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Objective To identify and analyze diverse longitudinal trajectories of physical growth of institutionalized children and their relation to child, family, and institutional factors. Methods 49 institutionalized children were studied for 9 months after admission. Weight, height, and head circumference were measured on 4 occasions, beginning at admission. Data were analyzed using latent class analysis, yielding diverse patterns of growth for each feature, and relations with child characteristics, early family risk factors, and institutional relational care were investigated. Results For each growth feature, 4 classes emerged: “Persistently Low,” “Improving,” “Deteriorating,” and “Persistently High.” Younger age at admission was a risk factor for impaired physical growth across all domains. Physical characteristics at birth were associated with trajectories across all domains. Lower prenatal risk and better institutional relational care were associated with Improving weight over time. Conclusions Discussion highlights the role of children’s physical features at birth, prenatal risk, and caregiver’s cooperation with the child in explaining differential trajectories.