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During a child’s checkup, I spend time showing parents – as well as older children – the child’s growth curve. This curve looks at a child’s weight and height, and for children age 2 and older, their body mass index (BMI).

This visual look at how a child is growing is always eagerly anticipated by parents, as they can compare their own child to norms by age, otherwise called a cohort.

I often use the growth curve as a segue into a discussion about weight trends and a healthy weight for their child. I really like to start this conversation after the 1-year checkup, when a child has stopped bottle feeding and is now getting regular meals and enjoying table food.

This discussion becomes especially important during the toddler years, as there is growing data that rapid weight gain may be associated with future obesity and morbidity. Discussions about improving eating habits and making dietary and activity recommendations needs to begin sooner rather than later.

I found an article in the July edition of the journal of Archives of Pediatrics especially interesting as it relates to this subject. A study out of the University of Maryland looked at the parental perception of a toddler’s (12-32 months) weight.

The authors report that 87 percent of mothers of overweight toddlers were less likely to be accurate in their weight perceptions that were mothers of healthy-weight toddlers.

They also reported that 82 percent of the mothers of overweight toddlers were satisfied with their toddler’s body weight. Interestingly, 4 percent of mothers of overweight children and 21 percent of mothers of healthy weight children wished that their children were larger. Part of this misconception may be related to the fact that being overweight is becoming normal. This is a sad statement about our society in general.

We need to begin counseling parents about diet and activity, even for toddlers. By doing this, we may be able to change perceptions of healthy weight, in hopes that the pendulum of increasing obesity in this country may swing the other way.

Dr. Sue Hubbard is a pediatrician, medical editor and media host. Submit questions at kidsdr.com.