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Health Issues

Your child’s body has undergone significant changes since the day  you brought her home from the hospital. By now, as she moves through her preschool years, your child’s baby fat has been replaced by increases in muscle development, accompanied by a slimming of her arms and legs and a tapering of her upper body. Many children at this age still have a small potbelly or pear shape. Some youngsters of this age appear skinny, and their parents often worry that their children are undernourished or perhaps have illnesses that make them look thin.

Then there’s the other end of the spectrum, where parents worry about something quite different. Their children are heavier than their playmates. These kids may be eating larger meals and snacking more often than their peers. They might be watching more hours of television and spending fewer hours being physically active.

The fact is that children come in many shapes and sizes. With their weights in mind, most kids fall within the normal range, although in recent years, more parents than ever are being told by their pediatricians that their youngsters are overweight. Your child’s doctor has been charting her height and weight since she was an infant, typically during every office visit in the first 2 years of life and then about once a year after 2 years. Your pediatrician can show you your child’s growth chart and tell you whether she has gained too much weight. The doctor may calculate your child’s body mass index (BMI), which after age 2 years is a good indicator of whether she is overweight. If your child’s BMI is above the 95th percentile for her age, she has a weight problem.

At the next office visit, ask your pediatrician’s guidance in using growth charts and body mass index (BMI) graphs. They can provide a clear picture of your youngster’s present status and areas that need attention. The growth charts will help you see how your child compares with her peers. Does she fall within the normal range of height and weight for her age? Most pediatricians use charts like these to evaluate your child’s growth from one visit to the next.

If your child is younger than 2 years, your pediatrician will be using charts (rather than calculating BMI) to determine her risk for being overweight or obese. If your youngster’s weight gain is crossing growth percentiles, this may also be a risk factor for overweight and obesity that needs the attention of you and your pediatrician.

Pediatricians consider BMI (a calculation of your child’s body weight relative to her height) important when determining whether your child is overweight.

Keep in mind that although BMI is not a specific measure of body fat, it is closely linked with body fat calculations. Your pediatrician may also use an instrument called skinfold calipers to gently pinch the flesh on your child’s trunk and the back of her upper arm to measure the body fat directly beneath the skin. Your pediatrician will be taking into account your child’s pattern of growth, family history, body composition, and laboratory studies as well.

To learn more about how to calculate Body Mass Index (BMI), click here.


Last Updated
A Parent's Guide to Childhood Obesity: A Road Map to Health (Copyright © 2006 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.