Can growth stunting from stimulant medicine be reversed?

[erick1822]

After a couple years of complaining to my pediatrician that my sons growth was decreasing, the doctor finally looked back on his growth chart far enough to see that since starting medication a few years ago (he's now 9), he has gone from the 50% percentile in height and weight to closer to the 10th percentile for both I feel guilty for causing such a significant decrease in his size, and feel like I've ruined how his body is "supposed" to be. I question if we will be able to last with no medication over the summer but I'm definitely going to try in hopes of bringing up his size. With those of you have that have seen growth stunted due to medication, did you feel you were ever able to regain it when you stopped? Im really hoping I didn't do permanent damage. Any advice for helping to pack on the pounds? Or for tips for surviving med free?

[Cjkchamp]

We were lucky in that our son’s appetite returned and we did not have that side effect. I have a friend whose son is on adderral and my 7 year old is bigger that her 10 year old. She said she was just told to let him eat when he is hungry and to push calories in him. She also does medication vacations when he is out of school. I am going to recommend you look into broad spectrum micronutrients. The two companies are Hardy Nutritionals and True Hope. Good luck with the growth. It’s hard because we are trying to help them get through life the best we can!

[erick1822 in reply to Cjkchamp]

Thanks I am going to look into those !

[Skywalkerfamily]

keeping in mind that I'm not a doctor and just a parent like you, here is what I can tell you (our son is 11, diagnosed ADHD at the age of 6, takes Ritalin since age of 7):

× we do not give him his meds on vacation - that was actually the physician's recommendation

× we found that many things are catching up for our son during vacations. notably he is eating way more (during school time he hardly eats at lunch - generally just skips it). during the holidays (when he is not medicated) he eats normally.

× his weight goes up and the specialist who monitors his height and weight told us that weight first had to up for height to very quickly follow

So based on that I would talk to your doctor about stopping treatment on vacation.

I have no particular advice about how to handle him with no meds. we tend to be more lenient during the holidays and so there is less opposition with him and that avoids crises.

hope that helps... good luck!

[erick1822 in reply to Skywalkerfamily]

I’m so glad to hear that thanks so much ! Have you seen height start to increase yet ?

[seyna]

Try vitamins.

[SylvieS]

My son lost weight in the first three months on medication and We were able to turn it around. The first thing we changed was to have a huge breakfast. He is most hungry in the morning before meds so we give him as much food as he will eat and try to make sure there is plenty of protein. He often gets up and has a bowl of cereal and then eats whatever breakfast we have made.

He barely touches his lunch and I’ve nearly given up on it. They don’t get enough time to eat at school and the lunch room is so distracting. I’ve resorted to peanut m&ms just to get some calories in. Then I offer a snack when he gets home and then we have dinner but often he isn’t really hungry until the evening so sometimes he has second dinner before bed.

We switched to whole milk, whole yogurt and the highest calorie versions of foods I can find. (No the best option for my middle aged body that’s for sure!!)

calories are what put weight on so I’ve become a little more relaxed about types of food he eats and allow more desserts. Smoothies are our go-to meal supplement and I can usually sneak some spinach in there for more nutrients.

It has worked. We rarely take med vacations because he is so much happier on medication. That’s a good option for kids who tolerate it better though. Our son got back on track with his weight after that first three months and his percentiles have stayed in the same range as before the medication. Good luck! It’s hard with the appetite suppression.

[Onthemove1971 in reply to SylvieS]

I love your post! The other thing about lunch time especially in middle school is that this time is the only time to be social and bond, what kid wants to take the time to eat. I never eat lunch in middle or high school, I always came right home and had a "lunch". Which of course impacts dinner. But what we do is have a later dinner time ( becuase of work, homework and sports). I know they say don't eat a large meal before bed.. not a win win..

We also have power cookies, power waffles.. anywhere we can we try to bulk up on. Our son devours breakfast and love breakfast foods ( bacon, sausage and pancakes or waffles) and I usually have a smootie for him with peanut butter and bananas.

Hope this helps.

[Testarossa1975]

I understand how you might feel bad for giving your son a medication that slows your son's growth, but despite how you feel, it is clear that you want to do what is best for your son so don't let guilt win. Sometimes we need to make decisions that are not ideal, but are the ones we believe to have the best overall outcome.

