Normal Baby Growth Development: Principles & Problems

What do parents need to keep in mind when it comes to their infant’s growth (height and weight)? Find out just what to expect from your baby’s growth development.

For parents, it’s hard to objectively evaluate your own child. Although one part of you may want to identify any problems with growth and development as soon as possible, another part wants deeply to have a normal child. This can lead to a certain amount of denial that a problem exists. But although it might feel intimidating at first, talking to a doctor about your concerns ultimately can give you definite answers and, if necessary, action plans.

And parents are rightly concerned about their children’s progress toward becoming physically and mentally competent adults. Problems with infant growth and development signal the need to provide additional services to the child to realize his or her full growth and development potential. The most useful information for parents is that which assists in detecting problems as early as possible and facilitates getting help to correct a problem—indeed, early intervention is crucial.

Because parents are so emotionally involved in their own child and because there are such nuances in every individual’s development patterns (sometimes referred to as “biological variability”), it definitely can be difficult to identify problems in children’s growth and development.

The definition of “normal” is broad and influenced by the infinite variations in genetic inheritance and environmental influence. For doctors, it is sometimes difficult to distinguish normal variation from true problems.

Standards and Principles of Growth

There are many standards available to help parents evaluate how their children are doing before birth, at birth, and throughout childhood. (In fact, the purpose of this website is to help parents find and use those standards.)

There are a few principles that will help you make sense of your infant’s growth and development as you monitor it:

  • Development follows definite patterns. The ranges of seemingly normal growth from conception to adulthood have been studied and published. Your infant’s doctor or nurse practitioner should routinely evaluate and graph your child’s progress against these standards. Unfortunately, there are not good standards for every racial and ethnic group.
  • Consistent development trumps peer comparisons. That is, a pattern of steady growth and development is more important than whether children are bigger or smaller than most of their peers. And graphing a child’s weight is much more effective than just collecting the measurements.
  • Size at birth poorly predicts final adult height or weight. This more accurately reflects the intrauterine environment.
  • Early accomplishments aren’t everything. Reaching developmental milestones earlier than most children does not necessarily indicate greater intelligence.
  • Abnormalities of hearing and sight require early corrective action to permit normal language and intellectual development. Be especially watchful of any apparent problems in these areas.

Growth Problems before Birth

Babies who are smaller or larger than the usual are of concern. Both groups are more likely to have problems during labor and delivery and in the immediate neonatal period. Babies that are smaller than usual are sometimes called small for gestational age (SGA). Another, less often used term is intrauterine growth retardation (IUGR). Babies that are SGA should be evaluated to determine the cause. SGA infants tend to be small throughout their lives, especially if they are born prematurely or are very small compared to the standards.

Growth Problems in Infancy

Babies normally lose weight in the first few days after birth. Breastfed babies lose more weight than bottlefed infants, but suffer no adverse consequences to this normal weight loss. Within the first two weeks or so infants should regain their birth weight.

Within the first few months after birth, the infant usually establishes a growth rate that will be consistent for many years. This growth rate should keep her at about the same position relative to her peers. A child who is smaller than 75 percent of his same-age peers may be perfectly healthy. Concern would arise only if the child were losing ground compared to his same age peers.

Growth Problems in Childhood

By two to three years of age a child should have established a rather consistent growth pattern. Height at this time is a fairly good predictor of final height. Significant reductions or increases in the rate of growth often indicate a medical problem.

Key Measurements

At well-baby visits, there are four key areas that physicians look at when considering a child’s growth:

  • Weight
  • Height (Before your child is able to stand, this is best done by measuring the difference between the top of the head and bottom of the feet with the child lying on the floor.)
  • Head circumference
  • Developmental milestones

Increases in size, cognitive, and motor skills are the hallmark of childhood. The first few months after birth are a time of particularly rapid growth. You should partner with your doctor or nurse practitioner to make sure that your baby is growing and developing appropriately.

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