Taking steps toward answers.

Many parents wonder when they should talk to their child’s doctor about his or her growth. To help you determine when and what to ask, we’ve put together a few suggestions, but always talk to your health care provider if you have concerns.

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When to ask about growth.

Your child’s growth should be regularly measured and plotted on a chart—for example, during routine physical examinations. If you or the doctor notice a lack of growth, your child should be measured more often to confirm whether there is an issue.

In general, you should ask your child’s doctor to specifically look at growth if your child:

  • Is much shorter than his or her peers or classmates
  • Is growing more slowly than their peers or classmates
  • Is not outgrowing their clothes or shoes
young boy

What does accurate measurement look like?

To accurately track your child’s growth, the doctor may take some of these measurements:

  • Length or height – for children 2 years of age and younger, length should be measured with an infantometer; for children 2 and over, height should be measured with a stadiometer
  • Weight
  • Head circumference – the length around your child’s head
  • Arm span – the length from the tip of one hand to the other with outstretched arms
  • The ratio between upper and lower body measurements
Doctor measuring child

It’s important that measurements are done properly. For example:

  • Some common practices, such as marking the examination paper, can be extremely inaccurate
  • Children should stand straight, with hips and shoulders touching the flat surface behind them
  • It’s important to remove the child’s shoes, jacket, and hair ornaments, and adjust hairstyles that impede measurement

About growth charts.

Your child’s measurements will be plotted on a growth chart. Growth charts are used to document and create an ongoing picture of your child’s growth. Here’s what you should know:

  • Growth charts are age–based and gender–specific
  • Lines, called percentile curves or percentiles, show the percentage of children at the same height or weight for the age group
  • Your child’s doctor will plot his or her height measurements on the chart and draw a line (called a "growth curve") to connect the points
  • The current percentile rank will be compared to previous measurements to identify any shifts in your child’s growth patterns
growth chart

This is an example of a growth chart and should not be used to plot measurements.

What does 50th percentile mean?

Questions to ask.

Regular measuring and plotting is key to identifying if your child has a growth issue, but if you have any concerns, it’s important to let your child’s doctor know. Here are a few questions to get the ball rolling:

  • Can you explain the measurements you’ve taken?
  • My child’s percentile has fallen since the last measurement. Does that suggest an issue with my child’s growth?
  • What are some possible causes for lack of growth?
  • Should my child see a specialist?

What is growth velocity? Growth velocity is a term that your doctor may use when discussing your child’s growth progress, or rate of growth over time. For example, a rate of 2 inches per year is slower than 3 inches per year. Calculating growth velocity is important because it creates a picture of your child’s growth pattern, whether or not changes in actual height are occurring. Growth velocity can indicate whether your child is growing at a constant rate—if not, it could be a sign of a medical condition.

Referral to a specialist.

If there is a problem with your child’s growth, the doctor may run some tests to determine the cause. If it turns out to be a medical issue, ask about a referral to a specialist, such as a pediatric endocrinologist.

Endocrinologists are specially trained doctors who diagnose and treat diseases of the glands and hormone imbalances. Pediatric endocrinologists are also trained to diagnose and treat children with growth disorders.

Keep in mind, early recognition of abnormal growth patterns, along with referral to a specialist, may offer the greatest opportunity for proper diagnosis and treatment.

Should I just wait to see a specialist? A “wait and see” approach could delay potential identification of the cause of short stature—and referral to a specialist may lead to proper diagnosis and treatment.