At what age do children grow the most

The growth

Growth is not an easy walk for our children and adolescents. In this guide for parents you will learn what growth is, what it means for the body and what symptoms can occur in children at various stages of development.

Growth, development, expansion, development, increase and expansion, all these terms are vital aspects for maintaining and strengthening a genome in business, banking, industry, population, plants as well as humans.

Human beings begin to grow as soon as the egg cell is fertilized. First of all, not only the functional differentiation of cells is in the foreground, but also cell enlargement and cell proliferation, cell division through pressure and tension mechanisms (3). According to the definition of the WHO (World Health Organization), growth is defined as cell reproduction (proliferation) or hyperplasia and cell enlargement (hypertrophy). M.a.W. there is an enlargement and reproduction of tissue without changing the morphology (shape, shape and structure). Histologically, a distinction is made between appositional growth, growth through the addition of layers of tissue from the outside, and interstitial growth. This means the growth that occurs through cell proliferation in the tissue (1). From birth onwards, the growth is controlled by hormones and after the age of 17 after the growth in length has ended, only mitosis and apoptosis are present (cell structure and cell breakdown).

Or also through external triggers, e.g. through a higher functional load (additional muscular load - training stimuli), cells can multiply in the muscles in the sense of an adaptation to a load.

In the philosophy of osteopathy, standstill is backlog. Certain factors are necessary for growth to induce growth. The way up is no walk in the park for many adolescents.

Even in the womb, the fetus grows up to 51 cm long within 40 weeks of pregnancy and weighs an average of 3400 g. Pressure and tension mechanisms and so-called biodynamic metabolic fields induce human development. If you consider that the fetus is 2mm in length of the crown of the head in the 5th week of pregnancy, 2.5 cm in the 10th week of pregnancy, in the 20th week of pregnancy 25 cm in length in the length of the crown heel and 300 g Has weight. In the 30th week of pregnancy, the average height is 40 cm and 1400 g. Weight (4). Growth is a process that extends from the first hour after fertilization to the age of 18. The ontogenesis (individual development - functional development) and morphology (form and shape) are decisive for the later functionality of the human body. An egg becomes a chicken and not a fish (3). The embryological development is a harbinger of the later physical performance of a person. Every nascent cell is already functioning and its basic function is the growth function.

In this way, the body often has difficulties adapting to the body due to the increase in length, with various symptoms. The body has intervals with latitudinal growth phases, but these are less of a problem.

The growth phases

After birth, the increase in body length is not always continuous. There are three distinct growth phases: (2)

  1. Phase I is from birth to the age of 3. This is where the growth rate is fastest. It is up to 43 cm in average. The rate of growth continues to decrease from year to year.
  2. Phase II is from the 3rd year of life until just before puberty. Here the children grow up to 5 -6 cm per year on average.
  3. In phase III the growth spurt reaches its climax. During puberty, children gain 7-9 cm in height per year. During this time, boys gain an average of 20-24 cm in size. The growth stagnation is between the ages of 14 and 17. Girls are far behind. In girls, the average growth is 17-20 cm and the growth arrest begins at 13-15 years of age. Puberty is the most difficult phase. The development of secondary sexual characteristics (gender-specific hair, distribution of fat pads, growth of the female mammary gland and voice breakage due to the increase in length of the larynx) is particularly noticeable here (2). Furthermore, the expansion of the jaw due to the change of teeth has an influence.

The growth cascade

Growth factors are the body's own substances that stimulate cell growth, e.g. hormones that (STH) have an effect on different cell groups. The thyroid hormones and sex hormones also have an impact on our size. The pituitary gland is a very important organ for growth. It is a small endocrine, bean-shaped gland weighing 0.8 grams. This is where the hormones necessary for growth are formed. The hormone somatotropin STH is a peptide hormone that promotes body growth and cell growth or reproduction. The hypothalamus is superordinate to the pituitary gland and releases growth-promoting and growth-inhibiting hormones. They are located in the middle of the skull in the so-called Turkish saddle of the brain (only those hormones relevant for growth are mentioned in this section).

