09_BT_Sept 2022

Baby & Toddler
Health & Medical Diary
Also in this category are babies who are considered small for
their gestational age. This can be due to factors concerning
the mother (eg having chronic conditions such as high blood
pressure, chronic kidney disease), the baby (eg being a twin
or having a birth defect) or the placenta (eg decreased blood
flow to the placenta, placenta previa or placenta abruption).
While most children in this group tend to catch up in growth
after birth, about 15% don’t and will remain small throughout
their lives if not diagnosed and treated early enough.
Secondary Causes of Short Stature
There are multiple causes within this category, but one
of the most common in Malaysia is that of nutritional
deficiency including protein calorie malnutrition, iron and
vitamin D deficiency.
Vitamin D deficiency is common among children as nowadays
kids tend to spend most of their time indoors, resulting in a
lack of exposure to sunlight. The sun’s ultraviolet B (UVB) ray
is a critical component in the production of vitamin D in our
body. Vitamin D is, in turn, vital for the absorption of calcium
to build and maintain our bones. In vitamin D deficiency, the
bones are soft and bowed especially in the weight-bearing
lower limbs resulting in short stature.
Other secondary causes of short stature include systemic
disorders such as gut problems, heart disease or a weak
immune system, as well as hormone deficiencies (eg growth
hormone deficiency).
Act fast
It is important that parents bring their child to see the
appropriate specialist – a paediatric endocrinologist, or at
least, a general paediatrician – if they start having doubts
about their child’s growth.
Do not be complacent and hope your child will catch up in
height later. Delaying diagnosis shortens the window period
for remedy as the bones continue to mature with time. Once
fully mature, nothing more can be done to help them grow
any taller.
Besides this, if your child has an underlying medical condition
that is hindering his or her growth, delaying diagnosis and
treatment may lead to prolongation of a poor quality life and
emergence of complications.
Hence, if you notice that your child does not seem to be
growing as he or she should, seek help from a paediatric
endocrinologist. Do not delay. You may make a significant
difference to your child’s future.
As regular measurement of your child’s growth is important,
parents can play an active role in monitoring their child’s
height. Convenient digital tools such as the Growth
JourneyTM app endorsed by the Malaysian Paediatric
Association can help parents chart their child’s growth as well
as getting serial measurements to ensure growth is on track.
14 BabyTalk | September 2022