberty. Math formulas that use parents’ height can help calculate a range of what we might expect for the child, but race and weight play a part as well. For example, Hispanics, African-Americans, and overweight children tend to start puberty a bit earlier than Caucasians or Asians.

A girl’s growth spurt typically starts at age 11 or 12, while a boy’s growth spurt tends to happen at age 13 or 14 — with lots of variation in between. On average, the main growth spurt lasts two years. Because the arms and legs tend to grow before the spine, some parents actually notice their child looks a little disproportionate or lankier before their child’s overall height starts to change.

A child may feel “abnormal,” or simply out of control, as this “natural” process takes its time. Although some mood changes are a normal part of puberty, don’t be afraid to raise your concerns with your doctor if your child seems stressed, withdrawn, nervous, or suddenly doesn’t want to do certain activities he or she used to enjoy.

An adolescent can feel self-conscious having to shop in the kids’ clothing or shoes section while their close friends wear older teen clothes because their bodies are changing more rapidly. At home, if there are siblings of various ages, genders, or with different parents, they can be reminded over and over again of how different they feel.

There's no exact cut-off date to when a child should grow.
A girl's growth spurt starts around age 11 or 12, while boys
 grow around age 13 or 14 - with variation in between.
Many families wonder if there is a medicine that can speed up the process. Before deciding if that is an appropriate course for your child, your doctor might start by taking a single x-ray of the child’s hand, a “bone age” study. The x-ray helps show how your child’s development compares with other kids their age. If your child’s development is not on track, there are hormone-related medications pediatric endocrinologists can prescribe, but as with every medicine, these may have side effects and risks.

It is important to remember that growing too fast and too early is not necessarily a good thing. The fastest gain in height is during puberty, so if a child’s growth spurt occurs early, he may be the “tall kid” in middle school, only to have his growth slow down later on — just as his peers’ growth starts to speed up.

If a child is growing at her own pace, and especially if her parents were also “late bloomers” themselves, it is often safe to let nature run its course. During this time, parents can help by encouraging positive eating and exercise habits, which helps provide all the right ingredients the body needs to keep growing in a healthy way.

Having all of your child’s height and weight measurements in the same place is one reason taking him or her to the same doctor’s office every year can be helpful. Tracking the growth over time can help your health care team decide whether your child’s pattern looks suspicious, or if he or she is simply following in the parents’ footsteps.

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