The control circuit of the pituitary gland starts from the superordinate brain region, the hypothalamus. This sends somatoliberin to release and somatostatin to reduce the release of somatotropin. The secretion of somatotropin varies widely. The release is not continuous and also changes with age. Before puberty there are only a few amounts of somatotropin that are released, during puberty it is 10-20 thrusts per day. The release mostly occurs during sleep and it behaves antagonistically to insulin. The older the pubescent, the less the payout. Now, when a growth spurt is induced by the release of STH, it gets to the liver. The liver produces so-called somatomedins, which help the STH to work (1). The somatomedins reach the blood vessel system from the liver, where they are bound to a transport protein. They cause increased cell division in the bone and thus make the bone grow in length. The thyroid also plays an important role in growth. The thyroid not only influences the energy metabolism via the production of T 3 and T4, but also promotes the release of STH. Therefore, a screening test for TSH (Tyroid Stimulating Hormone from the Pituitary Gland) is carried out in newborns. A lack of TSH causes a reduced maturation of the nervous system and has a negative impact on development. The formation of androgens, the male and female sex hormones, is important for the growth of muscles and secondary sexual characteristics during puberty. Due to the protein-building effect, they play an important role in the growth spurt. This is the case with both boys and girls. Testosterone is produced in boys' testicles and in girls in the adrenal gland. Testosterone is responsible for the growth of bones and muscles of both sexes. The formation of estrogen in the expectant woman is also an important aspect. The estrogens attack the genitals directly and are also responsible for the secondary sexual characteristics. This leads to increased mineralization and closure of the epiphyseal plates (growth plates). This is also the reason why some girls suddenly stop growing during puberty. Most of them are growing

Children at night, because here the body is in sleep mode. A fever is often generated in the pyrogenic center of the brain to stimulate the metabolism. The thyroid gland produces more hormones T 3 and T 4 to stimulate the metabolism. One consequence of the growth is the release of catecholamines consisting of adrenaline, cortisol from the adrenal gland, which in turn results in the release of glucagon from the pancreas. When the body needs energy to grow, the above-mentioned hormones are released, which ultimately results in the release of glucose from the liver (5).

The different stages of life

In this way, the body often has difficulties adapting to the body due to the increase in length, with various symptoms. The body has intervals with growth phases that are less of a problem.

  • Birth - 28th day = Newborn
  • 29th day - 12 months = Infant
  • 1st - 3rd year small child
  • 3rd - 6th year Preschooler
  • 6th - 16th year School child
  • 16th - 18th year Adolescent

Growth signs in newborns from the 5th week (7)

  • The baby wants to be breastfed more, cries a lot and seeks to be close to the mother.
  • After the first growth phase, hearing and eyesight are improved and the baby has more strength when breastfeeding.

Growth signs from the 8th week of life (7)

  • The babies can differentiate between strangers and prefer to be with their mother.
  • It is often the case that some babies have a preferred posture, e.g. For example, that the head looks to one side or the entire spine tilts to one side and is born. The cause here is the child's intrauterine position. With each surge in length, these characteristics can intensify.
  • The children often show nocturnal attacks of fever, diarrhea, are simply unbearable, restless at night and constantly express hunger during a growth phase.

Growth signs at the age of 4 - 8 years (7)

