Growth charts are bread and butter practice for paediatricians. Every child we see, subconsciously we, compare against a ‘normal’ range for the community.
We discussed two scenarios of a young person who was bullied at school and was smallest in his friends group and a child who started losing weight at 7 months.
Learning points were:

• Know growth charts well. You can run into them in the exam.
• ALL ‘marks’ on the chart are for a reason – NOT an error
• If NOT sure of a mark – ASK? Confirm.
• Difference in Bone age to chronological age is important to know.
• Learn how to communicate with parents in a simple easy to understand language.
• Do not complicate matters by suggesting very rare diagnosis
• 7 month failure to thrive is likely to be weaning related – coeliac – NOT IBD
• Suggest relevant investigations with results you will be expecting.