Dear Doctor,

I feed my child properly but at three years she still looks very tiny and stunted. My husband and I are ‘giants’ so I would imagine it has nothing to do with our genes. What could be the problem and how do we handle it so our baby grows well? Alice

Dear Alice,

You have not specified what you mean by, "stunted” and,”tiny” for your child. Growth spurt varies from one child to another. It depends on height, weight, head circumference, nutrition, intercurrent illness and hereditary factors. Some children grow gradually progressively. Some seem to be stunted, but have increase in height and weight around puberty or immediately after it. Few children rarely grow as a teenager as well. Growth is said to be stunted only if the child’s growth parameters deviate from normal growth chart.

Deficiency of necessary amount of calories and proteins can lead to stunted growth and wasting. Regular physical activity, adequate sleep also help in achieving growth. It can be due to recurrent worm infestations as well. Hormonal disorders like those of pituitary and thyroid can cause stunted growth in children. Drugs like corticoids or amphetamine(used to treat ADHD in children) can cause stunted growth in children as adverse effect. If your child is feeding and sleeping well, is alert and active, does not fall sick frequently, do not worry. See that she takes a balanced diet, remains active and wait few more years.