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Growth Tracking

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Growth Tracking

A newborn being weighed after birth.

Image by Oliver H

Childhood Growth - Physical Development

Pregnancy and Weight Gain - Timing Matters, Birth Weight, High Birth Weight

Image by TheVisualMD

Childhood Growth - Physical Development

In infancy, toddlerhood, and early childhood, the body’s physical development is rapid (Figure). On average, newborns weigh between 5 and 10 pounds, and a newborn’s weight typically doubles in six months and triples in one year. By 2 years old the weight will have quadrupled, so we can expect that a 2 year old should weigh between 20 and 40 pounds. The average length of a newborn is 19.5 inches, increasing to 29.5 inches by 12 months and 34.4 inches by 2 years old (WHO Multicentre Growth Reference Study Group, 2006).

Children experience rapid physical changes through infancy and early childhood. (credit "left": modification of work by Kerry Ceszyk; credit "middle-left": modification of work by Kristi Fausel; credit "middle-right": modification of work by "devinf"/Flickr; credit "right": modification of work by Rose Spielman)

During infancy and childhood, growth does not occur at a steady rate (Carel, Lahlou, Roger, & Chaussain, 2004). Growth slows between 4 and 6 years old: During this time children gain 5–7 pounds and grow about 2–3 inches per year. Once girls reach 8–9 years old, their growth rate outpaces that of boys due to a pubertal growth spurt. This growth spurt continues until around 12 years old, coinciding with the start of the menstrual cycle. By 10 years old, the average girl weighs 88 pounds, and the average boy weighs 85 pounds.

Source: CNX OpenStax

Additional Materials (1)

3:21

Child Development, What is it? The 5 stages of a child development explained in this video.

BabyPillars/YouTube

Measuring Children's Height and Weight Accurately At Home

Measuring Height and Weight Accurately At Home

Image by mojzagrebinfo/Pixabay

Measuring Children's Height and Weight Accurately At Home

Measuring Height Accurately At Home

To measure height accurately at home to calculate BMI-for-age:

Remove the child or teen’s shoes, bulky clothing, and hair ornaments, and unbraid hair that interferes with the measurement.
Take the height measurement on flooring that is not carpeted and against a flat surface such as a wall with no molding.
Have the child or teen stand with feet flat, together, and against the wall. Make sure legs are straight, arms are at sides, and shoulders are level.
Make sure the child or teen is looking straight ahead and that the line of sight is parallel with the floor.
Take the measurement while the child or teen stands with head, shoulders, buttocks, and heels touching the flat surface (wall). (See illustration.) Depending on the overall body shape of the child or teen, all points may not touch the wall.
Use a flat headpiece to form a right angle with the wall and lower the headpiece until it firmly touches the crown of the head.
Make sure the measurer’s eyes are at the same level as the headpiece.
Lightly mark where the bottom of the headpiece meets the wall. Then, use a metal tape to measure from the base on the floor to the marked measurement on the wall to get the height measurement.
Accurately record the height to the nearest 1/8th inch or 0.1 centimeter.

Measuring Weight Accurately At Home

To measure weight accurately at home to calculate BMI-for-age:

Use a digital scale. Avoid using bathroom scales that are spring-loaded. Place the scale on firm flooring (such as tile or wood) rather than carpet.
Have the child or teen remove shoes and heavy clothing, such as sweaters.
Have the child or teen stand with both feet in the center of the scale.
Record the weight to the nearest decimal fraction (for example, 55.5 pounds or 25.1 kilograms).

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (1)

8:37

Height and Length Measurement — English

Holt Nutrition Program/YouTube

What Is BMI-for-age Growth Chart?

BMI for age percentiles for girls 2 to 20 years of age.

Image by U.S. Centers for Disease Control and Prevention

Using the CDC BMI-For-Age Growth Charts to Assess Growth in the United States Among Children and Teens Aged 2

The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) recommend that health care providers in primary care settings use the 2000 CDC growth reference charts for children and teens aged 2 to 20 years to monitor growth in the United States (Grummer-Strawn, Reinold, Krebs, 2010).

The 2000 CDC growth reference charts include the weight-for-age, stature-for-age, and BMI-for-age charts for boys and girls aged 2 to 20 years. This training focuses on using the BMI-for-age growth charts.

What is BMI?

An anthropometric index of weight and height

Body Mass Index (BMI) is an anthropometric index of weight and height that is defined as body weight in kilograms divided by height in meters squared (Keys et al., 1972).

BMI = weight (kg) / height (m)²

BMI is the commonly accepted index for classifying adiposity in children, teens, and adults.

A screening tool

BMI is a screening tool used to identify individuals who are underweight, overweight, or obese. BMI is NOT a diagnostic tool (Barlow, 2007).

