Key takeaways:
The term “late bloomer” refers to a child who goes through puberty later than their peers.
Constitutional growth delay, the medical term for this condition, runs in families.
Late bloomers will catch up on their growth and reach standard adult height, but it may take a little extra time and patience.
People often use the term “late bloomer” to describe someone who “hits their stride” later in life. It might refer to someone who begins to excel in school, sports, or other activities later than their peers.
But a late bloomer is also a real medical condition called constitutional growth delay. It describes a child who doesn’t start puberty or have a growth spurt at the same time as others their age. Here’s everything you need to know about late bloomers.
What is a late bloomer (constitutional growth delay)?
About 1 out of 7 kids is a late bloomer. A late bloomer is a child who:
Has their childhood and/or pubertal growth spurts later than their peers
Goes through puberty later
Is shorter than their peers until their growth spurt begins
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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 professionals and caregivers use the term late bloomer.
Signs of a late bloomer
Most late bloomers start out as an average or even above-average height as infants and toddlers. But around age 3 or 4, their growth starts to slow down. They still grow a normal amount each year, but not as much as their peers.
Other signs of a late bloomer include:
Not developing early signs of puberty until 13 years old (for females) or 14 years old (for males)
Starting the pubertal growth spurt after 12 years old (for females) or 14 years old (for males)
Getting a first period after 14 years old
Some medications may slow growth. Here’s what to know about how steroids can affect your child’s growth.
Puberty can start early, too. Learn the signs of early (precocious) puberty and what they mean for your child.
Have more questions about your child’s health? Our Children’s Health Hub has the answers you’re looking for.
When do teens usually have their growth spurt?
Female teens usually have their pubertal growth spurt between the ages of 10 and 14. Male teens have 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 extra 2 years of growth before puberty. They also tend to grow slightly more during this growth spurt. This is why, on average, adult males are taller than adult females.
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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. About 66% of children with constitutional growth delay have at least 1 parent who was a late bloomer.
How do you know if your child is a late bloomer?
Talk to your child’s healthcare team if you’re concerned about your child’s growth and pubertal development. Your child’s healthcare team can help you figure out if your child is a late bloomer.
They’ll also make sure nothing else is causing slow growth or puberty delays.
Your child’s pediatrician 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 your child still has a lot of growing to do. This is called a “delayed bone age.” For example, a 14-year-old may have bones that look more like those of a 10- or 11-year-old. So, your child will eventually hit their growth spurt, but it might take a while longer.
Do a growth hormone challenge: A growth hormone challenge checks for growth hormone deficiency. Most children don’t need this test because the other (less expensive) options above usually give an answer.
Does my child need treatment for constitutional growth delay?
Most children don’t need treatment for constitutional growth delay. They’ll eventually hit their growth spurt, finish puberty, and reach their expected adult height. This just happens a few years after their peers. It can be hard for a teen to feel left behind, so try to reassure them and offer support. You can also consider having them work with a mental health professional.
Children who start puberty very late may be at risk for not reaching their full adult height. Children with more severe constitutional growth delay may benefit from hormone therapy to help “jump-start” growth and development.
Frequently asked questions
There are several ways to estimate your child’s adult height. But remember that these only provide estimates:
Double at 2: This is the easiest method, but it’s less accurate. Double your child’s height at 24 months old to get their predicted adult height.
Mid-parental height: Add the heights of both genetic parents and divide by two. For a male child, add 2 ½ inches to this number. For a female child, subtract 2 ½ inches from this number. This gives your child’s predicted adult height.
There’s no evidence that late puberty has any physical or psychological benefits. There’s some evidence that children who go through puberty later may have lower bone mineral density as adults. But they may also have a slightly lower risk of developing breast cancer.
Very strenuous exercise can cause delayed menstruation and puberty in female children. However, most children don’t exercise at this level. Your child’s outdoor playtime, gym class, and sports keep them active and healthy. But you should work with an experienced healthcare team if your child is an elite athlete or dancer. They can make sure your child is growing and developing as expected.
There are several ways to estimate your child’s adult height. But remember that these only provide estimates:
Double at 2: This is the easiest method, but it’s less accurate. Double your child’s height at 24 months old to get their predicted adult height.
Mid-parental height: Add the heights of both genetic parents and divide by two. For a male child, add 2 ½ inches to this number. For a female child, subtract 2 ½ inches from this number. This gives your child’s predicted adult height.
There’s no evidence that late puberty has any physical or psychological benefits. There’s some evidence that children who go through puberty later may have lower bone mineral density as adults. But they may also have a slightly lower risk of developing breast cancer.
Very strenuous exercise can cause delayed menstruation and puberty in female children. However, most children don’t exercise at this level. Your child’s outdoor playtime, gym class, and sports keep them active and healthy. But you should work with an experienced healthcare team if your child is an elite athlete or dancer. They can make sure your child is growing and developing as expected.
The bottom line
A child’s growth is an important indicator of health. Some children are “late bloomers,” meaning they have a constitutional delay in growth. These children will eventually reach their expected height, just later than their peers. In order to figure out if your child is a late bloomer, their healthcare team may order blood tests, a urine sample, and a bone age (a type of X-ray). Most children with constitutional growth delay don’t need any treatment — just patience and reassurance. They’ll go through puberty and hit their expected adult height, just later than their peers.
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References
Abacı, A., et al. (2024). A current perspective on delayed puberty and its management. Journal of Clinical Research in Pediatric Endocrinology.
Aguilar, D., et al. (2023). Constitutional growth delay. StatPearls.
Bertelloni, S., et al. (2006). Effects of sports training in adolescence on growth, puberty and bone health. Gynecological Endocrinology.
European Society for Pediatric Endocrinology. (2019). Hormone disorders: Constitutional delay of growth and puberty: Patient’s guide.
HealthyChildren.org. (2015). Delayed puberty in boys: Information for parents. American Academy of Pediatrics.
HealthyChildren.org. (2016). Predicting a child’s adult height. American Academy of Pediatrics.
Nemours KidsHealth. (2019). Growth and your 13- to 18-year-old.
Pediatric Endocrine Society. (2020). Constitutional growth delay. American Academy of Pediatrics.
Zhu, J., et al. (2017). Adult consequences of self-limited delayed puberty. Pediatrics.
