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Understanding Your Child’s Growth Chart

Growth charts are tools that medical professionals use to track trends in your child’s growth. They are also used to diagnose conditions that indicate growth issues, such as obesity or failure to thrive. For more information about how growth charts are used and interpreted, read on.

Understanding when to use which growth chart:

The Centers for Disease Control and Prevention’s website provides growth charts used for the majority of typically developing kids. It is important that medical professionals use the right growth chart for their patient.

  • For kids < 2 years old:  The growth charts labeled 0-2 years old from the World Health Organization should be used until age two. Recently, growth charts for this age were updated using data that is representative of a wider range of ethnicities and primarily breastfed babies.
  • The “Birth-36 months” growth charts:  These should be used when the child’s length is measured recumbently (lying down). If the practitioner is able to get repeatedly accurate standing height measurements of the child age 24-36 months, then the “2-20 years old” growth chart would be used to plot height and BMI. Weight-for-length is plotted using recumbent length, and BMI is calculated and plotted using standing height.
  • The “2-20” growth charts: These are used for typically developing kids in this age range, and for kids ages 2-3 if their height has been measured standing up. These are also used for kids with special needs or specific diagnoses, such as Down Syndrome and Cerebral Palsy, according to recent recommendations. However, it is imperative that a trained medical professional interpret growth of kids with special needs on standard growth charts. I find it useful to use both standard growth charts and growth charts designed for kids with specific diagnoses as multiple pieces of information in overall growth assessment.

BMI Measurements:

  • Weight for Length and BMI. This single data point is very important, as opposed to the other growth measurements where the overall trend is more important. These growth charts are used diagnostically as follows:
  • Weight-for-length or BMI < 5th percentile. This is considered “underweight”, which means that the infant or child does not have adequate body mass for how long he or she is. Kids who are underweight may be at higher risk for nutrient deficiencies, compromised immune function, lethargy, impaired cognitive development, and more. These cases should be referred to a pediatric dietitian. If underweight status worsens over time or is a chronic issue, the child may be diagnosed failure to thrive.
  • BMI 85th – 94th percentile. This is diagnosed as overweight. Weight loss is not recommended for these kids, but rather weight maintenance. Then as their heightcontinues to increase, the BMI will normalize.
  • BMI > 95th percentile. This is diagnosed as obese. These kids should be referred to a pediatric dietitian for assessment and a weight management plan.
  • Note, children under 2 years old are not diagnosed overweight and obese. This is because growth patterns are very different in infants than older kids. Many factors should be taken into consideration by the trained medical professional for infants who have weight-for-length > 95th percentile before changes to their diet intake are made.

“Within Normal Limits”

This phrase describes the percentiles of the growth chart that are considered to be within a normal range of growth for kids that age. The normal range concept applies mostly to the BMI growth chart and the Weight-for-Length growth chart. BMI is within normal limits if it falls between the 5th and 85th percentiles.

It’s all about the trend.

When it comes to weight and length or height, in most cases, the bigger picture is more important than individual measurements. This means that as long as your child’s growth is “tracking along its usual curve”, his or her growth is probably normal for them. If weight or length/height drop or increase more than two growth channels over a span of 6 months, this is cause for concern and needs further evaluation by the pediatrician and dietitian.

Click here for strategies to talk to your kids about weight and healthy eating.

How to Talk to Your Kids about Weight and Healthy Eating

We all want our kids to be the healthiest they can be. In recent years, we are seeing serious health problems presenting in young kids and adolescents. An unhealthy diet and lifestyle affects kids’ quality of life, and this is often what hurts them most. Kids with weight issues may get teased at school or start to withdraw from activities that were once a big part of their life, such as sports. This can make the weight issues even worse for them.

If you find yourself in a position of having to talk to your child about his or her weight, consider some of the points below. These tips apply to both overweight and underweight issues.

Explain BMI and the importance of being in a healthy range.

BMI stands for body mass index. Your child’s pediatrician should be measuring your child at well checkups and plotting their BMI on a growth chart. You can explain BMI to kids by saying, “BMI is a measurement of how much weight is on your body for how tall you are.” Read more

Breakfast for a Better Kid and Day!

Breakfast often gets skipped in the haste of the typical morning. Mom and dad are getting themselves ready, getting the kids ready, and tying up loose ends around the house. Many people report not having an appetite in the morning. Often, this is caused by over-eating in the later part of the day. family breakfastKids will model their parents, so think about what example you may be setting for your kids. In any case, the fact is, this morning a lot of kids woke up late and got breakfast at a fast food drive thru or ate nothing at all.

Studies show that kids who eat breakfast do better on tests in school. Nourishment in the morning provides brain fuel needed for concentration and energy. Even behavior and general attitude is better. Have you been around a hungry, tired kid lately? Not so fun and probably not the kid who’s skipping to the head of the class, so to speak.

Not only do kids who eat breakfast do better in school, but kids who eat breakfast tend to have healthier BMIs. It’s hard to say exactly why this is, but likely it has at least something to do with kids having less energy during the day to be active, and then over-eating later in the day. Eating in a balanced way throughout the day will prevent over-eating later, and leave room for a good appetite in the morning.

Here are some tips for a breakfast for a better kid:

  1. Change your morning so that breakfast is a requirement. Would you let your kids go to school in their pajamas? Just like getting dressed is a morning requirement, eating breakfast should be too. Carve that time into the morning, for yourself and your kids. Remember you are the most important role model in shaping their eating habits.
  2. Make breakfast count. Breakfast is just as important as lunch or dinner in terms of creating a complete, healthy meal. Strive for the healthy plate model at breakfast, which is to include whole grains, a protein source, and plenty of fruits and veggies. Vegetables are not typically the stars of the breakfast show, but try things like homemade hash browns or omelets with a variety of veggies. Potato pancakes are usually a hit if you have time to make them.
  3. Something is better than nothing. I would really recommend avoiding the fast food drive thru breakfast. Usually this isn’t going to be the healthiest food, but also, eating on the run results in poor digestion and tummy aches.If on occasion, you are late and have to do breakfast in the car, try a trail mix with dried fruit, nuts, and cereal. Another option would be a Clif ™ bar or Larabar ™ with a string cheese.
  4. Use the weekend to make breakfast a special meal for your family. The weekend breakfast can be such a fun family (and friends) tradition. Eating breakfast at home gives kids another chance to have a family meal at the table, which builds good habits, communication skills, and relationships. Breakfast foods tend to be popular with kids, and can be made with a healthy spin.

Examples of a Better Breakfast for Children:

  • Multigrain pancakes with blueberries and scrambled eggs. Try a maple-agave syrup blend (it’s less expensive than 100% maple syrup but still contains whole ingredients instead of high fructose corn syrup). Another healthy topping is homemade strawberry-rhubarb syrup which you can make by simmering chopped rhubarb and strawberries with a few tablespoons of water.
  • Granola, fruit, and yogurt parfait. Make it seasonal by stirring in pumpkin spice granola or farmers market fruit. Make it a winner by setting bowls of yogurt at the kids’ places at the table, and allow them to pick from an array of mix-ins on the table that they can spoon in themselves.
  • Organic bacon or sausage, whole grain English muffin spread with fruit preserves.
  • Whole grain toast, egg scramble or omelet with any of the following: chopped peppers, spinach, broccoli, peas, mushrooms, onions, tomatoes virtually any vegetable, black beans, cheese.
  • Oatmeal, berries, and nut butter mixed in. Top with homemade coconut whipped cream, which can be made by whipping canned coconut milk with beaters on high until foaming and thick.

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