How to Know If Your Toddler's Growth Is Normal

measuring kid's height
Grown-ups come in all shapes and sizes, so it only stands to reason that kids would, too. But as parents, when our little ones are smaller than their peers, we worry about whether they're growing and developing healthily.


The good news is, more often than not, there isn't any cause for serious concern if your child is on the petite side ... as long as he or she is making normal progress.

"If your child's height is tracking along the growth chart curves, then he or she is growing normally," Danelle Fisher, MD, FAAP, chair of pediatrics at Providence Saint John's Health Center in Santa Monica, California, tells CafeMom. "Abnormal growth would look like a plateau on a growth chart (a straight line instead of an upward curve), and this could represent a problem with linear growth due to hormone problems or other medical conditions."

Sometimes, though, there are underlying issues to be addressed. So what should you do if you're concerned about your kid's size? First, consider any obvious reasons.

Family History

"If your child is short, it could be because it runs in the family," says Fisher. In that case, you'll want to watch that growth chart at your child's checkups. As long as your kid sticks to an upward swing that resembles the chart's curve, he or she is growing normally.

More from CafeMom: Your Child's Growth Chart Percentile: When to Worry and When Not To

Growth Delay

Children who are small for their age but grow at a consistent rate could have what's known as "constitutional growth delay," one of the most common growth concerns among parents.

"[These kids] tend to reach puberty and other developmental milestones later than their friends," LeAnn Kridelbaugh, MD, president and chief medical officer at Children's Health Pediatric Group in Dallas, tells CafeMom. "Because they also tend to grow until an older age [than other kids do], they usually catch up with their peers."

So just because a kid is a "late bloomer" doesn't mean he or she has a growth disorder. In this case, your child's doctor may want to simply watch your child's growth on the chart or perhaps take some tests to be sure it's not some other problem.

Toddlerhood & Picky Eating

It's also important to keep your child's age in mind when considering his or her individual growth pattern. Toddlerhood is one time when growth might seem to be suddenly dropping off.

"Children grow the fastest in their first year of life -- and their appetite shows it," says Adina Pearson, RD, who has a blog called Healthy Little Eaters. "Once toddlerhood hits, that growth slows down considerably -- and with it comes a smaller appetite and fussy eating. This tends to worry many parents, particularly if their child is on a lower weight percentile."

But, she adds, while many parents think that normal growth means their child should be close to the 50th percentile for weight, "there is no 'normal' percentile. The 50th percentile just happens to be where 50 percent of kids fall -- it's not correct or better than, say, the 10th or the 80th. A true sign of normal growth is a child growing consistently along a similar percentile."

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Hormonal Problems

All that said, there are times when a child's diminutive stature is linked to very real medical conditions. 

"A big concern with abnormal growth could be because of problems with growth hormone," says Fisher. "There can be a lack of growth hormone, or the hormone that is produced is not properly used by the body. There are other less common causes of problems with growth, but in a normal healthy child whose growth does not follow normal curves, the most common cause is problems with growth hormone."

If you suspect there might be an underlying problem that's causing your child's slow growth, consult your pediatrician. One of the first things the doctor might suggest with growth problems is to get a "bone age," which involves getting a simple X-ray of your child's left hand and comparing it to an atlas of normal growth. There are also blood tests that can be conducted, sometimes in conjunction with a visit to a pediatric endocrinologist.

Depending on your child's diagnosis, the doctor might recommend treatments including injections of growth hormone or thyroid hormone replacement therapy. With help, in most situations you'll be able to get your child's growth back on track -- even if you don't end up with a future basketball player!

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