  • Ottitis media - the otitis media, triggered by the strong expansion of the jaw during the change of teeth. This leads to a relocation of the so-called Tuba Auditiva, the Eustachian tube. This channel provides ventilation for the inner ear. Due to the laying, simple rhinoviruses (cold viruses) or bacteria that migrate to the middle ear can cause inflammation of the middle ear. The children often react with hearing loss, snoring and the symptom can be accompanied by or without a fever. With the otoscope you can see a reflective surface of the eardrum. The danger here is perforation of the eardrum with accompanying hearing loss. This often chronic disease becomes less after the age of 8 and disappears completely when the jaw is fully grown.
  • “The young girl knee syndrome” (7) describes knee pain often in girls aged 11-17 years. The pain is usually located laterally on the outside of the kneecap. Due to the hormonal influence, the female forms change. The child becomes a woman. This leads to a widening of the pelvis and, associated with this, a change in both leg axes, so that the patella (kneecap) moves more on the lateral part of the plain bearing and this results in knee pain. From an orthopedic point of view, in this case a surgical procedure is used to cut through the lateral suspension apparatus of the kneecap (lateral release). Alternatively, one can exert a good influence with physiotherapy, leg axis training and osteopathy. In my experience, this problem often disappears after the length growth phases are completed. One indication for surgery would be a chronic dislocation of the patella.
  • Headaches, difficulty concentrating, abdominal pain, tics, and bone pain
  • (7) The release of STH and testosterone and estrogen leads to an increased accumulation of bone cells on the growth plates
    - the bone elongates. The resulting pain can show a different appearance. Typical growing pains are: often at night, alternating on one or both sides of the lower extremities, there are no external changes or joint stimuli such as swelling and reddening of the joints and the gait is inconspicuous. For an explanation of the pain, one reads in the literature about a fluid deficit in the area of ​​the epiphyseal plates. From an osteopathic point of view, the pain arises from the growth in length of the bone, where the periosteum is stimulated and pulled. Many adolescents experience headaches and difficulty concentrating during their growth phases. You have to
    imagine that the body grows up to 3 cm in length in one night. The youngsters feel as if they are wearing a suit that is 3 sizes too small. A stretching stimulus arises on the dura mater - the hard meninges - which can be responsible for the headache and concentration disorders. Although the base of the skull is in a cartilaginous state until the age of 17 in order to compensate for these tensile mechanisms, such symptoms often occur. As a result, many young people show poor posture. This is a compensation of the tension and the body has the most comfort. Braces treatments have a drastic impact during growth. The brace creates additional tension on the skull and body system so that the above-mentioned complaints can become significantly worse.
  • Musceltics (7) can also be typical features of growth. Especially in the 14-17 year old adolescents who are in the final phase of growth, involuntary muscle twitching can occur in the face and extremities. These also result from the high tension in the dura mater, which can also be increased by regulating the jaw and stress at school. Of course, the pain should also be clarified by a pediatrician or orthopedic surgeon. The classic treatment by the doctor is usually symptomatic, with paracetamol or ibuprofen to influence the pain. Whereby one has to consider the toxic influence on the liver and kidneys. Alternatively, such complaints can be well influenced with homeopathic or phytotherapeutic agents.
  • Abdominal pain, (7) - periumbilical around the belly button can also be a growth mark. Mostly girls are affected. The symptoms often occur at night without any changes in bowel movements or flatulence. There is also no fever. During palpation, auscultation and percussion there is increased tension in the intestinal wall. In the differential diagnosis, appendicitis or other inflammatory processes of the organs must be ruled out by a doctor.
  • Inflammatory affections on the growth plates (7) - in the adolescents who are active in running, excessive stress can lead to inflammatory non-bacterial affections on the growth plates during growth, e.g. on the knee of the Osgood – Schlatter. Training breaks, physiotherapy and moist, cool compresses all help to alleviate the problem.
  • The growth-related torticollis, (7) the torticollis - in growing children, the enormous tension on the tissue can lead to a blockage and strong tension of the muscles in the cervical spine. The head position shows a sideways tilt to one side and a rotational position to the opposite side. Usually the symptom shows up early in the morning when you get up. The children say: "Mom, help, I can no longer turn my head". Chirotherapeutic, hard manipulations on the cervical spine are, in my opinion, contraindicated here, as the tissue needs time again to normalize and adapt. Moist heat, light, gentle massage, or osteopathic treatments with the aim of gently reducing tension and improving the passive limit of movement are a good solution. In the differential diagnosis, neck stiffness, as occurs in meningitis, should be excluded.

In summary, one can say that these growth symptoms listed above is from my own documentation of my years of treatment of children and adolescents. Most of the adolescents may show more or less or no growth symptoms at all. But a certain number of children and adolescents can show symptoms. As already mentioned, it is important to have a pediatrician or orthopedic surgeon clarify this pain or sign. The aim of osteopathic treatment is to alleviate the symptoms and to give the body more passive mobility, so that the growing child or adolescent has more comfort in the maturation phase. With this type of treatment one can support the maturing body well in its growth in length.


  1. Flexikon-Docckeck Grooth
  2. Prof. B. Westhoff - Developmental and Molecular Biology Heinrich-Heine-Uni Düsseldorf
  3. Prof. Dr. Erich Blechschmidt Human Anatomy and Ontogenesis 1978 Source and Meyer-Verlag Heidelberg
  4. Moore Persaud - Embryology 4th edition Schattauer Verlag
  5. Biochemie des Menschen 5th edition Thieme Verlag
  6. Pschyrembel - Clinical Dictionary
  7. Symptoms collected from our own long history of practice

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