Regarding the medication, how significantly impairing are your son's ADHD symptoms, and how much and in what ways does the medication help him with functioning? Would not having the medication result in problems for your son that would be worse than being short or smaller in size?

Regarding the stimulant's effect on growth, I recall reading that growth is slowed temporarily, but by adolescence, those treated with stimulants are back to their normal growth pattern. I looked for documentation on what I remember reading, but was unable to find it now. If I do, I will post it. I will also add that there are studies that do support the idea that stimulants may lead to a lower than expected adult height.

For my son, who at one point, before ever taking stimulant medication, was not even on the BMI chart for his age, weight gain is a significant concern. One thing I do is make him a protein shake that he can drink throughout the day at school. (Our school did not object since there is a medical reason). My son does tend to gain weight over the summer even though we don't really do a long medication holiday. (I think last summer he went 2 weeks without medication, so I could see how he was doing off of it.) My son also takes a medication called cyproheptadine that is supposed to increase hunger. I am not sure if it does this, but I know it does help with sleep as it causes drowsiness shortly after it has been ingested (he is able to take it before bedtime).

Finally, there are non-stimulant options, but they are 2nd and 3rd line treatments. They may help some, but they are not known to be as effective as stimulants. You could ask your doctor about whether this is something worth considering and you may be able to combine a non-stimulant with a lower dose of stimulant.

[erick1822 in reply to Testarossa1975]

Thank you so much for your reply, your reassuring words meant a lot to me ! As far as how impaired he is off the medication, I’m in the process of observing that now. He’s been on medication for a few years now, so I think part of me thought he had outgrown issues the medication was just helping. He does ok at home, running the neighborhood with friends when i medicated, but it near impossible to try to take places/get errands done with. Situations that require controlled behavior seem to somehow cause flare ups in his behavior! School would be a major struggle without it, and friendships are impacted by his energy/behavior being a little much for other children. I’m trying to decipher if certain foods are contributing to the flare ups. SO to answer your question, yes I do think the benefits of medication are needed. I am just wondering if we could learn skills to get him by on a lower dosage maybe , or possibly tweak diet to avoid it... but I know a lot of people cite dairy as a culprit and that’s what my dr recommended for weight gain! So many things to worry about !!

[Elijah1]

Here is a long term study that shows no change in growth rate in the long term.

ncbi.nlm.nih.gov/pubmed/251...

[anirush]

We have never done a medication holiday. My 14 year old grandson used to be on the short side. We have had to do medication adjustments as he's gotten older. Now that he reached puberty he has shot up and is close to 5' 11". I don't see any permanent stunting here. He is still on medication by the way.

His mother was on ritalin and other medications such as Anti-depressants as a child and teen. She is 5' 9".

[erick1822 in reply to anirush]

That’s great! Thank you for sharing!

[Reeeba1]

We hoped for a summer growth spurt when taking my son off last year. We didn’t get it. I think it’s different for each kid but I will say this - don’t blame yourself. First of all for all you know he would have been this exact same height with no meds. It could just be how he is growing. Secondly you made the best choice you could. If any of us felt that our kids would be fine without meds we would not medicate. I’m sure it was a choice you made after much deliberation. Hindsight is 20/20 as they say. Good luck. I am following this post to see if anyone has other thoughts.

[erick1822 in reply to Reeeba1]

Thank you so much for sharing your thoughts. They are the same things I try to remind myself, but sometimes the nagging voice at the back of my mind can get the better of me. I appreciated your points and agree

[SylvieS]

This is a website I found to be helpful with recommendations for high calorie/high protein foods for low appetite kids.

chw.org/medical-care/macc-f...

[erick1822 in reply to SylvieS]

Thank you this is a great resource! One thing I have been wondering in my past few days of no medication , is if dairy is affecting his behavior . Did you notice that at all? So many of the weight gaining ideas are based in dairy so I hope that’s not the case !

[SylvieS in reply to erick1822]

That’s a great question! I don’t know. My son is an incredibly picky eater and dairy is one of the few things he will eat. I don’t think it affects his mood but I can’t really test it out without starving him. He would literally rather starve than eat something he doesn’t want. I think if you have a child that will eat alternative proteins it would be interesting to try non dairy for a month and see if it makes a difference.