Category Archives: Child Development

Growth Hormones and Cerebral Palsy

Many parents facing their child’s cerebral palsy diagnosis have no grasp of the impact the disorder will have on their child’s physical and cognitive development. I remember when our daughter was first diagnosed with cerebral palsy at 3 weeks of age. The physician explained to us the extent of her brain injury and how it may impact her life. He explained that it may impact her growth but not her cognitive abilities, or it may impact her cognitive development but physically, her growth would be normal.

Since Danielle was our first child, I had no knowledge of normal infant development, either physically or cognitively. As it turned out, she did grow relatively normally but was severely neurologically delayed. However, many other cerebral palsy children do experience retarded growth. What causes this and are there steps a parent can take to correct it?

Understanding Hormones

In order to understand why some children with cerebral palsy experience growth retardation, we need to first understand growth hormones.

Endocrine glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, thymus, thyroid, adrenal glands and pancreas. Hormones are your body’s chemical messengers. They travel in your bloodstream to tissues or organs and affect many different processes, including:

  • Growth and development
  • Metabolism
  • Sexual function
  • Reproduction
  • Mood

The pituitary is the “master control gland” – it makes hormones (including growth hormones) that affect growth and function of other glands in the body. When the pituitary gland is compromised, it can have strong effects on the rest of the body.

Growth Hormones and Cerebral Palsy

Most children with cerebral palsy exhibit a short stature and grow at a progressively slower rate from birth to puberty. Scientists have begun studying several possible causes of growth retardation in cerebral palsy kids, including growth hormone deficiency. A 2010 study tested whether a lack of normal growth might be due to impaired or deficient growth hormone secretion. The study found that 70% of the children studied lacked normal growth hormone secretion. The researchers then began to investigate the link between cerebral palsy and growth hormone deficiency.

Scientists have discovered a number of growth receptors in the brain and central nervous system, including the hypothalamus and hippocampus part of the brain. It’s believed that memory and cognitive functions may be closely linked to growth hormone receptors in the hippocampus. In cases of severe brain damage, such as cerebral palsy, the neurotransmitter pathways involved in GH control may be impaired, affecting the normal secretion of the hormone.

There are other possible causes of growth hormone deficiency in cerebral palsy children, including psychosocial deprivation and suboptimal nutrition. In all cases, growth hormone deficiency can cause stunted growth.

Symptoms of Growth Hormone Deficiency

Not all children with cerebral palsy experience growth hormone deficiency. To determine whether your child may have a deficiency, look for one or more of these symptoms:

  • Slow or flat rate of growth, usually less than 2 inches per year. The slow growth may not become apparent until the child is 2 or 3 years old.
  • Child is much shorter than most or all children of the same age and gender.
  • Face appears younger than children of the same age. They may also have a chubby body build.
  • Puberty may come late or may not come at all, depending on the cause.

If your child exhibits these symptoms and you suspect growth hormone deficiency, consult an endocrinologist. Endocrinologists evaluate and treat pituitary disorders, such as growth hormone deficiency. Because the diagnosis and treatment of such disorders require special expertise, primary care physicians who suspect patients have growth hormone abnormalities should refer them to an endocrinologist.

Growth Hormone Replacement Therapy

Hormone replacement therapy is one method used to treat the symptoms of growth hormone deficiency. To learn more about growth hormone replacement therapy, read next week’s article, “Is Growth Hormone Replacement Therapy Right for Your Child?”

About CP Family Network

CP Family Network offers comprehensive information about cerebral palsy along with practical resources for parents like Care Guides: Medical and Emergency Information to organize and update medical records, and Survival Guides, listing available disability services in all 50 states.

Additional Resources:

Hormone Health Network –

Medline Plus – Growth Disorders –

Costa Rica Study: Current indications for indications for growth hormone therapy for children and adolescents –

MAGIC (Major Aspects of Growth in Children) Foundation –

Johns Hopkins Children’s Center – Growth Hormone Deficiency –

U.S. Department of Health and Human Services – National Endocrine and Metabolic Diseases Information Service – Human growth Hormone and Creutzfeldt-Jakob Disease Resource List

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Periods and CP: Tips for Parents

Tips for CP Parents
When we post our “Question of the Day” on Facebook, we always expect some interaction. After all, our community is very active and loves to help other families facing the same issues. However we were pleasantly surprised when we received an overwhelming amount of feedback to this question: “Can anybody offer advice on what to do for a teenage girl with CP who has hit puberty and is now menstruating?” You can read the comments here.

The average age for a girl to get her first period is 12. However a girl can start her period as early as age 8. The Office of Women’s Health states that most girls will start their first period about 2 years after they have started developing breasts.

