Treating restricted growth

Some people with restricted growth may be able to have treatment to help them grow more than they otherwise would, although not everyone will need treatment.

Support and treatment is also available to help with related problems, such as associated health conditions and difficulties with daily activities.

Growth hormone medication

The National Institute for Health and Care Excellence (NICE) recommends human growth hormone treatment (somatropin) as an option for children whose poor growthis associated with:

• growth hormone deficiency
• Turner syndrome
• Prader-Willi syndrome
• chronic kidney disease
• a particular genetic fault known asshort stature homeobox-containing gene (SHOX) deficiency

NICE also recommends the treatment for children who are born small and fail to catch up in growth by the age of four or later.

Somatropin treatment should be started and monitored by a child health specialist (paediatric endocrinologist) with expertise in managing growth hormone disorders in children. It's given as a single daily injection, which can usually be done by a parent or carer.

Skin reactions are the most commonly reported side effect of somatropin. In very rare cases, the treatment is associated with persistent severe headaches, vomiting and vision problems.

Children with growth hormone deficiency respond very well to growth hormone treatment and may be able to reach a relatively normal adult height. The effectiveness in children with other conditions can vary.

Growth hormone treatment may stop once your child stops growing, but in some cases it may be giveninto adulthood because it can sometimes helpprevent problems such as weak bones ( osteoporosis ).

For more information, read the NICE guidelines on Human growth hormone (somatropin) for the treatment of growth failure in children and Human growth hormone (somatropin) in adults with growth hormone deficiency .

Leg-lengthening surgery

If a person has particularly short legs, a leg-lengthening process, known as distraction, may be an option. This involves dividing the leg bone and fixing it to a special frame. This is gradually adjusted every day to encourage the bone to grow over time.

This can sometimes result in a significant increase in height, but it's a lengthy treatmentandhas a risk of complications, so it's not always recommended.

NICE says there is uncertainty about the safety and effectiveness of this procedure, so they recommend making sure youunderstand exactly what it involves and to talk to your surgeon or doctor about the risks ifit's suggestedas a treatment.

Some people have pain after the limb-lengthening procedure. Other possible complications include:

• poor bone formation
• infection
• bone lengthening at an inappropriate rate
• blood clots

For more information, read NICE guidelines on Intramedullary distraction for lower limb lengthening .

Support and treatment forrelated problems

As restricted growth can be associated with several related conditions and problems (read more about the symptoms of restricted growth ), affected children and adults are likely to be cared for by ateam of different healthcare professionals.

These may include:

• apaediatrician (child health specialist)
• a nurse specialists
• a physiotherapist
• an occupational therapist
• a dietician
• an audiologist (hearing specialists)
• a speech and language therapist
• a neurologist (specialist in nervous systemdisorders)
• an orthopaedic surgeon
• a geneticist

You may have regular check-ups with members of your care team, so your health can be monitored and any problems that develop can be treated.