A healthy living blog from Marshfield Clinic

Your child’s growth chart: Can it signal health concerns?

Nurse measuring a baby's foot - What do growth charts mean?

Lower percentile for height on a growth chart might be a hormonal condition, or nothing of concern.

Your child’s pediatrician may give you a growth chart that explains how your child compares physically to other children his age.

When a child is in a lower percentile, providers and parents may become concerned with good reason.

“Growing is one of the most important things a child needs to do. If they’re not growing, it can signal a significant health concern,” said Dr. David Holz, a Marshfield Clinic pediatrician.

Components of a growth chart

According to Centers for Disease Control and Prevention (CDC), providers have used growth charts dating back to 1977.

Many factors go into the creation of a growth chart, Holz said. Genetic components, calories in, calories out and general metabolism are a few of those factors.

Generally, health care providers use World Health Organization (WHO) growth standards for infants and children ages 0 to 2 years and CDC growth charts for children ages 2 years and up.

Children in lower percentiles

A growth chart is not used alone to diagnose medical conditions. “Instead, growth charts are tools that contribute to forming an overall clinical impression for the child being measured,” as stated by the CDC.

Children in a low percentile for weight signal providers to ask questions about a child’s environment and habits:

  • Does the family have access to food?
  • If so, does the child have difficulty swallowing or processing food?
  • What is the child’s metabolism like?

These questions can help a provider and parent understand whether the growth is related to environment and habits, or if there may be an underlying medical condition.

Low percentile for height might be a hormonal condition, or nothing of concern.

Children in higher percentiles

High percentiles may be less worrisome.

“Gaining more weight than appropriate is almost always a caloric imbalance, taking in more calories than burning, and often can be adjusted with diet recommendations and activity changes,” Holz said.

Height is more difficult to dissect.

“Our growth charts do not predict at what age a child stops growing, so charts do not always correlate with how tall or heavy a child will be later in life,” Holz said.

Ask questions

Pediatricians don’t want parents leaving the doctor’s office confused, reminds Holz.

Ask your child’s provider about growth charts at your next appointment if you have any questions or concerns.

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