Growth Guidelines for a Six-Year-Old Child
For a six-year-old child, growth should be evaluated using the CDC growth charts, with height and weight measurements between the 5th and 95th percentiles considered within normal range. 1
Recommended Growth Charts and Standards
The CDC recommends different growth charts based on age:
- Children under 24 months: WHO growth charts should be used
- Children 24-59 months and older: CDC growth charts should be used 1
For a six-year-old child, the CDC growth charts are the appropriate standard since they extend up to age 20 years and provide continuity in growth assessment.
Normal Growth Parameters for a Six-Year-Old
Height
- Normal height typically falls between the 5th and 95th percentiles on CDC growth charts
- Evaluation is warranted if height is below the 3rd percentile or when height velocity is below the 25th percentile for age and sex 2
- Growth velocity (rate of growth) is as important as the absolute percentile
Weight
- Normal weight typically falls between the 5th and 95th percentiles on CDC growth charts
- Weight-for-height ratio provides important context for overall growth assessment
Growth Monitoring Recommendations
Measurement Techniques
- Height should be measured standing (not recumbent length) at this age
- Weight should be measured with minimal clothing
- Measurements should be plotted on appropriate CDC growth charts to establish patterns
Frequency of Monitoring
- Children with normal growth should have height and weight measured at routine well-child visits
- Children with growth concerns should be monitored every 3-6 months 2
Interpreting Growth Patterns
Normal Growth Patterns
- Most children maintain relatively consistent growth percentiles over time
- Minor fluctuations between percentile lines are common and usually normal
- Crossing two major percentile lines may warrant further evaluation
Red Flags for Growth Concerns
- Height below the 3rd percentile
- Height velocity below the 25th percentile for age and sex
- Persistent growth failure for 3 months or longer 2
- Significant discrepancy between height and weight percentiles
Factors Affecting Growth in Six-Year-Olds
- Genetic factors: Parental heights strongly influence a child's growth potential
- Nutritional status: Adequate nutrition is essential for optimal growth
- Chronic medical conditions: Various health issues can affect growth patterns
- Socioeconomic factors: Lower family income has been associated with altered growth patterns 3
Evaluation of Growth Concerns
If a six-year-old shows concerning growth patterns:
- Review comprehensive medical history including birth history, feeding patterns, chronic illnesses, and family growth patterns 2
- Consider initial screening tests including complete blood count and comprehensive metabolic panel if growth failure persists 2
- Bone age radiography may be used to assess growth potential in children with persistent growth concerns 2
Comparison with International Standards
The CDC growth charts used for six-year-olds in the United States may differ from international standards. For example:
- Chinese growth charts show that Chinese children at age 6 are slightly taller than WHO and CDC standards 4
- By adolescence, these differences change, with U.S. children ultimately growing taller 4
Remember that growth charts are tools to identify potential concerns, not absolute determinants of health. A child whose measurements fall outside the "normal" range may still be healthy, but further evaluation may be warranted.