During each visit to the pediatrician, the doctor measures the height of the child. The measurement of height is plotted on a graph based on which the pediatrician can tell the parents the child’s height percentile.
If you have just learned that your baby’s height is, say, in the 70th or 90th percentile, what exactly would it mean?
Is it good to have your child in the 90th percentile of height? Is 70th percentile height a cause of concern? Does this mean your child is not going to be tall enough when he grows up?
If you are worried about these questions, read on to learn what height percentile means for your baby and what are the different ways to interpret the height percentile.
Measurement of the height percentile
During your visits to the pediatrician for the treatment of any specific health concern as well as routine check-ups, the doctor would measure the weight, length, and the head circumference of your child.
These measurements are usually taken until the age of 2 years. The measurements are plotted on the standardized growth chart based on the age and gender of the child. [1]
The CDC (Centers for Disease Control and Prevention) has recommended using the WHO (World Health Organization) growth charts for the infants at birth until they are age 2.
For children above 2 years of age, most pediatricians prefer to use the CDC growth chart that includes height, weight, and body mass index (BMI) plotted through age 20 years.
This graph allows the physician to track the growth and development of your child and compare it with the normal range for the kids of the same age and gender. This comparison can allow the doctor to predict the height percentile of your baby and also, help to assess the possibility of developing any disorder that could have an impact on the child’s growth pattern and body weight.
After age 2, the growth chart expands between the ages from 2 to 20 years. In addition to height and weight at every age, other factors like the body mass index are also captured to assess the child’s proportionality. Comparing the height percentile of the child with that of his weight and BMI percentile could also help to predict his risk of obesity or undernutrition.
Plotting the child’s weight, height, and BMI on the graph is considered the most effective way to ensure the baby’s growth is progressing as expected.
The growth chart is created based on the national data of kids from various ethnic groups and geographical regions. Your pediatrician would be able to determine the percentile for your baby’s weight, height, and head circumference based on these charts.
As the child grows, the pediatrician would plot these measurements on a growth chart to find whether he is following the curve that suggests a healthy pattern of growth.
The higher the percentile, the bigger and taller would your baby be compared to other kids of the same age and gender.
For instance, if your daughter is in the 75th percentile for weight, she would be larger than about 75 out of 100 girls, and smaller than 25 out of 100 girls of her age.
A lower percentage represents a shorter height or smaller size than an average child.
In healthy and well-nourished children, these measurements would improve at a predictable rate, thus creating a smooth curve on the growth chart.
The child’s growth gets influenced by a complex interplay or a combination of different factors such as genetics, environment, nutrition, physical activities, and the specific health problems he or she might be suffering from.
The numbers indicating your child’s percentile, for both height and weight, need to be interpreted after taking into consideration these factors.
Hence, parents are advised to not get too hung up about these numbers.
A healthy child may fall anywhere on these charts. A higher or lower percentile does not always mean there is something abnormal or wrong with your child.
Regardless of whether your baby is in the 15th or 95th percentile, what really matters is whether he or she is growing at a consistent rate with age. You need to ensure your child receives good nutrition and has adequate physical activities while being protected against adverse factors like toxins, pollution, and so on to be able to promote healthy growth and development.
The height percentile of a child, when interpreted in combination with these factors, could be beneficial for identifying the issues related to the growth and help parents seek early treatment for the disorder the child might be suffering from.
Let us learn more about what is meant by the child’s height percentile and when it could be a cause of concern.
When should I worry about my baby’s height percentile?
Your child’s growth should ideally follow a consistent curve. If the child’s growth pattern changes suddenly, the pediatrician would want to assess the overall health to identify the factors that might be creating an adverse impact on the child’s overall development.
This would help the doctor detect and address the medical, nutritional, and developmental issues.
For example; a dramatic change in your child’s growth with a sudden drop from being in the 50th percentile to the 10th percentile could be considered a red flag.
Moreover, the child’s weight and height percentiles should roughly have the same proportions.
If your son is in the 20th percentile for weight but in the 80th percentile for height, the pediatrician would monitor his nutritional intake closely to detect the possible causes for the discrepancies in the growth in the height against that in the body weight.
As far as the baby’s height keeps pace with his weight, the chances are good that he is perfectly fine. This is why; measuring the child’s height and weight and plotting them on a chart to find the percentiles are integral aspects of assessing his health.
You should also keep in mind that the genetic make-up of your baby plays a huge role in how he would grow and his height and weight percentiles. It will also determine what could be normal for your baby depending on what is normal for both the parents and close family members.
For example, if both the parents are relatively shorter in stature, it is likely that the height percentile of the child will fall on to the shorter side on the growth chart.
Hence, the role of genetics needs to be factored in while interpreting the curves on the growth charts.
Now that we have learned the importance of height percentiles, let us have a look at the basics of growth charts and how they can help to assess the growth of your baby. [2]
Understanding growth charts and height percentiles
The growth charts are meant to find how well your child is growing. It is important not to compare the baby’s height and weight with that of other children as this could be misleading at times.
This means that the child’s height percentile is primarily used to assess the child’s own growth pattern and to ensure there are no abrupt changes in the curve of his growth.
Such an abrupt or drastic change in the growth curve could be indicative of a medical or nutritional issue that is creating an adverse impact on the child’s growth. Hence, the child’s growth percentile, both for his height and weight, is compared first to his own growth curve.
Having said that; it does not mean that the growth charts can not be used to evaluate the child’s growth in comparison to that of others.
The height percentiles can definitely be used to find whether the child’s growth is normal for his age and gender. A much lower or higher height percentile would again indicate the possibility of the child suffering from a health issue.
Let us learn more about the interpretation of the height percentile in children.
