Pediatric Endocrinologists are most often consulted about issues surrounding growth. Many times parents are looking for reassurance that their child is growing normally, and can expect to reach a normal height. Sometimes a child is not growing normally, and the pediatric endocrinologist is asked to do a further evaluation as to the cause of the problem. Normal Growth At birth, a baby’s weight and length are measured. The weight and length reflect the health of the baby, the health of the mother, and the nutrition supplied to the baby during the mother’s pregnancy. During the first 18–24 months of life, the way a baby grows reflects the nutrition supplied to the child during the mother’s pregnancy, the baby’s ongoing nutrition, and over all health of the baby. Once reaching about the age of 2 years, children will establish their own growth pattern independent of some of the factors that influenced their earlier growth. Children have a regular rhythm to their growth. Physicians will use growth charts to monitor a child’s growth throughout their growing years. By marking the child’s height and weight on a growth chart, the doctor can monitor for any pattern of growth that is abnormal. Once a child has established their growth pattern, until puberty, the growth does not normally change from that pattern. Look at your child’s growth chart if you are concerned. If your child is being measured accurately and is growing normally, you will see consistent growth from each year to the next. Impaired Growth Growth in children is a sensitive indicator as to their health. Many different problems can develop that can affect the way a child grows. A child may develop a hormonal problem that impairs growth. Or another disease, such as inflammatory bowel disorders, kidney disease, and chromosomal abnormalities, may affect the way a child grows. A full evaluation by a qualified pediatric endocrinologist will focus on the factors that affect growth in the child. Onset of Puberty The earliest that it is normal for a girl to begin puberty is around the age of 9 years. Usually puberty will start with changes in the breast and development of both pubic and underarm hair. While the average age of beginning periods is 12 1/2 years, it is still within the range of normal for periods to start as early as 10 1/2 or as late as 16 years. A girl who begins to show signs of puberty before the age of 9 or has had no pubertal development by age 14 may benefit from an endocrine evaluation. For boys, the ages are somewhat older. Most boys begin puberty around the age of 12 1/2 years. The earliest age that is still within the normal range is age 11. By age 14 years, most boys will have begun to have the body changes associated with puberty, including pubic hair, underarm hair, acne, and enlargement of the testicles. Boys who have pubertal development before the age of 11 or who have not had any pubertal development by age 14 may benefit from seeing a pediatric endocrinologist. During puberty, the rate of growth increases, with children growing faster than they did in childhood. Parents will remark that a teen seems to grow “Overnight”. Most girls will continue to grow until about 2 years after their first period. Most boys complete their growth 3–5 years after entering puberty.