During the third year of life, most toddlers gain about 4 pounds (1,800 grams) and grow about 2 to 3 inches (5 to 8 centimeters).

They're extremely active and mobile, and learning in very physical ways. They're sleeping less than they did in the year before, running around and exploring their world, and picking up new skills, like riding a tricycle.

Your toddler's appetite may fluctuate greatly now, which is common. Kids who are active, happy, and engaged and eat a variety of healthy foods are probably getting the nutrients they need and growing normally.

Although kids come in all shapes and sizes, a healthy child should continue to grow at a regular pace. The doctor will measure and weigh your child at routine checkups and plot the results on a growth chart. This helps ensure kids' steady growth pattern and tracks whether their size is in a healthy range compared with other kids of the same age and gender.

Helping Your Child Grow

Normal growth — supported by good nutrition, adequate sleep, and regular exercise — is one of the best overall indicators of a child's good health. But your child's growth pattern is largely determined by genetics. Pushing a child with "short genes" to eat extra food or greater than recommended amounts of vitamins, minerals, or other nutrients will not increase his or her height.

Malnutrition severe enough to affect growth rate is uncommon today in the United States and other developed countries unless a child has an associated chronic illness or disorder.

At the Doctor's Office

Despite data collected for growth charts, "normal" heights and weights are difficult to define. Shorter parents, for instance, tend to have shorter kids, whereas taller parents tend to have taller kids.

Although you may worry if your child isn't as tall as his or her peers, or weighs more, the more important question is whether your child is continuing to grow at a normal rate. If your doctor detects a problem — such as a growth rate that had been normal but has recently slowed — he or she may track your child's measurements carefully over several months to determine whether the growth pattern suggests a possible health problem or is just a variation of normal.

Most kids who are growing at or below the 5th percentile line on the growth chart are usually following one of these two normal variant growth patterns:

1. Familial (genetic) short stature. These kids have inherited genes for short stature from their parents. Usually one or both parents, and often other relatives, are short. Although they are shorter than average, they grow at a normal rate and are otherwise healthy, showing no symptoms of medical problems that can affect growth. They generally enter puberty at an average age and reach a final adult height similar to that of their parents. In general, no treatment is recommended or known to be effective in significantly increasing their final adult height.
2. Constitutional growth delay (delayed puberty). Although they are usually of average size in early infancy, these kids undergo a period of slower-than-average growth between 6 months and 2 years of age, causing them to fall to the 5th percentile or lower on the growth chart. After about age 2 or 3 years, kids with constitutional growth delay will grow at a normal childhood rate until they reach puberty and undergo a growth spurt at a later age than most other teens. Because they start puberty later, they will continue to grow after most teens have stopped, thus "catching up" to their peers in final adult height. Usually, there's a family history of this kind of growth pattern, and in general, there's no need for treatment.

If your child is growing too slowly, your doctor might order tests to determine whether this is related to a medical or genetic condition that would interfere with growth.

Be sure to discuss any concerns you have about your child's growth or development with your doctor.

Reviewed by: Barbara P. Homeier, MD
Date reviewed: October 2005