The Tall and Short of It
Everyone talks about how tall -- or short -- a child is, but does size really matter?
Such Great Heights
Eight-year-old Sam Merritt can jump on his bed without worrying about hitting his head; he can squeeze into tight spaces during hide-and-seek; and he figures he'll never have to duck when he gets off the school bus. But he does have to listen to endless comments from strangers, classmates, and even relatives about his size. At 3'10", Sam looks more like a kindergartner than a third-grader. To make matters worse, his 4'2" twin sister, Amanda, is tall for her age. "People make the most insensitive remarks like, 'No, they can't be twins -- he looks like the little brother,'" says their dad, Scott, of Loganville, Georgia. "It bothers me, so it must get to him."
Four-year-old Veronica Meyer, however, has inches to spare. The 4-foot-tall preschooler from Brooklyn is the same height as many 7-year-old girls. Her 2-year-old sister, Natalie, is tall too. "People ask what I feed them, like there's some super food for height," says their mother, Julie. "I'm nearly 6' and my husband is 6'2". Our daughters obviously inherited our tall genes, but people still feel the need to point out their size."
Kids come in all shapes: tall or short, round or pencil thin. And they all want to fit in and be accepted. But when you're dwarfed by classmates -- or you tower above them -- fitting in can be more of a challenge. "Kids get teased about physical differences like height, weight, having a big nose, or wearing glasses. Unfortunately, people make a lot of judgments -- and a lot of thoughtless comments -- based on appearances," says Meredith Dreyer, PhD, a pediatric psychologist at Children's Mercy Hospitals and Clinics, in Kansas City, Missouri.
This fixation on size begins moments after your baby's born. Everyone wants to know his height and weight stats. From then on, the pediatrician will measure him at every checkup. While inches and pounds are important, growth is key. First developed 30 years ago, government growth charts gauge how his measurements compare with those of other kids of the same age and gender. "We don't worry as long as a child grows steadily, but an unusual jump in height or a sudden falloff in growth can be a sign of a health problem," says Elizabeth Littlejohn, MD, a pediatric endocrinologist at the University of Chicago Comer Children's Hospital.
During his first year, your baby grows up to 10 inches in length. However, his early size isn't very predictive of his final height or weight. He'll add about five inches during his second year, and then starting at age 3, he'll grow about two and a half inches per year until a final growth spurt kicks in during puberty. Girls reach their adult height around 15 (the average American woman is 5'4"), while boys don't top out until 16 or 17 (the average American male is 5'9"). A school-age child who falls below the 5th percentile for height is considered to be of "short stature," a clinical term meaning he's shorter than 95 percent of kids his same age and gender, whereas a child who's in the 95th percentile is taller than all but a few of her peers. Average height is anywhere between the 40th and 60th percentiles. You can look at your family tree to figure out your child's future potential: Height is about 80 percent genetic. A child whose parents are both 6' is likely to be the tallest kid in kindergarten. If both parents are unusually short, their children probably will be short too. But even kids who have average-height or tall parents may inexplicably stop growing -- a condition known as idiopathic short stature (ISS). These children are significantly shorter than 99 percent of their peers, and will remain small as adults. "Boys generally won't grow to be more than 5'4", while the girls might hit 4'11"," says Dr. Littlejohn. Late bloomers, on the other hand, are small for their age but still growing at a normal rate and will eventually have a growth spurt and catch up to their peers.
People often presume that short kids -- especially boys -- aren't as popular as tall kids and are often teased, bullied, or depressed about their size. However, one study of almost 1,000 middle- and high-schoolers found that height made little difference in how much classmates like each other. "Short kids tend to be well-adjusted and to have just as many friends as taller classmates," says study author David E. Sandberg, PhD, a pediatric psychologist at the University of Michigan Medical School, in Ann Arbor. "If these older kids are faring okay at a time when height differences are most noticeable and bullying is more of an issue, then younger kids who are short are probably fine too."
Although the study's findings are encouraging, it can still be tough to be little -- particularly if you're a boy. "It's more socially acceptable for a girl to be small than for a boy to be short," says Dr. Dreyer. After all, girls are referred to in flattering ways -- petite, cute -- while boys tend to be called shrimp, shorty, or peewee.
Even parents would rather have tall sons. One study at the Children's Hospital of Philadelphia found that boys are taken to growth specialists twice as often as girls are, even though boys aren't more prone to shortness. "Society views tall men as being strong, confident, and desirable, and parents of small boys don't want their sons to have a disadvantage in life," says study author Adda Grimberg, MD, a pediatric endocrinologist.
