Pediatricians are prescribing growth hormone drugs to short children outside of the guidelines of the American Food and Drug Administration. Even though there is no scientific evidence that shows their treatment will help, the doctors are doing so fo

Many pediatric endocrinologists admitted to going outside of the guidelines in a survey carried out by the Case Western Reserve University in Cleveland, Ohio. Scientific trials will continue to be only one element in deciding whether to treat a child with growth hormones, the study discovered.

Although the therapy has been shown to help children who genuinely lack the growth hormone, it is very difficult to diagnose correctly, which would explain the hit and miss success rate, says Dr Barry Bercu from the University of South Florida College of Medicine.

One study found that hormone treatment did not improve final height in 14 patients. Most of the benefits seem to be psychological, and have not been held up to scientific scrutiny.

Side effects of the therapy also need to be considered, including allergy, impaired glucose tolerance, edema and leukemia.

Dr Bercu also says the cost of treatment is "staggering" around $30,000 a year. All of these concerns need to be weighed up before treatment begins, but ethics should also be considered. He questions whether it is justified to treat healthy children in this way, just because they fall below a perceived acceptable height.

!AJAMA, 1996; 276: 567-8 and 531-537.