Children, even those who share genetic material, come in a variety of shapes and sizes. Because most children aren't destined to look the same as each other, and because they grow at different rates, two children who are the same age and gender may weigh the same amount but be five inches apart in height, says the Nemours Foundation. This discrepancy doesn't necessarily make one any healthier than the other, either. When pediatricians assess weight and height in children, they consider a variety of contributing factors rather than taking numbers at face value.
Body Mass Index
Pediatricians use Body Mass Index, or BMI, to screen children and teens for weight categories that could lead to health problems down the line, according to the Centers for Disease Control and Prevention. A child's BMI is calculated based on her weight and height.
Percentiles
Whereas an adult's BMI is a specific number, a child's BMI is plotted on a growth chart that compares her number with BMIs of children in the United States who are the same age and sex. This helps pediatricians more accurately assess the child's standing, since children grow at different rates. If the child is below the 5th percentile, she is considered underweight; if she's at the 5th percentile or below the 85th percentile, she is considered to be at a healthy weight; if she's at the 85th percentile or under the 95th percentile, she's considered overweight; if she's at or above the 95th percentile she's considered obese, according to the Centers for Disease Control and Prevention.
Variations
BMI is considered an effective tool for most children, but it doesn't work for all children. For example, a child who has a lot of muscle may be considered overweight or obese based on BMI, or a child who is considered to be at a normal weight may have a lot of body fat in proportion to her size, according to the Nemours Foundation.
Diagnosing Weight Problems
Unlike underwater weighing or skinfold thickness measurements, BMI isn't a direct measure of body fat. It simply gives pediatricians an idea of where their patients stand. To accurately assess whether a child is underweight or has an excess fat issue, a pediatrician would have to perform a direct measurement and make assessments by gathering family history and evaluating the child's diet and activity levels, according to the Centers for Disease Control and Prevention.
Healthy Growth
More important than specific numbers is the rate of a child's growth, says the Nemours Foundation. For example, a child who is in the 25th percentile for children of his age and gender may be just as healthy as a child who is in the 75th percentile or the 95th percentile, but his pediatrician may become concerned if he suddenly dips down to the 5th percentile or jumps up to the 75th percentile. His height and weight should ideally grow at a steady pace and in proportion to each other, says the Nemours Foundation.
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