Ways to keep track

Until 2002, the growth chart -- the tool doctors use to make sure kids are growing normally -- was based exclusively on norms for bottle-fed Caucasian children. Since breastfed babies tend to be smaller, as do Hispanic and Asian-American babies, the chart now includes averages for all ethnic groups, as well as for breastfed infants. In addition, the new charts track body mass index, which helps pediatricians know when a child is at risk of obesity.

Most growth disorders are diagnosed by pediatricians, not parents, but sometimes a child who isn't growing normally can slip through the cracks. According to a study in the Archives of Disease in Childhood, about 70 percent of all kids are measured inaccurately at their checkups. (Measurements tend to be off by about half an inch.)

So watch carefully as your child is being measured. And feel free to pitch in, if needed, to hold a wiggly baby still, which will help make sure the measurement is accurate. Double-check to see if the nurse records this information on the correct chart for your child's age and sex, too. My son Sam was once briefly in the 110th percentile for height; then the nurse realized she'd charted him on the curve for girls, not boys.

By comparing your child's current place on the chart with earlier recordings, your doctor will be able to see if he's growing normally. Signs that something may be amiss:

• His height seems off, given the height of his parents or siblings.
  
• He's nowhere near the averages (see below).
  
• He drops 20 percentile points or more from one year to the next.
  
• He's gaining weight much more rapidly than he's gaining height.
  
• Puberty comes very early or very late.

In such cases, your doctor may suggest a specialist.

Most of the time, though, you just need to wait for the next growth spurt. And then you, like me, may find yourself buying your child another new pair of dress-up pants.

Inches and pounds: How much, how fast

Birth to 12 months
Infants add 10 inches in length and triple their birth weight.

12 to 24 months
Toddlers add 5 inches and 6 pounds.

2 to 10 years
Most kids have settled into their growth patterns, adding about 2 1/2 inches and 6 pounds each year.

Puberty
Girls grow 9 inches and gain 15 to 55 pounds; boys grow 11 inches and gain up to 65 pounds.

Margaret Renkl is a contributing editor to Parenting and the mom of three kids.

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