Once your child starts receiving growth hormone treatments for growth hormone deficiency (GHD), a lot will change. Most importantly, your child will grow.

A doctor will monitor and measure your child’s development, but you can also keep track at home. Here’s what to expect when keeping tabs on your child’s growth.

What to expect once treatment starts

You probably won’t start noticing any height differences until after three to six months of treatment.

During the first two years of growth hormone treatment, your child may grow 4 to 5 inches per year. Growth will likely slow down a bit from there, but your child can still grow up to 3 inches per year. It can take several years for your child to reach their adult height.

In the meantime, you may start noticing the following:

  • Your child’s appetite may increase.
  • Your child will probably have more energy.
  • Your kid will outgrow their shoes, meaning you’ll have to buy new ones more often.
  • Your child’s lean body mass will increase, so they may look skinny for a while.

At the doctor’s office

Your child’s doctor — most likely a pediatric endocrinologist — will need to see your child every three to six months to monitor their growth while on growth hormone therapy.

Doctors typically monitor growth using a tool called a growth chart. Growth charts allow a doctor to plot a child’s height (also called stature) and weight over time. The doctor can then compare your child’s height and weight to children of the same age and sex.

Your child’s growth will be reported in percentiles. So, if your child is in the 10th percentile in height, it means that 90 percent of children of the same age are taller than them.

Keep in mind that even if your child’s percentile is low, their rate of growth may still be considered in the normal range. It’s more important that your child is growing consistently, not that they are at a high percentile.

If your child isn’t showing steady growth over time, your doctor may want to run more tests. Depending on the results, the doctor may need to adjust your child’s dose of growth hormone.

Aside from monitoring growth, the doctor will need to make sure your child isn’t experiencing any side effects to their medication or having trouble with their injections. Periodically, your child may also receive tests to monitor cholesterol, blood glucose, and bone density.

Monitoring growth at home

You can also use growth charts at home. All you need is a tape measure to measure your child’s height and a blank copy of a growth chart.

You can access a blank growth chart for boys and for girls from the Centers for Disease Control and Prevention (CDC).

Here’s how to plot your child’s height:

  1. First, print out a clear version of the growth chart. (Make sure you are using the correct chart for your child’s sex.)
  2. Then measure your child’s height with a tape measure.
  3. Find the height (stature) measurement in either inches or centimeters on the side of the chart (inches are on both the right and left side of the chart, but you only need to find the measurement on one side).
  4. Locate your child’s age (in years) along the bottom of the chart.
  5. Find the place on the chart where the two points would intersect if you drew a line in from the side and up from the bottom.
  6. Using a pencil, place a dot on that point.
  7. To find out how your child compares to other children of the same age, look for the wavy curved lines already drawn on the chart. These lines represent percentiles. The dot you marked for your child’s height may fall near one of those lines or between two lines. (At first, your child’s height may not even reach the first line.)
  8. Find the corresponding percentile by following the line that is closest to the dot you marked and noting the number at the end. You may need to estimate the percentage if the dot you marked falls between two lines.
  9. Repeat this process every three months or so to track your child’s growth as they age.

For example, if your child is a boy, is 47 inches tall, and just turned 8 years old, they would be slightly above the 5th percentile for height. This means that roughly 95 percent of other boys of the same age are taller than your child.

Keep in mind that growth is a slow process and should be measured over the course of several months. There’s no need to measure your child’s growth on a weekly or even monthly basis. If you want, you can track your child’s growth monthly, but don’t expect dramatic increases in height every time.

If your child’s height doesn’t even make it to the first percentile line, that’s okay. Remember, the percentile that your child’s height falls in isn’t as important as their growth pattern over time.

When will treatment end?

The length of time that your child will need treatment varies. Your child will most likely have to keep taking growth hormone until they:

  • reach full adult height
  • have healthy and mature bones
  • grow less than half an inch over the last year

Children with more severe cases of GHD may require therapy as adults due to metabolic changes or complications caused by GHD.

Speak to your child’s doctor if you have any concerns about your child’s growth rate or if you’re having trouble understanding growth charts. A doctor can help you understand realistic short- and long-term growth for your child.