There are two times when the body grows extra fast. Newborn babies grow faster than at any other stage, but there is another main growth spurt in early teens. Survival is the first aim of treatment, and so newborn babies are often over-suppressed. Consequently, a big challenge of CAH treatment is to recognise and allow for the second major growth spurt.

I once pointed out that children don't grow in a smooth line like on the growth charts, and was reassured that over time, small growth spurts and times of inactive growth even out.

Andrew