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The Endocrine Unit, Cobbold Laboratories, Middlesex Hospital, London win 8aa *Department of Growth and Development, Institute of Child Health, Guilford Street, London wcin 1eh REVISED MANUSCRIPT RECEIVED 26 April 1988

Introduction: The human growth curve divides into three distinct time-spans. There is a period of rapid and rapidly decelerating growth during infancy. This changes in the third year to a period of steady and slowly decelerating growth during childhood. Growth is completed by the adolescent growth spurt which, because it occurs later and is slightly greater in magnitude in boys than in girls, accounts for the sex differences in adult height.

Growth in infancy: Clinical observation of patients born with congenital hypopituitarism indicates clearly that growth hormone is important for growth from the day of birth. On the other hand, it seems likely that nutritional influences play the major role in fetal and infantile growth; such

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