When Tami Turkovich’s son Trevor was born, it was no surprise to her that he was small. The average adult height in the United States is 5 feet 9½ inches. Both Tami and her husband Mark are shorter than average.

As he grew, Trevor typically fell within the fifth to 10th percentiles for height and weight for a boy his age, Tami says. But when he reached age 9, Trevor’s friends started to shoot up in height. He didn’t. And Trevor’s measurements were “off the charts” low—below the fifth percentile. So his pediatrician recommended a visit to an endocrinologist.

The fact that Trevor, now 11, was small in stature wasn’t a concern to his parents. They just wanted to make sure he was growing.

Growth charts are tools to help doctors establish exactly how a child stands in relation to peers, according to pediatrician Leslie Barakat, M.D. of Cigna Medical Group. That’s where the word “percentile” comes in. Say your 2-year-old daughter is in the 25th percentile in height when compared with all girls the same age. That means 25 percent of girls the same age are shorter and 75 percent are taller.

A recent study published by the American Academy of Pediatrics showed that many parents are baffled when it comes to understanding the information growth charts offer. Never hesitate to ask your child’s health care provider to explain anything you don’t understand.

Growth should be monitored at each well check because emerging patterns tell the real story, says Barakat. “If I see a child who is starting to fall below where they were, I’m going to raise that concern with the parents.”

In the first few years of life, children might hug the bottom of the chart because there is a disparity between what they are eating and the calories they are burning. Discussion between the pediatrician and parents should address eating habits, diet and how the introduction of solids is progressing.

Toddlers can reach a growth plateau once they start walking, running and exploring. “Grazing” may take the place of regular mealtimes. “They’re burning lots of calories, so briefly, there is a mismatch between what they are taking in and what their body is expending,” says Barakat.

Any concerns about a child’s rate of growth should be discussed with a doctor or health care provider who will also look at family history to determine if concern is warranted. In rare cases, growth charts can reveal signs of an underlying medical condition or disease, says Barakat. Additional tests or a referral to an endocrinologist may be warranted.

Trevor doesn’t mind that he likely will never be as tall as his peers. He says he’s “fun size” like the mini candy bars and isn’t even interested in trying human growth hormones, even though his endocrinologist indicated he could be a candidate for the therapy.

“I want to see how God will shape my body,” he says. “I just say to myself that I’m a normal-sized kid in a freakishly big world. It’s true.”

Growth tips

Teach kids to follow a healthy lifestyle and growth usually takes care of itself, says Leslie Barakat, M.D. Her tips:
• follow the Food Guide Pyramid and provide proper nutrition
• make sure your child is getting recommended vitamins and minerals
• make sure your child gets adequate rest because growth occurs during sleep
• encourage exercise; weight-bearing activities such as running, hiking and jumping promote the long bone growth that determines height
• talk openly about growth with your child, no matter where he or she falls on a growth chart
• stress that people come in all sizes

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