Is your child growing normally?

Height is health. Growth is an important indicator of child’s overall health and development. That’s why it is critical to know your child’s growth rate and what it should be, at any age.

A child’s growth is assessed by measuring his/her weight and height (for children >2 years)/length (for children <2 years). To know if your child is growing well, your paediatrician will check your child’s weight and height/length and plot the same on growth charts. Best way of assessing your child’s growth is to regularly record the parameters and keep a track of it in form of a growth chart.

What are Growth Charts?

A growth chart is a simple graph to monitor your child’s body parameters and to see if there are any diversions from normal ranges. It is maintained as a longitudinal record till 18 years of age. It helps the paediatrician in finding out if the child’s growth is falling within normal ranges for age and gender as per the population or not. Different graphs are available for girls and boys. These graphs are formulated taking into account the normal growth pattern of Indian children. Other countries have their own country specific growth charts as well.

Growth charts can also assess child’s weight for height for children under 5 years or body mass index (BMI) for older children. This gives an idea about the nutritional status of the child.

Why is it important to monitor growth?

Monitoring growth and plotting it on the growth charts can help to understand the child’s overall growth and development. If the child is growing parallel to the curve as seen on the growth chart that means the growth is within normal range. In case the child diverts from the curve, we may be able to pick up an organic cause of delayed growth earlier than any symptoms. In this way, any short stature can be picked up early and the cause can be treated. These charts also help us to know the genetic potential for height of the child based on parental heights.

How often should you record the growth parameters?

Children younger than 2 years should get their growth parameters, including head circumference recorded at every visit to the doctor, be it for routine vaccination or for childhood illness. In children older than 2 years, weight and heights should be recorded twice a year till 9 years of age and thereafter once a year.

Do boys and girls grow at different rates?

Boys and girls will be following similar trends till 10 years of age. During adolescence, both boys and girls gain height rapidly, but the growth spurt in girls appear earlier than boys. The growth spurt in boys tend to occur later and last longer than in girls and hence, boys end up being taller than girls in their final heights.

Weight gain also follows similar pattern in boys and girls. The majority of weight gain occurs during first 2 years of life and in adolescence when they also develop secondary sexual characters.

When should to worry about a child being short?

· Child seems shorter than his/her peers or not growing with a similar rate as them

· Child is not outgrowing his/her clothes

· Child is much shorter than his/her parents

What are the factors affecting height in a child?

The most important factor that determines a child’s height is his/her genetic potential, which depends on height of both parents. This factor is non-modifiable. Other factors affecting growth are environment, nutrition and hormones. The availability of conducive environment and nutrition is of utmost importance in order to achieve the child’s normal growth potential. A balanced diet, a good emotional environment with plenty of activities are responsible for adequate growth. Any underlying organic disease or disorder may also cause short stature in a child. There is no role of additional tonics/multivitamins in increasing height of a child.

How to evaluate short stature?

Your paediatrician will first confirm if your child is really short for his age, gender and genetic potential after plotting the parameters on the growth chart. Your doctor will first take a detailed history and do a clinical examination to ascertain the cause of growth failure. He/she will then prescribe routine blood investigations and X-ray for bone age to rule out any organic cause for short stature. In case your paediatrician feels that your child is short for his/her age then he/she might refer you to a paediatric endocrinologist (a doctor who treats in growth disorders). They may then do the next line of investigations including a growth hormone stimulation test. Based on the results, they will guide you towards suitable treatment options for your child.

Come, let’s evaluate your child’s growth!!!