Instructions for using hormone injection pen for children with growth retardation

The article is professionally consulted with Master, Doctor Nguyen Minh Tuan - Pediatrician - Pediatrics - Neonatology - Vinmec Danang International General Hospital

Using growth hormone injection pen is a home treatment for children with growth hormone deficiency that parents can do. By subcutaneous injection of recombinant growth hormone according to the instructions for use with the dose calculated by the pediatric endocrinologist so that the child still has the opportunity to grow up like his peers.

Growth hormone is a protein hormone made by the pituitary gland to help children grow. In children who have been identified with growth retardation, after being examined and tested by a pediatric endocrinologist and indicated to use growth hormone at a specific dose decided by the doctor, parents will be consulted. and training on how to inject recombinant growth hormone once a day at home. “Recombinant” means that this growth hormone is made in a laboratory to be similar to human growth hormone. As a result, growth hormone injection therapy needs to be maintained until the growth process is complete, often many years, to help the child mature in the most comprehensive, natural and safest way. It is important to note that children need to be periodically examined by a pediatric endocrinologist so that the dose of injectable drugs can be adjusted appropriately as prescribed by the doctor.
Indications used to treat with growth hormone pens include:
Children with growth retardation due to low or no growth hormone levels. Children are short and have Noonan syndrome, Turner syndrome, or are born small for their gestational age and do not catch up with their growth at 2 to 4 years of age. Children with idiopathic dwarfism. Non-adult children with Prader-Willi syndrome.

Parents need to read the detailed instructions for use that come with the growth hormone injection pen before making it on their own at home.
Preparations of growth hormone injectors are available in different dosages. The pediatric endocrinologist will prescribe the appropriate dosage for the child's medical condition. At the same time, the doctor will inject the child's body so that the parents can observe and monitor the practice before parents can self-inject the child at home.
Always observe the properties of the drug with the naked eye in the injection pen before injecting. Do not inject if the drug is not homogeneous such as precipitation, lumps or layering.
Growth hormone injection pen is used by subcutaneous injection. The injection site can be selected as the back of the upper arm, abdomen, buttocks or thighs. At the same time, it is necessary to regularly rotate injection sites to avoid fat tissue atrophy.
To avoid the injection causing pain for the child during the first injections, a local anesthetic procedure can be applied by applying ice or applying a local anesthetic cream or gel.
Remember that a growth hormone injection pen is for personal use only. Never share pens and needles with others, even if the needles have been changed, to avoid the risk of infection.

Before using the growth hormone injection pen for the first time:
Store the new, unused growth hormone pen in the refrigerator between 2 degrees Celsius and 8 degrees Celsius but do not freeze. Keep the growth hormone injection pen away from direct light. Do not use growth hormone pens that have been frozen or at temperatures warmer than 25°C or after the expiration date printed on the box and pen. After each use of the growth hormone pen, it is necessary to:
Store the remaining growth hormone pen in the refrigerator between 2 degrees Celsius and 8 degrees Celsius and use it within 4 weeks, or Store the remaining growth hormone pen in the refrigerator. Store at room temperature no more than 25°C and use within 3 weeks. Always be careful to keep growth hormone pens and other medications out of the reach of children.

Growth hormone injections are a daily routine and continue into adulthood. Therefore, as children get older, the time will come when they are ready to treat themselves.
This is a really positive step and allows the child to become more independent and also feel more in control of his or her situation. The following guidelines can help parents introduce their child to growth hormone self-administration :
Involvement: When your child is ready, give the child the responsibility of managing his or her own growth hormone use - get a growth hormone pens from the fridge, prepare doses, come up with a child's own timetable so he can do most of those tasks independently. Talk: Always talk to your child's follow-up doctor before making the decision to allow your child to self-administer growth hormone at home. Teach: Talk to the child about the technique to use and any tips parents have learned to make the injection less painful. Practice: Use a firm fruit such as oranges or plums with a spare needle device from your doctor. Practicing this way will give your child more confidence before the first injection. Technique: Teach your child where is the best place to inject themselves - it could be the thighs and belly, as there's more fat and fewer nerve endings. At the same time, it is necessary to remind children of the importance of rotating injection sites daily. Local anesthetic: Teach your child how to numb the area before the injection by using ice cubes or a local anesthetic cream or gel. Community involvement: Learn about and provide opportunities for children to participate in workshops with other children who are also receiving growth hormone injections. This will allow them to ask questions and get support from their peers. Teach your child relaxation techniques: These techniques will help reduce stress and any potential needle phobia, like guided breathing and muscle relaxation exercises.

Only when parents feel that the child is cognitively mature and ready to start learning how to inject themselves, remember:
Advise your child to give injections when the body is supported, such as sitting or lying down with a pillow below the injection site. Encourage and motivate the child during the first and several subsequent self-injections. Praise your child for his technique and ability to inject himself. Ask frequently about how your child feels about how his or her body is going. Sometimes a child's first shots may not go as smoothly as expected. Therefore, make sure that parents are always available to help children when needed. If there is a problem, parents should try to discuss with the child to identify and make suggestions, making the next injections more convenient. Parents need to always try to be patient and understanding in order to give their children the absolute confidence they need.
In case the child is not able to learn how to inject himself, consider what could be the cause and what the cause might be. This issue should be discussed between the parent and the child or even with the pediatric endocrinologist. As children are growing up to be more confident and responsible for their own health day by day, using growth hormone pens is the basic challenge they need to overcome.
In summary, the growth hormone injector pen is the basic modality in the treatment and monitoring of growth hormone deficiency in young children. When parents do it right under the guidance of an endocrinologist, the child will return to a normal growth curve to achieve the desired height as well as minimize the potential side effects.

Note: This article is part of the Vinmec International General Hospital System's Awareness Program on Growth Retardation, with the support of Novo Nordisk

References: gosh.nhs.uk, growingup.net, medicalnewstoday.com