It can be exciting to watch your new baby grow by leaps and bounds, doubling her birth length by age 3 thanks to a toddler growth spurt, but don't expect that rapid pace to continue. Once children leave toddlerhood, their growth continues at a slower yet steady incline until they hit puberty.
Until they begin pubertal development, "both boys and girls grow in tiny increments," says Danton Kono, M.D., pediatrician with Dignity Health Mercy Medical Group in California. Here's what expect.
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What Is a Growth Spurt?
A growth spurt, according to the National Institutes of Health (NIH), is a fast increase in an adolescent's growth in height and weight that occurs in "the long bones and most other skeletal elements." Because these intense periods of growth are fueled by hormones typically triggered at the onset of puberty, they are unusual in prepubescent children.
Elementary school-age kids gain about 6 pounds and grow 2 inches in height each year, but "a typical growth spurt in the middle of puberty can be twice that," says Zoltan Antal, M.D., chief of pediatric endocrinology at New York-Presbyterian Komansky Children's Hospital and Weil Cornell Medicine.
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Growth Spurt Symptoms
Your child may exhibit symptoms during "mini growth spurts," like eating and sleeping more than they normally would, for a couple of days or even a couple of weeks before going back to their usual routine. "That could be sign that they're going through a growth spurt," says Dr. Kono, who stresses the importance of sleep and nutrition for a child's development.
But keep in mind: Your child's diet shouldn't suffer just because they may be going through a growth spurt. Keeping up healthy habits is key when it comes to caring for growing kids.
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"One of the common misconceptions I hear from parents is that their child 'always chunks up before he gets tall,' and occasionally that's true, but more often than not kids are getting heavy and staying heavy because they're eating the wrong things or they're not getting enough exercise," says Dr. Kono. "They will grow just fine eating healthy foods—they don't need tons of calories or extra fat during times of growth."
Some obese children actually "drop" or slow down in growth during puberty because they've already had a significant increase in weight and height at a younger age, according to Dr. Antal. "They don't end up taller; their net sum at end of childhood is the same as their non-obese counterparts," he explains.
As for sleep, pre-tween kids need 10 to 12 hours per night because the body releases hormones that control growth during sleep. "Kids who don't get good sleep don't grow as well or heal from injuries as well, and they may suffer from emotional problems and get sick more often," says Dr. Kono.
Growing pains can happen during this age too—think calf, knee, or thigh pain that starts at bedtime and is gone by morning—but persistent pain shouldn't be brushed off as a growth spurt symptom. "If a kid's legs hurt and he or she keeps complaining of joint pain or swelling in the morning, that cold be juvenile arthritis," says Dr. Kono. "We don't want to miss something by incorrectly blaming it on growing pains."
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Growth Spurt Chart
Your child's pediatrician should track their long-term growth during regular checkups to make sure they're following a similar growth curve to their peers. To see which percentile your child falls into, check out the Centers for Disease Control and Prevention (CDC) growth chart for girls 2 to 20 years and growth chart for boys 2 to 20 years.
According to the American Academy of Pediatrics, girls typically experience a growth spurt after their breasts begin to develop, get their first period two to three years later, and then reach their final adult height about two years after that—around 14 or 15 for most girls.
Boys experience their peak growth later since they typically start puberty around age 12 (though some "early bloomers" may start at 9 or 10, says Dr. Antal). Some boys don't stop growing until 18 or later.
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Late Growth Spurts
The most accurate way to predict a child's adult height is to wait until they've started puberty, then compare their height and age to those mapped on a growth chart, and follow the corresponding curve out. Using the CDC's girls growth chart, for example, a 10-year-old girl who stands 54 inches tall (4'6") is in the 50th percentile and should reach a height just over 5'4" by the time she's 18.
Don't worry if your child falls below the 50th percentile on a growth curve chart. As long as they're "following that line at a steady rate," they are developing normally, says Dr. Kono.
If your child does appear to be falling off of the growth curve and not catching up with their peers, they could be experiencing constitutional growth delay (the clinical term for a "late bloomer") or something could be medically wrong, like a growth hormone deficiency. Pediatricians can do a bone age X-ray in office to determine if your kid is on track to reach average adult height. "If I get an X-ray of a 14-year-old boy and his bones look like those of a 12 year old, that tells me he's still got five or six years of growth left and he won't achieve his final adult height until maybe even college age," says Dr. Kono.
"It's important to ask your pediatrician about where the child is in puberty and whether they are growing appropriately for their stage of puberty," says Dr. Antal. If you wait until they're almost finished with puberty, there's not much an endocrinologist, a physician who specializes in conditions relating to hormones, can do to help.