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Normal growth patterns in infants and prepubertal children

Julieana Nichols, MD, MPH
Section Editor
Teresa K Duryea, MD
Deputy Editor
Mary M Torchia, MD


Normal growth is the progression of changes in height, weight, and head circumference that are compatible with established standards for a given population. The progression of growth is interpreted within the context of the genetic potential for a particular child [1]. Normal growth is a reflection of overall health and nutritional status. Understanding the normal patterns of growth enables the early detection of pathologic deviations (eg, poor weight gain due to a metabolic disorder, short stature due to inflammatory bowel disease) and can prevent the unnecessary evaluation of children with acceptable normal variations in growth.

A review of normal growth patterns during infancy and childhood will be provided below. Growth during puberty is discussed separately. (See "Normal puberty".)


Somatic growth and biologic maturation are influenced by several factors that act independently and in concert to modify a child's genetic growth potential. The influence of maternal nutrition and intrauterine environment are reflected primarily in the growth parameters at the time of birth and during the first month of life, whereas genetic factors have a later influence [2]. The correlation coefficient between length and adult height is only 0.25 at birth, but increases to 0.8 at two years of age [3,4].

Although primarily reflected in the growth parameters at birth, long-term influences of maternal nutrition and intrauterine environment on subsequent growth and pubertal development have been described [5,6]. Studies in various populations have demonstrated an association between catch-up growth or rapid growth in infancy or early childhood and subsequent obesity, suggesting that mechanisms that signal and regulate catch-up growth in the postnatal period may play a role in the development of obesity. (See "Definition; epidemiology; and etiology of obesity in children and adolescents", section on 'Metabolic programming'.)


Most healthy infants and children grow in a predictable fashion, following a typical pattern of progression in weight, length, and head circumference. Normal human growth is pulsatile; periods of rapid growth ("growth spurts") are separated by periods of no measurable growth [7-9]. Growth is also seasonal, with growth velocities increased during the spring and summer months [10].


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Literature review current through: Dec 2016. | This topic last updated: Fri Dec 09 00:00:00 GMT+00:00 2016.
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