Every parent wants their children to realize their full potential. One of the most obvious signs of growth: the height chart on their bedroom wall that captures snapshots of every phase, from curious toddler to high schooler on the go. But those growth trajectories offer more than just sweet memories. They can reveal important clues about your child’s health.

Missing critical growth milestones can be a sign of an underlying issue. In some cases, the answer lies in a hormone produced deep inside the brain. Synthetic growth hormone therapy mimics the body’s natural version, spurring growth throughout the body—particularly in the bones. And its use among children has tripled over the past two decades.

"When appropriate, growth hormones can improve height potential and body mass, and often normalize the speed of growth," said Bahareh Schweiger, DO, director of pediatric endocrinology at Cedars-Sinai Guerin Children’s.

Human growth hormone therapy (hGH) delivers somatotropin, a protein hormone, through daily or weekly injections. These “pens,” which are only available by prescription, replace human growth hormone in children whose bodies don’t produce enough.

Low hGH can result from issues in the pituitary or hypothalamus, small glands in the brain that regulate hormone production. Causes may include brain tumors, genetic conditions (such as Turner, Noonan, Prader-Willi, or Russell-Silver syndromes), or previous surgery or radiation. In other rare cases, children may have enough hGH but can’t properly use it, as in Laron syndrome.

Depending on the cause, pediatric growth hormone therapy can help children "catch up" in height, especially during puberty when growth typically ramps up. Therapy works best when it’s initiated early in the growth process, and research shows kids can grow 3 inches more compared to peers who don’t take the therapy. In fact, the Endocrine Society suggests the growth spurt could be as much as 4 inches in one year among hormone-deficient children.

In addition to a boost in height, hGH supports healthy metabolism, stabilizing blood sugar in younger kids, and promotes development of the brain, liver, teeth and hair.

"Our focus is on making sure children are growing in a healthy way," Schweiger stressed.

Read: The Growing Pains of Puberty

Annual well-child visits are your best opportunity to get your pediatrician’s assessment of your child’s height and weight to make sure they’re progressing appropriately.

“Bring your concerns to your doctor,” Schweiger encourages, “so you can work together to determine if your child is following your family’s typical pattern or if they have any underlying health issues.”

Before puberty, your son or daughter should grow about 1.5 to 2 inches between annual visits. Then the pace quickens: 4 to 6 inches per year for boys, and 3 to 5 inches for girls. If growth suddenly slows—or doesn’t ramp up during puberty—your doctor may refer you to a pediatric endocrinologist.

Specialists can run tests to pinpoint the issue, such as:

• Growth hormone stimulation, to assess how much hormone the pituitary gland secretes
• Blood tests, to check hormones and antibodies
• Bone age scans, using X-rays of the hand and wrist to assess development
• MRIs and CT scans, to spot structural issues in the brain

Your doctor will also rule out other issues that can stunt growth, such as thyroid, celiac and kidney diseases. Some kids, though, have persistent growth failure without a clear cause.

For those with no obvious cause nor family history of very short stature (typically defined as less than 5’3” for adult men and under 5 feet for women), hGH may still be an option, Schweiger explained.

Growth hormone therapy isn’t a one-size-fits-all solution, and it’s only plausible before your child’s bones have set and fused together, usually during adolescence.

Because the hormone affects multiple bodily systems, it can come with significant risks. In rare cases, hGH has been linked to diabetes, certain cancers and "pseudotumor cerebri syndrome," which builds pressure in the brain and triggers intense, frequent headaches and changes in vision.

There’s also an increased risk of scoliosis and other orthopedic issues as bones grow quickly. However, pediatricians note this may have more to do with rapid growth itself than the hormone therapy.

Teen athletes may take the drug to gain a competitive edge or score more baskets: Around 11% of high schoolers have used it nonmedically, according to the American Academy of Pediatrics, either to try to boost sports performance or feel better about how they look. But doctors warn against unsupervised hormone use, or even unregulated supplements, which could be dangerous.

A better approach: Focus on nutrition, said Cedars-Sinai Guerin Children’s pediatrician Sarah Mahmood, MD, alongside strengthening bones and muscles with 8 hours of sleep and weight-bearing exercise. Ensuring your child eats enough and well—mixing in calcium, vitamin D, zinc and plenty of fruits and vegetables—will naturally support their healthy growth and development.

Being shorter than classmates can be tough when kids are often desperate to fit in. But short stature doesn’t mean poor health—and it doesn’t diminish who they are.

"It's important to help children realize that everyone’s moving at a different speed," Mahmood said, "and we all come in different shapes and sizes.”

Instead of height, experts suggest concentrating on cultivating your child’s self-esteem. Your child might also benefit from a support group or therapy, where they can share their feelings freely without fear or judgment.

"We want to appreciate our children for the height they are, rather than pushing anyone to be taller than they were meant to be," Schweiger emphasized. "If they’re growing normally, even if they’re on the smaller side, then we support them on their height journey."

 Read: Promoting a Positive Body Image in Children