Cut out the panic! Know what to expect, at what age

It is important to know that each child is different and will follow its own unique growth pattern. Infact there is a wide range of ‘normal’ growth patterns! Know more… 
 

Why is it different for each child?

Dr Mathur: There are many things that affect how your child grows – state of nutrition, general health, level of physical activity, parents/family pattern and so on. Hence it is unfair to make direct comparisons and worry about them.  
 

How do we check for growth?

Dr Mathur: At each clinic visit, a child’s weight and height should be checked. For older children, the height should be checked at least yearly, weight once in 6 months or sooner if concerns. These measurements are then plotted by your doctor on a growth chart. 
 

Here is what you can expect from 3-9 years:  

3-5 years: Expected weight gain is 2 kg with a 7 cm gain in height per year. Children tend to lose baby fat from the face during these years and limbs get longer. By 4 years of age, an average child would weigh 40 pounds (18 kgs) and be about 40 inches tall (100 cm).   
 

5-7 years: Expected weight gain is similar 2 kg per year with a 6 cm gain in height 
 

7-9 years: Expected weight gain is 2 kg per year and 5 cm gain in height. A rate of growth less than 4 cm in a year would require evaluation 
 

Up until 8-9 years of age there is not much difference in the rate of growth between boys and girls. Some girls may enter puberty by 9 years of age and begin a growth spurt, which will make them taller than boys of the same age.   
 

 What is a growth chart?
 

Dr Mathur: Growth charts are the best way to see how your child is growing. They are a visual track of the child’s rate of growth. It is a graph with curved lines that represent normal growth patterns for children at different ages.  There are graphs for weight, height and also BMI (body mass index - helpful to determine obesity). Growth charts are usually attached to the vaccination booklet and are different for boys/girls and for younger/ older children. The charts commonly used are the WHO charts for children under 5years of age or the CDC charts for older children.  
 

How do I know that my child is growing well?
 

Dr Mathur: If your child is growing well, his weight and height measurements will track along lines that are close to the middle curve (50th centile) on the growth chart. Contrary to popular perception, this middle green line only indicates the average and not the ‘ideal’ weight or height…so one should not get too hung up on that as the goal. Infact many healthy children grow around the outermost lines on their chart! On an average, 3-6 year olds tend to grow 6-7 cm a year in height which then slows down to about 5 cm a year until puberty.  
 

What is not normal?
 

Dr Mathur: Weight or height measurements that are well outside the lines (both top and bottom) need to be monitored. Having said that, if their rate of growth is steady, this may well be normal for them. For example, babies that are born with a very low birth weight often grow below and parallel to the lowest curve. More importantly, a growth record that crosses 2 centile lines up or down over time requires a careful review. Such deviations may occur with poor feeding seen in prolonged illnesses, poor absorption of food as in coeliac disease, or hormonal problems like low thyroid levels that affect growth. 

Significant disproportion between height and weight is also important to note and can point to specific problems. On the BMI chart, readings above 85th centile are used to define overweight children and above 95th centile are termed obese. 

The most common pattern seen is the slowing of weight gain due to poor oral intake during illnesses, weaning etc. These tend to be temporary and the height remains unaffected unless there has been a prolonged period of starvation.   
 

Key pointers:  

• A child’s growth is affected by several factors including diet and family pattern
• Growth in children is best monitored by marking their weight and height on a growth chart on a regular basis
• Growth charts are a good and easy way to assess health too. It picks up problems that would need sorting out early, as growth is limited after puberty.
• Measurements over a period of time are more useful than a one off record
• It is normal to be growing along the top or bottom centiles as long as the weight and height are proportionate and the child is healthy and active.    

Disclaimer: The views, opinions and recommendations expressed in this article are solely those of the author and intended as an educational aid. This is an awareness drive powered by Horlicks Growth Plus to help your child catch up on lost growth. Horlicks Growth plus is clinically proven to show visible signs of growth in six months. You are encouraged to obtain professional advice concerning specific health / medical matters