Tracking your child’s development: What does it all mean?

By Dr. Tamisha Jones, Medical Director of Pediatrics

From the moment your baby is born, you are closely watching him or her for every possible milestone. Is my son the right weight for his age? Why is my daughter’s head so big? Many parents can’t help but compare their little one’s growth and progress to other kids their age.

Like adults, babies and children come in different shapes and sizes and hit developmental milestones according to their individual internal timetables. Pediatricians use growth charts to answer many parents’ questions about whether their child’s development is on track, but what does it all mean? We have answers.

How are growth charts used?

Starting with a baby’s first checkup, pediatric measurements and percentiles are used to determine whether children are growing appropriately over time.  Pediatricians and other healthcare providers can identify health issues that often directly relate to the growth of a child.  In some instances, abnormal weight gain or loss may be the first and most obvious sign of a problem.

Your child is measured and weighed at every checkup, which means at birth, after 3 to 5 days, 2 weeks and at months 2, 4, 6, 9, 12, 15, 18, 24 and 30. Then every year after that. Doctors are looking for signs of consistency.

Which growth charts does my child’s doctor use?

There are two types of growth charts that are used in the United States.  The first one was developed by the Centers for Disease Control (CDC), and uses measurements from a subset of US children to create the growth curves. The first CDC growth charts were created in 1977 and were last updated in 2000 to include a larger, more diverse group of children, as well as the growth charts for Body Mass Index (BMI).

The second version came from the World Health Organization (WHO) and utilizes a sampling of children in optimal living conditions from 6 countries, including the US. Unlike the CDC charts, the WHO charts include a larger number of infants who are breastfed. In the US, doctors use the WHO charts for children 0-2 years old and the CDC charts for children two and up.

Why are pediatric measurements and percentiles helpful?

Pediatric measurements and percentiles show how a child is growing relative to other healthy children of the same age.  At each medical visit, your child’s height, weight, and possibly head size will be measured. These measurements will be placed on a graph to determine each associated percentile.

For example, if your child’s height measures in the 85^thpercentile, it means that out of 100 children his age, he is taller than 85 of them.  As your doctor, I would say he’s probably one of the tallest kids in his class.

It’s also important to look at percentiles together. If your child is in the 95^th percentile for both height and weight, it may be appropriate.  However, if your child is in the 5^th percentile for height and 95^th percentile for weight, then this is likely an issue of concern. In fact, using height and weight together, your healthcare provider can calculate BMI to determine if your child is overweight or obese.

When should parents worry about the numbers?

Parents, along with pediatricians, should monitor their children percentiles at each wellness visit.  The percentiles for height and weight by themselves are difficult to interpret, but patterns over time can help us identify when issues arise.  BMI helps us diagnose children who are underweight, or more commonly overweight and obese.

A BMI between the 85^th percentile and the 95^th percentile is considered overweight, and a BMI greater than the 95^th percentile is considered obese.  A BMI less than the 5^th percentile is considered underweight.  More important than the label, however, is the risk for disease that is associated with having a BMI outside the healthy range.  A BMI greater than the 85^th percentile increases the risk for diabetes, heart disease, elevated blood pressure and cholesterol.

Reach out to your child’s Legacy pediatrician about any concerns or questions you may have about your child’s growth and development or to schedule a well child visit. Call 832-548-5000 or log on to our website to schedule an appointment.

Currently Legacy accepts the following Medicaid and CHIP plans: Amerigroup, CHIP, Community Health Choice, Medicaid, Molina Health Care, Superior Health Care, Texas Children’s Health Plan and United Healthcare. A full list of all plans and payment options can be found on our Insurance & Payment section. Our Eligibility Specialists are also available to discuss our sliding fee scale and potential programs to help reduce the cost of services.  

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