You Can Help UT Physicians Educate Patients

By Vicki Powers, UT Physicians
October 30, 2025

UT Physicians creates useful content that helps patients and their families understand their health care, like the article below featuring Professor of Community and General Pediatrics Amalia Guardiola, MD. If there is a topic about which you would like to share your expertise, please contact Department of Pediatrics Communications.

What growth charts say about your child’s health

A cheerful toddler being comforted by a caring doctor during a pediatric checkup.

Growth charts help track physical development, but they’re just one part of the story. Pediatricians look beyond the numbers at the whole child — health, behavior, nutrition, and development.

Growth charts are routine at the pediatrician’s office, but for many parents, they can be confusing or even concerning. What do percentiles mean? When should you worry? It’s helpful to remember they are one piece of the puzzle in the overall picture of your child’s health.

Amalia Guardiola, MD
Amalia Guardiola, MD

Understanding growth charts

Growth charts track a child’s physical development over time using measurements like height, weight, and head circumference (for children under 2), and body mass index (for children over 2).

“Growth charts help us monitor the growth of children and identify any concerns early,” said Amalia Guardiola, MD, a pediatrician at UT Physicians Pediatric Primary Care — Texas Medical Center and professor of pediatrics at McGovern Medical School at UTHealth Houston.

Percentiles are a key aspect of growth charts, but they’re often misunderstood. In simple terms, they compare a child’s growth to a group of children of the same age and sex. For example, if a child is in the 50th percentile for height, they’re taller than 50% of children their age.

At UT Physicians, pediatricians use the Centers for Disease Control and Prevention (CDC) growth chart. Another option is the World Health Organization (WHO) chart.

“The CDC chart describes the growth of children in a specific population — the United States — and is primarily for children 2 and older,” Guardiola said. “The WHO chart represents how healthy children should grow under optimal conditions from birth to 2 years, with breastfeeding as the standard.”

Recognizing patterns and concerns

One common phrase that parents may hear is that their child has “fallen off their growth curve,” which means that their percentiles have dropped in the growth parameters. Guardiola said this can be a sign of a health or nutrition issue.

“For example, if a child is always at the 50th percentile for weight, but dropped to the 25th percentile during the next two visits, this sudden change in percentiles can be a cause of concern,” she said.

A rapid drop or rise may signal a medical or nutritional issue and needs further evaluation. Common reasons for changes in growth patterns include illness, poor nutrition, changes in activity levels, stress, hormonal imbalances, or chronic conditions.

Health beyond the numbers

While growth charts are useful, they are only one piece of the puzzle. Guardiola emphasized the importance of looking at a child’s overall health. In addition to growth charts, pediatricians assess development, nutrition, behavior, and overall well-being during visits.

“We talk about energy levels, sleep, development, school performance, appetite, and family growth patterns — not just the growth chart,” Guardiola said.

For parents concerned their child is “too small” or “too big,” Guardiola offers reassurance. Every child grows at their own pace and in their own curve. She recommends parents focus instead on steady growth, healthy habits, and regular check-ups to identify issues early on. Child development goes beyond physical growth and includes how a child learns, moves, communicates, plays, and interacts with others.

“A child may be growing well on the chart but still need support in other areas of development,” Guardiola said. “We focus also on how they’re learning, behaving, and adjusting socially and emotionally.”