Which of the following features indicates poor growth milestones in Prader-Willi Syndrome?

In Prader-Willi Syndrome, a significant indicator of poor growth milestones is short stature. Individuals with this genetic condition often experience growth hormone deficiencies, which can lead to a height that is below average for their age. This short stature is compounded by other features of the syndrome, including hypotonia (decreased muscle tone) and a tendency to gain weight due to an insatiable appetite that develops later in childhood.

On the other hand, rapid weight gain typically occurs later in life as they transition from childhood, which can lead to obesity if not managed properly. Average height with obesity does not reflect the growth concerns typically associated with Prader-Willi Syndrome, as the syndrome's hallmark is often short stature in conjunction with a propensity for weight gain rather than average height. Height above average is contrary to what is expected in individuals with the syndrome, who normally do not reach typical growth milestones due to their underlying hormonal and metabolic issues. Thus, short stature is a clear indicator of poor growth milestones in the context of Prader-Willi Syndrome.