Dear Dr. Paul: I have a 12 month old daughter who seems to be very healthy and well. I am wondering why it is important to see a doctor for check ups even when most of the time all the doctor does is weigh and measure my daughter and quickly examines her only to tell me that all is normal?

Dr Paul Answers: One of the things that makes pediatrics different from adult medicine is that children are constantly changing. They grow at a tremendous rate, especially during the first few years of life. They also go through the stages of physical and mental development. A child will literally develop from being almost immobile at birth, into a talking, walking toddler within 18 months! An important role of the pediatric check up is to make sure that children grow and develop normally.

Having said that, let me discuss growth curves specifically.

When a child is assessed, three important measurements are taken. These measurements are then placed on a growth curve. A growth curve is a chart which illustrates the average rate and amount of growth in children within different age groups and allows us to see and document the pattern of child's growth. Whether a child is growing well or not depends on if the pattern of growth , over time, follows the average (or normal) patterns on the growth curve for a child's age and sex. Because boys grow at different rates than girls, we use separate growth curves - one for boys and different ones for girls. So in order to be able to properly asses a child's growth, the growth curve has to be looked at over several measurements and time. In this way the growth curve really charts out a child's life growth pattern until adulthood. Consequently, the growth curve is a vital part of any child's medical record, up until the age of 18 years.

The growth curve can also provide very good clues as to whether or not certain problems or symptoms are serious. For example, a common complaint is that a child is not eating enough or is a fussy or picky eater. How serious or worrisome the problem is depends in large part on the growth patterns. If the growth curve is normal, we can be assured that the child is growing normally, and despite the picky eating habits is getting enough calories to grow. Similarly, when assessing children for other problems such as frequent infections or colds an important part of the assessment is looking at the growth rates.

Again, if the growth rates are normal, chances are that there really is nothing seriously wrong with the child.

In conclusion, I view, the growth curve as a child's ( and parent's) best friend. However, a growth curve can only be kept up to date by attending regular check ups. I think even if all is normal, it is still very worthwhile doing!

Our sister site, The Baby Corner, has a great featured called Your Baby's First Year here: http://thebabycorner.com/parenting/calendar/month12.html
Our friends at Interactive Parent have these two related features:
New Growth Charts
http://InteractiveParent.com/directory/Health/Wellness/Growth_Charts/
Predicting Adult Height
http://InteractiveParent.com/cgi-bin/directory/jump.cgi?ID=115

I invite you to send me your child health and wellness related questions at drpaul@thefamilycorner.com. One of the most satisfying aspects of being a pediatrician is answering parents questions and concerns..as I feel that the more you know about your child's health and wellness (in terms of illness, normal growth/development and importantly prevention), the more comfortable you can be with your kids! You can visit Dr. Paul's website at http://www.drpaul.com The information provided in this column is designed to be an educational aid only. It is not intended to replace the advice and care of your child's physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition, always consult a physician.

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