This health article has been professionally reviewed by Dt Chen Zi Xin, a registered dietitian of the Malaysian Dietitians’ Association (MDA).
As parents, it’s natural to be concerned about your child’s growth and development. When your child seems shorter than their peers, you might wonder if there’s cause for concern. Are they truly too short for their age, and what steps can you take to address it?
This article talks about what you need to know to assess and support your child’s growth.
Assessing a Child’s Growth Patterns
Children’s growth varies widely, and there is no single “normal” height. Paediatricians use growth charts to compare your child’s height with that of other children of the same age and sex.
According to the WHO and CDC growth charts, a child’s weight and height should ideally fall within the percentile ranges for their age and gender:
- Infants (0–2 years):
Weight and height typically fall between the 5th and 95th percentiles.
For example, at 12 months:- Boys: Weight (8.9–11.8 kg), Height (71–79 cm)
- Girls: Weight (8.2–11.1 kg), Height (69–77 cm)
- Children (2–5 years):
Healthy weight and height should remain within the same percentile range.
At 3 years:- Boys: Weight (12.7–16.8 kg), Height (91–100 cm)
- Girls: Weight (12.0–16.1 kg), Height (90–99 cm)
- School-age children (5–12 years):
Growth rates vary, but staying within the percentiles is key.
At 7 years:- Boys: Weight (18.2–26.2 kg), Height (115–128 cm)
- Girls: Weight (17.5–25.6 kg), Height (114–127 cm)
- Adolescents (12–18 years):
Percentiles reflect the rapid changes during puberty.
At 15 years:- Boys: Weight (47.2–70.7 kg), Height (159–175 cm)
- Girls: Weight (46.4–64.4 kg), Height (156–167 cm)
If your child’s measurements are consistently below the 5th percentile or significantly deviate from the average range, it may indicate potential growth concerns that warrant further evaluation by a healthcare professional.
For more detailed and personalized growth tracking, refer to:
- WHO Growth Charts: https://www.who.int/tools/child-growth-standards
- CDC Growth Charts: https://www.cdc.gov/growthcharts
When You Should be Concerned
While occasional height discrepancies are usually not a cause for alarm, certain signs might warrant further investigation.
If your child consistently falls below the 5th percentile for their age, or their growth rate suddenly slows down, it’s worth discussing with a healthcare provider.
Potential Causes of Short Stature:
- Genetic Factors: Conditions like familial short stature or constitutional growth delay may cause shorter height, but are generally not alarming if the child is otherwise healthy. (1, 2, 3)
- Nutritional Issues: Poor nutrition, including malnutrition caused by picky eating, such as deficiencies in protein, calcium or iron, can significantly impact growth. Children who are extremely selective with food may not get the nutrients they need to grow properly. (4, 5)
- Health Conditions: Chronic conditions such as hypothyroidism, celiac disease, or growth hormone deficiencies can also affect growth. Regular health check-ups can help detect and address these conditions early. (6, 7, 8)
- Environmental Factors: Factors like stress, inadequate sleep, and lack of physical activity can also impact growth. (9, 10, 11)
Steps You Can Take
If you’re concerned about your child’s height, there are proactive measures you can take to support their growth and overall health.
- Promote a Balanced Diet:
- Ensure your child’s diet includes a variety of nutrient-dense foods. Focus on incorporating proteins, whole grains, fruits, vegetables, and dairy products to support healthy growth. If your child is a picky eater, try to introduce new foods gradually and in a fun, engaging way to ensure they get the necessary nutrients.
- Ensure your child’s diet includes a variety of nutrient-dense foods. Focus on incorporating proteins, whole grains, fruits, vegetables, and dairy products to support healthy growth. If your child is a picky eater, try to introduce new foods gradually and in a fun, engaging way to ensure they get the necessary nutrients.
- Address Picky Eating Habits:
- If your child’s pickiness is leading to malnutrition, such as lack of protein, consider working with a paediatrician or a dietitian to develop strategies that can improve their eating habits. Protein is crucial for growth as it provides the building blocks for muscle, bone, and tissue development. Without enough protein, children may struggle to grow at a normal rate. (4, 5)
- If your child’s pickiness is leading to malnutrition, such as lack of protein, consider working with a paediatrician or a dietitian to develop strategies that can improve their eating habits. Protein is crucial for growth as it provides the building blocks for muscle, bone, and tissue development. Without enough protein, children may struggle to grow at a normal rate. (4, 5)
- Encourage Physical Activity:
- Regular exercise is essential for stimulating growth hormones and strengthening bones and muscles. Activities such as sports, swimming, and cycling are great options for active development. (11, 12)
- Regular exercise is essential for stimulating growth hormones and strengthening bones and muscles. Activities such as sports, swimming, and cycling are great options for active development. (11, 12)
- Ensure Adequate Sleep and Rest:
- Growth hormone release occurs primarily during sleep. Ensure your child gets the recommended amount of sleep: about 10-12 hours for younger children and 8-10 hours for older kids. (9, 10, 11)
- Growth hormone release occurs primarily during sleep. Ensure your child gets the recommended amount of sleep: about 10-12 hours for younger children and 8-10 hours for older kids. (9, 10, 11)
- Keep Up Regular Check-Ups with a Paediatrician:
- Regular paediatric appointments are key to monitoring your child’s growth. If there are concerns, your paediatrician may refer you to a specialist for further evaluation.
