NEW YORK (Reuters Health) - Treating healthy children who are relatively short with growth hormone to give them a few extra inches in height has no effect on their self-esteem or quality of life, according to new research.

Researchers led by Dr. Nicolet C. M. Theunissen of Utrecht University in the Netherlands found that children who were given growth hormone experienced no change in their sense of self-esteem or their quality of life for up to 2 years after they received the treatment.

Some studies have suggested that children who are short for their ages have certain psychological and social problems as a result, perhaps from being treated as younger than they are, or from the limitations their height places on sports and other play activities.

In response, researchers have developed a "treatment" for otherwise healthy kids with short stature, during which they receive growth hormone, which can add between 3 and 9 centimeters in height.

During the study, Theunissen and her colleagues treated half of a group of 36 relatively short children with growth hormone, and gave no growth-enhancing treatment to the rest. They conducted three surveys over 2 years of kids, their parents and the children's pediatricians about the child's self-esteem and health-related quality of life (HRQOL), which combines a child's sense of physical, mental and social well-being.

Reporting in a recent issue of the Journal of Pediatrics, the investigators found that the short children who participated in this study did not appear to have lower self-esteem or HRQOL than their peers, but did seem to have slightly less ability in social functioning.

Children who received growth hormone during the study grew an average of 17 centimeters, or 6.7 inches, whereas untreated study participants grew only 10 centimeters, or 4 inches.

Despite the increase in growth, kids treated with growth hormone did not report any change in their self-esteem or HRQOL over the treatment period, and neither did their parents. The pediatricians, however, did note that they suspected some growth hormone-treated children did improve their attitudes over the course of therapy.

In an accompanying editorial, Dr. Basil J. Zitelli of the Children's Hospital of Pittsburgh suggests that growth hormone treatment for shorter than average children--which can cost up to $30,000 a year--may not help youngsters feel good about themselves, and, in some cases, may make them feel worse.

"Offering children and parents therapy for short stature raises expectations of success," he writes.

Zitelli points out that in children who have no underlying disorder that is causing their short stature, growth hormone can have widely differing effects on their height.

"With the variability and unpredictability of results for any particular child, growth hormone therapy becomes an intervention that may be more detrimental than the original complaint of short stature," Zitelli writes.

"Perhaps efforts toward increasing the height of normal short children should be redirected toward teaching the acceptance of individual differences and placing value on personal character," he concludes.

SOURCE: Journal of Pediatrics 2002;140:493-495, 507-515.

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• Growth Disorders