Growth Spurts and Typical Growth Periods

Istock 000017235059small Copy

Growth during childhood is a key indicator of a child’s overall well-being and is influenced by numerous factors such as diet, environment, genetics and hormones. Every child grows and matures differently. It can be completely normal for your child to be the smallest fifth-grader, only to tower above his peers two years later.

Heredity is a large factor in determining growth potential. If the child of two short parents aspires to be 6 feet tall, he likely will be in for disappointment down the road.

Normal rate of growth is characterized by periods of rapid growth (spurts) followed by alternating periods of slowing. There are four recognized growth periods:

• Infancy to 2 years.
• Preschool years.
• Middle childhood (7 to 10 years).
• Adolescence (11 to 20 years).

Infancy is a time of rapid growth. Healthy babies lose weight in the first days after delivery but are expected to be back to birth weight at 2 weeks old. Most babies double their birth weight by the time they are 5 months old, and triple it between 14-15 months. Birth length doubles around 3-4 years. In addition to measuring weight and length, your doctor plots head circumference as an indirect measure of brain growth. This can identify underlying neurological disorders or anatomic abnormalities.

A pediatrician measures weight and height at each visit and plots results on standardized growth charts. This allows the doctor to monitor the rate of your child’s individual growth from infancy to adulthood and compare it to well-established age- and sex-matched controls. By the time children are 2, pediatricians monitor body mass index to predict body fat based on weight and height.

The specific weight and height at each visit is not nearly as important as the trajectory of growth on each child’s individual curve. So-called “jumping” or “falling” off a curve can be the first sign of an underlying problem.

Causes of growth disorders are numerous, including environmental factors, inherited diseases, infection and hormone deficiency. Once children reach early adolescence, signs of puberty are also taken into account when evaluating growth. If there is concern for slow growth, delayed puberty or both, a doctor may consider doing lab work or referring your child to an endocrinologist.

If you have concerns about your child’s growth, it is important to discuss them with his or her doctor. Ask to see your child’s growth curve. Be prepared to answer questions about diet, including what and how much they eat and how it is prepared. Know your family history, including anyone with delayed growth, hormone problems, childhood heart disease or any other inherited conditions.

Attending all scheduled well-child visits and having open discussions with your pediatrician about any concerns are keys to early recognition of growth problems and overall promotion of good health.

Dr. Jeana Bush is a resident pediatrician at Carolinas Medical Center, and Dr. Erin Stubbs is a board-certified pediatrician at CMC Myers Park Pediatrics.