Plenty of parents worry about their child’s short stature ... but should they?
It happens all the time — a kid on your child’s sport’s team lags behind the others in height and he’s worried about it. So too are his mom and dad. It’s tough on a kid when he’s the shortest one on the team or in a classroom; competition makes us all want to keep up, do what we can to eliminate, well, our shortcomings. Nevertheless, all kids are different and spring from their family genetic pool and there’s nothing wrong with being little. But some parents are willing to take measures to give their kids a boost.
Enter growth hormones. Typically used to help children with medical issues, growth hormones are being re-examined for their use in helping healthy children gain ground in height and size. But are they the answer?
“Quite simply, human growth hormone is indicated for the treatment of very few conditions,” says Richard B. Heyman, M.D., a senior physician at Suburban Pediatric Associates. “These include certain congenital genetic disorders, growth hormone deficiency (which has a variety of causes), and some kidney diseases; it may also be useful in enhancing the growth of some infants born prematurely.”
Nana-Hawa Yayah Jones, M.D., assistant professor in the Department of Endocrinology at Cincinnati Children’s Hospital (CCHMC), says that human growth hormone can also be used to treat idiopathic short stature, which basically means, shortness in a child with no diagnostic explanation. However, a child has to fulfill certain requirements to be considered a good candidate — at least 2.25 standard deviations below the mean for his age, sex and population group.
“If your child’s below the first percentile,” says Jones, “he could be a candidate, but you have to consider his genetic potential.” If mom and dad are both less than average height, growth hormones aren’t going to make their child six feet tall.
Do ADHD Meds Stunt Growth?
A 2007 study published in the Journal of the American Academy of Child and Adolescent Psychiatry found that after three years on the ADHD drug Ritalin, participating children were about an inch shorter and 4.4 pounds lighter than their peers. Several other studies indicated the same results, but researchers are waiting for long-term data.
“The use of psychostimulants (such as Adderall, Ritalin, Vyvanse, etc.) is frequently associated with a temporary fall-off in weight and some studies show a slight fall-off in height,” says Heyman. However, he adds, “Most authorities consider the growth issues minimal, and unless weight loss is severe it’s not an indication to discontinue use of the drug. Competent physicians pay close attention to nutrition and growth for those children treated with these meds, and appropriate monitoring will minimize that side effect.”
Jones says nutrition is a big factor. Some stimulant medications — and even some non-stimulant ones — can cause a decrease in appetite. If a child isn’t getting the proper amount of calories, his ability to gain weight and grow taller will be affected. “So it’s important that we make sure the child’s nutritionally sound first,” she says.
Hormones and Risks
It’s natural to want to give a child every advantage, but giving growth hormones to a short but otherwise healthy child raises scientific and ethical questions for us all. For instance, are we teaching kids that being short is a disease in need of curing? Further, treatments are costly, with estimates ranging into the tens of thousands of dollars. And, as with all medications, side effects can happen, according to Jones and Heyman. These include growing pains, an elevated risk of diabetes (for those with a family history), fluid retention, an underactive thyroid gland, a hip slipping out of the socket, or the hormones causing a pre-existing condition (such as scoliosis) to worsen. Long-term side effects may include damage to the kidneys, pancreas or nervous system.
“It’s not for everybody,” says Jones. “You have to decide if it’s worth the risk. But if you’re concerned, start with your pediatrician.” Chances are good, though, that your child’s short stature is nothing to worry about.