Growth curves offer very important information-Ask Dr. Paul Library

DEAR DR.PAUL: I have a 12 month old daughter who seems to be very healthy and well. I am wondering why it is important to see a doctor for check ups even when most of the time all the doctor does is weigh and measure my daughter and quickly examines her only to tell me that all is normal?

PEDIATRICIAN DR.PAUL Answers: One of the aspects that makes the field Pediatrics different from adult medicine is that children are constantly changing. They grow at a tremendous rate, especially during the first few years of life. During this period, they also go through the stages of physical and mental development. Remarkably, a baby will literally develop from being almost immobile at birth, into a talking, walking toddler within 18 months! An important role of the pediatric check-up is to make sure that children are growing and developing normally. Other important roles of regular check ups include vaccination and the opportunity for parents to ask about and discuss any specific concerns or problems.

Let me now discuss growth curves specifically. When a child is assessed, three important measurements are taken: height ,weight and head circumference. These measurements are then placed or plotted on a growth curve or chart which illustrates the average rate and amount of growth in children within different age groups. In other words, growth charts allow us to record and follow the pattern of growth. Whether a child is growing normally or not depends on the rate of growth over time as compared with the average or normal rates for a child's age. Because boys grow at different rates than girls, we use separate growth curves. In order to be able to properly assess a child's growth, the curve has to be looked at a over several measurements and time. In this way, the growth curve really charts out a child's life growth pattern until adulthood. Consequently, the growth curve is a vital part of any child's medical record.

Growth curves, can also provide very good clues as to whether certain problems or symptoms are serious. For example, a common complaint is that a child is not eating enough or is a picky eater. How serious or worrisome the problem is, depends in large part on the growth pattern. If the growth rate is normal, we can be assured that despite the picky eating habits, the child is getting enough calories to grow. Similarly, when assessing children for other problems such as frequent infections or colds, an important part of the assessment is looking at the growth curve. Again, if the growth rate is normal, chances are that there really is nothing seriously wrong. I view, the growth curve as a child's, parent's and pediatrician's best friend. However, a growth curve can only be kept up to date by attending regular check-ups.

On a final note, a column on infant growth and development would be incomplete if I didn't mention the two most important aspects about ensuring baby's normal growth and development. One is providing proper nutrition including enough calories, adequate fat, calcium and iron, especially during the important first 18 months of life. The other aspect of course, is tender loving care!

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