Answer:

Growth hormone (GH), secreted by the pituitary gland, increases protein synthesis, promotes cell division, and stimulates bone and cartilage development. GH secretion occurs rhythmically, peaking most strongly during a child's deep sleep, and is also influenced by nutrition, exercise, thyroid hormones, and sex hormones.

However, height does not solely depend on GH. Genetics, diet, sleep, mineral absorption (calcium, zinc, vitamin D), and physical activity are all determining factors for height development.

Congenital or acquired GH deficiency can cause stunted growth and slow height development. However, a child not reaching expected height does not automatically mean they need GH injections; a comprehensive assessment of the underlying cause is required first. Most cases of children being shorter than their peers do not stem from endocrine disorders but rather from genetics, lack of sleep, poor nutrition, insufficient physical activity, or delayed puberty onset.

GH is only indicated when a child has growth hormone deficiency, meaning the pituitary gland does not produce enough hormone. GH can also be used for certain conditions such as Turner syndrome, Prader-Willi syndrome, premature or small for gestational age infants, and children with chronic kidney disease causing physical developmental delay.

In these cases, GH can improve physique, increase muscle mass, and reduce fat, helping children achieve an adult height 1-2 standard deviations higher than expected. However, the response varies depending on the condition, individual, and treatment adherence. Some cases may experience side effects such as progressive scoliosis, hyperglycemia, and headaches due to increased intracranial pressure.

Currently, GH hormone is only available as a daily subcutaneous injection, not an oral form, and treatment is typically long-term. Doctors assess effectiveness through regular tests for growth rate, IGF-1 levels, and potential side effects. The effects of GH are only significant when the child is still in the bone development stage.

If a child is shorter than their peers but their growth rate is normal, with no signs of hormone deficiency or endocrine disease, GH injections will not yield significant results. Parents who self-administer GH medication to children without a doctor's guidance risk many potential complications.

Doctor Son is advising a parent. Illustration: Tam Anh General Hospital.

Parents should be cautious of functional foods and products advertised to stimulate GH that lack clinical verification and contain ingredients of unknown origin. Uncontrolled supplementation of functional foods or hormones can affect overall endocrine balance.

Parents should seek medical consultation if they notice their child is the shortest in class, falling behind peers in height over the years, growing less than 4 cm per year, or if their height is more than -2 standard deviations below the World Health Organization (WHO) standard. A doctor will measure height and weight, plot a growth chart, assess bone age, and order necessary tests to determine the cause.

To support healthy growth, parents should ensure children get enough sleep at the right time and avoid using electronic devices before bed. The period from 10 PM to 2 AM is when the body secretes the most GH, so deep sleep during this time is essential. Children should also engage in regular physical activity, prioritizing exercises like swimming, basketball, cycling, and jumping rope to stimulate endogenous GH secretion. A daily diet should include adequate protein, calcium, vitamin D, zinc, magnesium, green vegetables, and milk. Parents should avoid creating excessive pressure regarding height and ensure the child's psychological stability.

Master of Science, Doctor Do Tien Son

Department of Pediatrics

Tam Anh General Hospital Hanoi