Toddlers and preschoolers will likely experience a growth spurt as they approach three or four years old. The third year of life is the time to watch for those first signs of independence and separation from parents, such as forming to sleep alone and playing with other children without adult supervision.
Children might also begin to feel negative feelings about themselves: feeling like the "fat one" in a family where all others are thin; wishing they were smaller; growing out of certain clothes; beginning to look different from their friends; etc. This can lead to eating problems such as lack of appetite, food refusal, or overeating.
What are growth norms for 3-4 years old?
Most children aged 3-4 years will grow about 5 cm (~ 2 in.) and gain 10-15 pounds. This is a time when many parents are anxious that their child isn't growing enough. However, it is important to understand that on average, this age group only grows about 1/2 inch per month.
For some children, these months may be slow ones while others might see spurts of growth each month. A general rule of thumb is if your child has recently had a birthday or milestone of some sort (i.e.: developed new motor skills), they have probably grown at least an inch since the last birthday or so which means they are growing fine overall.
Expected height for three-year-olds
A very helpful way to determine if your child is growing normally is to use a height prediction chart, such as those that can be found online at the Centers for Disease Control and Prevention (CDC) website. This site offers growth charts compiled from national data by age, gender, and weight percentile. Look for this section:
How does this happen?
During these growth spurts, children grow rapidly and unevenly, and they're likely to be hungrier than usual. Their appetites can last up to two years or more as their bodies grow at a rapid rate.
During this time, it is important for parents not to ignore comments such as "I'm hungry" or "I want a snack." Children need adequate nutrition during times of physical activity and growth. If your child needs additional calories, try adding low-fat milk products such as cheese sticks or yogurt along with fresh fruits and vegetables into his or her daily diet. It is also if you incorporate snacks into your child's meals, rather than having meals followed by snacks.
Don't put extra pressure on your child to eat more or less of certain foods. This can lead to dieting problems later in life. Children need a variety of healthy foods to provide the nutrients they need for proper growth and development. You know that you are providing adequate nutrition if your child shows no signs of malnutrition (no loss in weight or wasting).
Try not to worry about normal pickiness around mealtime because around this age children will often try new things, only to reject them shortly after. Learning what they like and don't like is part of their way of exploring throughout childhood. Be sure to offer new foods many times before you give up hope that your child will ever eat it.
Signs of growth spurts
The following are some general signs that your toddler or preschooler might be experiencing a growth spurt:
- Increased appetite – your child may want to eat more than usual
- Increased urination – due to increased fluids intake and/or hormones associated with growth spurts
- Increased energy – your child may seem very active and have difficulty settling down to sleep
- New skills or abilities – such as walking, talking, toilet training, etc. which could coincide with a growth spurt
Food and growth spurts
Parents often worry that their child's eating habits have changed because of a growth spurt. This is usually not the case as gaining weight during a growth spurt is normal.
Children need a lot of extra nutrients while they are growing because their bodies are using all the calories to make new cells. These extra nutrients come from protein, carbohydrates, and fat. The fats should mostly be healthy fats, which are found in foods like lean meats, oils, nuts, and fish.
Vegetables or fruit can be given instead of whole milk once your child turns one year old. Once your child is drinking more than 500ml/day (about two cups) you can switch them to low-fat milk after age two.
You may have heard that children should eat only plain food while they are having a growth spurt. This is not true! There is no "magic" food that will promote growth overnight - so please do not stress about your child's diet. As long as your child is eating a variety of healthy foods, they will be getting the nutrients they need.
However, there are some things to look out for:
- Has your child been more fussy or moody? In some cases, children might be hungry even if they don't show signs of hunger – such as crying – leading parents to feel like their child "refuses" certain foods when in reality they aren't hungry at mealtime yet.
- Does your child seem tired during mealtime? If so, this could mean your child isn't getting enough calories. Very young children also need longer periods between meals to allow their digestive system to rest.
- Is your child eating more junk food? In some cases, children might try to fill up on unhealthy foods because they aren't getting enough nutrients from their regular diet.
- Has your child lost interest in eating? This could be a sign that your child is not getting the right kinds of nutrients.
Activity and your baby`s growth
When babies are born, they grow very quickly in their first year of life. After that, growth slows down considerably (but never stops altogether). During the toddler and preschool years, most children follow a pattern of growth that is mostly on track.
However, if you want to follow your child's growth more closely you can buy an inexpensive measuring tape at your local pharmacy or supermarket. You should measure your child at least once every three months (once a month after age two). Physical activity is important for young children, but it may take some creativity to incorporate this into your child's day. Try the following ideas:
- Encourage active playtime by playing with your child outside or going on a short walk together.
- Make sure your preschooler has enough time and space to run around inside if he or she wants to.
- Look for physical activities at home that you can suggest during times when they are likely to be sedentary (such as watching television). Some examples of these types of activities include jumping jacks, squats, etc.
When should I worry about my child's growth?
Most children follow a pattern of growth that is mostly on track. However, if you are concerned about your child's growth, speak with your healthcare provider. There are a few things to look out for:
- Does your child have difficulty gaining weight or keeping weight on?
- Is your child very short for his or her age?
- Has your child stopped growing in height or weight?
- Do you have a family history of growth problems?
If you answer yes to any of these questions, please speak with your healthcare provider.
Endocrinology and growth
The hormones that control growth are produced by the pituitary gland, located at the base of the brain. These hormones (known as growth hormone and insulin-like growth factor) stimulate the cells in the bones and other parts of the body to grow. Growth hormone is released in short bursts during sleep, which is why youngsters often grow most quickly during their slumber.
Conditions that can affect growth hormone production or action can lead to slowed or stunted growth. These conditions include Turner syndrome, Down syndrome, Prader-Willi syndrome, and hypothyroidism. In children with these conditions, growth hormone therapy may be recommended. This treatment involves giving children injections of synthetic growth hormone every day.
Growth requires good nutrition. Children need a variety of nutrients in the right amounts to grow and develop normally. Some nutrients are more important for growth than others. These include protein, calcium, vitamin D, iron, and zinc.
What should you do if there are delays in growth?
There could be many reasons why a child is not growing at the expected rate. Some common causes of growth delays include poor nutrition, chronic illness, lack of physical activity, and exposure to environmental toxins. However, there can be other causes as well. If you think your child may be experiencing slow or stunted growth, talk to your healthcare provider.
What doctor should you visit?
If you are concerned about your child's growth, speak with your healthcare provider. A pediatric endocrinologist specializes in growth and development. And like other doctors, endocrinologists specialize in different areas of medicine. Endocrinology is one of these areas. So if you are concerned about slow or stunted growth, talk to your child's healthcare provider about seeing a pediatric endocrinologist.
What does the treatment involve?
When children don't grow at the expected rate, insulin-like growth factor (IGF) levels may be checked. If IGF levels are low, this suggests that there is an underlying problem with the amount of growth hormone produced or how it is used by the body that may require treatment with injections of synthetic growth hormone on a daily basis for several years. Be sure to talk to your child's healthcare provider to find out more about what the treatment may involve.
Bottom line
A growth spurt in a 3-4-year-old is often a sign that they are beginning to grow out of toddlerhood and their bodies are growing into childhood. This can be both exciting, energizing, and somewhat frightening for parents who may not know what to expect from their children in the coming years.
It's important not to add extra pressure by worrying about weight gain or height percentile charts during this time when your child still has plenty of time to grow up!