Clues to our children’s health are all around us. The food choices they make, the amount they play, the time they get up and the time they go to bed all affect children’s well-being.

As spring approaches and many of us go through our children’s closets to take care of the clothes kids have outgrown or no longer like to wear, be mindful that children’s clothing can provide a glimpse into their health. Whether you’re preparing for a garage sale, donating overused clothes to a thrift store or giving items to a friend or a relative, here are things to observe for insight into your children’s well-being.

Dirty Knees

Kids should have at least a couple of pairs of pants or tights that are stained or worn at the knees. Otherwise, you may want to think about encouraging more physical activity and outdoor play.

Children should participate in at least one hour of physical activity each day, according to the Centers for Disease Control and Prevention. Kids should also engage in rigorous physical activities, such as riding bicycles, participating in sports like soccer or baseball or simply playing tag, several times a week.

Getting adequate vitamin D, which is important for bone development, is also crucial for children’s healthy development. While many foods like milk and bread are fortified with vitamin D nowadays, encouraging kids to play outside for about ten minutes each day ensures appropriate vitamin D levels from the sun. Just confirm that kids are wearing broad-spectrum sunscreen if they’re outside for more than ten minutes.

Sizes

Consider your children’s ages and what size clothing they wear. Has your daughter been the same size for two or more years? Is your son routinely wearing out his clothes before he outgrows them? If so, you may want to ask your pediatrician about your child’s growth rate. Another clue about growth rate is whether or not your child has needed new shoes in the past year or two.

Healthy children should grow a minimum of two inches (five centimeters) per year between age 5 and puberty. It is important for your child’s pediatrician to measure and plot both height and weight on a growth chart at every visit. This alerts the doctor if your child is not growing normally or not gaining weight properly. There are a number of reasons children may not grow adequately, like if they are not getting enough food, which is uncommon in the United States, or cannot properly absorb their nutrients.

For any child who is not growing well, nutritional intake must be reviewed. The child may need to be evaluated by a nutritionist who might prescribe a change in diet and vitamins, or a gastroenterologist who might investigate the underlying reason for poor nutrient absorption.

Children with specific chronic medical issues may have poor growth, and may need to be evaluated specifically for poor growth. Children with persistent growth problems should be evaluated by a pediatric endocrinologist and may need to be tested for hormone deficiencies. If a child has a hormone deficiency, a pediatric endocrinologist will prescribe medication that serves as a replacement for the missing hormone. The earlier an accurate diagnosis is made, the more time a child can have to catch up on his or her growth. This makes it vital to bring up any growth concerns with a doctor as soon as they arise.

Food Stains

If children between 2 and 3 years old are still frequently getting food stains on their shirts and pants, you may want to take a closer look at their coordination and pincer grip, which involves muscles necessary for handwriting and many other important activities as a child gets older. A child may enjoy playing with his food, resulting in regular stains on clothing. But if you notice your child is struggling to hold his fork or spoon properly and keeps spilling food, you should mention your concerns regarding pincer grip and coordination with your child’s doctor. A pediatrician may recommend special exercises designed to improve coordination and pincer grip strength.

Waistlines

If your child tends to outgrow the waist before the length of pants, you may want to reflect on the foods he or she is eating. If necessary, talk with a pediatrician or a nutritionist about healthy alternatives to your child’s current meals. If your child is rapidly gaining weight and maintains regular eating habits, bring it up with your child’s pediatrician. Childhood obesity— whether caused by lifestyle, genetics or a hormone imbalance— is a serious medical condition that puts a child at higher risk for developing conditions including type 2 diabetes, metabolic syndrome and high blood pressure.

When you clean out the closets this spring, pay attention to the clues that your children’s clothing reveals and remember to always bring up any concerns you have with the child’s pediatrician or the family doctor.

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