During the third year of life, toddlers tend to gain about 4 pounds (1,800 grams) in weight and grow about 2 to 3 inches (5 to 8 centimeters) in height.
They're extremely active and mobile, and learning in very physical ways. These toddlers are sleeping less than they did in the year before, running around and exploring their world, and picking up new skills, like riding a tricycle.
Your toddler's appetite may fluctuate greatly at this stage. This is very common. If your child is active, happy, and engaged, and you're providing a variety of nutritious foods, he or she is probably getting the nutrients needed and there's likely no cause for concern.
Although kids come in all shapes and sizes, a healthy child should continue to grow at a regular pace. The doctor will measure and weigh your child at routine checkups and plot the results on a growth chart. This helps ensure your child's steady growth pattern, and tracks whether his or her size is in a healthy range compared with other kids of the same age and gender.
How Can I Help My Child Grow Normally?
Normal growth - supported by good nutrition, adequate sleep, and regular exercise - is one of the best overall indicators of your child's good health. Be aware, however, that your child's growth pattern is largely determined by genetics. Malnutrition severe enough to affect a child's growth rate is uncommon today in the United States and other developed countries unless the child has an associated chronic illness or disorder. Pushing a child with "short genes" to eat extra food or greater than recommended amounts of vitamins, minerals, or other nutrients will not increase his or her height.
At the Doctor's Office
Despite data collected for growth charts, "normal" heights and weights are difficult to define. Shorter parents, for instance, tend to have shorter children, whereas taller parents tend to have taller children.
Although you may worry if your child isn't as tall as his or her peers, or weighs more, the more important question is whether your child is continuing to grow at a normal rate. If your child's doctor suspects a problem - such as a growth rate that had been normal but has recently slowed - he or she may track your child's measurements carefully over several months to determine whether the growth pattern suggests a possible health problem or is just a variation of normal.
Most children who are growing at or below the 5th percentile line on the growth chart are usually following one of the two normal variant growth patterns below:
Familial (Genetic) Short Stature. These children have inherited genes for short stature from their parents. Usually one or both parents, and often other relatives, are short. Although they are shorter than average, these children grow at a normal rate and are otherwise healthy, showing no symptoms of medical problems that can affect growth. They generally enter puberty at an average age and reach a final adult height similar to that of their parents. In general, no treatment for these children is recommended or known to be effective in significantly increasing their final adult height.
Constitutional Growth Delay (Delayed Puberty). Although they are usually of average size in early infancy, these children undergo a period of slower-than-average growth between 6 months and 2 years of age, causing them to fall to the 5th percentile or lower on the growth chart. After about age 2 or 3 years, kids with constitutional growth delay will grow at a normal childhood rate until they reach puberty and undergo a growth spurt at a later age than most other teens. Because they start puberty later, they will continue to grow after most teens have stopped, thus "catching up" to their peers in final adult height. Usually, there's a family history of this kind of growth pattern, and in general, there's no need for any kind of treatment.
If your child's doctor finds your child is growing too slowly, tests may be ordered to figure out whether this is related to a medical or genetic condition that would interfere with growth.
Be sure to discuss any concerns you have about your child's growth or development with your child's doctor.
Reviewed by: Barbara P. Homeier, MD
Date reviewed: October 2005
Originally reviewed by: Steven Dowshen, MD
