One in 3,800 children born suffers from growth hormone deficiency, according to the Child Growth Foundation, and some may require hormone injections to reach their potential height. Children with short stature make up one- third of all children receiving growth hormone therapy in the U.S., according to a 1999 article published in the New England Journal of Medicine. Twice as many boys as girls are treated with growth hormone for short stature, according to a recent study published in the Journal of Clinical Endocrinology and Metabolism.
"The injections only get them around the height they would be had they not had a lack of the hormone," said Zanga.
According to Dr. Richard Levy, pediatric endocrinologist at Rush Presbyterian Hospital in Chicago, children will grow an average of 2.5 inches when on hormone therapy for about 10 years. However, the length of time a child is placed on hormone therapy depends on bone- age evaluation, or an x-ray of hands and wrists to see how much more he or she is able to grow, he said.
While growth hormone injection is generally safe, using the hormone may unmask a thyroid deficiency in some children once they stop therapy, he said.
"About 20 percent who were not before on thyroid medication end up on thyroid medication after they stop growth hormone," said Levy.
But not all children who feel shorter than their peers would benefit from growth hormones. For boys like Daniel, who may feel disadvantaged because of their short stature, Zanga said family encouragement may be a better treatment option.
"Sometimes the way to treat it is to redirect the family's way of thinking so the child will understand that he can do other things that will make them feel successful," said Zanga.
Parents should help their child understand that height should not be a defining factor in success, according to Besser.
"See what are their strengths and what is it that they excel at," said Besser. "What is it that they get excited about and helping them define themselves through their quality their characteristics."
Contrary to popular belief, many studies suggest that height is not related to success in life and does not have a lasting impact on self-esteem.
"If you're a jockey you'd rather be short stature, and if you're a basketball player you'd rather be tall," he said. "So depending on what you see as success, you may find yourself on the losing end."
While anecdotal evidence may suggest that size matters, others more likely rely on talent and ability to get the job done, said Zanga.
According to Zanga, in the business world, many people may see those who look taller as those who have a higher confidence level. But conflicting research shows that's hard to prove.
Although some call him short, but that's not the words Daniel uses to describe himself.
"Determined, opposite of shy, charismatic, hardworking," he said.
Daniel said it took a lot for him to rebuild his confidence after being bullied.
"It's something you have to work through if you're a short person," he said. "It tore me down a few times."
Today Daniel attends Democracy Prep Charter School in Harlem where he said he has outgrown feeling held back by this height.
"You only have one life and one person to live with, which is yourself," he said. "It's something you got to learn how to do."