To inject or not to inject

amother

Tue, Jun 08 2010, 8:40 am

I have a four year old daughter who is very short (1st percentile). She has been through all the testing and was found to be growth hormone deficient. We have a wonderful endocrinologist and he recommends growth hormone injections (as he does to all of his patients in this case) and I've gotten so far in this process that the medication arrived on my doorstep this morning and is now sitting in my fridge.

And yet. I'm still not sure whether or not I should give it to her. This isn't a question of putting unnecessary medication in her body, we have already weighed the risks of using the medication and decided that they are minimal enough from our perspective. The question is more a philosophical one-- does my daughter really need to be taller? As of now she is estimated to grow to be around 4'10 but is too young for an accurate prediction. That is short, but I don't think it's so short that she won't function. I've been looking around and noticing all the women who are shorter than me (I'm 5'2) and they don't seem to be any worse off for it. Also, my daughter is not meek or shy because she is smaller, she is a tough cookie who doesn't let anyone step on her. Maybe this part of her personality is developing because she is shorter, and who am I to tamper with that? On the other hand, why not give her the greatest advantage I can?

For various reasons we need to start the meds soon and I want to feel confident with my decision either way. I'm open to all opinions.

fiddle

Tue, Jun 08 2010, 8:45 am

I'm 4'11, and although next to my dh 6'0 am considered short, I do not see myself as having a handicap and a problem that would have needed taking care of. if she was to reach 3'5 in ht or even 4 ft. I would say you should do it, but to say that shes doing ok mentally socially and is still short and has a self esteem the size of a 6 ft girl then its not necessary to pump unnecessary hormones into her. so shell be a bit small. its not even considered abnormal.

lilacdreams

Tue, Jun 08 2010, 9:00 am

going thru exactly the same thing. I am 5.2 but my dd has 2 grandmothers who were/are 5.1 and 4.11. She doesnt have hormone deficiency. Its idiopathic (bh bh bh). We tested for everything else.

Why do you have to start at 4 yrs old? My dd is 8 and is part of the decision making process. I know the earlier you start the more height you can gain, but 4?? What percentile is she on? my dd is under the lowest line, but its not an easy yes answer for us either, even though she is so small - we still havent decided if we want to do the injections even though the doc says she will respond nicely to them.

have you spoken to a rav? that's our next step.

Chayalle

Tue, Jun 08 2010, 9:06 am

Wow I didn't know that they treat someone so young.

My DD is tiny (0-3 percentile for height and weight) but my pediatrician didn't recomment we test her until she was 10. At that point she was found to have normal hormone levels and a bone age of almost 7, so they predict she will hit 5 feet and did not recommend treatment at this time, just yearly follow-ups.

I wonder if things would've looked different if we'd gone earlier, and if at age 10 the picture is clearer. OTOH if there is a deficiency and it is treated earlier you gain years....but honestly I've never heard of someone taking a child so young to the endocrinologist.

Israeli Mother

Tue, Jun 08 2010, 9:27 am

amother wrote:

I have a four year old daughter who is very short (1st percentile). She has been through all the testing and was found to be growth hormone deficient. ... For various reasons we need to start the meds soon and I want to feel confident with my decision either way. I'm open to all opinions.

I can't tell you what to do, but if I were you I would probably give her the injections. I have cousins who are very, very short [one of them is somewhere between 4'6" and 4'9". She seemed to be fine emotionally all through school and college and got a degree and got married, but when she went to have children it almost destroyed her body -- she only has one child due to this fact. Driving is difficult at her size and many other things as well. A child in the first percentile is not going to become 4'10" without growth hormone help. She will probably end up much shorter than this. Yes, she can still live a fulfilling life and graduate from school, go on to college, marry, work, etc. but she will be handicapped due to her size and it will be hard for her to have children and possibly dangerous as well since she will always be the size of a young child.

If you are not worried about side effects but only the "hashkafic" side of things, I would vote for giving her the shots and making her life a LOT easier as an adult.

Liba

Tue, Jun 08 2010, 9:32 am

Growth hormones to treat growth hormone deficiency isn't just about height. Growth hormone is needed to keep blood sugar stable, and develop muscles and bones. Untreated growth hormone deficiency can cause developmental delay and problems with stamina.

Giving growth hormone to someone who is short but not growth hormone deficient is a different story. Then you can just discuss the inches and wait longer to start.

If there is a documented deficiency it is no different than any other disorder and should be treated appropriately.

sarahd

Tue, Jun 08 2010, 9:40 am

Israeli Mother wrote:

A child in the first percentile is not going to become 4'10" without growth hormone help. She will probably end up much shorter than this.

Do you really think so? shock

My son is well below the 0-3 %ile, and my pediatrician is very unconcerned. He asked my height and my dh's and calculated that our son is right on his own curve and will probably end up short, but not outlandishly so. Like 5'4" or 5'5". Do you think he's wrong?

Last edited by sarahd on Tue, Jun 08 2010, 9:50 am; edited 1 time in total

Isramom8

Tue, Jun 08 2010, 9:40 am

If it's just for height, my opinion is don't do it. So much annoyance and cost for something that won't make a difference. Maybe two inches are gained. It doesn't matter at all if a woman is 4'10'' or 5'.

Liba sounds like she knows what she is talking about where deficiency is concerned. I have no idea about that - ask your specialist. And do internet searches.

amother

Tue, Jun 08 2010, 10:02 am

Liba wrote:

According to my dr. you need to have an extremely low growth hormone level to have it affect anything but height-- like closer to zero, and these are the people who need to stay on growth hormone into adulthood. L'chol hadeyos my daughter is growth hormone deficient but it should affect anything but her height. I made sure I had full clarity on that.

As for why we took her so early-- it was for personal reasons. My ped didn't think it was necessary but when I told her our reasons for wanting to look into it she thought it was a good idea, and the endocrinologist didn't think I was crazy for coming at all. There are definitely benefits to starting earlier. Also, I know of people who wanted to do it but ended up having to do things like delaying puberty (with more hormones...) because they started too late.

Thanks everyone else for your responses, you've given me a lot to think about. My husband is for it, and I think I'm leaning toward it (I do have the meds already!) but I just want to feel like I'm doing the right thing.

amother

Tue, Jun 08 2010, 10:03 am

Liba wrote:

On second thought, my daughter doesn't have such great stamina... maybe this one of those things that doctors don't recognize even if it is the case?