Children Come in All Shapes and Sizes

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What kind of experience have you or your child had with being weighed and measured? Has it been positive, neutral, negative?

I’ve spoken with many worried parents over the years, with some of the worry coming as a direct outcome of the weighing and measuring and plotting that goes on at the pediatrician’s office. As you may know, the standard procedure for evaluating growth in children is to use growth charts developed from studying populations. In the US, it is standard to use the World Health Organization (WHO) growth chart from birth until age 2 and then switch over to the Center for Disease Control and Prevention (CDC) growth charts from ages 2 to 20.  The latest (2006) WHO growth charts were developed from studying the growth and development of breastfed children in six countries around the world (USA, Oman, Norway, Brazil, and select affluent areas of Ghana and India). The CDC growth charts (2000), however, were developed using data from the National Health and Nutrition Examination Surveys (NHANES) from 1963-1994. There are certainly benefits and drawbacks of the methods used in the creation of these charts.

The purpose of the growth chart is to track one child’s growth over time, based on what seems to be the expected pattern determined by population studies. Therefore, there is no right or wrong place to be on the growth curve. Simply, it is expected that one child will follow his own curve. That means that the child consistently tracking along the 3rd percentile does have to gain weight and the child consistently tracking along the 97th percentile does not need to lose weight. Body diversity should be expected. However, jumping from one curve to another curve should certainly raise some curiosity about eating behaviors.

If the Division of Responsibility (see previous post) is used, children can grow based on their own genetic potential. If growth patterns are not stable, here are some questions to ask:

  • Does my child experience structured meal and snack times?

  • Is my child sitting down to eat or mostly eating on the go?

  • Is food used as a reward or punishment?

  • Is there a “clean plate” policy at home?

  • Do all foods fit or are some foods praised or ridiculed more than others?

  • How are bodies spoken about?

I’d love to hear your thoughts.  Can you share this post with another parent who could benefit from this information?