​Although most children who are below average or average in size are otherwise normal, some may have underlying conditions which affect growth. These include chromosomal abnormalities, disorders of the hormonal system (including disorders of growth hormone secretion), bone disorders and chronic diseases. Early detection and treatment of these underlying conditions can enable these children to grow to their optimal potential.

Most children whose heights are between the 3^rd and 97^th percentile and who are growing at a steady rate are considered to have normal growth. However, a child who is growing less than 4 cm a year may have abnormal growth and should be evaluated for growth hormone deficiency.

An exercise growth hormone stimulation test will be conducted for children with suspected growth hormone deficiency. This simple screening test requires your child to run on a treadmill for 10 minutes. Blood samples will be drawn before and after the test. If the growth hormone level did not increase above the cut-off level after the exercise, your child is considered to have failed the test. More detailed tests such as the glucagon growth hormone stimulation test or insulin tolerance test may be performed thereafter.

The treatment of children with growth disorders depends on the underlying cause. Growth hormone treatment can be offered to children with certain conditions such as Growth Hormone Deficiency, Turner Syndrome, Chronic Renal Failure, Intrauterine Growth Retardation, Prader-Willi Syndrome and Idiopathic Short Stature.

​A child's growth potential is not only determined by his or her genes but also his or her lifestyle. The best way for your child to reach his or her maximum potential is to eat a good balanced diet and ensure your child has adequate sleep and exercise.

Clinical research is vital to the advancement of medical care. Our doctors are passionate about contributing to the future of child health and medicine not only through clinical practice but also research.

• Zhou Y, Aris IM, Tan SS, Cai S, Tint MT, Krishnaswamy G, . . . Lee YS (2015). Sleep duration and growth outcomes across the first two years of life in the GUSTO study. Sleep Medicine, 16(10):1281-6. doi: 10.1016/j.sleep.2015.07.006
• Lee YS (2007). Recent indications for growth hormone therapy. Paediatrics, Child and Adolescent Health, 47:48-51.