What Is Considered Normal Growth?

There is a wide range of normal heights during childhood. Click to see examples* of normal height ranges at different ages.

  • *Examples use the 3rd and 97th percentiles for US children as the upper and lower limits of the normal range.
2 Years of Age
Boys: About 32.0 to 37.0 inches
Girls: About 31.0 to 36.5 inches
There is a wide range of normal heights during childhood.

SELECT SAFETY INFORMATION

  • Do not take Humatrope if you are having serious complications after having open heart surgery, abdominal surgery, or serious injuries involving many body systems, or are having life-threatening breathing problems. Deaths have been reported in such cases.

How Is Growth Measured?

Regular, accurate measurements of weight and height are an important part of a child's health care. In infancy, length and weight should be regularly checked at doctor visits. During early childhood, measurements are usually taken about twice each year, and more frequently if there is anything unusual about a child's growth.

SELECT SAFETY INFORMATION

  • Do not use Humatrope in children with Prader-Willi syndrome who are severely obese or have a history of blocked upper airways or other severe breathing problems, or sleep apnea. Deaths have been reported in such cases. Humatrope is not approved for the treatment of patients with Prader-Willi syndrome.
  • Do not use Humatrope if you have active cancer. Growth hormone deficiency can be an early sign of some tumors in the brain or pituitary gland. The presence of these types of tumors should be ruled out by your doctor before you start Humatrope.
  • Serious allergic reactions have been reported with Humatrope. Humatrope is contraindicated if you know you have allergies to growth hormone or any of its ingredients. Tell your doctor if you have an allergic reaction. Do not mix Humatrope with the supplied diluent if you are allergic to metacresol or glycerin.
Many factors may affect how much and how rapidly a child grows, and how tall he or she will be as an adult. When determining whether Humatrope is an appropriate treatment option, doctors must rule out other common causes of growth problems, such as poor nutrition, deficiencies of hormones other than growth hormone, and other illnesses.

Evaluating Short Stature or Slow Growth

Just as many factors can influence height, there are various considerations that healthcare professionals may use to evaluate short stature or slow growth including:

Medical History

A detailed medical history, including information about the pregnancy and birth, growth during infancy, illnesses, appetite, diet, medications, and home environment, may provide the doctor with clues about the reasons for your child's short stature or slow growth (growth failure).

A child's height is influenced by the heights of the parents. Overall, children from short-statured families tend to be shorter than average as adults. Because heredity (genetic potential) plays a significant role in determining height, the medical history will include information about family members. The heights of the child's parents and the growth patterns of siblings are valuable pieces of information. It may be helpful to get information from the child's grandparents about anything unusual in the parents' growth patterns, especially the ages at which the parents went through puberty.

Your child's doctor will perform additional evaluations, because other factors besides hormone deficiencies also influence growth.

Physical Examination

During a detailed growth evaluation, measurements of your child's weight and height will be obtained. These are plotted on the appropriate growth charts for comparison with normal ranges. It is also helpful if you are able to provide the doctor with any other measurements taken during your child's life — for example, growth records from your family doctor or pediatrician or from your child’s baby book.

Additional measurements of your child's head circumference, arm and leg lengths, or other body parts also may be obtained. A careful examination will be performed to check for any signs of congenital conditions (conditions present at birth), chronic illness, hormone deficiencies, or other possible causes of reduced growth.

Growth Charts

As discussed earlier, the growth chart is an important tool used to determine whether a child has a growth problem. By plotting a child's measurements on a growth chart over time, a doctor can determine whether a child is growing normally or not. If a child fails to grow properly after a period of time, tests may be required to determine the cause.

Bone Age Evaluation

Your doctor may obtain an X-ray of your child's left hand and wrist — called a bone age X-ray — to evaluate the maturity of his or her bones.

