Normal Growth:
What to Expect in Healthy Children

Normal growth is an indicator of child's overall well being. Any deviation from expected growth velocity for age indicates compromised child health in terms of psycho-social stress in the family, chronic diseases, emotional deprivation or inadequate nutrition.

The term normal is synonymous with "being healthy" and the growth denotes "increase in the body mass". Growth is a unique process of an offspring to attain a mature form.

"S" shaped curve of normal growth pattern in children

Normal pattern of growth in children is represented by a "S" shaped curve as shown in the graph below.

S-shaped Curve of Normal Growth in Children

Growth process starts at conception. The intrauterine life and the first 2 years postnatal are active growth periods.

A fetus, during the last three months in mother's womb, gains weight and length very rapidly : 3 kilos and 20 centimeters in 3 months!

A newborn triples his birth weight by his first birthday and quadruples it by the second.

Tween: On an average a 10 year old weighs 30 kilos.

Teens: Beyond 10 years the rate of weight gain differs in boys and girls.

Major organs like muscles, heart, liver and kidney also follow the S-shaped growth pattern.

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The normal growth velocity of childhood

Growth Velocity is the rate of growth over a fixed time interval. It helps in determining if child's growth pattern is following the expected normal growth curve. The growth velocity that oscillates close to 50th percentile on growth chart is considered to be normal.

Normal Growth Velocity in Children

As shown in the graph above, velocity of growth is high during the first two years of life. Deceleration in child growth ends with onset of growth spurt of puberty.

However, there are many variations in the growth of a normal child, most of which are dependent on the familial predisposition.

On a growth chart, a measurement that falls "outside the normal range"; arbitrarily defined as 2 or 3 standard deviations on either side of the mean is atypical, but not necessarily indicative of illness.

The abnormal velocities are one with less than 3rd percentile which indicates "slow growth", and the other with more than 95th percentile which indicates "rapid growth"

The velocity change is the earliest diagnostic tool for alteration in growth pattern, which is seen on growth curve as the percentile shift and is specific for a particular child.

The growth velocity, measured as gain in head circumference, height and weight, is significantly accelerated during normal growth spurts.

Two more normal patterns of growth in children

  1. Cephalocaudal growth pattern implies that in a child head growth occurs before the neck growth, and arms and trunk grow before the legs.

  2. Distoproximal implies that a child's trunk and arms become functional before the hands and fingers.

These two patterns of child growth further add to specifications of normal growth pattern in children. And any deviation in these patterns could indicate child health concern.

Simple formulas to calculate expected growth in children

Average Weight for Age

Age

3 to 12 months

1 to 6 years

7 to 12 years

Weight in Kilos

[ Age(mo) + 9 ] divide by 2

[ Age(yr) x 2 ] + 8

{ [ Age(yr) x 7 ] - 5 } divide by 2

Average height (cm) for age (2 to 12 years) : [ Age(yr) x 6 ] + 77


Normal growth of other tissues in the body

Lymphoid tissue achieves the growth peak during prepubertal age of 6 to 9 years and declines steadily thereafter.

Reproductive organs experience remarkably rapid growth, both in size and function with the onset of puberty.

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Child Growth, an Indicator of Child Health

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Child Growth

Growth Potential

Growth Stages

Influences

Needs for Optimal Growth

Normal Expected Child Growth

Normal Growth Pattern

Normal Growth Velocity

Weight & Height Formulas

Brain Growth

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Teenage Brain Development

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Growth Variations

Catch Down Growth

Discrepant Percentile

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Short Stature- Constitutional

Weight & height gain discrepancy 

Child Height Predictor

Concept of Height Weight Prediction

Formulas

Mid Parental Height

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