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Monitoring a child’s growth is an important part of pediatric care. This is typically done by measuring the child’s weight, length/height, and body mass index (BMI) and comparing it with the expected parameters for their age and gender. This information is then plotted on a growth chart to track the child’s growth over time.

A growth chart is a simple graph that provides a longitudinal record of a child’s growth parameters. It helps to identify whether the child’s growth falls within the normal range or not. The curves of normal growth on the growth chart are based on measurements of thousands of normal children, taking into account the expected variations in height and weight.

A healthy child’s growth parameters should fall within the highest and lowest curve expected for their age and gender. If a child’s parameter is above the 97th centile or below the 3rd centile line on the growth chart, it indicates that the child’s parameter is below or beyond what is typically seen in nearly 94% of children of the same age. In such cases, the child should be evaluated for possible growth problems.

Serial recording of growth parameters provides an even better assessment of a child’s growth. Additionally, the doctor may evaluate and plot whether the child’s weight is appropriate for their height. This is done by plotting on a weight for height chart for children up to 5 years of age and on a BMI chart for older children.

As a pediatrician, I recommend regular monitoring of a child’s growth parameters and plotting them on a growth chart to identify and address any potential growth problems.


How can we monitor child’s growth?

Growth monitoring involves regularly tracking a child’s growth over time to ensure that they are gaining weight and height at a normal rate. To monitor a child’s growth, a doctor will regularly measure their weight and height and plot the results on a growth chart. In healthy children, the plotted points should form a curve parallel to the lines on the chart.

For children over the age of 2, it is recommended that height and weight measurements are taken at least twice a year, and for children over 9 years of age, at least once a year. Consult Dr. Sushma, Best Pediatrician near you, and by regularly monitoring a child’s growth, any potential growth problems can be identified and addressed early on, leading to better outcomes for the child’s overall health and development.

What are the common achievements (milestones) in development that parents should note in their children?

Developmental milestones refer to a set of skills that children are expected to acquire within a specific age range. Parents can use these milestones as a guide to track their child’s progress and identify any potential developmental delays. Some of the important developmental milestones include:

  • Gross motor skills: Control of the head, rolling over, sitting, crawling, standing, walking, running, climbing stairs, riding a tricycle, jumping, hopping, and skipping.
  • Fine motor skills: Focusing on objects, reaching out, using the thumb and fingers to grasp objects, scribbling, drawing basic shapes, building towers with blocks, and buttoning a shirt.
  • Social skills: Responding to familiar faces with a smile, recognizing the mother, expressing pleasure or displeasure, showing stranger anxiety, waving goodbye, playing “peek-a-boo,” playing with toys, and following simple rules in games.
  • Language skills: Making cooing sounds, saying monosyllabic words, bisyllabic words, babbling with multiple consonants, speaking meaningful words, forming two to three-word phrases, constructing full sentences, asking questions, narrating incidents, and communicating through gestures.
  • Cognitive skills: Imitating facial expressions, reaching out to be picked up, responding to “No,” identifying body parts, colors, numbers, letters, and shapes, counting, and following simple to complex instructions.

Parents should note that these milestones are general guidelines and not every child will meet them exactly on time. However, if there is a significant delay in achieving these milestones, consult Dr. Sushma, pediatrician for further evaluation and support.

When should I suspect delay in my child’s development?

For every skill, there is an acceptable age range for acquisition. If a child fails to attain a skill beyond that range, we consider it a delay. There are some red flag signs of delay in different domains we should all be aware of.


Red flags of cognitive delay and behavioral problems: 

  • Difficulty in following simple instruction and learning new skills 
  • Slow in daily activities 
  • Poor recall 
  • Poor expressive language 
  • Little interest in surroundings and other children 
  • Poor eye-contact/smiling 
  • Limited use of words or gestures to communicate needs 
  • Repetitive, parrot-like speech 
  • Repetitive, nonpurposeful play 
  • No pretend or imaginary play

Red Flag Signs at 18 months 

  • Has trouble seeing or hearing 
  • Does not say a single word 
  • Does not point, wave or use gestures 
  • Does not follow simple commands 
  • Does not enjoy eye contact or cuddles 
  • Is not walking alone 
  • Prefers to use one hand

Red Flag Signs at 2 years 

  • Poor vision or hearing abilities
  • Inability to run or climb stairs
  • Not yet using two-word phrases
  • Difficulty expressing emotions
  • No pretend play or imaginative play
  • Inability to copy actions or follow simple instructions
  • Not yet able to scribble or make marks on paper