Using this X-ray, a child's growth potential can also be estimated — that is, how much remaining growth he or she likely has left. As with all growth measurements, there is a wide range of normal development. Having a bone age that is somewhat younger or older than a child's chronological age (or "calendar age" — the actual age since birth) is not unusual. However, if the bone age is extremely advanced or delayed, this may suggest an underlying growth problem. The bone age evaluation is generally used along with the physical examination and growth charts to obtain a comprehensive picture of a child's growth and maturity.

SELECT SAFETY INFORMATION

  • Humatrope should not be used by children who have closed growth plates in their bones.
Laboratory Tests

Blood samples may be taken to look for evidence of any medical problems that can cause short stature or slow growth. These tests may help your child's doctor determine whether illness, poor nutrition, bowel disorders, hormone deficiencies, or other problems are affecting growth. To help confirm a diagnosis of growth hormone deficiency, more extensive testing — such as a growth hormone stimulation test — may be required (read about stimulation testing below).

Brain Scan

A special type of brain scan called a magnetic resonance imaging scan, or MRI scan, may be needed in some cases to look for any changes or disturbances in the area of the hypothalamus or the pituitary gland.

Stimulation Testing

The growth hormone stimulation test is one way to determine how much growth hormone your child's pituitary gland is making. Various stimulating agents are used to trigger the release of growth hormone by the pituitary gland.

After stimulating agents are given, blood samples are collected over the next few hours. The samples are sent to a laboratory, where the amount of growth hormone in the blood is measured. The response to this test may help determine whether sufficient growth hormone is being produced.

Helping a Child Who Has Short Stature

Children with short stature may need additional support and encouragement to help them deal with the challenges relating to their smaller size. Professional counseling may be helpful if children are distressed about their height or are being teased by other children. Doctors, other healthcare providers, or patient support groups may be able to provide useful suggestions.

Some practical suggestions

  • Treat children according to age, not size, and encourage others to do the same.
  • Talk with your child about how to handle teasing issues that might occur at school or outside the home.
  • Encourage children to participate in sports and other activities they enjoy. Help your child see that small size is not a disadvantage in some activities and may be an advantage in others.
  • Provide children with aids to ensure that they can reach important things at home, such as bathroom items, clothes, food, dishes, toys, and books.
  • Encourage children to talk about their feelings.
  • Answer questions as best you can and encourage your child to write down questions you can't answer. Let your child ask the questions at the next doctor's visit — children may feel more in control if they understand what's going on.

Support groups

Several organizations provide support and educational programs for families of children with growth disorders. Contact these organizations for information on services and local chapters.

The MAGIC Foundation®
1-800-3-MAGIC-3 (1-800-362-4423)
www.magicfoundation.org

Human Growth Foundation
1-800-451-6434
www.hgfound.org

Turner Syndrome Society of the United States
1-800-365-9944
www.turnersyndrome.org

