How do I know if my baby’s growth is normal?

The first year of a child’s life is a long milestone, especially for first time parents. It is incredible how rapidly children grow and develop. We all wonder if there is a sequence on how children develop and grow. Often parents worry if their little ones are on the right track. Sure there are “normal” growth patterns – sitting, crawling and walking, etc. But they are not the same for all children. What is normal really and is there more to a child’s growth than those three?

The main goal for year one is conquering gravity, this begins at birth and continues into adulthood. By 24 weeks babies have a fully developed brain and they are able to interpret sensory information from the environment once they are outside the womb. In the first three months after birth, these babies show off ever-expanding changes of movement and growth. To name just a few, babies can place their hands in their mouths; place their arms under their torsos; lift their heads off a surface; place their toes in their hands and kick their legs fanatically in all sorts of ways. All this is cute to watch and many keep this exciting milestone footage.

Rather than focusing on helping your baby to sit up or walk, give your baby time to play in a variety of positions on the floor. The emphasis should be on free movement and also to encourage them to discover themselves. This way, babies learn how to sit, how to crawl to reach a surface, how to climb up to stand and how to get walking. These are the basics that show normal growth in any child.

Regular Check-Ups

And of course, there are the regular check-ups with the doctor who will monitor weight, length and head circumference every month for the first six months to make sure growth is on track. Growth in head circumference averages 1.27cm per month during the first 6 months. It is interesting to note that the length and circumference should develop at the same rate for both bottle fed and breast fed babies. The doctor will have a growth chart, but these are standardised and are used to compare a child’s height and weight as such, the chart might not depict the same for all children as growth depends on the child’s appetite and eating patterns. Forcing children to eat is never a good idea as it may cause bigger problems – but of course, it is critical that they are getting the right nutrients.

measuring baby head growth

Growth charts

Growth charts are useful tools to monitor a baby’s growth at a glance by plotting the weights on a graph-like chart. It can be a good indication that the baby is feeding and developing well.  The baby should follow the percentile as he grows.  If a child drop below or exceeds the percentile he has been following, he needs medical attention.

Growth charts plot a baby’s growth against a series of percentile lines. A typical child may be at the 50th percentile for weight. This indicates that out of 100 children, 49 will weigh less or the same and 50 children will weigh more. As such, you should remember the following:

  • These charts describe the growth of one child by comparing him/her with others their age. Thus the 5th percentile is not necessarily “bad” or the 95th not necessarily “good”. Compare growth over a period of days, weeks or months. This will establish a consistent growth pattern.
  • The baby’s height, weight, and head size are checked with every visit to the clinic
  • The key issue remains: is the baby’s growth consistent? In other words, if the child is at the 50th percentile for height at three months, he should roughly be at the 50th percentile at six months
  • The only cause for concern is any excessive weight gain or weight loss

Your baby needs to be evaluated if their weight percentiles started off fine, then plateau or fall below the third percentile. The causes are various and include: poor feeding routines, incorrect formula preparation, and gastro esophageal reflux, mal-abso

rption of food from intestinal problems, and various types of disease and anemia.

So what should you look for in addition to the major steps and growth chart in terms of determining normal growth patterns:
  • Most babies regain their birth weight by 10 days to 2 weeks after birth, but remember that babies who are sick or premature take longer to regain their birth weight than healthy, full-term babies
  • Average weight gain for the first 3 – 4 months is about 150 – 200 gm per week but don’t panic if your baby doesn’t gain weight as quickly
  • Growth in length averages 2.5cm per month
  • Babies grow rapidly during the first three months, after which it typically slows down during months 4-12
  • The average breastfed baby doubles their birth weight by 4-6 months and generally breastfed babies put on more weight initially than bottle-fed babies
  • Your baby will go through a period of rapid growth and development from 6 months to about 3 years of life – growing faster than at any other time in their life in the first year and should treble their weight by the end of the first year.
    Baby growth
Additionally, look out for the below signs that your child is well hydrated, nourished and growing well:
  • Your baby’s skin is soft and moist
  • If pinched, the skin returns immediately to its normal appearance
  • If pressed, the skin returns to normal and does not remain dented
  • Tissue around the eyes and the mouth is pink and moist
  • He/she is active, alert and calm
  • He/she has at least six wet nappies a day

If you are concerned about your child’s growth rate, speak to your doctor as there could be a reason for the delay in growth including a chronic disease, but more often than not it’s just unnecessary worry every parent has.

It is normal for a parent to be worried when growth rate is slow and they lose appetite all of a sudden but if your child is energetic, active and is not sick all the time, usually a small change can go a long way to getting your little one back on track. The important thing to remember however is that growth patterns in children are very different and each has their own path to master. Monitor your child’s personal development, growth, feeding patterns, environment and general health and with regular check-ups and enjoy every second of them growing up!

*This article is an exclusive column from Dr Diana Du Plessis, spokesperson for Philips Mother and Child Division.


Dr Diana du Plessis

Dr. Diana du Plessis is the Breastfeeding Consultant and spokesperson for Phillips Avent South Africa. She obtained a B.Soc.Sc (Hons) at the University of the Free State, after which she worked as an operating room registered nurse in the Universitas and National Hospitals in Bloemfontein, receiving the Diploma in Operating Room Technique in 1978. She commenced her academic career in the Department of Nursing (UFS) in 1982 and holds diplomas in Nursing Administration (cum laude), Nursing Education and Community Health Nursing (cum laude) while being employed in the Department of Nursing at the University of the Free State. Later she obtained M.Cur and D.Cur in Midwifery and Neonatology from the University of Johannesburg. Dr du Plessis is in private midwifery clinical practice for the past 19 years.

  1. My precious son was born at 32 weeks on the 19/09/2016 weighing 1923g and now he weighs 4.8kg.
    I’m breastfeeding exclusively I even bought the Philips Avent Breast pump so I can express.
    He’s deffinately growing well☺😊

  2. My baby boy was diagnosed with Intrauterine growth retardation at 29 weeks of my pregnancy. He was born at 36 weeks weighing 2.4 kg. Ever since he was born I have been monitoring his growth and I used to get worried when we came home from hospital. He cried a lot and didn’t seem to be bonding or interacting with me. Now at 3 months we are so close, he smiles and follows me around when I move in the room.He is growing quite well and I am a happy mom.

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