Making Sense of Growth Charts: A Pediatrician’s Perspective

Why parents worry about growth charts (and why you don’t have to)

Every parent knows that feeling of going over the growth chart in the pediatrician’s office, staring at the percentiles, numbers, and curves, and suddenly it feels like you’re back in school, looking at a test you didn’t study for. Is my child failing at growing? Are they growing too much? Did I mess it up?

As a pediatrician, I can tell you: growth charts may look intimidating, but they’re not as complicated as they seem, and they are one of the most important tools I use to assess a child's health is the growth chart. Here’s a breakdown of what they are,  and just as importantly, what they are not.

✅ What Growth Charts Are

• A tool to track your child’s height, weight, and head size over time.

• A way to see patterns and trends in growth.
  One piece of the puzzle in understanding your child’s overall health.
  
  

❌ What Growth Charts Are Not

• A report card on your parenting.

• A measure of your child’s worth or potential.

• Something you can fully control.

When it comes to feeding, sleep, or choosing between breastmilk and formula, parents make lots of daily decisions. Growth, however, isn’t one of them,  it unfolds naturally.

Let’s take a closer look at what growth charts really are, how they work, and what they can (and can’t) tell you.

Let’s start with the basics: what is a growth chart?

A pediatric growth chart is a graphical tool that tracks a child’s measurements over time. It looks at height, weight, and head circumference, and compares them to standardized percentiles based on a large population of children.

WHO vs. CDC: Which growth chart does your pediatrician use?

The two most commonly used growth charts are those provided by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). Both are valuable, but they use slightly different data sets and methods.

• WHO growth charts are commonly used in the U.S. for the first two years of life. At this stage, your pediatrician’s office will measure your child’s length while lying down.
  
  

• CDC growth charts are typically used after age 2. At this point, practitioners measure standing height and also calculate BMI.
  
  

Both the WHO and CDC provide separate charts for boys and girls, since children grow differently by sex.

Your pediatrician will let you know which chart they are using and explain how it applies to your child.

How I read percentiles with parents

Growth charts display a child's measurements in percentiles, which show how your child compares to other children of the same age and sex.

What percentiles mean (and don’t mean)

Percentiles can feel intimidating at first glance, but they aren’t a score or a measure of success. They’re a tool that helps track patterns in your child’s growth over time. A baby in the 10th percentile can be just as healthy as a baby in the 90th — what matters most is whether they follow their own curve consistently.

What the 50th percentile actually means

Being in the 50th percentile doesn’t mean your child is “average” in the way a grade would suggest. It simply means that half of children are smaller and half are larger. Similarly, a baby in the 75th percentile for height is taller than 75% of children their age. These numbers don’t predict intelligence, athletic ability, or long-term health — they’re just reference points.

Why percentiles change over time, and when it’s okay

In general, babies and children tend to follow the same curve on the growth chart over time. But small shifts up or down are very common.

Some reasons a percentile might change include:

• Growth spurts (often in infancy or puberty)
  
  
• Illness or recovery from illness
  
  
• Changes in feeding or appetite
  
  
• Increased activity levels
  
  

Pediatricians expect some variation. What raises concern isn’t a single percentile shift but a consistent pattern of crossing several growth curve lines up or down over time.

What growth charts really tell me as a pediatrician

Pediatric growth charts are just one piece of the puzzle when it comes to understanding your child’s health. Pediatricians use them alongside other tools to get a fuller picture of growth, development, and nutrition.

Monitoring growth patterns, not single numbers

Regularly plotting your child's measurements on a growth chart helps identify trends. Sudden changes can indicate potential health issues that may need further evaluation.

Assessing nutritional status

Growth charts can help determine if a child is growing appropriately for their age. They provide insight into whether a child is underweight, at a healthy weight, or overweight, which can guide discussions about nutrition and activity.

Reviewing developmental milestones

Along with growth measurements, pediatricians evaluate developmental milestones. Growth charts can complement these assessments by offering a holistic view of a child's overall health.

Common questions I hear from parents about pediatric growth charts 

My child is smaller or taller than average — should I worry?

It's common for parents to be concerned if their child falls outside the "average" range. However, every child is unique, and genetics play a significant role in determining height and weight. If your child consistently tracks along their growth curve, they are likely just fine. Remember, being in a certain percentile does not define success or failure—it’s about individual growth patterns. Any drastic shifts, however, should be evaluated by a healthcare professional.

What if my child has a growth spurt?

Growth spurts are normal! Many children experience rapid growth during certain phases, particularly during infancy and puberty. These spurts can temporarily affect measurements on growth charts but typically even out over time. Fluctuations—whether up or down—are part of the process and should be viewed in the context of overall growth trends rather than isolated incidents.

What if my newborn is losing weight?

In the first few weeks of life, it is normal for babies to lose up to 10% of their birth weight. These first weeks are periods of immense change for you and your newborn!  Your baby is adjusting to life outside of the womb and getting used to chest or formula feeding. Ideally, babies will be at or above their birth weight by 2 weeks of life. This is why you may have many appointments with your pediatrician in these first few weeks of a baby's life! 

I don’t want weight conversations to be a focus with my pre-teen or teenager. 

While growth charts remain a useful tool for monitoring development and growth, it is understandable that you may not want weight to be the focal point of every check-up, especially as kids become more aware of their bodies. If you are concerned about how discussions around weight might impact your child’s self-esteem, it is perfectly reasonable to ask your pediatrician to focus on overall health and development rather than specific numbers. Before your appointment, consider having a conversation with your pediatrician and express your desire to emphasize healthy habits, such as balanced nutrition and regular physical activity, rather than focusing on weight alone. 

My tips for parents on tracking growth and development

You don’t need to memorize every detail about growth charts. That’s why your pediatrician is here, to keep an eye on patterns and let you know if something needs attention. What helps most is having a basic understanding so you can follow along and ask questions with confidence.

• Keep regular check-ups
  
  Regular pediatric visits are essential for monitoring growth and development. Ensure your child's measurements are taken accurately at each visit.
  
  

• Ask questions if the chart confuses you
  
  If you have concerns about your child's growth, don’t hesitate to discuss them with your pediatrician. Open communication is key to addressing any potential issues. Ask us questions if you don’t understand the chart!
  
  

• Focus on healthy habits, not numbers
  
  A single percentile doesn’t matter as much as the overall growth curve.
  
   

Final thoughts: Every child grows differently

Growth charts are a crucial tool in pediatric health that help you understand where your child stands in terms of growth and development. By familiarizing yourself with how these charts work, you can better engage in your child’s health journey. Remember, every child grows differently, and maintaining a supportive environment focused on healthy habits, nutrition, and physical activity is essential for fostering optimal growth.

Together with your pediatrician, you can navigate each stage of your child’s development in a healthy and informed way.

 

 

 

 

 

 

 

 

Written by Dr. Michelle Shiffman, MD

Pediatrician & Advisor at Bébé Foodie

Dr. Michelle Shiffman is a board-certified pediatrician based in Denver, Colorado. She brings her expertise in early development, food introduction, and culturally-sensitive care to Bébé Foodie, where she supports the creation of our evidence-based content and contributes to our expert panel. Michelle’s favorite part of her work is connecting with families during infant and toddler visits—especially when it comes to discussing developmental milestones and feeding. As a mom herself, she's also experienced the ups and downs of starting solids and managing picky eating.

This blog post is for information purposes only and shouldn’t be used as personal, health, nutritional, or medical advice. Always consult with your pediatrician before making any decisions about your child's health or readiness for various foods.