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Growth and Development
: Growth Curves

One of the aspects that makes the field Pediatrics different from adult medicine is that children are constantly changing. They grow at a tremendous rate, especially during the first few years of life. During this period, they also go through the stages of physical and mental development. An important role of the pediatric check-up is to make sure that children are growing and developing normally.

About Growth Curves

When a child is assessed, three important measurements are taken: height, weight and head circumference. These measurements are then placed or plotted on a growth curve or chart which illustrates the average rate and amount of growth in children within different age groups. In other words, growth curves allow your doctor to record and follow the pattern of growth. Whether a child is growing normally or not depends on the rate of growth over time as compared with the average or normal rates for a child's age. Because boys grow at different rates than girls, separate growth curves are used. In order to be able to properly assess a child's growth, the curve has to be looked at over several measurements and time. In this way, the growth curve really charts out a child's "growth pattern and rate" until adulthood. Consequently, the growth curve is a vital part of any child's medical record.

Growth curves, can also provide very good clues as to whether certain problems or symptoms are serious. For example, a common complaint is that a child is not eating enough or is a picky eater. How serious or worrisome the problem is, depends in large part on the growth pattern. If the growth rate is normal, then despite the picky eating habits, the child is getting enough calories to grow. Similarly, when assessing children for other problems such as frequent infections or colds, an important part of the assessment is looking at the growth curve. Again, if the growth rate is normal, chances are that there really is nothing seriously wrong. The growth curve is a child's, parent's and pediatrician's best friend. However, a growth curve can only be kept up to date by attending regular check-ups.

Growth Charts: Valid For All Children?

The currently used charts have been scientifically developed based on a North American population by the National Center for Health Statistics(NCHS), in Maryland, USA. Physicians working in a multicultural setting have come to realize that the NCHS charts may not be accurate for children from Asia or China who tend to be smaller than North American children. As a result, a child of Asian background may seem to always be below the "normal or average". This is like comparing apples to oranges. However, if one plots the same Asian child's weight on growth charts from China, that same child plots normally on this curve. However, the most important point is the trend or rate of growth, regardless of the child's ethnic origin and which growth chart one uses. If there is a fall-off in the rate at which a child is growing, this is a problem, no matter which curve one uses.

Other conditions or situations are associated with different growth rates and patterns: Breastfed children have different growth rates as compared to non-breastfed children. Also, babies born prematurely and children with chronic medical conditions display different growth rates. As a result, specific growth charts are currently available for children with specific situations such as for breast-fed infants, premature babies and for children with Down's syndrome.

Importantly, during the first 4 months of life, the growth curves are generally universal; If during this time, any baby, regardless of ethnicity is not following the growth curve or is plotting below the normal range (even on the NHCS chart), this is a problem which cannot just be discounted as a result of ethnic background.

In response to a growing multicultural population and the recognition that children with specific medical conditions or situations have their own growth rates, the approach has been "globalized" by developing and using growth curves which are either "culturally" specific or "condition/situation" specific.

Every child is different!

It is important to understand that each child is unique. Parents should not compare one child to another. This is not the purpose of growth charts who's role is to help make sure that a child is growing at a normal rate.


BOYS 0-36 Months
BOYS 2-20 Years
GIRLS 0- 36 Months
GIRLS 2-20 Years

Other Growth and Development Topics

The information provided in this site is designed to be an educational aid only. It is not intended to replace the advice and care of your child's physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition, always consult a physician.

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