FINDING OUT MORE ABOUT BEING BORN SMALL FOR GESTATIONAL AGE GLOBAL MASTER COPY - FOR INTERNAL USE ONLY

Transcription

1 FINDING OUT MORE ABOUT BEING BORN SMALL FOR GESTATIONAL AGE GLOBAL MASTER COPY - FOR INTERNAL USE ONLY

2 WHAT IS SMALL FOR GESTATIONAL AGE? HOW DID DOCTORS KNOW I WAS AN SGA BABY? When you were born, your weight and height were measured. Your doctor used this important information to plot your growth on charts like those shown below. These special charts were made from measuring the height and weight of lots of children of the same age and helped your doctor to compare your size with other boys or girls of your age. Gestational age means how many weeks your mother was pregnant with you before you were born. Small for gestational age (SGA) describes children who are born smaller than usual, in terms of height and/or weight, for the amount of time you were in your mother s womb. This booklet will help you learn more about SGA and explain the treatment that your doctor may recommend. These charts show the average growth curves for boys and the average growth curves for girls. The top line shows the average for tall/heavy children The bottom line shows the average for small/light children Most children s growth rates fall somewhere between the top and the bottom lines. If your growth curve is lower than the lowest curve on the chart for girls or boys of your age, you may benefit from help to grow.

3 WHAT CAUSES AN SGA BABY? There are lots of reasons a baby can be born small for their gestational age. For some, this may be because of environmental or maternal factors, but for many the reason for being born SGA remains unclear. 1 Usually, your growth mostly depends on the genes you inherit from your parents. Tall adults tend to have tall children and short adults usually have short children. Doctors can use a mathematical formula based on your parents heights to work out how tall they expect you to be once you have finished growing. This is called your target size. WHAT ELSE CAN AFFECT MY GROWTH? Growth can be affected by things that happen in children s lives. 2 Some things happen outside The reasons why some children don t grow properly can be very sad: There may be a war or a famine in their countries which makes it hard to find good food to eat. Children s lives may be very stressful if, for instance, their families are living in difficult circumstances. A long-term disease may be affecting their health. Fortunately, the problems are not always difficult to solve. There are often ways to help. If you are smaller than expected after looking at your parents, and if you are much smaller than other children of your own age, there may be a reason why you are not growing as quickly as you should. Some things happen inside Most babies grow inside their mother s belly for around 40 weeks before they are born. However, if you were born much earlier than this (known as pre-term) you are more likely to be an SGA baby. 3 Also, if you or your mother were unwell when you were developing, this may affect your growth. 4

4 CAN DOCTORS IDENTIFY SGA BEFORE I AM BORN? There are signs that can show up before you are born, which might make your doctor suspect SGA. Your mother would have had lots of tests and checks throughout her pregnancy to check that you were healthy and growing as expected. A baby s growth and development happens inside the tummy, hidden from view. However, doctors can use a special machine to take pictures of you as a baby inside your mother s tummy. This is known as an ultrasound and is very useful for showing whether or not you are growing as much as you should. WHAT HAPPENS IF I HAVE SGA? Most children born small for gestational age will catch up to other children by age 2. 5 Children who don t catch up by 4 years of age or later can be treated with growth hormone medicine. 6 Doctors would like you to take this medicine to help your bones, teeth and muscles to grow strong. Your doctors know that improving your growth and development now may help to avoid certain health problems in the future. This is why it is very important to have regular check-ups with your doctor. Your doctor can check that you are developing and growing well.

5 WHAT IS GROWTH HORMONE? Your body produces a hormone that plays a central role in the modulation of growth, called growth hormone. Growth hormone is needed to help your bones, teeth and muscles to develop as they should. It also affects the way that your body uses the protein, fat and sugar that comes from your food. 7 When your body does not make enough growth hormone naturally, you can get the extra growth hormone you need by taking medicine. WHERE IS GROWTH HORMONE MADE? Growth hormone is made in the anterior part of the pituitary gland, along with other hormones that your body needs. 7 This gland is only the size of a pea and it is positioned underneath your brain. 9 The pituitary gland releases several hormones (chemical messengers) into your bloodstream. These hormones travel through your body to target organs where they deliver their instructions. Growth hormone makes your bones, tissues and organs grow. 7 Hormones are your body s chemical messengers. They travel in your bloodstream telling your bones, tissues or organs what to do. 8 Doctors can do certain tests to find out if your body is not making enough growth hormone. Your condition can be treated with growth hormone injections, which increase the amount of growth hormone in your body, helping bones to grow and muscles to develop

