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The question: My five-year-old son has been at 5 to 10 per cent height and growth since birth. He's always the smallest in his class. My husband and myself are about 50 to 75 per cent height and weight. Should we take our son to a pediatrician?

The answer: Children definitely come in all shapes and sizes. Using parental height and weight as a benchmark to figure out whether a child's growth is normal is a reasonable first step.

Pediatricians use special growth charts onto which we plot children's weight and height to help us determine whether their growth is normal. For example, if a child's height falls on the 10th percentile line on the chart, this means that the child is taller than 10 per cent of children the same age (or shorter than 90 per cent of children the same age, depending on your point of view).

There are many children who are smaller than their peers, but this does not necessarily mean that their growth is abnormal or there is a medical concern. Some will be "late bloomers" who have their growth spurt later in childhood.

I am reassured by the fact that your child's growth has been consistent since birth. An assessment by a pediatrician is probably reasonable under these circumstances. Often all that is required is periodic follow-up to measure height and weight, but some children may require screening investigations to ensure there are no underlying medical concerns. Don't hesitate to discuss this further with your child's physician.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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