By a baby's first birthday, he/she will grow 7 to 10 inches and triple his/her birth weight. Growth slows a little after the first year, with most babies gaining about five inches in their second year and another three inches by the third birthday. Up until puberty, most children continue to grow at a steady pace of about 21/2 inches a year.

Girls enter puberty between 8 and 13 and boys between 10 and 15. During this time, adolescents undergo one last growth spurt (about 21/2 to 41/2 inches/year for girls and 3 to 5 inches/year for boys). Puberty also marks the development of secondary sex characteristics. By the time puberty ends (about 15 for girls and 16 or 17 for boys), the bones stop growing and a teen reaches his/her adult height.

Growth Considerations and Problems
Parents are sometimes concerned when a child appears to grow slowly or is much shorter than classmates. But a child's growth pattern and final height is largely determined by genetics. Parents who are short tend to have shorter children while tall parents are more likely to have tall children. However, poor nutrition, illnesses and chronic disease, genetic problems, hormone imbalance and psychological stress can affect growth and lead to reduced growth.

Doctors at the Children's Hospital of Philadelphia recently reviewed cases where children were referred for evaluation because of growth concerns or short stature. The researchers found boys were far more likely to be sent for further evaluation than girls. Yet, boys were more likely to be of normal height or short, but healthy. On the other hand, girls were much more likely to have medical conditions causing growth problems (like inflammatory bowel disease, celiac disease, cystic fibrosis, kidney disease or HIV infection). The sex difference in referrals and actual problems probably reflects society's prejudice of expectations for taller boys and shorter girls.

Another important concern came to light in looking at the referral patterns. The researchers found girls were referred for evaluation much later than boys. Since girls finish growing at a younger age, there is less time to provide needed treatment and enable a girl to reach her full height potential.

The researchers say it's important for doctors to plot a child's height and weight on a growth chart from birth through puberty and up to 21. The growth charts enable doctors to determine if a child is following a normal, predictable growth pattern. Since growth is a vital indicator of overall health, any changes or abnormalities may be an indication of the presence of an undiagnosed medical condition. If growth deviates from expectations, closer monitoring is warranted. And if that unexpected growth pattern continues, a child may need to be referred for further evaluation.

SOURCES
Adda Grimberg, M.D. (featured in story), Pediatric Endocrinologist, The Children's Hospital of Philadelphia, 34th St. and Civic Center Blvd, Philadelphia, PA 19104, interview, June 23, 2005. (Media Contact: Joey Marie McCool, (267) 426-6070.)

Additional Resources
For information on growth and potential growth problems:
KidsHealth
The Magic Foundation