6 YOUR DOCTORS HAVE FOUND THAT YOU NEED MEDICINE TO HELP YOU TO HOW DO I TAKE MY MEDICINE? GROW Getting a diagnosis of SGA is very important. It means that the doctors can treat you with growth hormone injections which increase the levels of growth hormone in your body 6 and support your natural growth and development. 7 Artificial growth hormone is made using special, biotechnical processes. It is made to be as close as possible to naturally occurring, human growth hormone. It works by increasing the amount of growth hormone in your body, helping your bones to grow and your muscles to develop. 14 You need to inject your medicine every day. The human body naturally makes more growth hormone at night than it does during the day so take your injections at bedtime. This will help copy the natural rhythm of your body. 15 You will need to take your injections every day until you reach the end of puberty because that is when bones stop growing naturally. Treatment with growth hormone is long-term, often lasting for several years. 16 Your doctor will check your progress regularly and take blood tests to make sure you are staying healthy in every respect. Rotate your injection site You need to inject your medicine every day under the skin. You should change the place where you inject your medicine each day.

7 Exercise regularly Run, walk, dance, play sports. Just have fun! But do remember that it is important to rest if you get tired WHAT ELSE CAN I DO TO LOOK AFTER MYSELF? Eat a healthy balanced diet Ensure you have the important vitamins and nutrients needed for healthy growth and development: 19 Eat small, nutritious snacks and meals throughout the day Eat a variety of foods which include fruit and vegetables, grains, dairy (milk, yogurt, cheese, and/or fortified soya beverages), protein foods (seafood, lean meats and poultry, eggs, beans and peas), and oils Take a look at [include link to local guidelines] Always make sure to follow the advice you ve been given by your doctor, nurse or dietitian. Have a routine Make your injections part of your normal routine. Let it become one of the things you always do before going to bed, like cleaning your teeth. Be patient Remember: growth is a slow process. Even though your growth hormone injections can help you to grow, it may take several months before you notice that you have grown taller. References: 1. Van der Steen M, Hokken-Koelega A. Endocrinol Metab Clin N Am 2016; 45: Medline Plus Delayed growth. Available at: Accessed May Clausson B et al. Br J Obstet Gynaecol 1998; 105: Lee PE et al. Pediatrics. 2003; 111: Clayton PE et al. JCEM 2007; 92: Sandoz. Omnitrope Summary of Product Characteristics. February Kato Y et al. Intern Med 2002; 41: Medline Plus Hormones. Available at: hormones.html. Accessed October Medline Plus Pituitary and Pineal glands. Available at: endocrine/glands/pituitary.html. Accessed October Salas PY et al. Int J Endocrinol 2013, Article ID Accessed May Johnston LB, Savage MO. Arch Dis Child 2004; 89: Southern Reh C, Geffner ME. J Clin Pharmacol 2010; 2: Takeda A et al. Health Technol Assess 2010; 14:1-209, iii iv. 14. US FDA Somatropin Information. Available at: ucm htm. Accessed October Morris CJ et al. Mol Cell Endocrinol 2012; 349: Medline Plus Growth Hormone Deficiency Children. Available at: Accessed October Healthy Children (from the American Academy of Pediatrics). How to get fit. Available at: Accessed October Healthy Children (from the American Academy of Pediatrics). Making fitness a way of life. Available at: healthychildren.org/english/healthy-living/fitness/pages/making-fitness-a-way-of-life.aspx. Accessed October Healthy Children (from the American Academy of Pediatrics). Making healthy food choices. Available at: gradeschool/nutrition/pages/making-healthy-food-choices.aspx. Accessed October Job code: HQ/OMN/ Date of preparation: December 2016