(Nelson Textbook of Pediatrics. 18th ed. Saunders; 2007:70–74, 677, 2434; Pediatr Rev 2006;27:e1; Pediatr Rev 2011;32:404)
• Term infants lose up to 10% of BW, then regain by 2 wk
• Avg infant BW doubles by 4 mo and triples by 1 yr; height doubles by age 3–4
• Exclusively breast-fed infants gain wt faster than formula-fed for first few mo, then more slowly after 3 mo; resolves by 1 yr
• Growth during puberty accounts for nearly 1/5 of height. Girls achieve peak height at Sexual Maturity Rating 2–3 compared with boys at Rating 3–4
• Anterior fontanelle: Normal size 20 ± 10 mm; closes at 9–18 mo
• Posterior fontanelle: Closes by 2 mo
• Excessively large fontanelle: IUGR, hypothyroid, prematurity, Trisomy 13/18/21, hydrocephalus, achondroplasia, Apert syndrome, cleidocranial dysostosis, cong. rubella, Hallermann–Streiff syndrome, hypophos, Kenny syndrome, osteogenesis imperfecta, pyknodysostosis, Russell–Silver syndrome, Vit D def rickets
• Excessively small fontanelles: Microcephaly, craniosynostosis, hyperthyroidism
• Average growth and caloric requirements (Adapted from Nelson Textbook of Pediatrics)
Midparental Height
• Boys: (Paternal height in in. + maternal height in in. + 5)/2 +/− 3 in.
• Girls: (Parental height in in. + maternal height in in. − 5)/2 +/− 3 in.
Growth Charts (Am Fam Physician 2003;68:879) (Growth charts at
www.cdc.gov/growthcharts)
• CDC recommends using WHO charts for ages 0–2 yr and CDC charts after 2 yr (MMWR Recomm Rep 2010;59(RR-9):1–15)
• WHO charts developed based on predominantly breast-feeding children in environments supporting optimal growth and are considered “ideal” growth charts compared with CDC charts representing “actual” growth patterns
• Length should be measured via length-board (<2 yo); height measured via stadiometer
• Head circ measured just above eyebrow and ears, across most prominent part occiput
• Special growth curves available for: Trisomy 21, Prader–Willi, Williams syndrome, Cornelia de Lange syndrome, Turner syndrome, Rubinstein–Taybi syndrome, Marfan syndrome, achondroplasia, and low and very low BW preterm infants <1,500 g (use Infant Health and Developmental Program [IHDP] growth curves)