Growth & Precocious Puberty Clinic

It's a good idea to get checked if your child is among the shortest 3 out of 100 children of the same age, grows 4 cm or less a year, or keeps getting seated closer to the front of the class. Missed growth is hard to make up, so it's better to check early if you're concerned.

It includes height and weight measurement with a growth chart review, a bone age test using a wrist X-ray, and blood tests for growth-related hormones. We will let you know if additional tests are needed.

A wrist X-ray showing bone age lets us see how much growth plate remains. If bone age is ahead of actual age, the remaining growth period may be shorter, so an earlier check is needed.

We can estimate a likely range based on bone age and parents' heights. However, this is only a prediction and can vary with growth rate, timing of puberty, nutrition and sleep. We cannot give a definite number.

Growth hormone therapy is a prescription-drug treatment that a doctor starts only when test results meet the indications. It is not needed by every child, nor does it work the same for everyone; responses vary widely. After testing, we explain during your visit whether it is needed and what range of results can be expected.

Growth hormone is released mostly during deep sleep, so we recommend 9–10 hours for elementary school students and 8 hours or more for middle and high school students. Bedtime matters as much as sleep length, so it's best to adjust a late-to-bed, late-to-rise pattern.

Jumping activities like jump rope and basketball, along with enough protein and calcium, support growth. However, no specific food or supplement can be said to increase height. Checking for shortages with tests and supplementing them is a more reliable approach.

If secondary sex characteristics appear before age 8 in girls or before age 9 in boys, a check is needed. When puberty starts early, a child may at first be taller than peers, but the growth plates may close early and reduce final height. If you notice breast buds, pubic hair or a sudden change in height, please see a doctor.

Growing children need a different approach from adults. While they are still growing taller, the basic approach is to maintain weight while height catches up, rather than losing weight. We do not recommend strict food restriction, as it may affect growth and puberty.

Unlike adults, we don't rely on a single BMI number. We use growth chart percentiles compared with children of the same age and sex. The 95th percentile or above is considered obesity. We also check the ratio of muscle to fat with a body composition test.

Children with obesity are often taller than their peers at first. However, if puberty starts early and the growth plates close sooner, final height may be affected. That's why we look at weight and growth together.

We do not use adult weight-loss procedures or medications for growing children. Care centers on changing eating and activity habits, and we first check with tests for metabolic problems or related conditions.

Genetics plays a role, but lifestyle has a bigger effect. Because families share eating and activity habits, results tend to show when the whole family makes changes together, not just the child.