If your child begins treatment with growth hormone, you will have new concerns to consider. To begin with, there is a danger of unrealistic expectations. Your child has endured endless tests and doctor's appointments, and he has undoubtedly heard lots of discussion about growth hormone and its effects. He may expect that once he begins treatment he will quickly grow as tall as his peers. Of course, with such high hopes he's likely to be disappointed if he doesn't see instant results.

Even if growth hormone treatment leads to immediate results for your child (some kids grow two to four inches during the first year, two to three times their pre-treatment rate of growth), he may be disappointed when his growth rate slows in the following years, which it is likely to do. Your child may feel a sense of failure or even guilt because his body isn't achieving the result he hoped for or that his parents and doctor seem to expect.

You can help by talking to your child about what to expect and making sure that his expectations -- and your own -- are realistic. You probably have your own hopes about the treatment, but avoid talking about them too much. After all, there's a very good chance that despite growth hormone treatment, your child will remain at the lower end of the height spectrum once he's an adult. You'll need to do all you can to combat the perception that this is negative, or something your child should be ashamed of. "For some kids, growth hormone treatment can actually be detrimental because there's a very real danger of `medicalizing' the child," says David Sandberg, MD, of Baltimore, Maryland. "Without meaning to, we can make the child feel that he doesn't measure up."

For most children, especially those with Idiopathic Short Stature (ISS) who do not have a growth hormone deficiency, the results of growth hormone therapy will be "very modest -- the child might end up two and a half inches taller than he would have otherwise," Sandberg says. So it's important not to let the relative success or failure of growth hormone therapy become a central focus of your child's life.

Sandberg also cautions parents to think seriously about undertaking growth hormone therapy for a child with ISS. "We make the mistake of thinking that a single factor, such as being short, can have an inordinate effect on a child's life when actually all sorts of other things could be more important. There is no evidence that children who go on growth hormone function better in school or are happier than short children who don't."

Since short kids may already feel a bit insecure about their physical size and strength, it's important to bolster their self-esteem in other areas. Help your child find activities that he excels in and enjoys, such as academic pursuits, sports, and arts and crafts. If he's musical, encourage him to take up an instrument or join the school band. If he's a crack science student, encourage him to enter your local science fair.

It turns out that some children for whom growth hormone treatment is successful may actually feel sad or experience feelings of loss. Change can be hard -- even positive change -- and a child may miss the attention he received when he was smaller than everyone else, or he may fear losing the role of baby in the family. And, like all kids, as your child reaches puberty he is likely to feel awkward in his growing body as it becomes less familiar to him.

Finally, keep in mind that any type of longterm medical treatment is difficult. Your child's treatment is adding stress to his life. Make sure he has plenty of opportunities to be a kid: to run and play and get dirty, to visit with friends and pursue his creative interests. After all, your child has many unique characteristics, and his height is probably the least important of all.

References

Walgreen's Pharmacy patient information for parents of children on growth hormone: http://www.walgreenshealth.com/whc/spharm/jsp/sp_patient_ghd.jsp

First published December 18, 2003
Last updated March 22, 2005
Copyright © 2003 Consumer Health Interactive

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