Know all about Short stature/Little people of the world

Dwarfism refers to a state when a person is short in stature either because of their genes or medical reasons. As per the Little People of the World Organization (LPOTW) any adult under the height of 4 feet 10 inches can be considered a dwarf. Other groups extend the criteria for certain forms of dwarfism to 5 feet, but the average height of an adult with dwarfism is 4 feet.

Types of Dwarfism:

Dwarfism can be divided into dichotomies i.e. disproportionate and proportionate. Disproportionate dwarfism refers to a condition when the torso is longer in length in comparison with the upper body. Whereas, proportionate dwarfism as the name itself suggests refers to a condition where both the upper half and the lower half are of the normal length.

Symptoms of Dwarfism:

Apart from short stature there are different symptoms that are attached to dwarfism depending upon the type.

Disproportionate dwarfism usually doesn’t hinder the intellect of a person but here are some common symptoms of it:

• Adults typically are about 4 feet tall
• Average-size torso and very short limbs, especially in the upper halves of arms and legs
• Short fingers
• Wide spaces between the middle and ring fingers
• Limited elbow mobility
• Disproportionately large head
• Prominent forehead
• Flattened bridge of the nose
• Bowing of legs that progressively worsens over time
• Swaying of the back that progressively worsens over time

Proportionate dwarfism is developed by a medical condition that hampers the growth of a child. More often than not it also occurs due the lack of hormones produced by the pituitary gland. Some common symptoms of proportionate dwarfism include:

• Slower growth rate than expected for their age
• Height lower than the third percentile on standard charts for age
• Delayed or no sexual development during the teen years

Complications related to Dwarfism during Childhood:

• Crowded Teeth– also known as overcrowding of the teeth, usually happens when there is no space for the new permanent teeth to grow. Poor stature, and jaw structure sometimes lead to teeth getting larger than jaw can support. It is a common sign of dwarfism since the growth has been stunt and affects all parts of the body.
• Frequent ear infections and possibility of hearing loss– the tubes leading from the ear to the throat are narrower for people with dwarfism. These tubes are called Eustachian tubes; which is why people with dwarfism are more susceptible to getting more ear infections and this can further lead to a permanent hearing loss.
• Sleep Apnea- breathing difficulties, snoring and regular cessation of breath while sleeping are a common factor due to the narrow nasal passage.
• Pressure on the spine- narrow foramen magnum (smaller opening of the skull where the spinal cord begins) can put a lot of pressure on the spinal cord and can press against the brain stem causing neurological symptoms as well as cessation of breaths.
• Reduced muscle strength- since the bones and the muscles are softer, the back and neck may need a lot of external support before the muscle group is strong enough to support it.
• Hydrocephalus- more often than not we notice larger heads on people with dwarfism, this happens due to the accumulation of cerebrospinal fluid in the brain. There is an increased chance (1 in 100) that your child may suffer from this.

Complications during Adulthood:

Nerve compression–

The nerves in the lumbar region are squished due to the narrow passage, this can often lead to the feeling of numbness in a lot of parts of the body especially the legs.

Obesity-

Due to disproportionate weigh distribution people with dwarfism often struggle with maintaining their weight and tend to move towards obesity. 

Complications during pregnancy-

Women with dwarfism are more likely to have respiratory issues and a C-section due to complications related to anaesthesia. Further the size of the pelvis and vagina usually makes it impossible for the woman to give normal birth.

Causes for Dwarfism:

The underlying cause for dwarfism is metabolic and genetic deficiency. The most common types of dwarfism, known as skeletal dysplasias, are genetic.

• Skeletal dysplasias are conditions of abnormal bone growth that cause disproportionate dwarfism.
• Diastrophic dysplasia arerecessively inherited. This means that the child must receive two copies of the mutated gene (one from the mother and one from the father) in order to be affected.
• Turner’ syndrome- it is a condition that is limited to women where instead of inheriting two fully functioning X chromosomes from each parent, you end up inheriting only one X chromosome or a partially functioning X chromosome.
• Achondroplasia, on the other hand, is inherited in a dominant manner. That means a child needs only one copy of the mutated gene to have that form of skeletal dysplasia.

Diagnosis of Dwarfism:

Some types of dwarfism are clearly evident in utero, at birth, or for the duration of infancy and may be recognized via X-rays and a bodily exam. A diagnosis of achondroplasia, diastrophic dysplasia, or spondyloepiphyseal dysplasia may be showed via genetic trying testing. In a few cases, prenatal testing is executed if there may be problem for specific conditions.

 Sometimes dwarfism doesn`t grow to be glaring till later in a kid’s life, usually the parents seek diagnosis. Here are symptoms and signs to search for in kids that imply a capability for dwarfism:

• Abnormally large head
• Problems in breathing
• Curvature of spine
• Bowed Legs
• Arthritis
• Severe back issues

Genetic testing– DNA tests may be done before or after birth to look for genetic mutations linked to dwarfism. Girls with suspected Turner syndrome may need DNA tests to check their X chromosomes. DNA testing may help parents with family planning if they wish to have more children.

Imaging- Doctors may use the X-rays of the foetus while in the pregnancy stage and observe carefully the growth. In many cases MRI scan show the deformities with the pituitary gland that can result in the same.

Lifestyle and Home remedies:

• Car seats- make sure you use infant car seats that can provide your child with a firm back and neck support. This will help you prevent any excessive pressure on the tissues.
• Avoid Infant carriers and playing tools– umbrella strollers, carrying slings, swings, jumper seats or any other device that doesn’t support the neck or can possibly curve the back into a “C” shape should be avoided at all costs.
• Adequate head and neck support- Support your child’s head and neck when he or she is seated by holding the head, neck and upper back in a safe and stable position. Padding can help to provide the right position and support.
• Complications- monitor your child for signs of complications, such as ear infection or sleep apnea.
• Promote a good posture– make sure you provide your child with a pillow along with a stool (preferably a footstool) whenever your child is sitting to promote a healthy posture.
• Healthy diet– you are what you eat, since a lot children with dwarfism end up becoming obese before they hit adulthood, it is quite pertinent for you to promote healthy eating habits to avoid the problem of weight gain at a later stage.
• Recreational activities– Encourage participation in appropriate recreational activities, such as swimming or bicycling, but avoid sports that involve collision or impact, such as football, diving or gymnastics.

While these are some common reasons why dwarfism happens and what are its impacts, there are a lot of ways through which it can be corrected. Please refer to our other article on dwarfism to understand further about it.