How to Ensure Your Child is Growing & Thriving with Growth Charts
By Kerry Jones, MPH, RDN, LDN
Nothing gives parents more anxiety at healthcare appointments than growth charts. For many parents, their child’s position on the growth chart is comparative to a grade on a test. So when they hear, “your child is below the 50th percentile” or “your child is falling off the chart,” they start to question not only the health and well-being of their child, but also whether or not they have failed as a parent. However, in reality, there may be nothing to worry about at all.
Understanding Growth Charts
Growth charts were first developed in 1977 as a way to help health professionals determine if children were growing adequately. However, these charts have been updated over the years to make them more representative of all ethnicities, races, feeding styles, and socioeconomic statuses, since the original CDC growth charts were based on white, formula-fed infants.(1)
Today, growth charts are still frequently used by pediatricians and pediatric health professionals to make sure children are gaining weight, height, and head size appropriately. While growth charts can be helpful tools for health professionals, they are frequently misinterpreted by parents and caregivers with up to 77% of parents incorrectly interpreting children’s growth charts.(2)
While the specific percentile can provide some information, it is more important to pay attention to the growth trend over time. This is because it is more important for your child to follow their own curve than be at the 50th percentile.
How to Ensure Your Child is Growing Properly
All growth charts have percentiles that allow health professionals to determine how your child compares to other children their age and gender. For example, if your daughter is in the 75th percentile for height then she is taller than 75% of other girls her age.
While the specific percentile can provide some information, it is more important to pay attention to the growth trend over time. This is because it is more important for your child to follow their own curve than be at the 50th percentile. Just like adults have natural variations in height and weight, it is normal for children to be different sizes as well. In fact, only 1% of children will naturally fall on the 50th percentile, but this does not mean these children necessarily have any advantages over other children academically or developmentally.
It is also important to note that it is normal for children to cross percentile lines, especially in infancy.3-4 In fact, research has found that between 30-64% of children will cross at least 1 percentile line on their growth curve before 2 years of age.(3-4) This is likely because children are moving to the growth percentile where they are naturally or genetically supposed to be.
When determining if your child is growing properly, remember that the most important thing is for your child to be following their curve. If your child is naturally on the 5th percentile or on the 85th percentile, then that is perfectly fine! Growth charts are just averages, they are not specific to your child. Therefore, it is typically best to allow your child to find their place on the chart and follow their own curve.
How to Respond If Your Child is Having Problems with Growth & Development
If your child’s pediatrician does have concerns about their growth chart trends, then it is important to consider what could be contributing to this change in growth. There are many factors that can impact growth and development, including underlying medical concerns, trauma or loss, environment, or nutrition – to name a few.
Here are five ways that may help your child get back to their growth curve:
- Discourage grazing. It is well-known that kids love snacks! However, when children are eating too many snacks throughout the day, it can start to displace calories and nutrients from meals. This can put children at risk for weight concerns. Instead of allowing your child to graze on snacks, set-up a meal and snack routine and offer only water in-between meals and snacks for children older than 1 year old.
- Allow children to be in-charge of how much food they eat at meals. Infants and children are the only ones that know how hungry they are, so it is important to allow them to be solely in-charge of how much food they eat at meals. Trust your child to follow their hunger and satiety cues to eat the amount of food that they need.
- Serve balanced meals & snacks. Make sure that meals and snacks are balanced and varied, so that children can get all of the nutrients they need throughout the day. Meals should have a protein, whole grain, and fruit and/or vegetable and snacks should have a protein paired with either a whole grain, fruit, or vegetable.
- Encourage activity. It is important for everyone to be active and move their body. Try starting a new activity routine as a family, such as walking after meals, going to the local playground, or having a dance party in the kitchen.
- Seek professional help. If your child is having trouble with intake, whether that is infants having latch issues, toddlers avoiding several food groups, or children having trouble eating enough due to medications, talk to your child’s pediatrician about who would be best to help them. Likewise, if your children’s growth issues may be related to underlying medical concerns or medication side effects, talk to your child’s pediatrician about the next steps to help your child grow and thrive.
If you are worried that your child is having issues growing and thriving, book a free discovery call today to get a second opinion and determine if your child would benefit from nutrition counseling.
References:
- CDC Growth Charts: United States. Centers for Disease Control and Prevention. Reviewed August 4, 2009. https://www.cdc.gov/growthcharts/background.htm.
- Ben-Joseph EP, Dowshen SA, Izenberg N. Do Parents Understand Growth Charts? A National, Internet-Based Survey. 2009; 124 4): 1100-9.
- Bennett WE, Hendrix KS, Thompson RT et al. The Natural History of Weight Percentile Changes in the First Year of Life. 2014. 168(7): 681-2.
- Marchand V, Canadian Paediatric Society, Nutrition and Gastroenterology Committee. The Toddler Who Is Falling Off the Growth Chart. 2012. 17(8): 447-50.
Disclaimer: This information contained in this blog is based on the experience of the author and science-based research. It is not intended to replace medical advice or diagnosis from a physician or other medical provider. This blog is not intended as a substitute for a consultation with a physician or other healthcare provider. The author is not responsible for any adverse effects or consequences resulting from the use of any suggestions discussed in this blog.
Kerry Jones, MPH, RDN, LDN is a Registered Dietitian with a Master’s degree in Public Health who is passionate about helping growing families navigate life and achieve all of their milestones along the way. She works with women who are trying to conceive, pregnant, breastfeeding, or postpartum and children to help manage medical conditions, tackle picky eating, and establish a good family relationship with food. With an overload of nutrition information available, Kerry understands how difficult it can be to know which foods are best for you and your family. Kerry owns a private practice called Milestones Pediatric & Maternal Nutrition.
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