Interpretation of the height percentile in children
An infant growth chart can help you and your doctor to keep track of how your child is growing. There are different growth charts for girls and boys and for infants and older children.
These growth charts are used by physicians to record the changes in the baby’s weight, height, and head circumference. The measurements are marked on the chart so that the changes occurring in these parameters over time can be assessed.
On the vertical or the up-down axis of the growth chart, the measurements are plotted while on the horizontal or side-to-side axis, the baby’s age is marked.
How to understand height percentiles?
The height, weight, and head circumference of each child are different. The growth chart shows this with the help of percentiles.
For example; a child on the 60th percentile for weight could fall a bit higher than the middle of the range that is considered normal for the specific age and gender. This would mean about 60% of boys of his age would be lighter than him, and 40% would be heavier.
A child on the 20th percentile would weigh less than 80% of the children of the same age and a child on the 70th percentile would weigh more than 70% of the children of that age.
Also, some babies would always be smaller while some would always be larger than others at all times along their phase of development.
This means a child who has been on a higher percentile of say 80 or 90% for height at the age of 6 months would ideally remain so even when he is 1 or 2 years of age.
The percentile in which your child falls on the graph for his weight and height should be consistent. It can be considered fine if his height percentile is 60% if it does not increase or decrease by a considerable range in a very short duration. As long as he remains in the range of 60% percentile, with minimal fluctuations of say between 50 to 70%, his growth can be considered to be steady and healthy.
So, the child may still be shorter than about 40% of boys of his age and taller than about 60% of boys of the same age throughout his phase of growth. This shorter or taller stature could be attributed to his genetic make-up, nutrition, and other factors that determine his adult height. But, as long as the percentile remains within the specific range that could be considered normal for him, you can say he is healthy and growing normally. [3]
There may be a few exceptions to this.
For example; in some cases, a child’s height percentile may drastically change by more than 20% within a very short duration.
In such cases, it is important to find the possible causes that could have led to the sudden change in the growth and development.
The factors may be both favorable or unfavorable.
For example, children who suffer from diseases or deficiencies that affect the growth of the bones such as the lack of calcium in the diet may show a drastic reduction in their height percentile.
The doctor would assess the child’s nutritional status and recommend appropriate medications, supplements, and other treatments, depending on the specific cause, to restore healthy growth and correct the underlying abnormality.
Similarly, in some cases, the height percentile may show a change due to certain favorable factors such as an improvement in nutrition or a better response to treatments.
Adopting healthy diary practices would improve the child’s nutrition the effect of which could be noticed in terms of faster growth in height. In these cases, the child’s height percentile may improve within a shorter duration.
Also, if the child has been diagnosed with a condition known to affect the development of bones, a favorable response of the body to the treatment would restore his normal growth pattern. In such cases, again, an improvement in the child’s height percentile can be observed.
Why use height percentiles?
The concept of height percentile is a bit difficult to understand for most parents.
We have been traditionally accustomed to using the growth charts that only show the measures of the height based on the age and gender.
We also try to know whether our child is growing well by comparing his height with that of his friends and other kids of the same age.
However, the comparison of heights may not always help you to detect the health issues he might be suffering from. This is where a height percentile chart could be useful.
The higher percentile is nothing but simply the extension of the traditional methods we have been using to assess the growth of a baby.
It is similar to our attempt to know whether the child is growing at a normal pace by comparing his height with that of his friends, though with a more research-based approach.
For children, measuring the height percentile makes more sense as it lets you know the range of height your child falls into as compared to that of other kids. Checking the height percentile will allow you to predict where your child would fall with respect to his height, in comparison to others, when he grows into an adult.
When you see that most of the friends of your child are taller than him, you know he would grow to be shorter in stature. Similarly, when you see most of the friends of your kids are shorter than him, it assures you that he would grow to be taller in height.
The height percentile helps you make similar predictions, though with more accuracy.
Plotting your child’s growth on the height percentile chart is a more effective and reliable way to find whether your child will have an average adult height or will be shorter or taller compared to other people.
If the height percentile chart reveals that your child falls into the lower percentile, you may consult your physician to know the effective ways to improve the height. It might help your child grow a few inches taller into his adulthood.
This marks the importance of using the height percentile for monitoring your child’s growth. It provides an accurate tool to assess the child’s adult height and allows you to adopt healthy measures to promote the growth to help your child become taller.
As discussed earlier, percentiles can also be used for the measurement of other health parameters like body weight and head circumference. [4]
Is height percentile like the grades in school?
Most parents believe that the height percentile is just like the grades in school: ‘the more, the better’.
However, this is not true.
What we want from the height percentile and the growth grid is to map out the healthiest or the most ideal growth pattern for children.
And this does not work like the grades in school. If your child falls at the 10th percentile for height, it is really no worse and better than falling into the 90th percentile.
What you should really care about is the trend at which the baby is gaining height. So, this whole idea of ‘the more, the better’ that we commonly apply for evaluating school grades is not really applicable to height percentile.
The focus should be on ensuring the child remains in the same percentile throughout his growth phase without major fluctuations.
A jump from 10th percentile to 90th percentile may be lauded if it is related to school grades. However, the same may be a cause of concern if it is about the height percentile. It could indicate the child is suffering from a disorder that is causing a sudden growth spurt.
Conclusion
Percentiles offer one of the best tools that your child’s pediatrician can use to evaluate and monitor his health. Each child is unique and as long as your kid is following his own unique growth pattern, the chances are high that he is healthy and fine.
The hallmark of a child’s overall health is reflected in the review of his growth. Growth can also be a reflection of the child’s nutrition, and the risk of certain medical conditions. This is why; monitoring your child’s growth pattern with the help of height percentile should be a priority.