The Hormone Health Network
1-800-HORMONE (1-800-467-6663)
www.hormone.org

Indications and Important Safety Information for Humatrope
Humatrope® (somatropin for injection) is used to treat:
  • Children who do not make enough growth hormone on their own, have short stature associated with Turner syndrome, or have SHOX deficiency; have idiopathic short stature, which means they are shorter than 98.8% of other children of the same age and sex, are growing at a rate not likely to allow them to reach normal adult height, and for whom no other cause of short stature can be found; were born smaller than normal for the number of weeks of pregnancy and who do not catch up in height by 2 to 4 years of age
  • Adults who have growth hormone deficiency that began either in adulthood (as a result of pituitary disease, hypothalamic disease, surgery, radiation therapy, or trauma) or in childhood. Patients treated for growth hormone deficiency in childhood whose bones have stopped growing should be reevaluated to determine if they should continue growth hormone
Important Safety Information for Humatrope
What is the most important information I should know about Humatrope?
  • Do not take Humatrope if you are having serious complications after having open heart surgery, abdominal surgery, or serious injuries involving many body systems, or are having life-threatening breathing problems. Deaths have been reported in such cases.
  • Do not use Humatrope in children with Prader-Willi syndrome who are severely obese or have a history of blocked upper airways or other severe breathing problems, or sleep apnea. Deaths have been reported in such cases. Humatrope is not approved for the treatment of patients with Prader-Willi syndrome.
  • Do not use Humatrope if you have active cancer. Growth hormone deficiency can be an early sign of some tumors in the brain or pituitary gland. The presence of these types of tumors should be ruled out by your doctor before you start Humatrope.
  • Serious allergic reactions have been reported with Humatrope. Humatrope is contraindicated if you know you have allergies to growth hormone or any of its ingredients. Tell your doctor if you have an allergic reaction. Do not mix Humatrope with the supplied diluent if you are allergic to metacresol or glycerin.
  • Your doctor should check your blood sugar regularly while you are taking Humatrope, especially if you have diabetes, pre-diabetes, or risk factors for diabetes. New cases of type 2 diabetes have been reported in patients taking Humatrope.
  • Tell your doctor if you have any visual changes accompanied by headache, nausea, and/or vomiting while taking Humatrope. This may be a sign of increased pressure in the brain.
  • Adults may retain water during Humatrope treatment. This may be brief and may increase with higher doses of Humatrope.
  • If you have hypoadrenalism and are on glucocorticoid replacement therapy, your doctor may increase your dosage when you initiate growth hormone treatment.
  • Your doctor should test your thyroid function periodically during Humatrope therapy. Thyroid hormone treatment may need to be started or adjusted.
  • Fracture in the ball of the hip joint can occur in children who have endocrine problems and in children who have rapid growth. Any child taking Humatrope who develops a limp or complains of hip or knee pain should be seen by a doctor to check for this.
  • Progression of curvature of the spine (scoliosis) can occur in children who have rapid growth. Humatrope has not been shown to increase the occurrence of this condition. If the child has scoliosis, the doctor should carefully monitor the progression of the scoliosis during Humatrope treatment.
  • Cases of pancreatitis (inflammation of the pancreas) have been reported rarely in children and adults receiving growth hormone. Consult a doctor if you develop abdominal pain while taking Humatrope.
  • You should rotate your injection sites to avoid breakdown of skin and fat. Seek prompt medical attention for any allergic reaction you experience to the injection of Humatrope.
Who should not take Humatrope?

Humatrope should not be used by:

  • People with serious complications after having open heart surgery, abdominal surgery, serious injuries involving many body systems, or with life-threatening breathing problems
  • Children with Prader-Willi syndrome who are severely obese or have a history of severe breathing problems
  • People with active cancer
  • People who have had an allergic reaction to growth hormone
  • People with diabetic disease of the retina (the lining in the back of the eyeball)
  • Children who have closed growth plates in their bones
What should I tell my doctor before taking Humatrope?

Tell your doctor about all of your prescription and over the counter drugs, including cyclosporine, hormone replacement therapy, insulin or other diabetes medications, drugs containing steroids, or drugs for seizures. These medications may need to be adjusted while taking Humatrope.

What are the possible side effects of Humatrope?

Common side effects reported in adults and children taking Humatrope include injection site reactions, allergic reactions to the diluent, and hypothyroidism. Additional common side effects in adults include swelling, joint pain, muscle pain, carpal tunnel syndrome, unusual skin sensations, and high blood sugar.

You are encouraged to report negative side effects of prescription drugs to the Food and Drug Administration (FDA). Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

How should I store Humatrope?

Humatrope must be kept refrigerated (36° to 46°F [2° to 8°C]) before and after it is mixed. Do not freeze. Once Humatrope has been mixed and is in liquid form, cartridges must be used within 28 days and vials must be used within 14 days. Throw away any unused Humatrope in a cartridge after 28 days and in a vial after 14 days. Before giving an injection, check the manufacturer’s expiration date on the cartridge or vial. Do not use the cartridge or vial if it has expired.

Humatrope is available by prescription only.
See Full Pen User Manual that accompanies the HumatroPen® 6 mg, 12 mg, and 24 mg.
HG CON ISI 14OCT2016