If your child's on the short side, it can be difficult for you to watch other kids, and even tactless adults, treat him differently because of his size -- especially if you had a similar experience when you were a kid. But if you're overly fixated on his height or get defensive when people comment about it, he could get the message that being small is bad or that his size defines him, says Dr. Grimberg. Instead, give your child the tools he needs to feel good about himself inside and out.
Find areas where he can shine. Small kids can excel at lots of sports, including soccer, gymnastics, and martial arts. But if your child wants to play basketball or volleyball, encourage him to try it. Of course, there are also plenty of nonphysical activities he can get involved in, such as playing a musical instrument or acting in the school play.
Problem-solve. If your child is being picked on, brainstorm solutions together and practice responses so she feels confident sticking up for herself. "Bullies want to get a rise out of their victim. When you don't react or you react unexpectedly, it takes away their fun," says Dr. Dreyer. Some deadpan replies for pint-size taunts: "Thanks a lot, I didn't know I was short" or "Wow, you're really observant."
Encourage him to speak up. When people mistakenly assume that Ethan Udell is only 6 years old, the fourth-grader from Dix Hills, New York, quickly corrects them and gives them something else to talk about. "He tells people, 'I'm actually 9 1/2, and I'm a really good hockey player,'" says his mom, Stacey. Other upbeat responses to try: "Shortness is only one of my great qualities" or "I take after my grandfather."
Respect her age. Don't say that your child is younger than she really is to get discounted tickets to movies or amusement parks. It might save you a few dollars, but it'll cost her self-esteem.
Tall kids might seem to be on top of the world, but height has its downsides. Because they look older than their years, adults -- and even peers -- often expect them to behave more maturely. When Marissa Cooper, then 3, had a perfectly age-appropriate meltdown in a mall in Greenwood, Indiana, her mom, Heather, got snippy comments from strangers who assumed the girl was at least 5. "A woman said loudly to her friend, 'Isn't she a little old for tantrums?'" says Cooper. Now 6, Marissa is as tall as many 9-year-old girls, and that complicates playdates. Kids her age assume an "older" child won't want to play with them and are intimidated by her size, while kids her height find her too immature. "It's tough being a tall girl, and it just gets worse during the dating years," says Cooper, who's 5'8" and knows from her own childhood experience.
Life's not a slam dunk for tall boys either. Adults generally expect that they're great at sports, but that's not necessarily true. Answering nonstop inquiries about his athletic abilities can be stressful for a child who's already tired of being singled out for his size.
And then there's bullying. "When you're 8 but look 10, older kids like to challenge you. They'll say, 'So I bet you think you're as tough as me. Prove it,'" says Carleton Kendrick, a family therapist in Boston who was the tallest kid in his class. Still, tall kids have been known to throw their height around. A study at the University of Southern California found that both boys and girls who stand a mere half-inch taller than their peers at age 3 tend to be more aggressive by age 11. Experts speculate that tall boys and girls have higher testosterone levels, which contributes to aggressiveness. Or it could also be that tall kids learn early on to use force to get what they want. When your child gets sick of all the bean-stalk remarks, try these tactics.
Take it as a compliment. Encourage your child to be proud of her height. Your daughter might say: "Thanks for noticing. I take after my dad," or "My grandma is tall too."
Tell your own tall tales. Know what it's like to stick out in a crowd? Share what you liked about being a tall child: You could sit in the back row and still see over classmates' heads. You could ride anything at the amusement park.
Rebound from stereotypes. Your child doesn't have to explain that he's not into basketball or other sports. He can just say, "No, I don't play," and mention what he does like to do: "I love to ride my bike," or "I'm really good at math."
Whether your child is tall or short or somewhere in between, remind him that all kids are teased for some reason or another, suggests Dr. Dreyer. And try to help him see his height isn't such a huge deal. Where bigness really counts -- in terms of kindness, generosity, intelligence, and love -- is on the inside.
Shots for Short Kids?
About one in 3,500 children have growth-hormone deficiency, meaning they don't produce enough growth hormone for normal development and need daily injections of synthetic growth hormone to achieve something close to a normal height. In 2003, the FDA expanded approval for growth-hormone therapy to include the 1 percent of kids with idiopathic short stature (ISS). With treatment, children with ISS can gain an average of two to five inches depending on the cause of the slow growth and how many years they're in treatment. Studies have found that growth-hormone therapy is very safe for children. Side effects are rare and may include ear infections, muscle or joint pain, headaches, nausea, breast growth, and skin rashes. However, the treatment costs about $20,000 per year, with some kids needing it for five years or longer, and insurance doesn't always cover the cost. For more information, visit the Human Growth Foundation at hgfound.org or the Magic Foundation at magicfoundation.org.
Copyright © 2007. Used with permission from the October 2007 issue of Parents magazine.
All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.