Look for Drugs and Conditions

 Dr Rajesh Khadawat, Professor, Department of Endocrinology, AIIMS

No child can gain height against genetic potential: Dr Rajesh Khadawat

There is an inherent desire in every parent that their child should look attractive and relatively more acceptable in society. Often parents fret over their children not gaining enough height according to their age. There is a popular perception that a person with a symmetrical face, sharp jaw lines and tall is considered more handsome and pretty by society. Many parents often express concerns when they observe that the height of their child does not increase as per their expectations.

However, according to the experts height increase is a natural process, determined by multiple factors. While some children continue to show height gain during growing age as per expectations, in some kids height growth stalls due to various diseases, including chest and urinary infections. Most often children and even parents get influenced by misleading advertisements claiming that medicines can help in gaining height at any age.

Drug Today Medical Times Correspondent Rohit Shishodia spoke exclusively to Dr Rajesh Khadawat, from the Department of Endocrinology at Delhi-AIIMS to get insights into issues related to children’s height.

DTMT: How do you see the issue of short height among children and what is the attitude of parents when they find their child's height does not increase?

Dr Khadawat: All parents want their children to be tall. Narratives set by the modern-day glamour world and the desire to have a good physic could be one of the factors behind it.

Parents try every method to make their children grow tall. However, I would like to tell you that in 90% of cases, a child’s height is broadly determined by that of their parents while in 10% of cases, height is expected to match that of their grandparents.

It may be noted that height growth can get stalled during a child’s growing age due to various factors, including ailments.

Therefore, we need to rule out that the child remains healthy and does not suffer from any disease like kidney, liver and anaemia and other conditions such as calcium and Vitamin D deficiency.

Whenever parents come to us with this problem, we initially measure the height of the child and parents as well. We assess if the height of children matches that of their parents or not by using scientifically validated charts.

If we come to know that height matches with parents we advise them to do nothing and if it does not match, then we try to find out whether the child is suffering from any kind of ailment, which can interrupt their height gain.

Many diseases remain asymptomatic but act as a hurdle to the progress of height gain. If a child does not suffer from any such disease and his height is not increasing then we assess at what speed his or her height can increase and then we decide if they require any future treatment.

Some children may suffer from a deficiency of growth hormone, produced in the pituitary gland. The main function of growth hormones is to increase the height of the children, as it is adequately secreted in the pituitary gland from the age of three years and it keeps secreting till puberty when a child gains adequate height.

However, once the child attains a certain height, these hormones have no role in increasing the height any further.

Some children are diagnosed and detected with growth hormone deficiency. If the injection of growth hormone is given children’s height increases suddenly and it looks as if the child has been stretched.

Many parents request us to give them extra growth hormones even if their child does not have any deficiency.

However, I would advise such parents it is not possible and if the parents are of short stature the height of their children cannot be increased by injecting them with growth hormones.

Growth hormones have their side effects as well. They will not help to increase height but they can trigger other issues.

DTMT: What complaints do parents often have about the height of their children?

Dr Khadawat: We observe that parents have an inferiority complex about the height of their children. They often compare their children’s height with that of their neighbouring children and classmates. They perceive it as their child being short. The sole reason is that children’s height depends on their parents.  

The most important thing is that parents often get trapped by the narratives set by misleading advertisements in newspapers and television. These advertisements often project unsubstantiated claims to depict that the users of their products registered height gains.

They often stress taking supplements made of multiple herbs whose effects are not established in powdered form often called churans, which they claim can help in gaining height. In my opinion, such claims are not only unethical but also against nature.

One myth is hanging from bars and playing sports that require regular stretching of the body like basketball can help in gaining height. However, there is no scientific data to validate such beliefs.

Resorting to self-medication without consulting a doctor can be very hazardous as it can cause multiple damages to internal organs, including the liver and kidneys. We cannot increase the height of the children against their genetic potential.

If the genetic potential in a particular case is five and a half feet it cannot be increased by another six inches by administering growth hormones.

One must understand that though a good height is desirable, it is not essential for life. It does not affect the quality of life in any way. If the liver or lung does not work one may not survive but if the height does not increase a person can survive.

 DTMT: Please tell us diseases that can stall height gain.

Dr Khadawat: Chest infection, allergy, TB, Asthma, wheat allergy, liver disease, kidney infection and iron deficiency can hamper height growth in a child. Therefore, we have to ensure that our kids do not have any of the above diseases to grow normally. Feeding them with extra protein, vitamins and calcium cannot help.

DTMT: Till what age a child can gain height?

Dr Khadawat: Height gain does not depend on age. We cannot say for certain that height will increase till 12 years of age in girls. It depends on the period of overall development of their body.

The overall development includes gaining height and weight along with mental and intellectual progress. All these aspects make a complete personality. It is often said that girls' height stops increasing after two years of getting periods and in boys after a year of developing beards and moustaches.

If puberty has not started the height can increase till late. But age is not a criterion which could determine how long the height will increase.  

DTMT: What role can a healthy diet play in overall development?

Dr Khadawat: It plays a crucial role. A child should eat wholesome food containing all the nutrients, like proteins, milk, cheese, green vegetables, fruits and pulses.

DTMT: How many patients visit AIIMS for height enhancement?

Dr Khadawat: Around 100-150 kids with height-related problems come every week in the growth clinic at AIIMS every Monday from 2 to 5 pm. Some children are given growth hormones while some are prescribed iron supplements. The course of treatment varies from case to case.

It is easy to predict the increase in height among children. We can predict it by just examining the x-ray of the left palm and can even tell if the child will gain height.

If all the palm bones have fused then the height gain is bound to stop.

DTMT: What should parents do if they find the height of their kid is not increasing according to his or her age?

Dr Khadawat: First parents should measure a kid's height at home. It is very easy. They should make their kid stand along the wall. The children should stand in such a way that their heels, calf muscles, heap region and shoulder and the back of their head touch the wall.

Parents should put cardboard on their heads and measure it through measuring tape in centimetres. They should make marks with a pencil. After three months they should again measure height.

Ideally, every birthday is the best occasion for assessing the height of children.

This will give an idea that the child is gaining height. If one finds that height has not increased then they should consult doctors. If the annual height gain is under five centimetres then doctors should be immediately contacted.

DTMT: What would be your message for parents who are concerned about the height of their kids?

Dr Khadawat: My message for parents is that kids should have a healthy diet and they should eat all kinds of food. Whenever they feel that a child is not gaining height they should not take it lightly.  They should go to the doctors and check if the increase in height is adequate or not.

DTMT: Tell us something about your research work on children’s height.

Dr Khadawat: We have done multiple studies on this subject.

In one of the studies, where we enrolled over five hundred children, we found that the comparison of a kid’s height to that of the neighbour is the most common reason behind a parent seeking medical intervention for their ward’s height issues.

Most of our studies reveal that it is the hereditary factor, which is the most dominant determinant of a person’s height. In most cases, we found that parents of shorter children were short themselves.

We also found that chest infections or chest-related diseases and urine diseases are the most common hindering height gain.


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