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You child’s body has undergone significant changes since the day you brought her home from the hospital. By now, as she moves through her preschool years, your child’s body fat has been replaced by increases in muscle and development, accompanied by a slimming of her arms and legs and a tampering of her upper body. Many children at this age still have a small potbelly or pear shape. Some youngsters of this age appear skinny, and their parents often worry that their children are undernourished or perhaps have illnesses that make them look thin.

Then there’s the other end of the spectrum, where parents worry about something quite different. Their children are heavier than their playmates. These kids may be eating larger meals and snacking more often than their peers. They might be watching more hours of television and spending fewer hours being physically active.

The fact is that children come in many shapes and sizes. When it comes to weight during the preschool years, most kids fall within the normal range, although in recent years, more parents than ever are being told by pediatricians that their youngsters are overweight. For patients who are sure to meet all the scheduled check up appointments, we have been charting kids’ height and weight since they were infants, typically during every office visit in the first 2 years of life and then about once a year after 2 years. We can show you your child’s growth chart and tell you whether she has gained too much weight. We can calculate your child’s body mass index (BMI), which after age 2 years is a good indicator of whether she is overweight. If your child’s BMI is above the 95th percentile for her age, she has a weight problem.

Amid the current epidemic of obesity, the preschool years are a time when a growing number of youngsters are first identified as overweight. If your child received this diagnosis, you and your family need to follow your pediatrician’s guidance on how to begin the journey toward successfully managing this condition. Healthier eating and increased physical activity are a must. Your doctor will monitor the strategies and efforts that your family begins adopting in the months and years ahead, making sure that your child is progressing in a healthy way.

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