Qestions about GH and caloric catch-up - Reah

[Guest guest]

Hi Reah!

Welcome to the RSS list serve! It's filled with a lot of wonderful,

informative, and supportive friends. Hopefully, we'll be able to answer some

of your questions.

Dr Harbison, an endo at Mount Sinai in NYC, is considered by many, to be the

#1 expert on RSS in the US. She generally wants our kids to reside somewhere

close to the 15% line on the weight-for-height chart (the weight-for-stature

(measured standing) and the weight-for-length (measured laying down) charts

are the same things) This web site

http://www.cdc.gov/nchs/about/major/nhanes/growthcharts/charts.htm

has all the different growth charts. You would just want to make sure that

you pick the one appropriate to your child's gender and age.

When I checked the weight-for-length chart, girls age Birth-36 months, it

looks like your daughter is just below the 3rd % line, so that's not too

bad, I've seen worse, but she definitely needs to put on some weight.

The problem with starting GH before the child has completed their caloric

catch-up, is that GH increases the child growth velocity by 1.5-2 times it's

non-GH rate. If the child is not calorically replete, it's no only harder

for them to catch up, but it hard for them to keep up, and as Dr H is very

fond of saying " kids don't grow on air " . To get the best out of the GH

you're using, your daughter needs to be able to keep up calorically.

As far as feeding clinics go, I haven't found one that does not treat poor

eating as a behavioral problem, instead of a metabolic problem. Many factors

can cause our kids not to eat well. Things like delayed gastric emptying,

and silent reflux make it downright uncomfortable for our kids to ingest

food. Once a pattern is established, such as the child eats and suffers from

painful reflux, the child quickly associates the pain with eating, and

chooses not to eat. These problems can go by undetected for years!!

My g-son, 's reflux went undiagnosed for over 8 months, and created

such a severe oral aversion that he required the placement of a g-tube, and

is still, at almost 4 years old, unable/unwilling to eat enough orally to

sustain him.

I didn't see any reflux meds as part of your daughter's regimen. Do you use

either an H2A (Zantac, Pepcid) or a PPI (Prevacid, Prilosec) as part of your

daughter's daily medications?? Periactin can cause, or increase existing

reflux, but this problem is far outweighed by the benefits of weight gain.

There are several kids on the list serve that have used Periactin for years

with no ill effects.

I hope this brings some enlightenment. Feel free to keep asking questions,

and we'll all try to answer them!

And again, Welcome!!

Pat (g-ma to , RSS, 3 yrs 10 months old, 25#, 34.6 " , G-tube, GHT)