Kids come in all shapes and sizes: big, small, tall, short. Genetics, gender, nutrition, physical activity, health problems, environment and hormones all influence a child’s height and weight.
So how does a doctor figure out whether a child’s height and weight measurements are “normal?” Whether a child is developing on track? Whether any health problems are affecting growth?
Pediatricians use growth charts to help answer these questions.
“One of the most important measures of overall health is measuring height and weight to make sure children are growing appropriately,” said Dr. Bradley Van Sickle, a pediatric endocrinologist at Akron Children’s Hospital. “I think one of the most important things parents can do is make sure their kids get regular checkups to get good reliable measures so any changes in growth patterns can be evident and addressed.”
One set of growth charts is used for babies, from birth to 24 months, and measures weight, length and head circumference. Another set is used for kids ages 2 to 20 years old and measures height, weight and body mass index. Girls and boys are measured on different growth charts because they grow in different patterns and at different rates.
Families can view and print their child’s growth charts anytime, anywhere using MyChart. Simply log into MyChart and under “My Medical Record,” click Growth Charts to easily track and monitor your child’s growth.
Here, Dr. Van Sickle answers 5 common questions about the long and short of growth charts.
Why do pediatricians use growth charts?
Growth charts are a standard part of any checkup, and they show pediatricians how kids are growing compared with other kids of the same age and gender. They also allow pediatricians to see the pattern of kids’ height and weight gain over time, and whether they’re developing proportionately.
“Once you get out of those first few years of life, kids who’ve been growing fairly steadily at a good percentile and all of a sudden slow down in their growth, that’s definitely concerning and could indicate a health problem,” said Dr. Van Sickle.
Does a different pattern indicate a health problem?
Not necessarily, he said. A pediatrician will interpret the growth charts in the context of a child’s overall well-being, environment and genetic background.
Is the child meeting other developmental milestones? How tall or heavy are the child’s parents and siblings? Was the child born prematurely? Has the child started puberty earlier or later than average? These are all factors that a pediatrician will use to help understand the numbers on the growth chart.
“We grow as long as our bones have the ability to grow, and in children, the growth plates don’t fuse until the end of puberty,” said Dr. Van Sickle. “We may get a boy who is late in his puberty and his growth will be delayed from his chronological age. There’s nothing wrong with that as long as his bone age delay matches his body’s maturation and development. He’s just considered a late bloomer.”
What do the percentiles mean?
On the growth charts, percentiles are shown as lines drawn in curved patterns. 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, comparatively.
For example, if a 4-year-old boy’s weight is in the 10th percentile, that means that 10% of boys his age weigh less than he does and 90% of 4-year-old boys weigh more.
Being in a high or low percentile does not necessarily mean that a child is healthier or has a growth or weight problem. Let’s say that 4-year-old boy, who is in the 10th percentile for weight, is also in the 10th percentile for height. That just means that he’s smaller than his peers. If his parents and siblings are also smaller than their peers, and there are other signs that he’s healthy and developing well, doctors would likely conclude that there’s no cause for concern.
What’s the ideal percentile for my child?
There is not an ideal number, said Dr. Van Sickle. Healthy children come in all shapes and sizes, and a baby who is in the 5th percentile can be just as healthy as a baby who is in the 95th percentile.
“Ideally, each child will follow along the same growth pattern over time, growing in height and gaining weight at the same rate,” he said. “Usually a child stays on a certain percentile line on the growth curve.”
What could signal a problem?
“Changes in growth patterns could indicate growth disorders, such as a growth hormone deficiency or thyroid disorders,” said Dr. Van Sickle. “They could also indicate other disorders that can affect a child’s growth, including celiac or Crohn’s disease.”
A few 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 5 years old, then the height has dropped to the 30th percentile at age 6, that might indicate that there’s a growth problem.
- When kids don’t get taller at the same rate at which they’re gaining weight. Let’s say a boy’s height is in the 40th percentile and his weight is in the 85th percentile. That might be a problem. On the other hand, if he’s in the 85th percentile for height and weight and follows that pattern consistently over time, that usually means that he’s a normal child who’s just larger than average.
Sign up for MyChart at mychart.akronchildrens.org to track and monitor your child’s growth patterns.