Growth and Your 4- to 5-Year-Old

Helping Your Child Grow

Normal growth — aided by good nutrition, adequate sleep, and regular exercise — is one of the best overall indicators of a child's good health. But your child's growth pattern is largely determined by genetics. Pushing kids with "short genes" to eat extra food or greater than recommended amounts of vitamins, minerals, or other nutrients will not make them taller. And eating too much may lead to excessive weight gain.

Preschoolers can be picky eaters, but it's important to continue to offer a variety of foods. In addition to good nutrition, preschoolers should get at least 60 minutes of physical activity each day. Kids at this age are naturally active, so it's up to you to encourage that activity and provide a safe environment for exploration.

At the Doctor's Office

There is a wide range of "normal" heights and weights. Shorter parents, for instance, tend to have shorter kids, whereas taller parents tend to have taller kids.

Although you may worry if your child isn't as tall as his or her peers, the more important question is whether your child is continuing to grow at a normal rate. If, for instance, your child's growth rate had been normal but has recently slowed, the doctor may track your child's measurements over a few months to see whether this is a possible health problem or just a variation of normal.

You may be concerned that your child is too small. Most kids who are very short — at or below the 5th percentile on the growth chart — are usually following one of two normal variant growth patterns:

1. The first is familial (genetic) short stature, in which kids have inherited genes for short stature but will grow at a normal rate, enter puberty at an average age, and reach a final adult height similar to that of their parents.
2. The second is constitutional growth delay, in which kids grow at a normal rate but are smaller than their peers, enter puberty later, and continue growing after their peers have stopped, thus usually reaching a normal adult height.

However, medical conditions like hypothyroidism also can affect a child's growth, so talk with your doctor if you have a concern.

Reviewed by: Mary L. Gavin, MD
Date reviewed: September 2011