5 Normal Growth

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THE HEALTH MAINTENANCE VISIT

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The American Academy of Pediatrics recommends routine office visits in the first week of life (depending on timing of nursery discharge): at 2 weeks; at 2, 4, 6, 9, 12, 15, and 18 months; at 2 years, 2½ years, at 3 years, then annually up to age 6; and every 2 years between age 6 and adolescence. During adolescence, a complete health maintenance visit is recommended every 2 years, with an annual risk-assessment visit every year

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Normal Growth

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Growth is assessed by plotting accurate measurements on growth charts and comparing each set of measurements with previous measurements obtained at health maintenance visits or at other visits if there is a concern over the child's growth pattern

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The body mass index

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The body mass index is defined as body weight in kilograms divided by height in meters squared. The body mass index is an index for classifying adiposity and is recommended as a screening tool for children and adolescents to determine whether an individual is overweight or at risk for being overweight

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Rules of Thumb for Growth

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WEIGHT
1. Weight loss in first few days: 5%-10% of birth weight
2. Return to birth weight: 7-10 days of age
Double birth weight: 4-5 mo
Triple birth weight: 1 yr
Quadruple birth weight: 2 yr

3. Average weights:
3.5 kg at birth
10 kg at 1 yr
20 kg at 5 yr
30 kg at 10 yr

4. Daily weight gain:
20-30 g for first 3-4 mo
15-20 g for rest of the first yr

5. Average annual weight gain: 5 lb between 2 yr and puberty (spurts and plateaus may occur)

HEIGHT

1. Average length: 20 in at birth, 30 in at 1 yr
2. At age 3 yr, the average child is 3 ft tall
3. At age 4 yr, the average child is 40 in tall (double birth length)
4. Average annual height increase: 2-3 in between age 4 yr and puberty

HEAD CIRCUMFERENCE (HC)
1. Average HC: 35 cm at birth (13.5 in)
2. HC increases: 1 cm/mo for first yr (2 cm/mo for first 3 mo, then slower); 10 cm for rest of life

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