For example, a child who is relatively heavy may have a high BMI for his or her age. To determine whether the child has excess fat, further assessment is needed. To determine a counseling strategy, assessments of medical risks, behavioral risks, including sedentary time, dietary and physical activity behaviors, and attitudes are needed (Barlow, 2007).

For children and teens, BMI is both sex-specific and age-specific (Barlow, 2007; Hammer et al., 1991; Pietrobelli et al., 1998). Age and sex are taken into consideration for children and teens for two reasons: (1) the amount of body fat differs between girls and boys; and (2) the amount of body fat changes with age.

An indirect measure of body fatness

BMI is not a direct measure of body fatness. However, BMI parallels changes obtained by direct measures of body fat, such as dual energy X-ray absorptiometry (DEXA). BMI can be considered a proxy for measures of body fat.

Note that the accuracy of BMI as an indicator of body fatness (adiposity) varies depending on the degree of body fatness. In other words, among relatively heavy children, BMI is a good indicator of excess body fatness; however, among relatively thin children (those with a BMI-for-age of <85th percentile), BMI is more an indicator of fat-free mass (Freedman and Sherry, 2009). Fat-free mass is total body mass excluding the fat. Fat-free mass includes everything from your skin, bones, ligaments, and tendons, to your organs and water content.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (2)

BMI for age percentiles for boys 2 to 20 years of age.

Original: U.S. Centers for Disease Control and Prevention / Vector: Scray/Wikimedia

2:02

Body Mass Index and your child's health

Chicago Parent/YouTube

BMI-for-age

Body Mass Index in Children and Teens

Also called: Pediatric BMI, Pediatric Quetelet Index, BMI Percentile, BMI-for-age

Body mass index (BMI) is an estimate of body fat calculated from a person's height and weight. For children and teens, BMI is age- and sex-specific and is often referred to as BMI-for-age. BMI-for-age is the measure that can be used continuously from age 2 to 20 years to screen for obesity, overweight, or underweight.

Body Mass Index in Children and Teens

Also called: Pediatric BMI, Pediatric Quetelet Index, BMI Percentile, BMI-for-age

Body mass index (BMI) is an estimate of body fat calculated from a person's height and weight. For children and teens, BMI is age- and sex-specific and is often referred to as BMI-for-age. BMI-for-age is the measure that can be used continuously from age 2 to 20 years to screen for obesity, overweight, or underweight.

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Use the slider below to see how your results affect your health.
{percentile}
5
85
95
Your result is Healthy Weight.
A BMI-for-age between the 5th percentile to less than the 85th percentile indicates that your child is at a healthy weight for the height.
Related conditions

After BMI is calculated for children and teens, it is expressed as a percentile obtained from either a graph or a percentile calculator linked below. These percentiles express a child’s BMI relative to US children who participated in national surveys from 1963-65 to 1988-94. Weight and height change during growth and development, as does their relation to body fatness. Consequently, a child’s BMI must be interpreted relative to other children of the same sex and age.

The BMI-for-age percentile growth charts are the most commonly used indicator to measure the size and growth patterns of children and teens in the United States. BMI-for-age weight status categories and the corresponding percentiles were based on expert committee recommendations and are shown in the following table.

BMI-for-age weight status categories and the corresponding percentiles
Weight Status Category	Percentile Range
Underweight	Less than the 5^th percentile
Healthy Weight	5^th percentile to less than the 85^th percentile
Overweight	85^th to less than the 95^th percentile
Obesity	Equal to or greater than the 95^th percentile

The following is an example of how sample BMI numbers would be interpreted for a 10-year-old boy.

The CDC BMI-for-age growth charts are available at: CDC Growth Charts: United States.

Obesity during childhood can harm the body in a variety of ways. Children who have obesity are more likely to have:
- High blood pressure and high cholesterol, which are risk factors for cardiovascular disease.
- Increased risk of impaired glucose tolerance, insulin resistance, and type 2 diabetes.
- Breathing problems, such as asthma and sleep apnea.
- Joint problems and musculoskeletal discomfort.
- Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).
Childhood obesity is also related to:
- Psychological problems such as anxiety and depression.
- Low self-esteem and lower self-reported quality of life.
- Social problems such as bullying and stigma.
1. [accessed on Feb 05, 2022]
2. Childhood Obesity Causes & Consequences | Overweight & Obesity | CDC [accessed on Feb 05, 2022]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (14)

Overweight, Underweight, Just Right

One tool that may be used in evaluating body composition for children and teens (age 2-19) is the body mass index (BMI). BMI is calculated differently for children and teens than for adults because, in children, the normal amount of body fat changes with age and also differs between girls and boys. (Adult BMI calculators don’t take into account age or sex.) There is no universal normal range as there is with BMI for adults. provides BMI and the corresponding BMI-for-age percentile on a BMI-for-age growth chart. It’s important to remember that BMI is not a diagnostic tool. It only indicates the possible presence of a weight problem. If your child’s BMI number is in the unhealthy range, he or she should be taken to a healthcare professional. Further assessments may then be done, such as plotting weight and height on a growth chart, measuring skinfold thickness with a caliper, evaluating physical activity and eating habits, and looking at family history.

