Paediatric growth and development chart
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CDC developmental milestones 2026 growth charts WHO children official
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Paediatric Growth and Development Chart
1. Growth monitoring
| Age | Weight | Length/Height | Head circumference | Useful clinical points |
|---|---|---|---|---|
| Birth | 3-3.5 kg | 50 cm | 35 cm | Physiological weight loss of up to 7%-10% may occur in first days |
| 5 months | Doubles birth weight | 65 cm | 42 cm | Regains birth weight by about 10-14 days |
| 1 year | Triples birth weight, about 9-10 kg | 75 cm | 46 cm | Birth length increases by about 50% |
| 2 years | About 12 kg, quadruples birth weight | 85-87 cm | 48 cm | Estimate height: age in years × 6 + 77 cm |
| 4 years | About 16 kg | 100 cm | 50 cm | Height at 4 years is about double birth length |
| 5 years onward | Gain about 2-3 kg/year | Gain about 5-6 cm/year | Usually not routinely plotted after 2 years | Prepubertal growth velocity is fairly steady |
| Adolescence | Variable | Pubertal growth spurt | - | Girls: earlier, commonly 8-13 years; boys: commonly 9-14 years |
Plot serial measurements, not one isolated value. Use sex-specific percentile charts and assess the trajectory. In the US, CDC recommends WHO standards from birth to 2 years and CDC charts from 2 years onward. WHO charts include weight-for-age, length/height-for-age, weight-for-length/height, and BMI-for-age measures. CDC chart recommendations and WHO child-growth standards provide the official charts.
2. Developmental milestones
| Age | Gross motor | Fine motor / vision | Language | Personal-social |
|---|---|---|---|---|
| 2 months | Holds head briefly when prone | Opens hands briefly, watches face | Coos | Social smile, calms when spoken to/picked up |
| 4 months | Good head control, rolls tummy to back | Reaches and grasps objects | Laughs, makes sounds to gain attention | Smiles spontaneously, recognizes familiar people |
| 6 months | Rolls both ways, sits with support | Transfers object hand-to-hand | Babbles consonant sounds | Knows familiar people, enjoys mirror |
| 9 months | Sits without support, crawls, pulls to stand | Immature pincer grasp | “Mama/dada” nonspecific, responds to name | Stranger anxiety, peek-a-boo |
| 12 months | Stands alone, walks with support or a few steps | Mature pincer grasp, puts objects in container | 1-2 meaningful words, understands simple command | Waves “bye-bye,” points to request |
| 18 months | Walks well, runs stiffly, climbs steps with help | Scribbles, stacks 2-3 blocks | 10-25 words, points to named body parts | Uses spoon with spilling, removes simple clothing |
| 2 years | Runs well, kicks ball, goes up/down stairs two feet per step | Stacks 6 blocks, copies vertical line | Two-word phrases, about 50+ words, follows two-step commands | Parallel play, helps with simple tasks |
| 3 years | Pedals tricycle, alternates feet climbing stairs | Copies circle, builds tower 8-9 blocks | Three-word sentences, speech about 75% understandable | Toilet training progressing, imaginative play |
| 4 years | Hops on one foot, catches large ball | Copies cross, uses scissors | Four or more word sentences, tells a simple story | Cooperative play, dresses with some help |
| 5 years | Skips, balances on one foot | Copies square, prints some letters | Clear speech, counts, uses future tense | Follows rules, dresses independently |
3. Quick memory aids
- Birth weight doubles by 5 months, triples by 1 year, and quadruples by 2 years.
- Birth length doubles by about 4 years.
- Head circumference: about 35 cm at birth, 46 cm at 1 year, and 48 cm at 2 years.
- Social smile: 2 months
- Head control: 4 months
- Sits without support: 9 months
- Walks independently: around 12-15 months
- Two-word phrases: 2 years
- Tricycle: 3 years
- Hops on one foot: 4 years
4. Developmental red flags requiring assessment
- Any age: loss of language, motor, social, or other previously acquired skills.
- By 4 months: poor head control or absent social smile.
- By 9 months: cannot sit independently.
- By 12 months: no babbling, gestures, pointing, or response to name.
- By 18 months: not walking independently, no meaningful single words.
- By 2 years: no two-word spontaneous phrases or poor response to spoken language.
- At any visit: poor eye contact, absent shared attention/pointing, marked asymmetry, persistent toe walking, abnormal tone, or a declining growth percentile trajectory.
Milestones are screening guides rather than diagnoses. A child with delay in more than one domain, regression, or concerning growth pattern needs a detailed developmental, hearing, vision, nutritional, and medical assessment. A recent systematic review also supports that delayed motor-milestone timing can be associated with later motor difficulties, but timing alone does not establish a neurodevelopmental diagnosis (Bowler et al., 2024, PMID 39067834).
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