- Regular paediatric appointments are key to monitoring your child’s growth. If there are concerns, your paediatrician may refer you to a specialist for further evaluation.
- Consider Supplements if Necessary:
- In some cases, nutritional supplements might be recommended to fill nutritional gaps, but they should be used under recommendation or supervision from a healthcare provider such as your child’s paediatrician or a dietitian.
- Maintain a Supportive Environment:
- Encourage and support your child without focusing solely on their height. Celebrate their achievements and strengths to foster a positive self-image and overall well-being.
When to Seek Professional Advice
If your child’s height is a significant concern or if they show other symptoms such as delayed puberty, fatigue, or unusual weight changes, seek medical advice. Early intervention can help address potential health issues affecting growth.
Concerns about your child’s height are common, but it’s important to remember that growth varies widely among children. By ensuring your child has a balanced diet, regular physical activity, adequate sleep, and proper medical care, you can support their healthy development.
If picky eating is a concern, addressing it early—such as a sufficient protein intake—can make a significant difference in your child’s overall growth and health. Keep in mind that every child grows at their own pace, and with the right support, they can reach their full potential.
For personalized advice and to address specific concerns, always consult with a healthcare professional. Your child’s growth is just one aspect of their overall health, and providing a nurturing environment will help them thrive in all areas of their life.
References
- Aguilar D, Castano G. Constitutional Growth Delay. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK539780/
- Mastromauro C, Chiarelli F. Novel Insights Into the Genetic Causes of Short Stature in Children. touchREV Endocrinol. 2022;18(1):49-57. doi:10.17925/EE.2022.18.1.49
- Seattle Children’s. (n.d.). Short stature: Understanding causes and treatment options. Retrieved January 3, 2025, from https://www.seattlechildrens.org/healthcare-professionals/provider-news/short-stature/
- Taylor CM, Northstone K, Wernimont SM, Emmett PM. Macro- and micronutrient intakes in picky eaters: a cause for concern?. Am J Clin Nutr. 2016;104(6):1647-1656. doi:10.3945/ajcn.116.137356
- Endrinikapoulos A, Afifah DN, Mexitalia M, Andoyo R, Hatimah I, Nuryanto N. Study of the importance of protein needs for catch-up growth in Indonesian stunted children: a narrative review. SAGE Open Med. 2023;11:20503121231165562. Published 2023 Apr 17. doi:10.1177/20503121231165562
- Almahmoud E, Alkazemi DUZ, Al-Qabandi W. Growth Stunting and Nutritional Deficiencies among Children and Adolescents with Celiac Disease in Kuwait: A Case–Control Study. Children. 2024; 11(9):1042. https://doi.org/10.3390/children11091042
- Giovenale D, Meazza C, Cardinale GM, et al. The prevalence of growth hormone deficiency and celiac disease in short children. Clin Med Res. 2006;4(3):180-183. doi:10.3121/cmr.4.3.180
- Cammisa I, Rigante D, Cipolla C. Growth Outcomes and Final Height in Children with Acquired Hypothyroidism: A Systematic Review. Children. 2024; 11(12):1510. https://doi.org/10.3390/children11121510
- Hermes FN, Nunes EEM, Melo CM. Sleep, nutritional status and eating behavior in children: a review study. Rev Paul Pediatr. 2022;40:e2020479. Published 2022 Sep 9. doi:10.1590/1984-0462/2022/40/2020479IN
- Lampl, M., & Johnson, M. L. (2011). Infant growth in length follows prolonged sleep and increased naps. Sleep, 34(5), 641–650. https://doi.org/10.1093/sleep/34.5.641
- Fonseca, A. P. L. M., de Azevedo, C. V. M., & Santos, R. M. R. (2021). Sleep and health-related physical fitness in children and adolescents: a systematic review. Sleep science (Sao Paulo, Brazil), 14(4), 357–365. https://doi.org/10.5935/1984-0063.20200125
- Hanifah, L., Nasrulloh, N., & Sufyan, D. L. (2023). Sedentary Behavior and Lack of Physical Activity among Children in Indonesia. Children, 10(8), 1283. https://doi.org/10.3390/children10081283
