Paeds · growth-development-and-behaviour
Normal growth from fetal life through adolescence
Also known as Normal paediatric growth · ICP growth model · Life-course growth
Fellowship guide to normal fetal-to-adolescent growth physiology, ICP phases, chart interpretation, mid-parental height, puberty and red-flag growth patterns.
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Red flags
- Severe faltering with instability or refeeding risk
- Rapidly rising or falling head circumference
- Height more than 2 SD below mean with poor velocity
- Suspected neglect with multi-parameter growth failure
- Suspected precocious or markedly delayed puberty with growth concern
Life stages
Care settings
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- General and Community Paediatrics
- Growth and development
- Renewed curriculum for first-year trainees from 2027 — Learning goal 5: Clinical assessment – essential general paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 10: Clinical assessment and management – developmental and behavioural paediatrics
- Clinical Applications
- Long Cases
- Short Cases
- 4. Professional skills and knowledge: Patient management
- 5. Professional skills and knowledge: Health promotion and illness prevention
- Foundation of Practice (FOP)
- Theory and Science (TAS)
- Applied Knowledge in Practice (AKP)
- Clinical
- History
- Communication
- Development
- General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
- General Pediatrics Content Outline — Domain 12: Growth and Endocrinology
- Patient Care 1: History and Physical Examination
- Patient Care 4: Clinical Reasoning
- Medical Knowledge 1: Clinical Knowledge
- Medical Expert
- Pediatrics: Foundations EPA — Assessing growth and development
Standard versus reference
Growth standard
Growth reference
Infancy — nutrition and early environment · Childhood — GH–IGF-1 · Puberty — sex steroids plus GH synergy. Use this before you invent a diagnosis. [5]
Overview & Definition
Growth is the increase in body size over time. Development is skill acquisition. This page owns growth. Fellowship candidates must explain life-course physiology, choose the right chart, and know when a “small” child is a healthy variant versus a disease signal. [1] [8]
Normal growth is not one centile forever. Healthy children often cross centiles in infancy as they find their genetic channel, then track more steadily in childhood, then accelerate in puberty. The clinical verb is velocity — how fast size is changing — not a single point. [1] [5]
References12ShowHide
- [1]WHO Multicentre Growth Reference Study Group WHO Child Growth Standards based on length/height, weight and age. Acta paediatrica (Oslo, Norway : 1992). Supplement, 2006.PMID 16817681
- [2]de Onis M Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization, 2007.PMID 18026621
- [3]Grummer-Strawn LM Use of World Health Organization and CDC growth charts for children aged 0-59 months in the United States. MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2010.PMID 20829749
- [4]Kuczmarski RJ 2000 CDC Growth Charts for the United States: methods and development. Vital and health statistics. Series 11, Data from the National Health Survey, 2002.PMID 12043359
- [5]Karlberg J Analysis of linear growth using a mathematical model. I. From birth to three years. Acta paediatrica Scandinavica, 1987.PMID 3604665
- [6]Hokken-Koelega ACS International Consensus Guideline on Small for Gestational Age: Etiology and Management From Infancy to Early Adulthood. Endocrine reviews, 2023.PMID 36635911
- [7]Cohen P Consensus statement on the diagnosis and treatment of children with idiopathic short stature: a summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop. The Journal of clinical endocrinology and metabolism, 2008.PMID 18782877
- [8]Barstow C Evaluation of Short and Tall Stature in Children. American family physician, 2015.PMID 26132126
- [9]Fenton TR A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC pediatrics, 2013.PMID 23601190
- [10]Cole TJ Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ (Clinical research ed.), 2000.PMID 10797032
- [11]Hampl SE Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics, 2023.PMID 36622115
- [12]Forkey H Trauma-Informed Care. Pediatrics, 2021.PMID 34312292