Child growth in the early years

  • Why measure growth?

    • Measuring children at regular intervals can reassure parents their child is growing well
    • Growth assessment is important for identifying problems and assessing the effectiveness of treatment or interventions. 
    • Altered growth can be an early indicator of underlying health or development issues. 

    Worrying patterns of growth can sometimes not be recognised. For example measurements may be:    

    • taken incorrectly,
    • plotted inaccurately, or
    • not plotted at all.

    Growth assessment is only effective in improving child health if discussion with the family takes place and referral for further assessment is made if appropriate. 

    Birth weight and weight gain

    • Ninety-four percent of babies born in Australia have a birth weight between 2.5 and 4.5 kg (AIHW 2012)
    • Weight loss of ten percent in the first week of life is normal
    • Birth weight is usually regained by 10 - 14 days of life
    • There is wide variation in 'normal' weight gain; the usual range of weight gain  is shown in Table 1 
    Child's age

    0 - 3 months

    150 - 200 g / week

    3 - 6 months

    100 - 150 g / week

    6 - 12 months

    70 - 90 g / week

    Between birth & 1 year

    Birth weight doubles (or more)

    1 - 2 years

    2 - 3 kg / year (40 - 50 g / week)

    2 - 5 years

    2 kg / year

    Table 1  Range of weight gain birth to 5 years of age (NHMRC Infant Feeding Guidelines 2012) 

    What factors affect growth?

    Children's growth can be affected by a range of factors including: 

    • Genetics - short parents are more likely to have short children
    • Environment - the general health and age of the mother, number of pregnancies, food security, socio-economic status and substance use such as smoking affect birth weight and growth 
    • Nutrition - breastfed infants have different growth patterns in the first year of life compared to non-breastfed babies.
    • Biological causes - children who are large for gestational age at birth (for example due to maternal diabetes or maternal obesity) have a higher risk of developing obesity and metabolic syndrome later in life.
    • Health and wellbeing - frequent infections, developmental delays, feeding difficulties, long term medications and medical conditions such as kidney or heart disease can all affect infant and young children's growth. 

    Previously it was thought that ethnicity or race affected children's growth but this was refuted in the WHO growth study. 

    When to weigh and measure children 

    • The National Health and Medical Research Council recommends children's growth should be monitored at regular intervals
    • Each state and territory in Australia has health monitoring schedules for infants and young children when growth measures are taken and plotted on the relevant charts. 
    • These schedules are for otherwise healthy children and allow for early detection of altered growth should it occur. 
    • Children with ongoing health concerns may need to have their growth monitored more frequently. 

    Growth monitoring is especially important during infancy for:

    • Detecting slow or excessive growth
    • Checking the impact of illness and response to treatment
    • Screening for high risk individuals
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