1. Aggressive Feeding and Diet Management
The main treatment for Russell-Silver syndrome is aggressive feeding. Making sure your child gets the necessary calories every day is crucial. Your child desperately needs calories to catch up in growth and gain weight. It is always recommended to work with a gastroenterologist or nutritionist to create and manage a healthy diet that is high in calories. In some cases, an antihistamine called periactin is used to stimulate appetite.
Additionally, you should diligently monitor your child's glucose level to prevent hypoglycemia. Frequent meals--day and night--are usually required to prevent blood sugar levels from falling to dangerously low levels. If your child does not experience significant weight gain or hypoglycemia is uncontrolled, a gastrostomy feeding tube may be needed. If so, you will need to learn how to use, clean and maintain the tube or hire home-health services for follow up.
2. Human Growth Hormone Regimen
If your child has not been able to show an inclination for catch-up growth by 2 years of age, growth hormone therapy becomes an option. Daily injections of human growth hormone are given. In some cases, this therapy can cause growth to catch up to a normal height range by the first grade. While long-term effects of human growth hormone on adult height have yet to be fully determined, continuing the growth hormone regimen through teenage years may eliminate your child's height discrepancy in adulthood.
3. Treatment Options for Limb-Length Differences
Hemihypotrophy, or the undergrowth of one side of the body, is a common symptom of RSS. This causes the limbs on one side of your child's body to be shorter than the limbs on the other side. Leg-length differences can cause problems with posture and walking. In mild cases, this can be easily treated with a lift in the shoe of the shorter leg. When the difference is more pronounced, limb-lengthening surgery can be considered when your child's growth has stopped in the teenage years. In limb-lengthening surgery, the leg bones are broken and an external extender is fixed to the bones. Gradually the extender is lengthened and new bone grows between the break. This can be a long and painful process for your child, but the results are typically good.
4. Physical and Psychological Therapy
In the early years of Russell-Silver syndrome, some physical and occupational therapy may be needed to help your child bridge developmental delays. These delays are caused by your child's small size and underdeveloped musculature. Therapy for learning disabilities may also help. Additionally, children who do not develop in the same way as their peers often need some psychological counseling to help them with feelings of low self-esteem. As your child catches up in growth, his self-image may also improve, however.
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