Growth Shots for Jr.

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uld a child who is short but otherwise perfectly healthy be given growth hormones to make him or her taller? That's the question facing thousands of parents in the wake of the Food and Drug Administration's decision last month to approve the use of human growth hormone (HGH) for children whose predicted adult height is less than 5 ft. 3 in. for boys and 4 ft. 11 in. for girls. Before the decision, HGH had been approved only for children whose short stature was due to a medical condition.

This is a really tough call. It's not easy being short in a world filled with tall people. You get teased. You're picked last in gym class. When you get older, you have trouble making dates and finding mates. Even reaching the foot pedals in a car can be hard.

On the other hand, parents don't want to send their children the message that they're somehow deficient because they're not NBA material. Taking HGH is a big commitment. To get the best results requires daily shots with a cold needle of a drug that can cost $20,000 a year. Even then the results may be modest. In one trial, children who took Eli Lilly's Humatrope three times a week for years gained an average of only 1.5 in. over a group taking a placebo. In a higher-dose trial, children taking the drug six times a week gained up to 4 in.

As with any drug, there are risks. Growth hormone is a natural substance produced by the pituitary gland, but taking more than your body makes on its own can cause problems. Athletes and body builders who buy HGH on the Internet to increase muscle mass have developed all sorts of strange abnormalities, from misshapen hands and faces to enlarged livers, kidneys and hearts. Nobody knows what the long-term effects on children might be, but, according to the Physicians Committee for Responsible Medicine, they could include metabolic changes, kidney problems and a higher risk of cancer. The committee also warns that the treatments could backfire, reinforcing a negative self-image and making children feel even shorter — and more stigmatized — than they did before.

Dr. Gupta is a neurosurgeon and CNN medical correspondent