Growth Charts

Look at any class picture and you’ll see kids of the same age in all shapes and sizes. Some kids look small next to their peers, while others literally stand head and shoulders above their classmates. Kids grow at their own pace. Big, small, tall, short — there is a wide range of healthy shapes and sizes among children.

A child’s height and weight can be influenced by genetics, gender, nutrition, physical activity, health problems, environment and hormones. No two children’s growth is exactly the same.

So how do you and your doctor know whether a child’s height and weight measurements are “normal”? If he or she is developing on track? Or if any health issues are affecting the child’s growth?

A doctor uses growth charts to help answer these questions.

“Growth charts are a standard part of any checkup, and they show doctors and nurses how kids are growing compared with other kids of the same age and gender,” says James Ebert, MD, lead physician for the lipid clinic at Dayton Children’s. “Growth charts also allow health care providers to see the pattern of kids’ height and weight gain over time, and whether they’re developing proportionately.”

What are percentiles?

Percentiles are measurements that show where a child is compared with others. On the growth charts, the percentiles are shown as lines drawn in curved patterns.

When doctors plot a child’s weight and height on the chart, they see which percentile line those measurements land on. The higher the percentile number, the bigger a child is compared with other kids of the same age and gender, whether it’s for height or weight; the lower the percentile number, the smaller the child is. For example, if a 4-year-old boy’s weight is in the 10th percentile that means that 10 percent of boys that age weigh less than he does and 90 percent of 4-year-old boys weigh more.

What’s the ideal percentile for my child?

There is no one ideal number but it’s important to determine with your doctor what is a healthy weight and height for your child.

“Ideally, each child will follow along the same growth pattern over time, growing in height and gaining weight at the same rate, with the height and weight in proportion to one another,” says Ebert. “This means that usually a child stays on a certain percentile line on the growth curve. So if our 4-year-old boy on the 10th percentile line has always been on that line, he is continuing to grow along his pattern, which is a good sign.”

What could signal a problem?

A couple different growth chart patterns might signal a health problem, such as:

• When a child’s weight or height percentile changes from a certain pattern it’s been following. For example: If height and weight consistently are on the 60th percentile line until a child is 4 years old, then the height drops to the 30th percentile at age 5, that might indicate that there’s a growth problem because the child is not following his or her previous growth pattern. While this can be a cause for concern, there are points in development, such as during infancy and puberty, when it’s normal for children’s growth rates to vary.

• When kids don’t get taller at the same rate at which they’re gaining weight. For example: Let’s say a girl’s height is in the 40th percentile and her weight is in the 85th percentile. (So she’s taller than 40 percent of kids her age, but weighs more than 85 percent of kids her age.) That is a problem the doctor may want to address.

It’s important to get regular check-ups for your child and if you have any questions about your child’s growth – or growth charts – talk with your doctor.

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