Growth
Disorders
in Children

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How do children grow?

How do Children grow?

Normal growth is a reflection of a child’s wellbeing. The way a child grows tells us a lot about his or her health and nutritional status.1  Children have 3 different phases of growth:2

During the first 2 years of life, linear growth is rapid  but slows down thereafter.2 As a child approaches puberty, there is a brief dip in growth followed by a major growth spurt.3

During the first 2 years of life, linear growth is rapid but slows down thereafter.2

As a child approaches puberty, there is a brief dip in growth followed by a major growth spurt.3

Notes: Merck copyright for image

During childhood, growth occurs at a relatively steady pace. Most children grow at the following rates:1

• 5‒6 cm per year for children 2‒6 years

• At least 4 cm per year for children  6‒12 years

Linear growth is completed when the bone ends fuse.3 Final height is achieved usually by 18 years of age.1

During childhood, growth occurs at a relatively steady pace. Most children grow at the following rates:1

• 5‒6 cm per year for children 2‒6 years

• At least 4 cm per year for children  6‒12 years

Linear growth is completed when the bone ends fuse.3 Final height is achieved usually by 18 years of age.1

Measuring your child’s height

One way to check how well your child is growing is by tracking his or her height using a growth chart. Growth charts are marked by lines called centiles or percentiles and give an idea of how well your child is growing compared with his or her peers.3

For infants and children up to 2 years old, length is measured lying down.2 This will be routinely done by a trained nurse during your child’s well-child and immunisation visits to the clinic. Remember to bring the Health Booklet for these visits!

For children older than 2 years old, height is measured standing up. The child should stand without shoes against a wall where a measuring tape is attached.

The child’s head, shoulders, buttocks, and heels should be touching the wall.3

Growth takes time.
Repeated measurements at regular intervals, preferably every 3‒4 months for children <2 years old and every 6‒12 months for older children, are needed to give a clear picture of your child’s growth pattern.1

For children older than 2 years old, height is measured standing up. The child should stand without shoes against a wall where a measuring tape is attached. The child’s head, shoulders, buttocks, and heels should be touching the wall.3

Growth takes time. Repeated measurements at regular intervals, preferably every 3‒4 months for children <2 years old and every 6‒12 months for older children, are needed to give a clear picture of your child’s growth pattern.1

Figure 1. How to measure height accurately at home4

① Have your child stand against the wall, arms at the side, legs straight and shoulders relaxed.

② Place a flat object (a ruler or hard-cover book) at a right angle with the wall. Lower it until it firmly rests the top of your child’s head.

③ Make sure that your eyes are at the same level as the rule or book.

④ Lightly mark the wall with a pencil at the point where the ruler or book meets your child’s head.

⑤ Use a measuring tape to measure the distance from the floor to where you marked the wall.

⑥ Read your child’s height to the last completed 0.1 cm. Do not round up!

Growth charts for children 2 to 6 years old

BOYS (AGES 2 TO 6 YEARS)
Height-for-Age Chart

Age (months)

Download pdf

GIRLS (AGES 2 TO 6 YEARS)
Height-for-Age Chart

Age (months)

Download pdf

Anthropometric Study on Pre-School Children in Singapore, 2000
National Healthcare Group Polyclinics

BOYS (AGES 4 TO 18 YEARS)
Height-for-Age Chart

Age (years)

Download pdf

GIRLS (AGES 4 TO 18 YEARS)
Height-for-Age Chart

Age (years)

Download pdf

Anthropometric Study on School Children in Singapore, 2002
Health Promotion Board

What does normal
growth look like?

The normal height for children ranges between  the 3rd and 97th percentile.4

If your child’s height is at the 50th percentile, he or she is right in the middle of the normal range.

If a child’s height is at the 85th percentile, it means that he or she is taller than 85% of children of the same age and sex.

If a child’s height is at the 15th percentile, it means that he or she is taller than 15% of children of the same age and sex.

Having a child who is in the high or low percentile does not mean he or she is more or less healthy than other children. Rather, a healthy child will show consistent growth along a given percentile line or “curve”.5

If your child’s height for their age tracks along the same curve on the growth chart, this is considered normal growth.

Even if your child’s height for their age is beneath the lowest percentile for age, his or her growth is still normal as long as it follows along the same curve on the chart.

What does abnormal growth look like?

Deviations from normal growth may be an early sign of a medical problem and should be discussed with your doctor. Prompt diagnosis and treatment the underlying cause provides the best chance to normalize growth and to achieve his or her full potential adult height.5

Poor growth occurs when a child’s growth curve flattens or moves away from its expected path to below the lowest percentile.

Poor growth can also occur when there is a drop in height measurements across two or more major percentiles, even if the curve is still within the normal range on the growth chart.

It is normal for infants to move up or down the percentiles of the growth curve due to catch-up or lag-down growth. After the age of 2 and until the onset of puberty, growth should be a relatively stable process. The crossing of growth percentiles during this age period may require further evaluation.3

Early diagnosis and treatment are important to ensure that your child
has the opportunity to reach his or her  genetic height potential.

Potential Height Calculator

One way to estimate how tall a child will be when fully grown is to look at the heights of both parents. 3 Use the calculator below to work out your child's potential height.

Child’s Gender

Enter Father’s Height

Enter Mother’s Height

Child’s Estimated Height

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