During the third year of life, most toddlers gain about 4 pounds
(1,800 grams) and grow about 2 to 3 inches (5 to 8
They're extremely active and mobile, and learning in very
physical ways. They're sleeping less than they did in the year
before, running around and exploring their world, and picking up
new skills, like riding a tricycle.
Your toddler's appetite may fluctuate greatly now, which is
common. Kids who are active, happy, and engaged and eat a
variety of healthy foods are probably getting the nutrients
they need and growing normally.
Although kids come in all shapes and sizes, a healthy child
should continue to grow at a regular pace. The doctor will measure
and weigh your child at routine checkups and plot the results on a
. This helps ensure kids' steady growth pattern and tracks
whether their size is in a healthy range compared with other kids
of the same age and gender.
Helping Your Child Grow
Normal growth - supported by good nutrition, adequate sleep, and
regular exercise - is one of the best overall indicators of a
child's good health. But your child's growth pattern is
largely determined by genetics. Pushing a child with "short
genes" to eat extra food or greater than recommended amounts
of vitamins, minerals, or other nutrients will not increase his or
Malnutrition severe enough to affect growth rate is uncommon
today in the United States and other developed countries unless a
child has an associated chronic illness or disorder.
At the Doctor's Office
Despite data collected for growth charts, "normal"
heights and weights are difficult to define. Shorter parents, for
instance, tend to have shorter kids, whereas taller parents tend to
have taller kids.
Although you may worry if your child isn't as tall as his or
her peers, or weighs more, the more important question is whether
your child is continuing to grow at a normal rate. If your doctor
detects a problem - such as a growth rate that had been normal but
has recently slowed - he or she may track your child's
measurements carefully over several months to determine whether the
growth pattern suggests a possible health problem or is just a
variation of normal.
Most kids who are growing at or below the 5th percentile line on
the growth chart are usually following one of these two normal
variant growth patterns:
Familial (genetic) short stature.
These kids have inherited genes for short stature from their
parents. Usually one or both parents, and often other relatives,
are short. Although they are shorter than average, they grow at a
normal rate and are otherwise healthy, showing no symptoms of
medical problems that can affect growth. They generally enter
puberty at an average age and reach a final adult height similar
to that of their parents. In general, no treatment is recommended
or known to be effective in significantly increasing their final
Constitutional growth delay (delayed puberty).
Although they are usually of average size in early infancy, these
kids undergo a period of slower-than-average growth between 6
months and 2 years of age, causing them to fall to the 5th
percentile or lower on the growth chart. After about age 2 or 3
years, kids with constitutional growth delay will grow at a
normal childhood rate until they reach puberty and undergo a
growth spurt at a later age than most other teens. Because they
start puberty later, they will continue to grow after most teens
have stopped, thus "catching up" to their peers in
final adult height. Usually, there's a family history of this
kind of growth pattern, and in general, there's no need for
If your child is growing too slowly, your doctor might order
tests to determine whether this is related to a medical or genetic
condition that would interfere with growth.
Be sure to discuss any concerns you have about your child's
growth or development with your doctor.
Steven Dowshen, MD
Date reviewed: August 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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