Should Children Take a Growth Hormone?
If your child is growing at a slower rate than their classmates and friends, start a conversation with your pediatrician. Height, weight, and other physical markers are key indicators of child and adolescent development.
Kids who are growing slowly compared to their peers may have an underlying medical condition that’s delaying their growth. Others are simply short-statured, and there may be no cause for concern.
Society emphasizes this single physical characteristic, giving us the false impression that being taller is always better. Intervening with growth hormone isn’t always a simple fix and is often not medically necessary. But, when children are diagnosed with a condition that’s stalling their expected growth, early diagnosis and treatment can help them reach their full potential.
When should a child see a specialist?
“If you have concerns about your child’s short stature, it’s valid to bring up these concerns with your provider,” says Patricia Gomez, M.D., a pediatric endocrinologist with the University of Miami Health System. “Ask questions regarding why your provider is not concerned. Sometimes it takes several evaluations to determine that growth is problematic. Therefore, it is important to continue follow-up as recommended.”
A pediatric endocrinologist should evaluate a child if:
- they are below the growth curve for height
- they have an abnormal growth velocity for their age or pubertal stage
- or their height percentile is significantly different than expected for your family
What causes abnormally short stature?
Delayed growth or significant below-normal height may be caused by human growth hormone deficiency.
Other conditions that can trigger short stature or growth failure, including:
- Turner syndrome
- Noonan syndrome
- SHOX deficiency
- Prader-Willi syndrome
- chronic kidney disease
Some children are small for their gestational age at birth and don’t catch up to their peers. Many others are short-statured, perhaps because their family members are also below average height with no medical cause (called idiopathic short stature).
What does growth hormone treatment do?
By mimicking the body’s naturally produced human growth hormone (GH), synthetic (man-made) GH is injected to stimulate height and related developmental features in pediatric patients with a number of medical conditions, including those listed above.
“Growth hormone, when used appropriately, is generally effective in helping augment growth,” Dr. Gomez says. “The typical goal is to help children reach a normal adult height — close to their genetic potential, if possible.”
How many inches can a child gain from this treatment?
It depends on many factors, including underlying conditions, the child’s age when treatment begins, their estimated height potential based on their sex and genetic factors, and the dosage and duration of treatment.
“For children who have diagnoses that may benefit from GH, treatment should begin once there is evidence of suboptimal growth velocity or adult height prediction,” Dr. Gomez says.
“For some diagnoses (e.g., Turner syndrome), earlier initiation of GH treatment is recommended (starting at ages 4 to 6 years old), especially if the child’s growth failure is already evident. It is too late to start GH treatment once growth is complete and the child’s growth plates are fused.”
In 2003, the FDA approved GH for children with short stature when experts cannot identify the cause.
Giving GH to children with idiopathic short stature is controversial because it’s an elective, aesthetic choice. If your child meets this qualification, consider the potential emotional ramifications of this decision.
Regularly giving injections to children who truly do not need growth hormone may give them the impression that something is wrong with them, being short is undesirable, and if they don’t ultimately reach a certain height, they are defective and disappointing in some way.
On the other hand, many adults who were treated with GH for idiopathic short stature as children are pleased with the results and grateful for the tough decision their parents made.
Is growth hormone safe?
“GH is generally safe,” Dr. Gomez says, “but there are potential side effects associated with its use.”
These include thyroid dysfunction, headaches, scoliosis, hip and/or knee pain, and abnormal glucose levels that may increase the risk of developing type 2 diabetes. There is less data about any long-term risks that may develop in late adolescence or adulthood following pediatric GH treatment.
“It is important to discuss your child’s individualized risks and benefits with your physician prior to starting GH therapy.”
Dana Kantrowitz is a contributing writer for UMiami Health News.
