What is Growth?

A child's physical growth refers to the increases in
height and weight and other body changes that occur as a
child matures. Hair grows; teeth come in, come out, and
come in again; and eventually puberty hits. It's all
part of the growth process.


What's Normal?
The first year of an infant's life is a time of
astonishing change. During this time, a baby will grow
rapidly. On average, babies grow 10 inches (25
centimeters) in length while tripling their birth
weights by their first birthday.

Given all the growth that occurs in the first year of
life, new parents may be surprised when their child
doesn't continue to grow through the roof. But no child
continues the rate of growth experienced during infancy.
After age 1, a baby's growth in length slows
considerably, and by 2 years, growth in height usually
continues at a fairly steady rate of approximately 2 1/2
inches (6 centimeters) per year until adolescence.
At the Doctor's Office


Beginning in infancy, a child will visit a doctor for
regular checkups. At each of these visits, the doctor
will record the child's height and weight on a growth
chart. This chart shows the doctor and parents how the
child's height and weight compare to that of other
children the same age. This valuable tool can help your
child's doctor determine whether your child is growing
at an appropriate rate or whether there might be any
problems.
What Can You Do?
There are several things you can do to help ensure that
your child grows and develops normally. Make sure he or
she gets the following, which are critical to your
child's overall health and wellness:

adequate exercise - Because obesity is a growing problem
in kids, parents should make sure that their children
exercise regularly, as well as receive proper nutrition.
Bicycling, hiking, in-line skating, sports, or any
enjoyable activity that will motivate your kid to get
moving will promote good health and fitness and help
your child maintain a healthy weight.
Talking to Your Child About Growth
Children differ in growth and development during
childhood - just like adults, some kids are taller or
shorter. Generally, girls hit puberty earlier than boys,
although some girls might lag behind their peers in
breast development and the onset of menstruation. All of
this is usually completely normal.


Try to avoid comparing growth among siblings or other
children. Drawing attention to a child's height, for
example, will only make that child feel self-conscious
about his or her size. Encourage your child to accept
his or her own growth and development. Explain that some
children grow and develop at different rates - and late
bloomers generally will catch up eventually.


Kids who are short often face teasing by peers and may
need help coping. You can help a short child by
supporting his or her self-esteem. For example, although
it might be difficult for a small boy to make the
football team, emphasizing alternatives, such as soccer
or tennis, may make him feel better about himself and
what he can do. A small teen might have concerns about
dating, driving, and participating in sports. It's
important to try to understand your child's feelings and
to keep the lines of communication open.
If You Suspect a Problem
Parents sometimes become concerned about their child's
growth and development, but it can be reassuring to know
that most children who are short or delayed in
development are healthy and normal. For example, shorter
parents tend to have shorter children and not all kids
develop at the same rate.

If you're concerned about your child's growth, the first
step is to consult your child's doctor, who can
thoroughly evaluate your child and your family history
and, if necessary, order some basic lab tests to see if
there may be a medical condition affecting growth. The
doctor may choose to monitor your child's growth more
frequently on a growth chart.
Bone Growth
Bones grow in length at the epiphyseal plate by a
process that is similar to endochondral ossification.
The cartilage in the region of the epiphyseal plate next
to the epiphysis continues to grow by mitosis. The
chondrocytes, in the region next to the diaphysis, age
and degenerate. Osteoblasts move in and ossify the
matrix to form bone. This process continues throughout
childhood and the adolescent years until the cartilage
growth slows and finally stops. When cartilage growth
ceases, usually in the early twenties, the epiphyseal
plate completely ossifies so that only a thin epiphyseal
line remains and the bones can no longer grow in length.
Bone growth is under the influence of growth hormone
from the anterior pituitary gland and sex hormones from
the ovaries and testes.

Even though bones stop growing in length in early
adulthood, they can continue to increase in thickness or
diameter throughout life in response to stress from
increased muscle activity or to weight. The increase in
diameter is called appositional growth. Osteoblasts in
the periosteum form compact bone around the external
bone surface. At the same time, osteoclasts in the
endosteum break down bone on the internal bone surface,
around the medullary cavity. These two processes
together increase the diameter of the bone and, at the
same time, keep the bone from becoming excessively heavy
and bulky.
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