Childhood growth

Childhood growth

There are a number of undergrowth and overgrowth conditions we support. For more information about the conditions our families are diagnosed with you can see our individual condition pages and find links to more information, including CGF information booklets.

Growth during infancy and childhood is a complex, changing process that is influenced by a variety of genetic, nutritional, environmental, and hormonal factors. Monitoring a child’s growth is crucial for ensuring their overall health and well-being and is the most sensitive indicator of health in childhood. Whilst it is rare for a growth condition to be the cause of poor growth, recognising potential issues early can lead to timely interventions and ensure the best outcomes for children.  

In the UK a baby’s growth is monitored throughout pregnancy. Foetal growth is the most rapid period of growth and mostly dependent upon the health of the mother and placental function. , Following birth, three further stages of growth are seen and are classified as infancy, childhood and puberty. 

Growth is monitored by healthcare professionals at various points throughout childhood, your baby’s midwife will carry out checks from birth and until 2 weeks of age and then your health visitor will take growth measurements through the pre-school years.  

At school entry (age 4-5 years) and in year 6 (age 10-11 years), growth measurements (height and weight) are taken by the school nursing team as part of the National Childhood Measurement Programme. This programme primarily looks at BMI (body mass index), so may not detect all growth irregularities. However, the school nursing team are there to support and discuss any growth concerns (height growth or weight) you may have. They can be contacted about this at any point throughout your child’s school years. 

Additionally, if your child attends an outpatient appointment or is admitted to hospital, they should be weighed and a height measured each time. 

The Child Growth Foundation suggests additional growth measurement checks and has the following recommended growth monitoring guide: 

Growth in infancy and early childhood 0 – 3 years

In the first year of life, there is some continuation of rapid growth; usually, infants will double their birth weight by about 4-6 months and triple it by the end of the first year. During the first year, environmental influences on growth, such as nutrition and chronic and acute illnesses, can impact growth and a baby’s length increases by about 50%. Between the ages of 1-3 years, growth slows compared to infancy. 

Childhood growth 4 years – puberty 

Whilst a healthy balanced diet is incredibly important throughout childhood, nutritional influences become less influential and hormones, particularly thyroid and growth hormone become the main regulating mechanisms for this period of growth. During this time families will see average height increases of around 4-8cms per year. 

Late childhood and puberty 

Growth rates may increase as children approach puberty, 8-12 cm per year of height growth occurs during this time. Not every child starts puberty at the same time. It typically begins with breast development between age 8 and 13 years in girls, and typically begins with an increase in testicle size between age 9 and 14 years in boys. The average age for girls to start puberty is age 11 years, while for boys the average age is 12 years. The process can take up to four years, but it can be different for everyone.

The pubertal growth spurt, is where growth hormones and sex hormones work together, resulting in accelerated growth. In girls the growth rate declines approximately two years after their first menstrual cycle and with boys it slows after they start to grow facial hair. Growth ends with the fusing of the growth plates. Growth plates are the part of the long bone where new growth takes place, when these fuse no further growth is possible. 

If you are concerned about early or late puberty it is recommended to seek medical advice if: 

Girls – signs of puberty before the age of 8 years or no signs at 13 years. 

Boys- signs of puberty before the age of 9 years or no signs at 14 years. 

More information on the different stages of puberty can be found here: 

Possible causes of growth issues in childhood 

Watching your child grow and develop throughout childhood can be one of the most exciting parts of parenting. If you notice your child’s growth is not as expected it can be worrying. It’s important to remember there are many different reasons causing these unexpected growth patterns, some of which are rare. Whilst this is not an all-inclusive list, below are some of the possible causes of growth issues in childhood:

 1. Nutritional deficiencies:

If a child’s diet lacks essential vitamins, minerals, and proteins, their body might not have what it needs to grow properly. 

2.Chronic illnesses/health conditions:

Sometimes, ongoing health problems (or medication to treat chronic conditions) can affect a child’s growth. Conditions like asthma, heart defects, or digestive problems can make it harder for the body to absorb nutrients or use energy effectively, slowing down growth. Some infections, particularly if they are recurring or chronic, can interfere with growth.  

3. Hormonal imbalances/endocrine disorders:

Hormones can play a crucial role in helping children grow. Producing too much or too little of hormones such as growth hormone or thyroxine could lead to faster or slower growth for your child.  

4.Genetic conditions:

Several genetic conditions can affect a child’s growth, for example children with Silver-Russell syndrome, Turner syndrome and Down syndrome tend to be shorter than expected. Conditions such as Sotos syndrome, Weaver syndrome, Tatton-Brown Rahman syndrome and Malan syndrome tend to be taller than expected. 

5. Emotional stress or trauma:

Children who experience significant stress or emotional trauma might grow more slowly. Stress can affect the body in many ways, including growth. 

Monitoring your child’s growth 

While variations in growth patterns are normal, certain signs may indicate potential issues that warrant further assessment by a healthcare professional.

There are many things you can do, such as ensuring your child attends check-ups and appointments and is measured at every point of contact with a healthcare professional. Whether that is the routine checks completed by health visitors, or by school nurses as part of the National Child Measurement Programme, or additional reviews carried out at hospital and GP appointments.

Always take your child’s red book – their Personal Child Health Record (PCHR) to appointments so that the measurements taken are recorded in it. Between the ages of 5 and 10years old, it is unlikely your child’s height will be checked unless they have health issues requiring healthcare input. During this time, we would suggest tracking your child’s growth at home every six months, we have produced the following guide to support you: