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JAMA Pediatrics Patient Page
June 2018

# Growth and Growth Charts in Children

JAMA Pediatr. 2018;172(6):604. doi:10.1001/jamapediatrics.2018.0601

Growth is a result of your child’s genetics, environment, and culture.

When your children come to a well-child check, their pediatrician will measure their height and weight at each visit and head circumference when they are 3 years and younger. Not only can it be fun to see how much they have grown between visits, but these measurements also provide important information about their health and development. Growth charts can be on paper or in an electronic medical record. These charts are standardized graphs that use information from a larger population to show how your child compares with other children of the same age and sex. Pediatricians are interested in the “percentile” in which your child falls, as well as if your child is tracking along the same percentile over time. For example, if your child is on the 50% percentile, it means that on average, 50% of children of the same age and sex are bigger than your child and 50% are smaller.

Weight and Height, Which Together Make Body Mass Index

• Children grow at different rates. As an infant, they may gain an ounce (30 g) a day. Teenagers usually have a growth spurt in which they can grow up to 4 inches in a year. All of this can be normal.

• Children who have medical illnesses, undereat, or have chronic stress often have trouble gaining or maintaining weight or growing taller. Pediatricians use weight loss, inadequate weight gain, or slowed growth as early sign of a problem.

• In contrast, children who gain more weight than expected could have a medical problem or be at risk for lifelong overweight or obesity.

• Parents sometimes have questions about feeding their child and appropriate growth. Ask your child’s pediatrician if their growth is on track.

• Children grow in bits and spurts, not smoothly as the growth charts appear, so differences usually are normal.

• Pediatricians calculate body mass index (BMI) from a child’s weight in kilograms divided by height in meters squared. For children and teenagers, this calculation is standardized based on their age and sex.

• Up to age 3 years, your health care professional will measure your child’s head circumference and plot it on a growth chart.

• While less common, inadequate or excessive head growth may represent a medical problem that a pediatrician can address.