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Children's Health

Length of Toddler Dropped Percentile

08/09/2011

Question:

My son had his 24 month wellness check and measured 34 1/4 inches which put him in the 50th percentile. His 18 month visit measured at 33 inches which was 75th percentile which I`d where he has been since birth Also his measurements are always done lying down I just learned that length is the most important indicator of a problem His weight is 28 lbs and has remained consistent in 50th percentile. Drop in length percentile concerns me and also only growing 1 1/4 inch in 6 month period concerns me at this young age. I thought growth stayed rapid till 24 months. Is drop in length percentile in this period of time cause for concern?

Answer:

There are many factors which play into a child's height and the most common reason for a change in percentile tracking is measurement error due to wiggling. Another common reason is that the child is just moving into a growth spurt. These situations are of no concern and by keeping up with your regular check-ups, your health care provider will keep track of these with you.

There are times that, due to illness or malnutrition, a child will deviate from their growth curve. As health care providers, we become most concerned if the child's weight plateaus and THEN their height levels off. With very rare exception, one dip in height velocity is not a cause for testing or investigation. I would advocate keeping up with your regularly scheduled health care appointments and monitor this situation with your health care provider.

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Response by:

Sarah Sauntry, RN, MS, CPNP-PC
Assistant Professor of Clinical Nursing
College of Nursing
University of Cincinnati