Image by TheVisualMD

BMI-for-age – Boys Growth Chart

The BMI-for-age percentile growth charts are the most commonly used indicator to measure the size and growth patterns of children and teens in the United States.

Document by CDC

BMI-for-age – Girls Growth Chart

The BMI-for-age percentile growth charts are the most commonly used indicator to measure the size and growth patterns of children and teens in the United States.

Document by CDC

Our Supersized Kids

Video by KSPS Public TV/YouTube

Why BMI Is BS

Video by Seeker/YouTube

Overweight/Obese Adult, teenager and child with visible inner anatomy

Overweight/Obese Adult, teenager and child with visible inner anatomy

Image by TheVisualMD

Obesity Prevention Begins in Childhood

Obesity in children has risen dramatically worldwide. Worldwide, an estimated 1 in 10 children is overweight, a total of 155 million. Of those children, 30-45 million are obese. By 2010, nearly half of the children in North and South America and about 38% of the children in the European Union will be overweight. Photo of Child: Copyright 2007, Emer & Sam

Image by TheVisualMD

A Global Epidemic

Childhood obesity is an epidemic around the globe. In the US, an estimated 17% of children and adolescents ages 2-19 are obese. In the last three decades, the percentage of obese children doubled in children ages 2-5 and tripled in children and adolescents ages 6-19. Up to 80% of obese youth become obese adults, who are at high risk for type 2 diabetes and cardiovascular disease—the leading cause of death in North America. In the European Union, about 30% of all children are overweight, and over 5 million of them are obese. Some 300,000 children in the EU become obese each year. But obesity is no longer a problem that affects only children in the developed world. The easy availability of cheap, high-calorie, low-nutrition food, along with less-active lifestyles, have made childhood obesity a major health issue in countries all over the world, including China, Brazil, Thailand, South Africa, and many others. Globally, about 10% of all children ages 5-17 are overweight, and 2-3% in that age group are obese, according to the International Obesity Task Force. Obese kids are more likely to be depressed and have low self-esteem, sleep apnea, insulin resistance, and even type 2 diabetes. If your child has a weight problem, you have reason to be concerned. But there are many ways you can help. With your support, your child can get healthy—and stay healthy.

Image by TheVisualMD

What Are the Signs and Symptoms of Obesity Hypoventilation Syndrome?

Side view of an overweight (195 lbs) 16-year old boy's stomach.

Image by OctoMocto

Consequences of Childhood Obesity

Consequences of Childhood Obesity : Even though overweight kids tend to have denser bones, they have more bone fractures than nonoverweight children. This may be because being overweight interferes with balance and also because overweight children fall with greater force.

Image by TheVisualMD

Adding to the Burden

Even though overweight kids tend to have denser bones, they have more bone fractures than nonoverweight children. This may be because being overweight interferes with balance and also because overweight children fall with greater force.

Image by TheVisualMD

Obesity and Related Health Problems

Obesity and Related Health Problems : Overweight and obese children are more likely to have gastrointestinal (digestive) disorders, including nonalcoholic fatty liver disease, constipation, gastroesophageal reflux disease (GERD), and gallstones.

Image by TheVisualMD

Fit Food

You want your child to be fit and healthy for a whole lifetime. That’s why it’s so important for you to start helping him or her to develop healthy eating habits now. Changing habits is easier when you’re young. What’s more, tackling overweight early on can prevent many or all of the devastating medical effects of obesity.

Image by TheVisualMD

Child nutrition

child nutrition - Picnic time

Image by dhanelle

Overweight, Underweight, Just Right

TheVisualMD

BMI-for-age – Boys Growth Chart

CDC

BMI-for-age – Girls Growth Chart

CDC

30:00

Our Supersized Kids

KSPS Public TV/YouTube

3:02

Why BMI Is BS

Seeker/YouTube

Overweight/Obese Adult, teenager and child with visible inner anatomy

TheVisualMD

Obesity Prevention Begins in Childhood

TheVisualMD

A Global Epidemic

TheVisualMD

What Are the Signs and Symptoms of Obesity Hypoventilation Syndrome?

OctoMocto

Consequences of Childhood Obesity

TheVisualMD

Adding to the Burden

TheVisualMD

Obesity and Related Health Problems

TheVisualMD

Fit Food

TheVisualMD

Child nutrition

dhanelle

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