The severity of cerebral palsy can be a huge factor in determining the appropriate actions to take. Additionally, children may suffer from associative conditions that may further complicate the issue. Some parents may be able to have that infamous “talk” about becoming a woman, but other parents may not. Some girls may not be able to understand what is happening to their bodies. Others may comprehend but cannot physically manage their own hygiene or sanitary needs.

So what advice did parents have to offer?

Speak to a medical professional. When you suspect that your daughter may be reaching that point in her life, seek medical advice. Your daughter’s physician has her medical history and can make recommendations appropriate for her.

If your daughter is able to understand, talk to her. Explain what will happen to her body, and teach her how to take care of herself during this time. It is recommended to speak to your daughter before it happens so that both the parent and daughter feel prepared.

Contact manufacturers of feminine hygiene products. A lot of times you can get free samples directly from the manufacturer so you can test out which products work best for your daughter. You might even get some coupons for future purchases too!

Pads or adult diapers. Some people commented that pads with wings work well to prevent accidents, but there’s also a chance for leaks. Adult diapers can work as an alternative during that time of the month. Additionally feminine wipes, either in travel packets or zip-lock bags, are recommended for cleanliness and hygiene.

Heating pads. Cramps are no joke. They can be extremely painful and uncomfortable, and no parent enjoys seeing their children in pain. Heating pads are one option to relieve painful cramping. Drug stores also sell small heating pads that can be worn discreetly under clothing. Be sure to read the manufacturer’s directions! These can get pretty hot, so proper attention is required in order to prevent burns.

Pain killers. Over-the-counter pain killers work well to prevent and reduce cramping during menstrual cycles. Be sure to contact your daughter’s physician for recommendations, and read the manufacturer’s directions for dosage information.

Keep a calendar.Track your daughter’s cycle on a calendar. If she’s able, teach her to how to track it herself so there are less surprises every month. This also helps with tracking any patterns, such as bloating or discomfort, and planning for these issues in the future.

There’s an app for that. Finding it overwhelming to track your daughter’s cycle? Yes, there is an app for that. Women’s Health Magazine found the best apps for tracking your period. One example is PeriodTracker, which predicts future cycles after 3 months of tracking. Another is MyPill which will remind you to take your pill or replace your patch.

Hormonal options. Some parents may choose to use medical intervention to control, reduce, or stop their daughter’s periods. The following require a prescription and medical supervision:

    • Lupron injections. This medication is typically reserved for children who are starting puberty early. The injections stop the body from producing hormones that are causing the body to mature. Breast tissue will soften, and the periods will stop. The treatments continue until the child reaches an age where puberty is considered normal. Once the injections are stopped, puberty restarts, and the body returns to normal hormone production.
    • Supprelin LA or Histrelin implant. The medicine is given by an implant that is placed into the child’s upper arm. It is left there for 12 months and is replaced annually. It will also stop the body from producing the hormones that start puberty.
    • The pill. Birth control pills are not only used as contraceptives. Often the pill reduces menstrual cramps and makes periods lighter, among other benefits. There are many kinds of oral contraceptives at different price ranges.
    • The patch. Ortho-Evra, aka “the patch”, is small plastic patch that is placed on the skin once a week for three weeks in a row, followed by a patch-free week. Like the pill, it helps regulate periods, reduces menstrual cramping, and can alleviate premenstrual symptoms such as mood swings and headaches.
    • The shot. Depo-Provera is an injection of the hormone progestin, which prevents pregnancy. It is injected on the arm and is effective for 3 months. It does not contain estrogen like the pill or the patch. It can reduce or even stop periods over time. However in the first 6 to 12 months of use there can be some irregular bleeding.
    • IUD. Intrauterine devices are small, t-shaped devices made of plastic that are inserted into the uterus. A health care provider must insert the device. There are two kinds of intrauterine devices: copper and hormonal. Hormonal IUDs can reduce menstrual cramping and make periods lighter by up to 90%, but in the first 3 to 6 months, periods may be irregular. Hormonal IUDs are effective for 3 to 5 years.


    Of course, every medicine has risks and side effects. Your daughter’s physician will have more information and may recommend a specific treatment for your daughter based on her medical history. Remember, you know your daughter best, so don’t be afraid to bring up any concerns to her physician!

    Thank you to everybody for providing such great information on Facebook! Parents were appreciative to be part of such an honest and open discussion on our page. This is not an easy subject to talk about, and a lot of great advice was shared.

    How did you handle your daughter’s transition into womanhood? Do you have any other advice to offer? Share your thoughts!


    Facebook Question of the Day
    Office on Women’s Health
    Talking to your child about puberty
    Birth Control Methods
    The Best Apps for Tracking Your Period
    Cincinatti Children’s Hospital – Leuprolide Acete (Lupron Depot)


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