What Is a Late Bloomer, and When Does a Growth Spurt Happen? - GoodRx (2024)

People often use the term “late bloomer” to describe someone who hits their stride later on. It might refer to someone who starts excelling in school, sports, or other activities later than their peers.

But a “late bloomer” is also a medical condition. Accordingly, there’s also a medical term for it — constitutional growth delay. In this situation, a late bloomer is a child who doesn’t hit their growth spurt or start puberty at the same time as their peers. If your child seems like they’re not hitting their growth spurt, here’s everything you need to know about late bloomers.

What is a late bloomer (constitutional growth delay)?

A late bloomer is a child who:

• Experiences their pubertal growth spurt later than their peers

• Goes through puberty later

• Is shorter than their peers until they hit their growth spurt

There are several other medical terms for this condition, including:

• Constitutional delay of growth and puberty

• Constitutional short stature for prepubertal children

• Constitutional growth delay

All these terms mean the same thing, but they’re a mouthful to say. So many healthcare providers and caregivers use the term “late bloomer.”

Most late bloomers start off as an average or even above average height as infants and toddlers. But around their third or fourth birthday, they start to slow down on their growth. While they still grow a normal amount each year, it’s often not as much as their peers. As a result, over time, they end up being shorter than their peers.

Your child’s healthcare provider tracks how your child’s growth compares to their peers over time using a growth chart. You can get a copy of these growth charts on the CDC’s website if you want to follow along with your child’s growth.

When do teens usually have their growth spurt?

Female teens experience their pubertal growth spurt between 10 and 14 years old. Male teens hit their growth spurt about 2 years later, usually between 12 and 16 years old.

The puberty growth spurt is the biggest growth spurt a child experiences during their lifetime. They’ll gain about 20% of their adult height during this growth spurt.

Since male teens hit their growth spurts 2 years later, they get an additional 2 years of prepubertal growth. On average, they also grow slightly more during this growth spurt. This is why, on average, male adults are taller than female adults.

What causes someone to be a late bloomer?

Genetics play a big role in determining a child's growth potential. It also plays a huge role in determining when a child starts puberty.

If your child has a constitutional growth delay, it’s likely that you had one, too. Among children with constitutional growth delay, 66% have at least 1 parent who was a late bloomer.

You were likely a late bloomer if you started puberty later, hit your own growth spurt as an older teen, or didn’t get your first period until you were older than 14.

Your child’s healthcare provider will ask about family history to figure out if your child may be a late bloomer. They will also measure your height and use that to calculate your child’s expected adult height.

They will also make sure there isn’t another reason your child isn’t growing as expected. Your child’s provider may:

• Order blood work: Some medical conditions can cause a child to have poor growth. Simple blood tests can check for things like celiac disease, hypothyroidism, growth hormone deficiencies, and other medical conditions.

• Ask for a urine sample: Chronic kidney conditions can lead to poor growth. A urine sample can show signs of chronic kidney disease.

• Get an X-ray of the wrist: A bone age is an X-ray that looks at the growth plate in the wrist. It can help confirm a constitutional growth delay. A child finishes growing when growth plates close. A very open growth plate is a sign a child still has a lot of growing to do. This is called a “delayed bone age.” It means that while your child may be 14 or 15 years old, their bones look more like those of a 10 or 11 year old. So eventually your child will hit their growth spurt, but it might take a while longer.

• Do a growth hormone challenge: A growth hormone challenge is a test that can help tell if your child has growth hormone deficiency or constitutional growth delay. Most children don’t need this test because the other (less expensive) options above provide an answer.

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How do I figure out my child’s expected adult height?

There are several ways you can figure out your child’s expected adult height. But remember, all of these methods only provide estimates:

• Double at 2: This is the easier method, but it’s less accurate. Double your child’s height when they were 24 months old — that’s their predicted adult height. Of course this only helps if you remember or recorded their height. Your child’s healthcare provider may also have it on file.

• Mid-parental height: The mid-parental height takes some extra math. Add together the heights of both genetic parents and divide by two. For a male child, add 2.5 inches to this number. For a female child, subtract 2.5 inches from this number. This is your child’s predicted adult height.

Does my child need treatment for constitutional growth delay?

Your child doesn’t need treatment for constitutional growth delay. They will hit their growth spurt, finish puberty, and reach their expected adult height in time.

But it can be hard for a teen to feel left behind as they watch their peers go through puberty. Try to reassure your teen and offer support. In some cases, a brief course of testosterone therapy can help “jump-start” growth. But this is only an option for male children.