Big things come in small packages

Nobody wants to be the odd one out in a crowd. Do children suffering from Growth Hormone Deficiency (GHD) feel this way?  Does being short and small impact them psychologically? It is essential to find solutions to make their life happier.

Globally, children from all races, classes or communities are affected by GHD. One of the major causes of growth failure in children is GHD. If the body does not produce enough growth hormone (a substance produced and released by pituitary gland located in the centre of the brain), there is a good chance of the child suffering from  GHD.

Growth hormone is primarily responsible for developing height to its full potential. Pituitary insufficiency may be genetic, acquired or through developmental abnormality. Children suffering from the deficiency have normal body proportions and often tend to look younger than their peers.  A GHD child shows normal growth till he/she is two to three years old after which the growth process starts getting delayed. Later the growth velocity becomes very poor i.e. often less than three cm/year. Even bone age of the affected child gets retarded.

Detection & therapy
As soon as parents suspect growth failure in their child, they should consult a specialist such as a pediatrician or endocrinologist. In order to check if the child has GHD, the following tests should be conducted:    

• Height measurement corresponding to age
• X-ray of child's wrist to know his or her bone age
• Blood sample test to check for the possibility of thyroid hormone deficiency
•  Growth hormone stimulation tests to assess growth hormone deficiency.
• Other tests such as CT scan or an MRI of brain can be conducted.  Images obtained from these tests can reveal presence of tumours or malfunction of pituitary gland.

If the result for GHD tests is positive then required growth therapy should be given to the child as recommended by the doctor. Growth therapy is given daily or several times a week.  

Parents should take extra care in such cases because there is a high possibility that their children will be affected psycho-socially by their short stature and small size. Generally, there can be two types of scenarios. A child may feel disturbed and even traumatised because people think he is much younger than he/she is. The child may self-interpret and behave in an immature manner thinking he/she is still as young as he/she looks.  
In both cases, parents should be highly alert and keep a strict watch on their child's behaviour changing wrong perceptions.

They should boost the morale and develop the confidence of their child encouraging the build-up of positive energy.  

Parents should identify their child's strengths, be it swimming, writing, singing or painting, and work towards enhancing the skills. The child should be made to believe that every individual is unique. Changing the child's mindset can change his/her world.

By boosting the child's inner confidence pent-up emotions (negativity) can be wiped out  promoting a healthy present and a promising future for the child.  

(The writer is an endocrinologist)