Assessing Your Child's Growth

Your little one's well-child exams will consist mainly of assessing her growth. We tell you what else to expect from these trips to the pediatrician.


When you take your 1-year-old in for a well-child exam, your pediatrician will first get an overall impression of his health. Is he alert and bright-eyed? Does he display curiosity and an interest in the doctor and the examination procedure? Next the doctor will weigh and measure your child and chart his height and weight on a graph that displays his growth in terms of percentiles. This is a way of comparing your child with others of the same age and gender. If your son's height is at the 75th percentile, for instance, it means that he is as tall as or taller than 75 percent of the boys in his age group.

It is important to remember that normal height and weight encompass a wide range. Your child's weight at 1 year is likely to be approximately three times her birth weight; by the end of this year, her birth weight should have quadrupled. As for height, girls generally double their birth height at around 19 months; it takes boys approximately 6 months longer.

Pediatricians are often asked to predict at age 1 or 2 what a child's adult height will be. Some still rely on the formula that adult height will be approximately twice the child's height at the end of the second year. Others, calling this a popular bit of folk wisdom, believe there are too many variables involved to make a definite prediction. Generally, a child's eventual height can be predicted by the average of his two biological parents. There are exceptions, so don't worry even if your child is much smaller or larger than average.

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After checking to see how your child is growing, the pediatrician will proceed with the rest of the examination. Much of assessing your child's health at this age will depend on your report-the doctor will discuss with you what the child's daily activities are, the status of his motor skills such as walking, climbing, and handling small objects, and his speech (as likely as not, your little chatterbox will refuse to display his new verbal skills for the doctor, only to regale you with his new vocabulary during the ride home). Your physician will also ask you what your little one likes to eat, how much he eats, and whether he appears to be allergic to any foods.

Much of the physical exam can be conducted with your child on your lap, especially if she is shy or hesitant with the doctor. A child who is comfortable with the doctor can sit on the examining table (with you standing by to prevent a fall). The doctor will listen to your child's heart and lungs, check her eyes and ears, and examine her mouth (tongue, throat, palate, and teeth). With your child lying on her back on the table, the doctor will feel her abdomen and examine her ribs and chest. A quick check of your child's hips, genitals, legs, and feet and a general overview of her skin to make sure it is clear and free of rashes complete the physical exam. To allay your child's anxiety, bring along her favorite doll or stuffed animal-the doctor can demonstrate on the toy what she'll be doing during the exam.

Before your visit is over, be sure to discuss with the doctor any questions or concerns you have. These may be about strictly medical issues ("When will she need to have her next immunization?"), but questions about milestones are perfectly appropriate ("My neighbor's baby is walking now-should I be concerned that my child is still not cruising much?"), as are more general questions about care and behavior ("What can I do about biting?" "I'm going back to work next month; could you give me some tips about making a smooth transition to daycare?").

Your child's pediatrician can also give you safety tips and will likely remind you that your 1-year-old's new mobility and boundless curiosity warrant a new level of childproofing in your home.

Have Fun With Baby's Development: Tracking Growth at Home

At the pediatrician's office, you may have been shown the graph on which your child's growth is charted. Such charts are readily available-from your doctor, in childcare books, or in reference books.

But is it really essential for parents to keep meticulous, detailed records of their child's physical development? As a rule, the growth of a child getting regular primary pediatric care is being observed carefully enough. Plotting the growth curve at home, as your pediatrician does at the office, is unnecessary. Better indicators of adequate growth are whether the child is energetic, alert, curious, and contented. Daily, weekly, or even monthly weighing and measuring, plotting and calculating, will only divert attention from these more important indicators of his health and probably try the patience of both you and your child. If you're more interested in keeping a historical record than in keeping a medical record, periodic height marks penciled on a door frame can be a fun way to mark an all-too-fleeting childhood.

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All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.



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