Doctors and other health professionals in the United States began using growth charts in the late 1970s to track growth in infants and children. Over time, pediatricians began routinely sharing them with parents, a practice that probably grew from growing consumer activism, when many patients began insisting on getting more medical information and having a greater role in medical decision-making for themselves, and, in this case, their children.
There are issues that preoccupy parents, and one in particular includes asking the question, is my child growing normally? When the percentiles on the growth chart seem off, parents worry, but experts say there’s rarely reason for concern. For starters, healthy kids come in a wide range of shapes and sizes, and they don’t grow at a steady rate, either. Your child can look very different from your friends’ kids, or from his own siblings at the same age, and still be completely normal.
Your child’s growth chart can give you a general picture of how they are developing physically. By comparing their measurements – weight, length, and head circumference to those of other children of the same age and sex, and to these same measurements from previous checkups, your child’s doctor can determine whether they are growing in a healthy way.
What Growth Charts Do Tell Us:
The growth percentiles by themselves don’t say much. What really matters is the rate of growth shown on the growth chart:
· A normal rate of growth means the child’s growth points closely follow a percentile line on the chart.
· We usually don’t worry about insufficient (or excessive) growth until a child’s growth rate has crossed at least two percentile lines (e.g., from above the 90th percentile to below the 50th).
· If a child’s weight, height, or head size is below the 5th percentile, it’s important to see if their growth points have always paralleled the 5th percentile line, which would mean their growth rate is normal, or if they are suddenly falling further behind, which may be more concerning.
To see if your child is too skinny or overweight, there is a “weight for height” chart or a “BMI” index. These new charts track body mass index, which helps pediatricians know when a child is at risk of obesity. These charts also can tell if your child’s weight is close to what it should be, given her height.
What Growth Charts Do Not Tell Us:
Growth charts can say a lot about your child’s growth, but it is important to ask questions, especially if you do not see the statistics that you believe should be there.
At birth: A baby’s size when they are born is based partly on genetics. Firstborns tend to be smaller than subsequent children because the uterus is smaller and tighter in first-time moms. Boys are larger than girls, and multiples, boys and girls, are smaller than average. Some environmental factors that can influence a newborn’s size:
· The mother’s weight: very heavy women tend to have larger babies
· Weight gain during pregnancy: a very low gain (under ten pounds) usually means a smaller baby
· Whether or not the mother smokes or drinks a lot of caffeine, both of which can limit an unborn baby’s growth
· A mom’s chronic illness: those with diabetes, for instance, often have very larger babies.
During the first two years: A baby’s growth is based on a combination of their birth size and the size they are genetically programmed to be. A small newborn who’s going to be a big child will grow faster in the first two years than a big baby who’s going to be a small child.
During childhood: Both weight gain and increases in height come in short bursts of what can seem like rapid growth, which is why kids can sometimes look almost chubby one month but lean the next. The duration of a growth spurt, as well as how much a child grows during one, differs from child to child (and from spurt to spurt in the same child). However, it is not uncommon to see a visible difference in a very short time.
No one knows what causes a kid to have such a growth spurt one month and not in another, but there does seem to be a seasonal pattern. Although there is not really a good explanation for it, research has shown that children seem to grow fastest in the summer and slowest in the fall.
Doctors do know what triggers growth in the first place. It is called human growth hormone, a chemical produced in bursts throughout the day but released largely during sleep. That’s why it’s important for kids to get the sleep that they need throughout childhood and adolescence.
During puberty: After infancy, the tween and teen years are the period of most rapid change. For girls, the growth spurt begins between 10 and 11 and lasts until around age 15; for boys, it starts about two years later and lasts until age 17 or so. Girls typically stop growing about three years after they’ve had their first period, but boys continue to grow throughout their teens.
Don’t Focus Too Much on the Numbers:
Parents often say, “What percent is my child at?” Don’t focus too much on the number. Have your pediatrician help you understand what the trends are for your child’s growth.
If you have a challenge understanding how your child is growing or how the growth chart is presented, don’t be afraid to ask for clarification and explanation.